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Sleep Initiation and Maintenance Disorders: HELP
Articles from Monash University
Based on 25 articles published since 2008
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These are the 25 published articles about Sleep Initiation and Maintenance Disorders that originated from Monash University during 2008-2019.
 
+ Citations + Abstracts
1 Guideline Guidelines for sleep studies in adults - a position statement of the Australasian Sleep Association. 2017

Douglas, James A / Chai-Coetzer, Ching Li / McEvoy, David / Naughton, Matthew T / Neill, Alister M / Rochford, Peter / Wheatley, John / Worsnop, Christopher. ·The Prince Charles Hospital, Brisbane, Queensland, Australia. Electronic address: n.shillabeer@elsevier.com. · Adelaide Institute for Sleep Health, Flinders Centre of Research Excellence, Flinders University, Adelaide, South Australia, Australia; Sleep Health Service, Repatriation General Hospital, Southern Adelaide Local Health Network, Adelaide, South Australia, Australia. · Mater Medical Centre, Brisbane, Queensland, Australia. · The Alfred Hospital, Melbourne, Victoria, Australia; Monash University, Melbourne, Victoria, Australia. · WellSleep Sleep Investigation Centre, University of Otago, New Zealand. · Institute of Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia. · Ludwig Engel Centre for Respiratory Research, The Westmead Institute for Medical Research, Sydney, NSW, Australia; University of Sydney at Westmead Hospital, Sydney, NSW, Australia. ·Sleep Med · Pubmed #28648224.

ABSTRACT: -- No abstract --

2 Editorial Clinical Guidelines of the Australasian Sleep Association (ASA). 2017

Hamilton, Garun S. ·Clinical Associate Professor, Monash University and Monash Health, Australia; Board Member and Clinical Committee Chair, Australasian Sleep Association, Australia. ·Sleep Med · Pubmed #28648223.

ABSTRACT: -- No abstract --

3 Review Individual vulnerability to insomnia, excessive sleepiness and shift work disorder amongst healthcare shift workers. A systematic review. 2018

Booker, Lauren A / Magee, Michelle / Rajaratnam, Shantha M W / Sletten, Tracey L / Howard, Mark E. ·Institute for Breathing and Sleep, Austin Health, Austin Hospital, Heidelberg, Victoria, Australia; School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia. Electronic address: lauren.booker@monash.edu. · School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia. · Institute for Breathing and Sleep, Austin Health, Austin Hospital, Heidelberg, Victoria, Australia; School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia; Department of Medicine, University of Melbourne, Parkville, Victoria, Australia. ·Sleep Med Rev · Pubmed #29680177.

ABSTRACT: Shift workers often experience reduced sleep quality, duration and/or excessive sleepiness due to the imposed conflict between work and their circadian system. About 20-30% of shift workers experience prominent insomnia symptoms and excessive daytime sleepiness consistent with the circadian rhythm sleep disorder known as shift work disorder. Individual factors may influence this vulnerability to shift work disorder or sleep-related impairment associated with shift work. This paper was registered with Prospero and was conducted using recommended standards for systematic reviews and meta-analyses. Published literature that measured sleep-related impairment associated with shift work including reduced sleep quality and duration and increased daytime sleepiness amongst healthcare shift workers and explored characteristics associated with individual variability were reviewed. Fifty-eight studies were included. Older age, morning-type, circadian flexibility, being married or having children, increased caffeine intake, higher scores on neuroticism and lower on hardiness were related to a higher risk of sleep-related impairment in response to shift work, whereas physical activity was a protective factor. The review highlights the diverse range of measurement tools used to evaluate the impact of shift work on sleep. Use of standardised and validated tools would enable cross-study comparisons. Longitudinal studies are required to establish causal relationships between individual factors and the development of shift work disorder.

4 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.

5 Review Suvorexant: scientifically interesting, utility uncertain. 2017

Keks, Nicholas A / Hope, Judy / Keogh, Simone. ·Professor & Director, Monash Medical Centre and Centre for Mental Health Education and Research at Delmont Private Hospital, Monash University, Melbourne, VIC, Australia. · Consultant, Deputy Director & Senior Lecturer, Eastern Health and Centre for Mental Health Education and Research at Delmont Private Hospital, Monash University, Melbourne, VIC, Australia. · Senior Fellow, Centre for Mental Health Education and Research at Delmont Private Hospital, Melbourne, VIC, Australia. ·Australas Psychiatry · Pubmed #28994603.

ABSTRACT: OBJECTIVE: Suvorexant, a new hypnotic, is indicated for the treatment of insomnia characterized by difficulties with sleep onset and/or sleep maintenance, and is used long-term. This paper will briefly review suvorexant. RESULTS: Orexin is a hypothalamic peptide which promotes wakefulness. By blocking orexin receptors, suvorexant induces sleep. Peaking 2 h after ingestion, it has a half-life of 12 h and is hepatically metabolized mainly by CYP3A. Kinetics are not affected by age but concentrations are higher in females and obese patients. There may be interactions with benzodiazepines, antidepressants and antipsychotics. Suvorexant is available in 15 mg and 20 mg doses at which benefits are moderate: after three months' treatment users fell asleep 6 min faster and slept 16 min longer than those on placebo. Studies with 40 mg showed greater benefits but more side effects: next day somnolence, fatigue, xerostomia and peripheral oedema. Hallucinations, sleep paralysis and somnambulism occur rarely. Tolerance, withdrawal and rebound do not generally occur at recommended doses. CONCLUSION: Suvorexant has not been trialled against other hypnotics, is expensive and its utility for insomnia in patients with psychiatric disorders is unknown. Currently, use of suvorexant could be considered where more established treatments are inappropriate.

6 Review Chronic insomnia: diagnosis and non-pharmacological management. 2016

Cunnington, David / Junge, Moira. ·Melbourne Sleep Disorders Centre, East Melbourne, Victoria 3002, Australia. · School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia. ·BMJ · Pubmed #27852564.

ABSTRACT: -- No abstract --

7 Review Beyond the mean: A systematic review on the correlates of daily intraindividual variability of sleep/wake patterns. 2016

Bei, Bei / Wiley, Joshua F / Trinder, John / Manber, Rachel. ·Monash Institute of Cognitive and Clinical Neurosciences, Monash School of Psychological Sciences, Faculty of Biomedical and Psychological Sciences, Monash University, Australia; Centre for Women's Mental Health, Royal Women's Hospital, Australia. Electronic address: bei.bei@monash.edu. · Centre for Primary Care and Prevention, Mary MacKillop Institute for Health Research, Australian Catholic University, Australia. · Melbourne School of Psychological Sciences, University of Melbourne, Australia. · Stanford University School of Medicine, Department of Psychiatry and Behavioral Science, USA. ·Sleep Med Rev · Pubmed #26588182.

ABSTRACT: Features of an individual's sleep/wake patterns across multiple days are governed by two dimensions, the mean and the intraindividual variability (IIV). The existing literature focuses on the means, while the nature and correlates of sleep/wake IIV are not well understood. A systematic search of records in five major databases from inception to November 2014 identified 53 peer-reviewed empirical publications that examined correlates of sleep/wake IIV in adults. Overall, this literature appeared unsystematic and post hoc, with under-developed theoretical frameworks and inconsistent methodologies. Correlates most consistently associated with greater IIV in one or more aspects of sleep/wake patterns were: younger age, non-White race/ethnicity, living alone, physical health conditions, higher body mass index, weight gain, bipolar and unipolar depression symptomatology, stress, and evening chronotype; symptoms of insomnia and poor sleep were associated with higher sleep/wake IIV, which was reduced following sleep interventions. The effects of experimentally reduced sleep/wake IIV on daytime functioning were inconclusive. In extending current understanding of sleep/wake patterns beyond the mean values, IIV should be incorporated as an additional dimension when sleep is examined across multiple days. Theoretical and methodological shortcomings in the existing literature, and opportunities for future research are discussed.

8 Review Selective serotonin re-uptake inhibitors--a review of the side effects in adolescents. 2013

Gordon, Michael / Melvin, Glenn. ·MBBS, MPM, MD, is Consultant Psychiatrist, Unit Head Early in Life, Monash Health Early in Life and Adjunct Senior Lecturer, Monash University, Melbourne, Victoria. ·Aust Fam Physician · Pubmed #24024221.

ABSTRACT: BACKGROUND: Selective serotonin re-uptake inhibitors (SSRIs) are prescribed by general practitioners (GPs) for adolescents. GPs' prescribing patterns for SSRIs changed following warnings issued by United Kingdom and United States drug advisory bodies on the use of antidepressants in children and adolescents in 2003 and 2004, respectively. Recent studies shed further light on the safety profile of SSRIs with adolescents. OBJECTIVE: To provide a narrative review of the physical and psychiatric side effects of SSRIs as reported by adolescents. To provide GPs with practical advice regarding the prevalence and nature of side effects of SSRIs when prescribed for adolescents. DISCUSSION: The research literature suggests that adolescents taking SSRIs are at a small, but increased, risk of suicidal thoughts and behaviours. The prescribing GP needs to be aware of a number of potential side effects and interactions. Monitoring for common physical side effects and possible emerging suicidal ideas and behaviours, especially early in treatment, is recommended.

9 Review Searching for the daytime impairments of primary insomnia. 2010

Shekleton, Julia A / Rogers, Naomi L / Rajaratnam, Shantha M W. ·School of Psychology, Psychiatry and Psychological Medicine, Monash University, Building 17, Clayton Campus, Victoria 3800, Australia. ·Sleep Med Rev · Pubmed #19963414.

ABSTRACT: Primary insomnia is a sleep disorder where the subjective complaint of initiating or maintaining sleep, or the experience of sleep that is non-refreshing, cannot be directly attributed to a comorbid medical or psychiatric disorder. For a diagnosis of primary insomnia, a patient must also report that the nighttime sleep disturbance is impacting upon daytime functioning. Yet, while subjective complaints of impaired wake-time functioning are well documented, consistent objective evidence of these impairments has proved elusive, particularly with regard to cognitive functioning. We aimed to review the body of literature examining neurobehavioural impairments in primary insomnia to identify which cognitive domains appear to be most consistently impaired in this group. The relatively few studies that have investigated neurobehavioural performance deficits in patients with primary insomnia have produced inconsistent and sometimes conflicting findings. It is suggested that methodological limitations, including heterogeneous test populations, variable testing protocols and conditions as well as unsuitable cognitive tasks have contributed to our inability to describe unequivocally the daytime impairments associated with insomnia. Based on our review, it appears that the deficits associated with insomnia are relatively subtle and may be qualitatively different to those that result from other sleep disorders and from imposed sleep deprivation. Attention tasks, which have a high cognitive load, and working memory tasks appear to show performance deficits more often than not in insomnia patients. It is important to more definitively characterise the daytime impairments associated with primary insomnia so that the efficacy of treatments to remedy the wake-time consequences of the disorder, in addition to the nighttime symptoms, can be investigated.

10 Article Going direct to the consumer: Examining treatment preferences for veterans with insomnia, PTSD, and depression. 2018

Gutner, Cassidy A / Pedersen, Eric R / Drummond, Sean P A. ·National Center for PTSD Women's Health Sciences Division, VA Boston Healthcare System, Boston, MA, USA; Boston University School of Medicine, Boston, MA, USA. Electronic address: cgutner@bu.edu. · RAND Corporation, Santa Monica, CA, USA. · Monash Institute for Cognitive and Clinical Neuroscience, School of Psychological Sciences, Monash University, Australia. ·Psychiatry Res · Pubmed #29524908.

ABSTRACT: Inclusion of consumer preferences to disseminate evidence-based psychosocial treatment (EBPT) is crucial to effectively bridge the science-to-practice quality chasm. We examined this treatment gap for insomnia, posttraumatic stress disorder (PTSD), depression, and comorbid symptoms in a sample of 622 young adult veterans through preference in symptom focus, treatment modality, and related gender differences among those screening positive for each problem. Data were collected from veteran drinkers recruited through targeted Facebook advertisements as part of a brief online alcohol intervention. Analyses demonstrated that veterans reported greater willingness to seek insomnia-focused treatment over PTSD- or depression-focused care. Notably, even when participants screened negative for insomnia, they preferred sleep-focused care to PTSD- or depression-focused care. Although one in five veterans with a positive screen would not consider care, veterans screening for both insomnia and PTSD who would consider care had a preference for in-person counseling, and those screening for both insomnia and depression had similar preferences for in-person and mobile app-based/computer self-help treatment. Marginal gender differences were found. Incorporating direct-to-consumer methods into research can help educate stakeholders about methods to expand EBPT access. Though traditional in-person counseling was often preferred, openness to app-based/computer interventions offers alternative methods to provide veterans with EBPTs.

11 Article Distress and sleep quality in young amphetamine-type stimulant users with an affective or psychotic illness. 2018

Crouse, Jacob J / Lee, Rico S C / White, Django / Moustafa, Ahmed A / Hickie, Ian B / Hermens, Daniel F. ·Youth Mental Health Team, Brain and Mind Centre, University of Sydney, NSW, Australia. Electronic address: jcro8838@uni.sydney.edu.au. · Youth Mental Health Team, Brain and Mind Centre, University of Sydney, NSW, Australia; Brain and Mental Health Laboratory, Monash University, VIC, Australia. · Youth Mental Health Team, Brain and Mind Centre, University of Sydney, NSW, Australia. · School of Social Sciences and Psychology, Western Sydney University, NSW, Australia. · Youth Mental Health Team, Brain and Mind Centre, University of Sydney, NSW, Australia; Sunshine Coast Mind and Neuroscience Thompson Institute, University of the Sunshine Coast, QLD, Australia. ·Psychiatry Res · Pubmed #29475104.

ABSTRACT: Misuse of amphetamine-type stimulant (ATS) drugs may disrupt key neurodevelopmental processes in young people and confer protracted neurocognitive and psychopathological harm. ATS users with a co-occurring psychiatric illness are typically excluded from research, reducing generalisability of findings. Accordingly, we conducted a cross-sectional examination of key clinical, sleep, socio-occupational and neurocognitive measures in current, past and never users of ATS drugs who were accessing a youth mental health service (headspace) for affective- or psychotic-spectrum illnesses. Contrary to hypotheses, groups did not differ in psychotic symptomology, socio-occupational functioning or neurocognitive performance. Current ATS users were however significantly more distressed and reported poorer subjective sleep quality and greater subjective sleep disturbances than never users, with a trend toward greater depressive symptomology in current users. Regression analyses revealed that depressive symptoms, daily ATS use and socio-occupational functioning predicted distress, and depressive symptoms and distress predicted subjective sleep quality. Our findings suggest that distress and poor sleep quality reflect a particular pathophysiology among ATS-using patients, which may negatively impact treatment engagement. Delineating the factors that disrupt social and neurobiological development in young people (such as substance use) warrants further investigation, including longitudinal study.

12 Article Dietary disinhibition mediates the relationship between poor sleep quality and body weight. 2018

Blumfield, Michelle L / Bei, Bei / Zimberg, Iona Z / Cain, Sean W. ·Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia. Electronic address: michelle.blumfield@monash.edu. · Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia; Centre for Women's Mental Health, Department of Psychiatry, University of Melbourne, Royal Women's Hospital, Victoria, Australia. · Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia. · Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia; Division of Sleep and Circadian Disorders, Department of Medicine and Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Division of Sleep and Circadian Disorders, Harvard Medical School, Boston, MA, USA. ·Appetite · Pubmed #29042189.

ABSTRACT: BACKGROUND: Inadequate sleep independently influences eating habits and weight status. However, the relationship between these three factors has not been well quantified. The objective of this study was to examine if eating behavior (i.e. dietary restraint, disinhibition and hunger) mediates the relationship between sleep and body mass index (BMI) in a large sample of American adults. METHOD: Cross-sectional data from the Nathan Kline Institute Rockland sample were assessed (n = 602; 38.9 ± 14.5 years). Self-reported sleep and eating behavior were measured using the Pittsburgh Sleep Quality Index and Three Factor Eating Questionnaire, respectively. Path analysis was used to examine relationships amongst the construct, with mediation tested via bootstrapped confidence intervals. RESULTS: Poorer sleep quality was associated with both greater hunger (P = 0.03) and higher disinhibited eating (overeating in the presence of palatable foods or other disinhibiting stimuli like emotional stress; P < 0.001) behaviors. Higher disinhibited eating behavior was also associated with higher BMI (P < 0.001). There was a significant indirect relationship between sleep quality and BMI via disinhibition (b [95% CI] = 0.13 [0.06, 0.21], P = 0.001). No significant effects were found when total sleep time or time in bed were replaced as predictors in the mediation model. CONCLUSION: Disinhibited eating behavior mediated the relationship between sleep quality and weight status in both males and females. This mediation was due to aspects of sleep quality other than duration. These results suggest that improving sleep quality may benefit weight loss by helping to reduce an individuals' susceptibility to overeating.

13 Article Circadian Phase and Phase Angle Disorders in Primary Insomnia. 2017

Flynn-Evans, Erin E / Shekleton, Julia A / Miller, Belinda / Epstein, Lawrence J / Kirsch, Douglas / Brogna, Lauren A / Burke, Liza M / Bremer, Erin / Murray, Jade M / Gehrman, Philip / Rajaratnam, Shantha M W / Lockley, Steven W. ·Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston. · Division of Sleep Medicine, Harvard Medical School, Boston. · Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia. · Allergy, Immunology and Respiratory Medicine, Alfred Hospital, Melbourne, Australia. · Central Clinical School, Monash University, Melbourne, Australia. · Department of Psychiatry, University of Pennsylvania, Philadelphia. · Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Australia. ·Sleep · Pubmed #29029340.

ABSTRACT: Objectives: We aimed to identify the prevalence of circadian phase and phase angle abnormalities in patients with insomnia. Methods: We conducted a cross-sectional, multicenter study at three sleep laboratories in the United States and Australia. Patients with insomnia and healthy control participants completed a sleep log for 7 days. Circadian phase was assessed from salivary dim light melatonin onset (DLMO) time during a 12-hour laboratory visit. Results: Seventy-nine patients meeting the Research Diagnostic Criteria for Primary, Psychophysiological, Paradoxical, and/or Idiopathic Childhood Insomnia (46 females, 35.5 ± 12.3 years [M ± SD]) and 21 controls (14 females, 34.4 ± 11.8 years). As compared to controls, patients with insomnia tried to initiate sleep on average at the same clock time (24:17 ± 1:17 hours vs. 24:13 ± 1:30 hours, respectively; p = .84) but had a later average DLMO times (20:56 ± 1:55 hours, 18:17-01:21 vs. 22:02 ± 2:02 hours, 17:11-04:52, respectively; p = .04). Consequently, patients with insomnia slept at an earlier circadian phase than controls (phase angle, bedtime-DLMO 2:13 hours (± 1:43) vs. 3:10 hours (± 1:08), respectively; p = .008), of whom 10% tried to sleep at or before DLMO (compared to 0 controls), and 22% tried to sleep before or within 1 hour after DLMO (compared to 6% of controls). Conclusions: A substantial proportion (10%-22%) of patients with insomnia initiate sleep at too early a circadian phase, implicating a circadian etiology for their insomnia. Outpatient circadian phase assessments should be considered to improve differential diagnoses in insomnia and to inform the development of appropriately timed circadian-based treatments.

14 Article Too Long, Too Short, or Too Variable? Sleep Intraindividual Variability and Its Associations With Perceived Sleep Quality and Mood in Adolescents During Naturalistically Unconstrained Sleep. 2017

Bei, Bei / Manber, Rachel / Allen, Nicholas B / Trinder, John / Wiley, Joshua F. ·Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia. · Centre for Women's Mental Health, Department of Psychiatry, University of Melbourne, Royal Women's Hospital, Parkville, Victoria, Australia. · Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA. · Department of Psychology, University of Oregon, Eugene, OR. · Melbourne School of Psychological Sciences, University of Melbourne, Victoria, Australia. ·Sleep · Pubmed #28364491.

ABSTRACT: Introduction: Research has extensively examined the relationship between adolescents' mental health and average sleep duration/quality. Using rigorous methodology, this study characterized adolescents' objective sleep intraindividual variability (IIV) and examined its role on mood beyond the effects of their respective individual mean (IIM) values. Aims and Methods: One hundred forty-six community-dwelling adolescents (47.3% male) aged 16.2 ± 1.0 (M ± SD) years wore an actigraph that assessed bedtime, risetime, time-in-bed (TIB), and sleep onset latency (SOL) throughout a 15-day vacation with relatively unconstrained sleep opportunity. Self-report sleep quality (SSQ), negative mood (MOOD), and other covariates were assessed using questionnaires. For each sleep variable, individuals' mean values (IIM) and IIV were used to simultaneously predict MOOD with SSQ as a mediator. Models were estimated in a Bayesian IIV framework; both linear and quadratic effects of the IIM and IIV were examined. Results: Longer and more variable TIB, as well as more variable SOL (but not mean SOL), were associated with poorer SSQ (ps < .01), which in turn, was associated with more negative MOOD (ps < .05). The indirect effect of SOL IIV was curvilinear, such that as SOL became more variable, the deteriorating effect of high SOL IIV accelerated. Neither bedtime nor risetime IIV was significantly associated with SSQ or MOOD. Conclusions: During relatively unconstrained sleep opportunity, more variable TIB and SOL were associated with more negative mood, mediated by poorer perceived sleep quality. Significant effects of IIV were over and above that of mean values, suggesting that unique aspects of sleep IIV are relevant to how adolescents perceive sleep quality and their mood.

15 Article The direction of the relationship between symptoms of insomnia and psychiatric disorders in adolescents. 2017

Alvaro, Pasquale K / Roberts, Rachel M / Harris, Jodie K / Bruni, Oliviero. ·School of Psychology, University of Adelaide, South Australia, Level 4, Hughes Building, The University of Adelaide, South Australia 5005, Australia; The Institute for Breathing & Sleep, Austin Health, 3084, Heidelberg, Victoria, Australia; School of Psychological Sciences Monash University, Melbourne, Australia. Electronic address: pasquale.alvaro@austin.org.au. · School of Psychology, University of Adelaide, South Australia, Level 4, Hughes Building, The University of Adelaide, South Australia 5005, Australia. · Centre for Treatment of Anxiety and Depression, 30 Anderson St, Thebarton, SA 5031, USA. · Department of Social and Developmental Psychology, University of Rome La Sapienza, Via dei Marsi 78 - 00185, Rome, Italy. ·J Affect Disord · Pubmed #27723540.

ABSTRACT: BACKGROUND: This study assessed the direction of the relationship between symptoms of insomnia disorder, depression, various anxiety disorders and obsessive compulsive disorder (OCD) in adolescents after controlling for age, gender, chronotype, and outcome variable at baseline. METHODS: Data was collected in eight high schools in Adelaide, South Australia, at two time-points approximately 6 months apart. The study was completed by 318 and 255 high school students at baseline and follow-up, respectively, aged 12-18 (M=14.96, SD=1.34) in grades 7-11 at baseline. Hierarchical regression analyses were used to assess each relationship, the first model controlling for age, gender and chronotype, and the second controlling for outcome variable at baseline. RESULTS: Insomnia symptoms predicted and were predicted by symptoms of each psychiatric disorder in model 1. In model 2, insomnia symptoms predicted symptoms of depression, and vice-versa. Symptoms of insomnia also predicted symptoms of separation anxiety disorder (SAD) once SAD, but not vice-versa, in model 2. Symptoms of obsessive compulsive disorder (OCD) and social phobia (SP) predicted symptoms of insomnia disorder in model 2, but not vice-versa. Insomnia symptoms were no longer related to symptoms of other anxiety disorders in model 2. LIMITATIONS: The use of self-report measures, and potential predisposing, precipitating, perpetuating or preventative factors were not assessed. CONCLUSIONS: Symptoms of insomnia disorder are bidirectionally related to depressive symptoms independent from baseline symptoms, and unidirectionally related to symptoms of OCD and SP where OCD and SP are independent risk-factors of the development of insomnia symptoms.

16 Article Ongoing daytime behavioural problems in university students following childhood mild traumatic brain injury. 2016

Albicini, Michelle S / Lee, James / McKinlay, Audrey. ·aFaculty of Medicine, Nursing and Health Sciences, School of Psychology and Psychiatry, Monash University, Clayton bSchool of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia. ·Int J Rehabil Res · Pubmed #26704343.

ABSTRACT: Sleep is often disrupted in traumatic brain injury (TBI) and may be related to persistent behaviour problems; however, little is known about this relationship in young adults. This study explored associations between TBI, behavioural problems and sleep disturbances in 247 university students (197 non-TBI, 47 mild TBI, two moderate TBI, one severe TBI) aged 18-25 years, who completed validated measures for behaviour, sleep quality and history of TBI. Because of small group numbers, participants reporting moderate to severe TBI were excluded from the analyses. Results indicated that students with mild TBI reported higher levels of daytime dysfunction, somatic complaints, withdrawal, other behavioural complaints and internalizing behaviours compared with students with no TBI history. A correlational analysis indicated a moderate relationship between the above significant variables. Our results suggest that university students with a history of mild TBI are more likely to experience certain ongoing daytime behavioural problems, which are likely to negatively influence their academic functioning in tertiary education. This study highlights the importance of research on long-term problems following mild TBI in young adults aged 18-25 years--an age group often overlooked within the literature.

17 Article Health-care utilisation amongst pregnant women who experience sleeping problems and/or tiredness or fatigue: secondary analysis of a cross-sectional survey of 1835 pregnant women. 2016

Lauche, Romy / Hall, Helen / Adams, Jon / Steel, Amie / Broom, Alex / Sibbritt, David. ·Department of Internal and Integrative Medicine, Kliniken Essen Mitte, Faculty of Medicine, University of Duisburg-Essen, Knappschafts-Krakenhaus, Essen, Germany. · Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia. · School of Nursing and Midwifery, Monash University, Frankston, VIC, Australia. · Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia. amie.steel@uts.edu.au. · Office of Research, Endeavour College of Natural Health, Fortitude Valley, QLD, Australia. amie.steel@uts.edu.au. · Faculty of Arts and Social Sciences, University of New South Wales, Sydney, NSW, Australia. ·Sleep Breath · Pubmed #26407961.

ABSTRACT: INTRODUCTION: Sleeping problems and fatigue in pregnancy are often accepted as a normal part of pregnancy; however, these conditions can be linked to serious consequences for both the mother and child. Despite established links between sleeping disturbance and a wide range of pregnancy complications, little is known about the health-care utilisation of women experiencing sleeping problems and fatigue. This study addresses the existing gap in the literature by examining cross-sectional data to identify health service utilisation patterns of pregnant women experiencing sleeping problems and/or tiredness or fatigue. METHODS: In 2010, a sub-study of the Australian Longitudinal Study on Women's Health was conducted as a cross-sectional survey of 2445 women who had recently given birth. Associations between reported symptoms of sleeplessness and/or tiredness or fatigue and health service utilisation were determined using logistic regression analysis. RESULTS: During their pregnancy, 15.2 % of women experienced sleeping problems while 35.4 % experienced tiredness or fatigue. Women most commonly consulted with an obstetrician (n = 96) or a general practitioner (GP) (n = 74) for their tiredness or fatigue rather than a midwife (n = 56). A substantial number of women sought help from a complementary and alternative medicine (CAM) practitioner for sleeping problems (33 %) or tiredness/fatigue (28 %). DISCUSSION: Sleeping problems and/or tiredness or fatigue is reported by a reasonable percentage of pregnant women, and women obtain assistance from conventional and CAM practitioners for their symptoms, but not all seek help. Given the serious implications of untreated sleep- and fatigue-related symptoms for mother and baby, this area of research deserves and requires more attention.

18 Article Prevalence and Mental Health Correlates of Insomnia in First-Encounter Veterans with and without Military Sexual Trauma. 2015

Jenkins, Melissa M / Colvonen, Peter J / Norman, Sonya B / Afari, Niloofar / Allard, Carolyn B / Drummond, Sean P A. ·Department of Psychiatry, University of California, San Diego, CA. · Research Service, VA San Diego Healthcare System, San Diego, CA. · Psychology Services, VA San Diego Healthcare System, San Diego, CA. · Center of Excellence for Stress and Mental Health (CESAMH), San Diego, CA. · National Center for PTSD, White River Junction, VT. · School of Psychological Sciences, Monash University, Clayton, VIC, Australia. ·Sleep · Pubmed #26085301.

ABSTRACT: STUDY OBJECTIVES: There is limited information about prevalence of insomnia in general populations of veterans of recent wars in Iraq and Afghanistan. No studies have examined insomnia in veterans with military sexual trauma (MST). We assess prevalence of insomnia, identify types of services sought by veterans with insomnia, and examine correlates of insomnia in veterans with and without MST. DESIGN: A cross-sectional study of first-encounter veterans registering to establish care. SETTING: Veteran Affairs San Diego Healthcare System. PARTICIPANTS: Nine hundred seventeen veterans completed questionnaires assessing insomnia, MST, service needs, traumatic brain injury, resilience, and symptoms of depression, posttraumatic stress disorder (PTSD), pain, alcohol misuse, and hypomania. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: 53.1% of veterans without MST and 60.8% of veterans with MST had clinically significant insomnia symptoms, with the MST subsample reporting more severe symptoms, P < 0.05. Insomnia was more prevalent than depression, hypomania, PTSD, and substance misuse. Veterans with insomnia were more likely to seek care for physical health problems and primary care versus mental health concerns, P < 0.001. For the veteran sample without MST, age, combat service, traumatic brain injury, pain, and depression were associated with worse insomnia, P < 0.001. For the MST subsample, employment status, pain, and depression were associated with worse insomnia, P < 0.001. CONCLUSIONS: Study findings indicate a higher rate of insomnia in veterans compared to what has been found in the general population. Insomnia is more prevalent, and more severe, in veterans with military sexual trauma. Routine insomnia assessments and referrals to providers who can provide evidence-based treatment are crucial.

19 Article Risky drug use and effects on sleep quality and daytime sleepiness. 2015

Ogeil, Rowan P / Phillips, James G / Rajaratnam, Shantha M W / Broadbear, Jillian H. ·Eastern Health Clinical School and School of Psychological Sciences, Monash University, Victoria, Australia. · Turning Point, Eastern Health, Victoria, Australia. · Auckland University of Technology, Auckland, New Zealand. · School of Psychological Sciences, Monash University, Victoria, Australia. · Spectrum, Eastern Health, Victoria, Australia. ·Hum Psychopharmacol · Pubmed #26010431.

ABSTRACT: OBJECTIVE: Sleep problems are commonly reported following alcohol and cannabis abuse, but our understanding of sleep in non-clinical drug using populations is limited. The present study examined the sleep characteristics of alcohol and cannabis users recruited from the wider community. METHODS: Two hundred forty-eight self-identified alcohol and/or cannabis users (131 women and 117 men) with a mean age of 26.41 years completed an online study that was advertised via online forums, print media and flyers. As part of the study, participants completed validated sleep scales assessing sleep quality (Pittsburgh Sleep Quality Index) and excessive daytime sleepiness (Epworth Sleepiness Scale) in addition to validated drug scales assessing alcohol (Alcohol Use Disorders Identification Test) and cannabis (Marijuana Screening Inventory) use. RESULTS: Problems with sleep quality were more commonly reported than were complaints of excessive daytime sleepiness. Clinically significant poor sleep quality was associated with comorbid problem alcohol and cannabis use. Women reporting problem alcohol and cannabis use had poorer sleep outcomes than men. CONCLUSIONS: Social drug users who report risky alcohol and cannabis use also report poor sleep. Poor sleep quality likely exacerbates any drug-associated problems in non-clinical populations.

20 Article Common sleep disorders increase risk of motor vehicle crashes and adverse health outcomes in firefighters. 2015

Barger, Laura K / Rajaratnam, Shantha M W / Wang, Wei / O'Brien, Conor S / Sullivan, Jason P / Qadri, Salim / Lockley, Steven W / Czeisler, Charles A / Anonymous3480817. ·Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA. · Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA. · School of Psychology and Psychiatry, Monash University, Clayton VIC, Australia. · Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. ·J Clin Sleep Med · Pubmed #25580602.

ABSTRACT: STUDY OBJECTIVES: Heart attacks and motor vehicle crashes are the leading causes of death in US firefighters. Given that sleep disorders are an independent risk factor for both of these, we examined the prevalence of common sleep disorders in a national sample of firefighters and their association with adverse health and safety outcomes. METHODS: Firefighters (n = 6,933) from 66 US fire departments were assessed for common sleep disorders using validated screening tools, as available. Firefighters were also surveyed about health and safety, and documentation was collected for reported motor vehicle crashes. RESULTS: A total of 37.2% of firefighters screened positive for any sleep disorder including obstructive sleep apnea (OSA), 28.4%; insomnia, 6.0%; shift work disorder, 9.1%; and restless legs syndrome, 3.4%. Compared with those who did not screen positive, firefighters who screened positive for a sleep disorder were more likely to report a motor vehicle crash (adjusted odds ratio 2.00, 95% CI 1.29-3.12, p = 0.0021) and were more likely to self-report falling asleep while driving (2.41, 2.06-2.82, p < 0.0001). Firefighters who screened positive for a sleep disorder were more likely to report having cardiovascular disease (2.37, 1.54-3.66, p < 0.0001), diabetes (1.91, 1.31-2.81, p = 0.0009), depression (3.10, 2.49-3.85, p < 0.0001), and anxiety (3.81, 2.87-5.05, p < 0.0001), and to report poorer health status (p < 0.0001) than those who did not screen positive. Adverse health and safety associations persisted when OSA and non-OSA sleep disorders were examined separately. CONCLUSIONS: Sleep disorders are prevalent in firefighters and are associated with increased risk of adverse health and safety outcomes. Future research is needed to assess the efficacy of occupational sleep disorders prevention, screening, and treatment programs in fire departments to reduce these safety and health risks.

21 Article Neurobehavioral performance impairment in insomnia: relationships with self-reported sleep and daytime functioning. 2014

Shekleton, Julia A / Flynn-Evans, Erin E / Miller, Belinda / Epstein, Lawrence J / Kirsch, Douglas / Brogna, Lauren A / Burke, Liza M / Bremer, Erin / Murray, Jade M / Gehrman, Philip / Lockley, Steven W / Rajaratnam, Shantha M W. ·Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA ; Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA ; School of Psychology and Psychiatry, Monash University, Melbourne, Australia. · Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA ; Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA. · Allergy, Immunology and Respiratory Medicine, Alfred Hospital, Melbourne, Australia ; Central Clinical School, Monash University, Melbourne, Australia. · Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA ; Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA ; Sleep HealthCenters, Brighton, MA. · Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA. · Behavioral Sleep Medicine Program, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA. · School of Psychology and Psychiatry, Monash University, Melbourne, Australia. ·Sleep · Pubmed #24470700.

ABSTRACT: STUDY OBJECTIVES: Despite the high prevalence of insomnia, daytime consequences of the disorder are poorly characterized. This study aimed to identify neurobehavioral impairments associated with insomnia, and to investigate relationships between these impairments and subjective ratings of sleep and daytime dysfunction. DESIGN: Cross-sectional, multicenter study. SETTING: Three sleep laboratories in the USA and Australia. PATIENTS: Seventy-six individuals who met the Research Diagnostic Criteria (RDC) for Primary Insomnia, Psychophysiological Insomnia, Paradoxical Insomnia, and/or Idiopathic Childhood Insomnia (44F, 35.8 ± 12.0 years [mean ± SD]) and 20 healthy controls (14F, 34.8 ± 12.1 years). INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Participants completed a 7-day sleep-wake diary, questionnaires assessing daytime dysfunction, and a neurobehavioral test battery every 60-180 minutes during an afternoon/evening sleep laboratory visit. Included were tasks assessing sustained and switching attention, working memory, subjective sleepiness, and effort. Switching attention and working memory were significantly worse in insomnia patients than controls, while no differences were found for simple or complex sustained attention tasks. Poorer sustained attention in the control, but not the insomnia group, was significantly associated with increased subjective sleepiness. In insomnia patients, poorer sustained attention performance was associated with reduced health-related quality of life and increased insomnia severity. CONCLUSIONS: We found that insomnia patients exhibit deficits in higher level neurobehavioral functioning, but not in basic attention. The findings indicate that neurobehavioral deficits in insomnia are due to neurobiological alterations, rather than sleepiness resulting from chronic sleep deficiency.

22 Article Actigraphic assessment of sleep disturbances following traumatic brain injury. 2014

Sinclair, Kelly L / Ponsford, Jennie / Rajaratnam, Shantha M W. ·a School of Psychology and Psychiatry, Monash University , Australia. ·Behav Sleep Med · Pubmed #23394102.

ABSTRACT: The current study examined the use of actigraphy in measurement of sleep following traumatic brain injury (TBI). Twenty-one patients with TBI and self-reported sleep and/or fatigue problems and 21 non-injured controls were studied over seven days using actigraphy and sleep diary reports. Although strong associations between diary and actigraphic assessment of sleep duration were observed in both participant groups, agreement between these methods appeared to weaken in patients with TBI. Associations between sleep diary and actigraphic assessments of sleep disturbance, i.e., wake after sleep onset (WASO) and sleep onset latency (SOL) were not apparent in either group, although weaker agreement between methods for WASO was again observed in patients with TBI. Actigraphy may prove useful to supplement self-report measures of sleep following TBI. More work is required to understand the accuracy of these measures in this population.

23 Article Persistent sleep disturbance is associated with treatment response in adolescents with depression. 2013

Manglick, Maneesha / Rajaratnam, Shantha M / Taffe, John / Tonge, Bruce / Melvin, Glenn. ·Centre for Developmental Psychiatry and Psychology, School of Psychology and Psychiatry, Monash University, Notting Hill, Australia. maneesha.manglick@gmail.com ·Aust N Z J Psychiatry · Pubmed #23508680.

ABSTRACT: BACKGROUND: Sleep disturbances are highly prevalent in adolescents with depressive disorders. To date there is limited evidence of the extent to which sleep disturbances are associated with treatment response in adolescents. This study aimed to examine the extent to which self-reported sleep disturbances are associated with treatment response in adolescents with depression. METHOD: Sleep data were gathered from a sample of 166 adolescents (aged 12-18 years) with a diagnosis of a DSM-IV depressive disorder who underwent 3 months of treatment (psychosocial and/or pharmacotherapy (sertraline)) in community-based research programs. The subjective report of sleep disturbance within depressive disorders was assessed using the Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children at three time points: pre-treatment, post-treatment and 6-month follow-up. RESULTS: Sixty-nine percent of participants had a sleep disturbance pre-treatment and approximately 75% of these participants had threshold symptoms. Threshold sleep disturbances that persisted from pre- to post-treatment assessments were positively associated with depression at the 6-month follow-up. An ordered logistic regression model controlling for gender, treatment group and comorbid anxiety estimated a 70% risk of depression or partial remission for those with persistent sleep disturbance. Treatment group, anxiety and gender generally had no significant effect on the relationship between sleep and depression. CONCLUSION: Sleep disturbances were highly related to depressive state and were associated with poorer treatment response in adolescents with depression. These results provide a rationale for further exploration of sleep-related treatments for adolescents with depression. Knowledge of patient-reported persistent sleep disturbances can help clinicians to predict treatment outcomes and may direct them to augment treatment or focus on sleep-related treatment strategies.

24 Article Alcohol and energy drinks: a pilot study exploring patterns of consumption, social contexts, benefits and harms. 2012

Pennay, Amy / Lubman, Dan I. ·Centre for Alcohol Policy Research, Turning Point Alcohol and Drug Centre, Eastern Health, Monash University, Melbourne, Australia. amyp@turningpoint.org.au ·BMC Res Notes · Pubmed #22824297.

ABSTRACT: BACKGROUND: Young people around the world are increasingly combining alcohol with energy drinks (AEDs). However, as yet, limited research has been conducted examining this issue, particularly in terms of exploring patterns of consumption, social practices and the cultural contexts of AED consumption. We sought to understand how AEDs are used and socially constructed among young people. METHODS: We conducted 25 hours of observation in a variety of pubs, bars and nightclubs, as well as in-depth interviews with ten young people who regularly consumed AEDs during a session of alcohol use. RESULTS: In this pilot study, participants were highly organised in their AED consumption practices and reported rarely altering this routine. Some young people consumed upwards of eight AEDs on a typical night, and others limited their use to between three and five AEDs to avoid unpleasant consequences, such as sleep disturbances, severe hangovers, heart palpitations and agitation. Wakefulness and increased energy were identified as the primary benefits of AEDs, with taste, reduced and increased intoxication, and sociability reported as additional benefits. Young AED users were brand sensitive and responded strongly to Red Bull imagery, as well as discounted AEDs. Finally, some young people reported substituting illicit stimulants with energy drinks. CONCLUSIONS: Combining energy drinks with alcohol is now a normalised phenomenon and an integral and ingrained feature of the night-time economy. Despite this, many young people are unaware of recommended daily limits or related harms. While some young people consume AEDs to feel less drunk (consistent with motivations for combining alcohol with illicit stimulants), others report using AEDs to facilitate intoxication. While preliminary, our findings have relevance for potential policy and regulatory approaches, as well as directions for future research.

25 Article Falling asleep: the determinants of sleep latency. 2009

Nixon, G M / Thompson, J M D / Han, D Y / Becroft, D M O / Clark, P M / Robinson, E / Waldie, K E / Wild, C J / Black, P N / Mitchell, E A. ·Ritchie Centre for Baby Health Research, Monash Institute of Medical Research, Monash University, Melbourne, Australia. ·Arch Dis Child · Pubmed #19633062.

ABSTRACT: BACKGROUND: Difficulty falling asleep (prolonged sleep latency) is a frequently reported problem in school-aged children. AIMS: This study aimed to describe the distribution of sleep latency and factors that influence its duration. METHODS: 871 children of European mothers were recruited at birth. 591 (67.9%) children took part in the follow-up at 7 years of age. Sleep and daytime activity were measured objectively by an actigraph worn for 24 h. RESULTS: Complete sleep data were available for 519 children (87.8%) with a mean age of 7.3 years (SD 0.2). Median sleep latency was 26 minutes (interquartile range 13-42). Higher mean daytime activity counts were associated with a decrease in sleep latency (-1.2 minutes per 102 movement count per minute, p = 0.05). Time spent in sedentary activity was associated with an increase in sleep latency (3.1 minutes per hour of sedentary activity, p = 0.01). CONCLUSIONS: These findings emphasise the importance of physical activity for children, not only for fitness, cardiovascular health and weight control, but also for promoting good sleep.