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Sleep Initiation and Maintenance Disorders: HELP
Articles by Charles M. Morin
Based on 79 articles published since 2009
(Why 79 articles?)

Between 2009 and 2019, C. M. Morin wrote the following 79 articles about Sleep Initiation and Maintenance Disorders.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Editorial Cognitive Behavioral Therapy for Chronic Insomnia: State of the Science Versus Current Clinical Practices. 2015

Morin, Charles M. · ·Ann Intern Med · Pubmed #26052868.

ABSTRACT: -- No abstract --

2 Editorial Insomnia and healthcare-seeking behaviors: impact of case definitions, comorbidity, sociodemographic, and cultural factors. 2013

Morin, Charles M / Jarrin, Denise C. · ·Sleep Med · Pubmed #23791693.

ABSTRACT: -- No abstract --

3 Editorial Definition of acute insomnia: diagnostic and treatment implications. 2012

Morin, Charles M. · ·Sleep Med Rev · Pubmed #22070898.

ABSTRACT: -- No abstract --

4 Review Cognitive Behavioral Therapies for Insomnia and Hypnotic Medications: Considerations and Controversies. 2019

Cheung, Janet M Y / Ji, Xiao-Wen / Morin, Charles M. ·School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Room S303, Pharmacy and Bank Building (A15), Science Road, Camperdown Campus, Sydney, NSW 2006, Australia; École de psychologie, Université Laval, Pavillon Félix-Antoine-Savard, local 1036, Québec, QC G1V 0A6, Canada; Centre d'étude des troubles du sommeil, Institut universitaire en santé mentale de Québec, Québec, QC, Canada. · École de psychologie, Université Laval, Pavillon Félix-Antoine-Savard, local 1036, Québec, QC G1V 0A6, Canada; Centre d'étude des troubles du sommeil, Institut universitaire en santé mentale de Québec, Québec, QC, Canada. · École de psychologie, Université Laval, Pavillon Félix-Antoine-Savard, local 1036, Québec, QC G1V 0A6, Canada; Centre d'étude des troubles du sommeil, Institut universitaire en santé mentale de Québec, Québec, QC, Canada. Electronic address: cmorin@psy.ulaval.ca. ·Sleep Med Clin · Pubmed #31029191.

ABSTRACT: Insomnia is a costly health problem, where management has remained suboptimal despite advances in the understanding and treatment of the condition. This article provides an overview of the evidence-based treatment options of insomnia, looking at short-term and long-term therapeutic outcomes for cognitive behavioral therapies and pharmacologic therapies. Key issues of treatment delivery and implementation are highlighted at the patient and health system levels, and novel approaches for combining and sequencing treatment to maximize therapeutic outcomes for insomnia are discussed. The impact of recent updates of major clinical guidelines and future research directions for the field are discussed.

5 Review Insomnia and hypertension: A systematic review. 2018

Jarrin, Denise C / Alvaro, Pasquale K / Bouchard, Marc-André / Jarrin, Stephanie D / Drake, Christopher L / Morin, Charles M. ·École de psychologie, Université Laval, Québec City, Québec, Canada; Centre d'étude des troubles du sommeil, Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec City, Canada. Electronic address: dcjarrin@gmail.com. · The Institute for Breathing and Sleep, Austin Health, Heidelberg 3084, Victoria, Australia; School of Psychological Sciences, Monash University, Melbourne, Australia. · École de psychologie, Université Laval, Québec City, Québec, Canada; Centre d'étude des troubles du sommeil, Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec City, Canada. · Clinical Science Department, American University of Antigua College of Medicine, Antigua and Barbuda. · Henry Ford Hospital, Detroit, MI, USA. ·Sleep Med Rev · Pubmed #29576408.

ABSTRACT: Insomnia is a prevalent sleep disorder that is associated with a multitude of health consequences. Particularly, insomnia has been associated with cardiovascular disease and its precursors, such as hypertension and blood pressure (BP) non-dipping. The present systematic review aimed to summarize the evidence on the concurrent and prospective associations between insomnia and hypertension and/or BP. Using electronic search engines (PubMed, SCOPUS, PsycINFO), 5,618 articles published from January 1970 to December 2017 were identified, and 64 met the inclusion criteria (26 to 162,121 participants; age range: 18-100; 46.4% male). Insomnia was based on diagnostic or non-diagnostic criteria. Hypertension was based on self-or physician-reports, antihypertensive medication use, and/or measured BP. Findings indicate that when insomnia is frequent, chronic, and/or accompanied with short sleep duration or objective markers of arousal, there is a strong association with hypertension/BP. Based on limited studies, hypertension did not significantly predict future insomnia in middle-aged adults, but did in older adults. Based on a majority of case-control studies, no differences in BP were found between participants with and without insomnia. Further research is needed to identify putative pathophysiological mechanisms underlying the link between insomnia and hypertension. The impact of insomnia therapy on BP should also be further examined in the future.

6 Review Cognitive and behavioral therapies in the treatment of insomnia: A meta-analysis. 2018

van Straten, Annemieke / van der Zweerde, Tanja / Kleiboer, Annet / Cuijpers, Pim / Morin, Charles M / Lancee, Jaap. ·Department of Clinical Psychology & EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands. Electronic address: a.van.straten@vu.nl. · Department of Clinical Psychology & EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands. · Université Laval, École de Psychologie, Québec City, QC, Canada. · Department of Clinical Psychology, University of Amsterdam, The Netherlands. ·Sleep Med Rev · Pubmed #28392168.

ABSTRACT: Insomnia is a major public health problem considering its high prevalence, impact on daily life, co-morbidity with other disorders and societal costs. Cognitive behavioral treatment for insomnia (CBTI) is currently considered to be the preferred treatment. However, no meta-analysis exists of all studies using at least one component of CBTI for insomnia, which also uses modern techniques to pool data and to analyze subgroups of patients. We included 87 randomized controlled trials, comparing 118 treatments (3724 patients) to non-treated controls (2579 patients). Overall, the interventions had significant effects on: insomnia severity index (g = 0.98), sleep efficiency (g = 0.71), Pittsburgh sleep quality index (g = 0.65), wake after sleep onset (g = 0.63) and sleep onset latency (SOL; g = 0.57), number of awakenings (g = 0.29) and sleep quality (g = 0.40). The smallest effect was on total sleep time (g = 0.16). Face-to-face treatments of at least four sessions seem to be more effective than self-help interventions or face-to-face interventions with fewer sessions. Otherwise the results seem to be quite robust (similar for patients with or without comorbid disease, younger or older patients, using or not using sleep medication). We conclude that CBTI, either its components or the full package, is effective in the treatment of insomnia.

7 Review Qualitative studies of insomnia: Current state of knowledge in the field. 2017

Araújo, Taís / Jarrin, Denise C / Leanza, Yvan / Vallières, Annie / Morin, Charles M. ·École de psychologie, Université Laval, Québec City, Québec, Canada; Centre d'étude des troubles du sommeil, Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec, Canada. Electronic address: tais.araujo.1@ulaval.ca. · École de psychologie, Université Laval, Québec City, Québec, Canada; Centre d'étude des troubles du sommeil, Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec, Canada. · École de psychologie, Université Laval, Québec City, Québec, Canada; Laboratoire Psychologie et Cultures, Québec, Québec, Canada. · École de psychologie, Université Laval, Québec City, Québec, Canada; Laboratoire Psycho|Socio|Culturel du sommeil, Centre de recherche de l'Institut en santé mentale de Québec, Centre de recherche du Centre hospitalier universitaire de Québec, Québec, Canada. ·Sleep Med Rev · Pubmed #27090821.

ABSTRACT: Despite its high prevalence and burden, insomnia is often trivialized, under-diagnosed, and under-treated in practice. Little information is available on the subjective experience and perceived consequences of insomnia, help-seeking behaviors, and treatment preferences. The use of qualitative approaches (e.g., ethnography, phenomenology, grounded theory) may help gain a better understanding of this sleep disorder. The present paper summarizes the evidence derived from insomnia studies using a qualitative research methodology (e.g., focus group, semi-structured interviews). A systematic review of the literature was conducted using PsycINFO and Medline databases. The review yielded 22 studies and the quality of the methodology of each of them was evaluated systematically using the critical appraisal skills programme (CASP) appraisal tool. Selected articles possess at least a very good methodological rigor and they were categorized according to their main focus: "Experience of insomnia", "Management of insomnia" and "Medicalization of insomnia". The main findings indicate that: 1) insomnia is often experienced as a 24-h problem and is perceived to affect several domains of life, 2) a sense of frustration and misunderstanding is very common among insomnia patients, which is possibly due to a mismatch between patients' and health care professionals' perspectives on insomnia and its treatment, 3) health care professionals pay more attention to sleep hygiene education and medication therapies and less to the patient's subjective experience of insomnia, and 4) health care professionals are often unaware of non-pharmacological interventions other than sleep hygiene education. An important implication of these findings is the need to develop new clinical measures with a broader scope on insomnia and more targeted treatments that take into account the patient's experience of insomnia. Greater use of qualitative approaches in future research may produce novel and more contextualized information leading to a more comprehensive understanding of insomnia.

8 Review Insomnia disorder. 2015

Morin, Charles M / Drake, Christopher L / Harvey, Allison G / Krystal, Andrew D / Manber, Rachel / Riemann, Dieter / Spiegelhalder, Kai. ·Université Laval, École de psychologie, 2325 rue des Bibliothèques, Québec City, Québec G1V 0A6, Canada. · Henry Ford Hospital Sleep Disorders and Research Center, Detroit, Michigan, USA. · Department of Psychology, University of California, Berkeley, Berkeley, California, USA. · Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA. · Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA. · Department of Clinical Psychology and Psychophysiology/Sleep Medicine, Center for Mental Disorders, University of Freiburg Medical Center, Freiburg, Germany. ·Nat Rev Dis Primers · Pubmed #27189779.

ABSTRACT: Insomnia disorder affects a large proportion of the population on a situational, recurrent or chronic basis and is among the most common complaints in medical practice. The disorder is predominantly characterized by dissatisfaction with sleep duration or quality and difficulties initiating or maintaining sleep, along with substantial distress and impairments of daytime functioning. It can present as the chief complaint or, more often, co-occurs with other medical or psychiatric disorders, such as pain and depression. Persistent insomnia has been linked with adverse long-term health outcomes, including diminished quality of life and physical and psychological morbidity. Despite its high prevalence and burden, the aetiology and pathophysiology of insomnia is poorly understood. In the past decade, important changes in classification and diagnostic paradigms have instigated a move from a purely symptom-based conceptualization to the recognition of insomnia as a disorder in its own right. These changes have been paralleled by key advances in therapy, with generic pharmacological and psychological interventions being increasingly replaced by approaches that have sleep-specific and insomnia-specific therapeutic targets. Psychological and pharmacological therapies effectively reduce the time it takes to fall asleep and the time spent awake after sleep onset, and produce a modest increase in total sleep time; these are outcomes that correlate with improvements in daytime functioning. Despite this progress, several challenges remain, including the need to improve our knowledge of the mechanisms that underlie insomnia and to develop more cost-effective, efficient and accessible therapies.

9 Review Sleep-wake disturbances after traumatic brain injury. 2015

Ouellet, Marie-Christine / Beaulieu-Bonneau, Simon / Morin, Charles M. ·Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS), Québec, QC, Canada; École de Psychologie, Université Laval, Québec, QC, Canada. Electronic address: marie-christine.ouellet@psy.ulaval.ca. · Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS), Québec, QC, Canada; École de Psychologie, Université Laval, Québec, QC, Canada; Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec, Québec, QC, Canada. · École de Psychologie, Université Laval, Québec, QC, Canada; Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec, Québec, QC, Canada. ·Lancet Neurol · Pubmed #26067127.

ABSTRACT: Sleep-wake disturbances are extremely common after a traumatic brain injury (TBI). The most common disturbances are insomnia (difficulties falling or staying asleep), increased sleep need, and excessive daytime sleepiness that can be due to the TBI or other sleep disorders associated with TBI, such as sleep-related breathing disorder or post-traumatic hypersomnia. Sleep-wake disturbances can have a major effect on functional outcomes and on the recovery process after TBI. These negative effects can exacerbate other common sequelae of TBI-such as fatigue, pain, cognitive impairments, and psychological disorders (eg, depression and anxiety). Sleep-wake disturbances associated with TBI warrant treatment. Although evidence specific to patients with TBI is still scarce, cognitive-behavioural therapy and medication could prove helpful to alleviate sleep-wake disturbances in patients with a TBI.

10 Review Hypnotics in insomnia: the experience of zolpidem. 2014

MacFarlane, James / Morin, Charles M / Montplaisir, Jacques. ·Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; MedSleep (Network of Clinics) Toronto, Canada. Electronic address: j.macfarlane@utoronto.ca. · School of Psychology, Université Laval, and Sleep Research Center, Institut Universitaire en Santé Mentale de Québec, Montreal, Québec, Canada. · Department of Psychiatry, Université de Montréal, Montreal, Québec, Canada; Center for Advanced Research in Sleep Medicine (CARMS), Sacré-Coeur Hospital, Montreal, Québec, Canada. ·Clin Ther · Pubmed #25455931.

ABSTRACT: PURPOSE: One of the most commonly prescribed medications to treat insomnia is zolpidem, a nonbenzodiazepine compound that is available as an immediate-release oral tablet formulation, an extended-release oral formulation, an oral spray formulation, and as sublingual formulations. The purpose of this review was to summarize the data currently available on the efficacy and safety of zolpidem in the treatment of insomnia among adults. METHODS: Published studies on the use of zolpidem in the treatment of insomnia were identified by using combinations of relevant search terms in PubMed and Google Scholar. Studies were included if they were placebo- or active comparator-controlled studies, with the exception of trials on the long-term use of zolpidem. Studies were limited to those conducted in adults. Studies were not included if the patient population was small, if the study was not designed or powered to assess the efficacy or safety of zolpidem, if insomniac patients had a medical condition in addition to insomnia (with the exception of comorbid depression or anxiety for studies on comorbid insomnia), or if zolpidem was given concomitantly with any other therapy (with the exception of selective serotonin reuptake inhibitors for studies on comorbid insomnia). FINDINGS: Twenty-five studies designed to evaluate the efficacy of zolpidem in insomnia and 51 studies reporting the safety of zolpidem in insomnia were included in this review. IMPLICATIONS: The studies discussed in this review report the efficacy and safety of zolpidem in both young adults and the elderly. It can be used for either bedtime or middle-of-the-night administration, over the short or long term, with minimal risk of withdrawal or abuse. The use of zolpidem is associated with rebound insomnia, complex sleep-related behaviors, and next-day residual effects (after middle-of-the-night dosing) on driving ability, memory, and psychomotor performance.

11 Review The evidence base of sleep restriction therapy for treating insomnia disorder. 2014

Miller, Christopher B / Espie, Colin A / Epstein, Dana R / Friedman, Leah / Morin, Charles M / Pigeon, Wilfred R / Spielman, Arthur J / Kyle, Simon D. ·Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Sydney Medical School, University of Sydney, Australia; Institute of Neuroscience & Psychology, University of Glasgow, UK. Electronic address: chris.miller@sydney.edu.au. · Nuffield Department of Clinical Neurosciences and Sleep & Circadian Neuroscience Institute, University of Oxford, UK. · Phoenix Veterans Affairs Health Care System, USA; Arizona State University College of Nursing and Health Innovation, USA. · Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA. · Université Laval, Québec City, Québec, Canada. · Sleep & Neurophysiology Research Lab, University of Rochester Medical Center, USA; Center of Excellence for Suicide Prevention, U.S. Department of Veterans Affairs, USA. · Cognitive Neuroscience Doctoral Program, The City College of the City University of New York, USA; Weill Cornell Medical College, Center for Sleep Medicine, NY, USA. · School of Psychological Sciences, University of Manchester, UK. ·Sleep Med Rev · Pubmed #24629826.

ABSTRACT: Sleep restriction therapy is routinely used within cognitive behavioral therapy to treat chronic insomnia. However, the efficacy for sleep restriction therapy as a standalone intervention has yet to be comprehensively reviewed. This review evaluates the evidence for the use of sleep restriction therapy in the treatment of chronic insomnia. The literature was searched using web-based databases, finding 1344 studies. Twenty-one were accessed in full (1323 were deemed irrelevant to this review). Nine were considered relevant and evaluated in relation to study design using a standardized study checklist and levels of evidence. Four trials met adequate methodological strength to examine the efficacy of therapy for chronic insomnia. Weighted effect sizes for self-reported sleep diary measures of sleep onset latency, wake time after sleep onset, and sleep efficiency were moderate-to-large after therapy. Total sleep time indicated a small improvement. Standalone sleep restriction therapy is efficacious for the treatment of chronic insomnia for sleep diary continuity variables. Studies are insufficient to evaluate the full impact on objective sleep variables. Measures of daytime functioning in response to therapy are lacking. Variability in the sleep restriction therapy implementation methods precludes any strong conclusions regarding the true impact of therapy. A future research agenda is outlined.

12 Review Chronic insomnia. 2012

Morin, Charles M / Benca, Ruth. ·Université Laval, Québec City, QC, Canada. cmorin@psy.ulaval.ca ·Lancet · Pubmed #22265700.

ABSTRACT: Insomnia is a prevalent complaint in clinical practice that can present independently or comorbidly with another medical or psychiatric disorder. In either case, it might need treatment of its own. Of the different therapeutic options available, benzodiazepine-receptor agonists (BzRAs) and cognitive-behavioural therapy (CBT) are supported by the best empirical evidence. BzRAs are readily available and effective in the short-term management of insomnia, but evidence of long-term efficacy is scarce and most hypnotic drugs are associated with potential adverse effects. CBT is an effective alternative for chronic insomnia. Although more time consuming than drug management, CBT produces sleep improvements that are sustained over time, and this therapy is accepted by patients. Although CBT is not readily available in most clinical settings, access and delivery can be made easier through use of innovative methods such as telephone consultations, group therapy, and self-help approaches. Combined CBT and drug treatment can optimise outcomes, although evidence to guide clinical practice on the best way to integrate these approaches is scarce.

13 Clinical Trial Cognitive impairment in individuals with insomnia: clinical significance and correlates. 2014

Fortier-Brochu, Emilie / Morin, Charles M. ·Université Laval, Québec (Québec), Canada. ·Sleep · Pubmed #25364074.

ABSTRACT: STUDY OBJECTIVES: The aims of this study were to (1) investigate the nature of cognitive impairment in individuals with insomnia, (2) document their clinical significance, (3) examine their correlates, and (4) explore differences among individuals with insomnia with and without cognitive complaints. DESIGN: Participants underwent 3 consecutive nights of polysomnography. On the morning following the third night, they completed a battery of questionnaires and neuropsychological tests. PARTICIPANTS: The sample included 25 adults with primary insomnia (mean age: 44.4 ± 11.5 y, 56% women) and 16 controls (mean age: 42.8 ± 12.9 y, 50% women) matched for sex, age, and education. INTERVENTION: N/A. MEASUREMENT AND RESULTS: Participants completed neuropsychological tests covering attention, memory, working memory, and executive functions, as well as questionnaires assessing the subjective perception of performance, depression, anxiety, fatigue, sleepiness, and hyperarousal. There were significant group differences for the attention and episodic memory domains. Clinically significant deficits were more frequent in the insomnia group. Within the insomnia group, individuals with cognitive complaints exhibited significantly poorer performance on a larger number of neuropsychological variables. All impaired aspects of performance were significantly associated with either subjective or objective sleep continuity, and some were also independently related to sleep microstructure (i.e., relative power for alpha frequencies) or selected psychological variables (i.e., beliefs or arousal). CONCLUSIONS: These findings suggest clinically significant alterations in attention and episodic memory in individuals with insomnia. Objective deficits were more pronounced and involved more aspects of performance in a subgroup of individuals with cognitive complaints. These deficits appear associated with sleep continuity, and may also be related to sleep microstructure and dysfunctional beliefs.

14 Article A systematic review of cognitive behavioral therapy for insomnia implemented in primary care and community settings. 2019

Cheung, Janet M Y / Jarrin, Denise C / Ballot, Orlane / Bharwani, Annika A / Morin, Charles M. ·School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; École de psychologie, Université Laval, Québec, QC, Canada; Centre d'étude des troubles du sommeil, Institut universitaire en santé mentale de Québec, Québec, QC, Canada. Electronic address: janet.cheung@sydney.edu.au. · École de psychologie, Université Laval, Québec, QC, Canada; Centre d'étude des troubles du sommeil, Institut universitaire en santé mentale de Québec, Québec, QC, Canada. · Faculty of Medicine, Chinese University of Hong Kong, New Territories, Hong Kong. ·Sleep Med Rev · Pubmed #30612061.

ABSTRACT: The advent of stepped-care and the need to disseminate cognitive behavioral therapy for insomnia (CBT-I) has led to novel interventions, which capitalize on non-specialist venues and/or health personnel. However, the translatability of these CBT-I programs into practice is unknown. This review evaluates the current state of CBT-I programs that are directly implemented in primary care and/or community settings. A literature search was conducted through major electronic databases (N = 840) and through snowballing (n = 8). After removing duplicates, 104 full-texts were extracted and evaluated against our initial inclusion criteria. Twelve studies including data from 1625 participants were subsequently evaluated for its study design and methodological quality. CBT-I program components varied across studies and included cognitive therapy (n = 6), relaxation (n = 7), sleep restriction therapy (n = 9), stimulus control therapy (n = 11) and sleep psychoeducation (n = 12). The respective interventions produced small to moderate post-treatment weighted effect sizes for the Insomnia Severity Index (0.40), Pittsburgh Sleep Quality Index (0.37), sleep efficiency (0.38), sleep onset latency (0.38), and wake time after sleep onset (0.46) but total sleep time (0.10) did not reach statistical significance. While non-specialist community settings can potentially address the demands for CBT-I across clinical contexts, intervention heterogeneity precluded the full impact of the 12 CBT-I programs to be evaluated.

15 Article Prevalence of insomnia for Canadians aged 6 to 79. 2018

Chaput, Jean-Philippe / Yau, Jessica / Rao, Deepa P / Morin, Charles M. ·Healthy Active Living and Obesity Research Group of the Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario. · Behaviours, Environments and Lifespan Team, Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario. · École de psychologie, Université Laval, Québec, Quebec. ·Health Rep · Pubmed #30566205.

ABSTRACT: This study estimates the prevalence of nighttime insomnia symptoms among Canadians aged 6 to 79, and examines trends over time (2007 to 2015). The study is based on 21,826 respondents from the 2007-to-2015 Canadian Health Measures Survey, a nationally representative, cross-sectional survey. Nighttime insomnia symptoms and duration were self-reported. A 42% increase in nighttime insomnia symptoms was observed for adults aged 18 or older (from 16.8% to 23.8%). The majority of Canadians with insomnia symptoms reported having the symptoms for more than one year. This study also showed nighttime insomnia symptoms to be more prevalent in older age groups, women, those from lower socioeconomic backgrounds, and individuals reporting poor health and quality of life. Efforts toward prevention and intervention strategies could reduce the burden of insomnia symptoms among Canadians.

16 Article Specific insomnia symptoms and self-efficacy explain CPAP compliance in a sample of OSAS patients. 2018

Philip, Pierre / Bioulac, Stéphanie / Altena, Elemarije / Morin, Charles M / Ghorayeb, Imad / Coste, Olivier / Monteyrol, Pierre-Jean / Micoulaud-Franchi, Jean-Arthur. ·Clinique du Sommeil, Service d'Explorations Fonctionnelles du Système Nerveux, CHU de Bordeaux, Bordeaux, France. · Univ. Bordeaux, SANPSY, Bordeaux, France. · CNRS, SANPSY, Bordeaux, France. · Université Laval, 2325, rue de l'Université, QC G1V 0A6 Québec, Canada et Centre de recherche CERVO, Institut universitaire en santé mentale de Québec, Québec, Canada. · CNRS, Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, Bordeaux, France. · Université de Bordeaux, Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, Bordeaux, France. ·PLoS One · Pubmed #29617414.

ABSTRACT: This study explores the association between specific insomnia symptoms (sleep onset, sleep maintenance and early morning awakenings symptoms) and self-efficacy (perceived self-confidence in the ability to use CPAP) with CPAP compliance in French patients with obstructive sleep apnea syndrome (OSAS). We performed a retrospective, cross-sectional analysis of CPAP compliance in a cohort of 404 patients diagnosed with OSAS. Patients completed mailed questionnaires on sleepiness (ESS), insomnia (ISI) and self-efficacy in sleep apnea (SEMSA). Linear regression modeling analyses were performed to explore the impact of measured variables on the number of hours of CPAP use. Of the initial pool of 404 patients, 288 returned the questionnaires (71% response rate). Their mean age was 63.16±12.73 yrs, 31% were females, mean BMI was 30.39±6.31 kg/m2, mean daily CPAP use was 6.19±2.03 h, mean number of years of use was 6.58±6.03 yrs, and mean initial AHI before CPAP use was 34.61±20.71 /h. Age (p<0.01), BMI (p<0.01), sleep onset insomnia symptoms (p<0.01), sleep maintenance insomnia symptoms (p<0.01) and self-efficacy (p<0.01) were significantly associated with mean daily CPAP use. We found that specific insomnia symptoms and self-efficacy were associated with CPAP compliance. Our findings underline the need to demonstrate that interventions that reduce insomnia symptoms and improve self-efficacy will increase CPAP compliance.

17 Article Treatment agreement, adherence, and outcome in cognitive behavioral treatments for insomnia. 2018

Dong, Lu / Soehner, Adriane M / Bélanger, Lynda / Morin, Charles M / Harvey, Allison G. ·Department of Psychology, University of California, Berkeley. · Department of Psychiatry, University of Pittsburgh School of Medicine. · Department of Psychology, Université Laval. ·J Consult Clin Psychol · Pubmed #29265834.

ABSTRACT: BACKGROUND: Patient adherence has been identified as an important barrier to the implementation of evidence-based psychological treatments. OBJECTIVE: In cognitive behavioral treatments (CBT) for insomnia, the current study examined (a) the validity of therapist ratings of patient agreement and adherence against an established behavioral measure of adherence, and (b) the relationship between treatment agreement, adherence, and outcome. METHOD: Participants were 188 adults meeting DSM-IV-TR criteria for chronic insomnia who were randomized to receive behavior therapy, cognitive therapy, or CBT for insomnia. Treatment agreement/adherence was measured by (a) weekly therapist ratings of patient agreement and homework completion, and (b) adherence to behavioral strategies (ABS) derived from patient-reported sleep diary. Outcome measures were Insomnia Severity Index and insomnia remission (Insomnia Severity Index <8). RESULTS: Therapist ratings of patient agreement as well as homework completion were significantly associated with sleep diary-derived global ABS. Therapist-rated patient agreement and homework completion as well as global ABS predicted greater insomnia symptoms reduction from pretreatment to posttreatment. Patient agreement also predicted insomnia symptoms reduction from pretreatment to 6-month follow-up. Patient agreement, adherence, and ABS measures during treatment significantly predicted insomnia remission at posttreatment, and all but therapist rating of homework completion predicted remission at 6-month follow-up. CONCLUSIONS: Greater patient agreement and adherence (therapist ratings and ABS) during treatment predicted better treatment outcome. Therapist-rated treatment agreement and adherence correspond well with patient-reported sleep diary-derived adherence measure. These simple, deployable therapist-rated patient agreement and adherence can potentially be useful for treatments for other disorders. (PsycINFO Database Record

18 Article Effects of Pharmacologic and Nonpharmacologic Interventions on Insomnia Symptoms and Self-reported Sleep Quality in Women With Hot Flashes: A Pooled Analysis of Individual Participant Data From Four MsFLASH Trials. 2018

Guthrie, Katherine A / Larson, Joseph C / Ensrud, Kristine E / Anderson, Garnet L / Carpenter, Janet S / Freeman, Ellen W / Joffe, Hadine / LaCroix, Andrea Z / Manson, JoAnn E / Morin, Charles M / Newton, Katherine M / Otte, Julie / Reed, Susan D / McCurry, Susan M. ·Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA. · Department of Medicine, Division of Epidemiology and Community Health, University of Minnesota, Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN. · Indiana University School of Nursing, Indianapolis, IN. · Departments of Obstetrics/Gynecology and Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA. · Dana Farber Cancer Institute, Harvard Medical School, Boston, MA. · Brigham and Women's Hospital, Harvard Medical School, Boston, MA. · Department of Family and Preventive Medicine, University of California-San Diego, La Jolla, CA. · Department of Psychology, Universite Laval, Quebec, QC, Canada. · Kaiser Permanente Washington Health Research Institute, Seattle, WA. · Department of Obstetrics and Gynecology, University of Washington, Seattle, WA. · Department of Psychosocial and Community Health, University of Washington, Seattle, WA. ·Sleep · Pubmed #29165623.

ABSTRACT: Study Objectives: The Menopause Strategies: Finding Lasting Answers for Symptoms and Health network conducted three randomized clinical trials (RCTs) testing six interventions treating vasomotor symptoms (VMS), and also collected self-reported sleep outcomes. A fourth RCT assessed an intervention for insomnia symptoms among women with VMS. We describe these seven interventions' effects relative to control in women with comparably severe insomnia symptoms and VMS. Methods: We analyzed pooled individual-level data from 546 peri- and postmenopausal women with Insomnia Severity Index (ISI) ≥ 12, and ≥14 bothersome VMS/week across the four RCTs. Interventions included the following: escitalopram 10-20 mg/day; yoga; aerobic exercise; 1.8 g/day omega-3 fatty acids; oral 17-beta-estradiol 0.5-mg/day; venlafaxine XR 75-mg/day; and cognitive behavioral therapy for insomnia (CBT-I). Outcome measures were ISI and Pittsburgh Sleep Quality Index (PSQI) over 8-12 weeks of treatment. Results: CBT-I produced the greatest reduction in ISI from baseline relative to control at -5.2 points (95% CI -7.0 to -3.4). Effects on ISI were similar for exercise at -2.1 and venlafaxine at -2.3 points. Comparably small decreases in ISI were observed with escitalopram, yoga, and estradiol. The largest reduction in PSQI from baseline was with CBT-I at -2.7 points (-3.9 to -1.5), although PSQI decreases of 1.2 to 1.6 points were significantly better than control with escitalopram, exercise, yoga, estradiol, and venlafaxine. Omega-3 supplements did not improve insomnia symptoms. Conclusions: This study's findings support current recommendations for CBT-I as a first line treatment in healthy midlife women with insomnia symptoms and moderately bothersome VMS.

19 Article Definitions and epidemiology of insomnia 2017

Jaussent, Isabelle / Morin, Charles / Dauvilliers, Yves. ·Inserm - unité 1061, hôpital La Colombière, Montpellier, France. · École de psychologie, université Laval ; centre de recherche CERVO, Institut universitaire en santé mentale de Québec, Québec, QC, Canada. · Centre national de référence narcolepsie, hypersomnies idiopathiques, unité des troubles du sommeil - département de neurologie, hôpital Gui-de- Chauliac ; Inserm U1061, hôpital La Colombière, université de Montpellier, Montpellier, France. ·Rev Prat · Pubmed #30512811.

ABSTRACT: Definitions and epidemiology of insomnia Complaints of poor sleep are numerous and frequent in the general population. One of the most important is insomnia. As it is a subjective complaint, it can be difficult to define and diagnose. Various nosologies propose a common definition even if no consensus has yet been reached. Insomnia may be associated to or be the consequence of various psychiatric and somatic comorbidities. The purpose of this article is to present various definitions used to diagnose insomnia and provide updated knowledge about its prevalence, incidence, determinants and consequences.

20 Article Investigating psychological and physiological responses to the Trier Social Stress Test in young adults with insomnia. 2017

Chen, Ivy Y / Jarrin, Denise C / Ivers, Hans / Morin, Charles M. ·École de psychologie, Université Laval, Québec City, Québec, Canada; Centre d'étude des troubles du sommeil, Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec City, Canada. ·Sleep Med · Pubmed #29221772.

ABSTRACT: OBJECTIVE: Stress and hyperarousal both contribute to insomnia. Elevated stress-related sleep reactivity is associated with hyperarousal, and might constitute a vulnerability to future insomnia. The present study examined acute stress-induced arousal and its association with nocturnal sleep. METHODS: Participants were 30 healthy adults (66.7% female, M RESULTS: The TSST elicited an increase in psychological and physiological arousal in all three groups. The INS group showed greater acute cortisol response (p < 0.05) and secretion at bedtime (p < 0.05), and higher pre-sleep cognitive arousal (p < 0.01) than the LV group; HV participants did not significantly differ from those in the INS or the LV group. Increased cortisol response and elevated sympathovagal imbalance (ie, low frequency/high frequency ratio) were each significantly associated with longer nocturnal awakenings (p = 0.048, p = 0.037, respectively). Heightened blood pressure was significantly associated with prolonged sleep onset latency, and reduced total sleep time and sleep efficiency (all ps < 0.05). CONCLUSIONS: These findings support the hyperarousal conceptualization of insomnia and indirectly suggest that increased stress reactivity and bedtime hyperarousal might represent a trait-like vulnerability in certain good sleepers. More research is warranted to validate and expand these preliminary findings.

21 Article Mediators and treatment matching in behavior therapy, cognitive therapy and cognitive behavior therapy for chronic insomnia. 2017

Harvey, Allison G / Dong, Lu / Bélanger, Lynda / Morin, Charles M. ·Psychology Department, University of California, Berkeley. · Université Laval. ·J Consult Clin Psychol · Pubmed #28956950.

ABSTRACT: OBJECTIVE: To examine the mediators and the potential of treatment matching to improve outcome for cognitive behavior therapy (CBT) for insomnia. METHOD: Participants were 188 adults (117 women; Mage = 47.4 years, SD = 12.6) meeting the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; text rev.; DSM-IV-TR; American Psychiatric Association [APA], 2000) diagnostic criteria for chronic insomnia (Mduration: 14.5 years, SD: 12.8). Participants were randomized to behavior therapy (BT; n = 63), cognitive therapy (CT; n = 65), or CBT (n = 60). The outcome measure was the Insomnia Severity Index (ISI). Hypothesized BT mediators were sleep-incompatible behaviors, bedtime variability (BTv), risetime variability (RTv) and time in bed (TIB). Hypothesized CT mediators were worry, unhelpful beliefs, and monitoring for sleep-related threat. RESULTS: The behavioral processes mediated outcome for BT but not CT. The cognitive processes mediated outcome in both BT and CT. The subgroup scoring high on both behavioral and cognitive processes had a marginally significant better outcome if they received CBT relative to BT or CT. The subgroup scoring relatively high on behavioral but low on cognitive processes and received BT or CBT did not differ from those who received CT. The subgroup scoring relatively high on cognitive but low on behavioral processes and received CT or CBT did not differ from those who received BT. CONCLUSION: The behavioral mediators were specific to BT relative to CT. The cognitive mediators were significant for both BT and CT outcomes. Patients exhibiting high levels of both behavioral and cognitive processes achieve better outcome if they receive CBT relative to BT or CT alone. (PsycINFO Database Record

22 Article Sleep the night before and after a treatment session: A critical ingredient for treatment adherence? 2017

Dolsen, Michael R / Soehner, Adriane M / Morin, Charles M / Bélanger, Lynda / Walker, Matthew / Harvey, Allison G. ·Department of Psychology, University of California, Berkeley. · Department of Psychiatry, University of Pittsburgh School of Medicine. · École de Psychologie, Université Laval. ·J Consult Clin Psychol · Pubmed #28394172.

ABSTRACT: OBJECTIVE: Sleep prepares key neural structures for next-day learning, and sleep obtained after learning promotes subsequent memory consolidation supporting long-term retention. This study examined whether sleep the night before and after a therapy session predicts aspects of treatment adherence. METHOD: As part of a randomized clinical trial, 188 adults (62.7% female, mean age = 47.5, 80.5% Caucasian) with persistent insomnia received cognitive-behavioral therapy for insomnia. Patients completed a sleep diary before and after treatment sessions. Minutes spent awake during the night (total wake time; TWT) and total sleep time (TST) were used as measures of sleep disturbance. At each treatment session, therapists rated participant understanding of the session and homework compliance from the previous session. RESULTS: Compared to longer TWT, before session shorter TWT was associated with increased treatment understanding the next day. After session shorter TWT was also associated with increased understanding, but not homework compliance the subsequent session compared to participants with longer TWT. Similar results were obtained for TST. CONCLUSIONS: Improving sleep may benefit patient adherence to treatment. Sleep may influence processes related to initial learning and subsequent consolidation of treatment information. Future studies should examine whether improved sleep within other psychiatric disorders is also an ingredient to the successful outcome of psychosocial interventions. (PsycINFO Database Record

23 Article Familial Aggregation of Insomnia. 2017

Jarrin, Denise C / Morin, Charles M / Rochefort, Amélie / Ivers, Hans / Dauvilliers, Yves A / Savard, Josée / LeBlanc, Mélanie / Merette, Chantal. ·École de psychologie, Université Laval, Québec City, Québec, Canada. · Centre d'étude des troubles du sommeil, Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec City, Québec, Canada. · National Reference Centre for Orphan Diseases, Narcolepsy, Sleep Unit, Department of Neurology, Gui de Chauliac Hospital, CHU Montpellier, Inserm, U1061 Montpellier, France. ·Sleep · Pubmed #28364499.

ABSTRACT: Study Objectives: There is little information about familial aggregation of insomnia; however, this type of information is important to (1) improve our understanding of insomnia risk factors and (2) to design more effective treatment and prevention programs. This study aimed to investigate evidence of familial aggregation of insomnia among first-degree relatives of probands with and without insomnia. Methods: Cases (n = 134) and controls (n = 145) enrolled in a larger epidemiological study were solicited to invite their first-degree relatives and spouses to complete a standardized sleep/insomnia survey. In total, 371 first-degree relatives (Mage = 51.9 years, SD = 18.0; 34.3% male) and 138 spouses (Mage = 55.5 years, SD = 12.2; 68.1% male) completed the survey assessing the nature, severity, and frequency of sleep disturbances. The dependent variable was insomnia in first-degree relatives and spouses. Familial aggregation was claimed if the risk of insomnia was significantly higher in the exposed (relatives of cases) compared to the unexposed cohort (relatives of controls). The risk of insomnia was also compared between spouses in the exposed (spouses of cases) and unexposed cohort (spouses of controls). Results: The risk of insomnia in exposed and unexposed biological relatives was 18.6% and 10.4%, respectively, yielding a relative risk (RR) of 1.80 (p = .04) after controlling for age and sex. The risk of insomnia in exposed and unexposed spouses was 9.1% and 4.2%, respectively; however, corresponding RR of 2.13 (p = .28) did not differ significantly. Conclusions: Results demonstrate evidence of strong familial aggregation of insomnia. Additional research is warranted to further clarify and disentangle the relative contribution of genetic and environmental factors in insomnia.

24 Article Long-Term Maintenance of Therapeutic Gains Associated With Cognitive-Behavioral Therapy for Insomnia Delivered Alone or Combined With Zolpidem. 2017

Beaulieu-Bonneau, Simon / Ivers, Hans / Guay, Bernard / Morin, Charles M. ·École de psychologie, Université Laval, Pavillon Félix-Antoine Savard, 2325, des Bibliothèques, Québec G1V 0A6, Canada. · Centre de recherche de l'Institut universitaire en santé mentale de Québec, 2601, de la Canardière, Québec G1J 2G3, Canada. ·Sleep · Pubmed #28364426.

ABSTRACT: Study objectives: To document the long-term sleep outcomes at 12 and 24 months after patients with chronic insomnia were treated with cognitive-behavioral therapy (CBT), either singly or combined with zolpidem medication. Methods: Participants were 160 adults with chronic insomnia. They were first randomized for a six-week acute treatment phase involving CBT alone or CBT combined with nightly zolpidem, and randomized for a six-month extended treatment phase involving CBT, no additional treatment, CBT combined with zolpidem as needed, or CBT with zolpidem tapered. This paper reports results of the 12- and 24-month follow-ups on the main outcome measures derived from the Insomnia Severity Index and sleep diaries. Results: Clinical improvements achieved 6 months following the end of treatment were well-maintained in all four conditions, with insomnia remission rates ranging from 48% to 74% at the 12-month follow-up, and from 44% to 63% at the 24-month follow-up. Participants receiving CBT with zolpidem taper in the extended treatment phase had significantly better results than those receiving CBT with continued zolpidem as needed. The magnitude of improvements on sleep diary parameters was similar between conditions, with a slight advantage for the CBT with zolpidem taper condition. The addition of extended CBT did not alter the long-term outcome over improvements obtained during the initial 6-week CBT. Conclusions: The results suggest that CBT for insomnia, when delivered alone or in combination with medication, produce durable sleep improvements up to two years after completion of treatment. These long-term results indicate that even if a combined CBT plus medication approach provide an added benefit immediately after treatment, extending CBT while tapering medication produce better sustained improvements compared to continued use of medication as needed.

25 Article Effect of a Web-Based Cognitive Behavior Therapy for Insomnia Intervention With 1-Year Follow-up: A Randomized Clinical Trial. 2017

Ritterband, Lee M / Thorndike, Frances P / Ingersoll, Karen S / Lord, Holly R / Gonder-Frederick, Linda / Frederick, Christina / Quigg, Mark S / Cohn, Wendy F / Morin, Charles M. ·Center for Behavioral Health & Technology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville. · The F.E. Dreifuss Comprehensive Epilepsy Program, Department of Neurology, University of Virginia School of Medicine, Charlottesville. · Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville. · Department of Psychology, Université Laval, Laval, Quebec, Canada. ·JAMA Psychiatry · Pubmed #27902836.

ABSTRACT: Importance: Although cognitive behavior therapy for insomnia (CBT-I) has been established as the first-line recommendation for the millions of adults with chronic insomnia, there is a paucity of trained clinicians to deliver this much needed treatment. Internet-delivered CBT-I has shown promise as a method to overcome this obstacle; however, the long-term effectiveness has not been proven in a representative sample with chronic insomnia. Objective: To evaluate a web-based, automated CBT-I intervention to improve insomnia in the short term (9 weeks) and long term (1 year). Design, Setting, and Participants: A randomized clinical trial comparing the internet CBT-I with internet patient education at baseline, 9 weeks, 6 months, and 1 year. Altogether, 303 adults with chronic insomnia self-referred to participate, of whom 151 (49.8%) reported at least 1 medical or psychiatric comorbidity. Interventions: The internet CBT-I (Sleep Healthy Using the Internet [SHUTi]) was a 6-week fully automated, interactive, and tailored web-based program that incorporated the primary tenets of face-to-face CBT-I. The online patient education program provided nontailored and fixed online information about insomnia. Main Outcomes and Measures: The primary sleep outcomes were self-reported online ratings of insomnia severity (Insomnia Severity Index) and online sleep diary-derived values for sleep-onset latency and wake after sleep onset, collected prospectively for 10 days at each assessment period. The secondary sleep outcomes included sleep efficiency, number of awakenings, sleep quality, and total sleep time. Results: Among 303 participants, the mean (SD) age was 43.28 (11.59) years, and 71.9% (218 of 303) were female. Of these, 151 were randomized to the SHUTi group and 152 to the online patient education group. Results of the 3 primary sleep outcomes showed that the overall group × time interaction was significant for all variables, favoring the SHUTi group (Insomnia Severity Index [F3,1063 = 20.65, P < .001], sleep-onset latency [F3,1042 = 6.01, P < .001], and wake after sleep onset [F3,1042 = 12.68, P < .001]). Within-group effect sizes demonstrated improvements from baseline to postassessment for the SHUTi participants (range, Cohen d = 0.79 [95% CI, 0.55-1.04] to d = 1.90 [95% CI, 1.62-2.18]). Treatment effects were maintained at the 1-year follow-up (SHUTi Insomnia Severity Index d = 2.32 [95% CI, 2.01-2.63], sleep-onset latency d = 1.41 [95% CI, 1.15-1.68], and wake after sleep onset d = 0.95 [95% CI, 0.70-1.21]), with 56.6% (69 of 122) achieving remission status and 69.7% (85 of 122) deemed treatment responders at 1 year based on Insomnia Severity Index data. All secondary sleep outcomes, except total sleep time, also showed significant overall group × time interactions, favoring the SHUTi group. Conclusions and Relevance: Given its efficacy and availability, internet-delivered CBT-I may have a key role in the dissemination of effective behavioral treatments for insomnia. Trial Registration: clinicaltrials.gov Identifier: NCT01438697.