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Sleep Initiation and Maintenance Disorders: HELP
Articles from Berkeley
Based on 39 articles published since 2008
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These are the 39 published articles about Sleep Initiation and Maintenance Disorders that originated from Berkeley during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2
1 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.

2 Review Insomnia as a transdiagnostic process in psychiatric disorders. 2014

Dolsen, Michael R / Asarnow, Lauren D / Harvey, Allison G. ·Department of Psychology, University of California, Berkeley, 2205 Tolman Hall #1650, Berkeley, CA, 94720-1650, USA. ·Curr Psychiatry Rep · Pubmed #25030972.

ABSTRACT: Insomnia is a major public health concern, and is highly comorbid with a broad range of psychiatric disorders. Although insomnia has historically been considered a symptom of other disorders, this perspective has shifted. Epidemiological and experimental studies suggest that insomnia is related to the onset and course of several psychiatric disorders. Furthermore, several randomized controlled trials show that cognitive behavioral therapy for insomnia delivered to individuals who meet diagnostic criteria for insomnia and another psychiatric disorder improves the insomnia as well as the symptoms of the comorbid psychiatric disorder. Taken together, these results encompassing a range of methodologies have provided encouraging evidence and point toward insomnia as a transdiagnostic process in psychiatric disorders.

3 Review Circadian rhythms and psychiatric illness. 2013

Asarnow, Lauren D / Soehner, Adriane M / Harvey, Allison G. ·University of California, Berkeley, California, USA. ·Curr Opin Psychiatry · Pubmed #24060916.

ABSTRACT: PURPOSE OF REVIEW: The present review provides a conceptual introduction to sleep and circadian research in psychiatric illness, and discusses recent experimental and intervention findings in this area. RECENT FINDINGS: In this review, studies published since January 2011 on circadian disturbance and psychiatric illness have been summarized. SUMMARY: Exciting new results have increasingly utilized objective and validated instruments to measure the circadian system in experimental studies. Since 2011, treatment research has still predominantly utilized self-report measures as outcome variables. However, research in the treatment domain for sleep/circadian disturbances comorbid with psychiatric illness has advanced the field in its work to broaden the validation of existing sleep treatments to additional patient populations with comorbid sleep/circadian disruptions and address how to increase access to and affordability of treatment for sleep and circadian dysfunction for patients with psychiatric disorders, and how to combine psychosocial treatments with psychopharmacology to optimize treatment outcomes.

4 Review MF101: a multi-component botanical selective estrogen receptor beta modulator for the treatment of menopausal vasomotor symptoms. 2012

Leitman, Dale C / Christians, Uwe. ·University of California, Department of Nutritional Science and Toxicology, 44 Morgan Hall Berkeley, CA 94720, USA. dale@leitmanlab.com ·Expert Opin Investig Drugs · Pubmed #22616988.

ABSTRACT: INTRODUCTION: The Women's Health Initiative Estrogen Plus Progestin clinical trial demonstrated the risks exceeded the benefits which have led to a decline in menopausal hormone therapy (MHT) by greater than 50%. MHT use was initiated long before there was a significant understanding of the molecular mechanisms of estrogens. It has become clear that the problem with the current estrogens in MHT is they act non-selectively as an agonist in all tissues that contain estrogen receptors. MF101 is an oral, botanically derived extract that was designed to selectively regulate estrogen receptor beta (ERβ) because the increased risk of breast and endometrial cancer is due to the activation of estrogen receptor alpha (ERα) by estrogens. Preclinical and clinical data support a role for selective ERβ agonists, such as MF101, for vasomotor symptoms without increasing cancer risks. AREAS COVERED: The review covers the biological, pharmacological and clinical advantages of MF101, and the unique ability of MF101 to selectively target the ERβ pathway for the treatment of hot flashes (HF). EXPERT OPINION: Preclinical and clinical studies indicate that MF101, a selective estrogen receptor beta agonist, represents a new class of drugs that is safe and effective for treating HF and nighttime awakenings.

5 Review (Mis)perception of sleep in insomnia: a puzzle and a resolution. 2012

Harvey, Allison G / Tang, Nicole K Y. ·Department of Psychology, University of California, Berkeley, 3210 Tolman Hall, Berkeley, CA 94720-1650, USA. aharvey@berkeley.edu ·Psychol Bull · Pubmed #21967449.

ABSTRACT: Insomnia is prevalent, causing severe distress and impairment. This review focuses on illuminating the puzzling finding that many insomnia patients misperceive their sleep. They overestimate their sleep onset latency (SOL) and underestimate their total sleep time (TST), relative to objective measures. This tendency is ubiquitous (although not universal). Resolving this puzzle has clinical, theoretical, and public health importance. There are implications for assessment, definition, and treatment. Moreover, solving the puzzle creates an opportunity for real-world applications of theories from clinical, perceptual, and social psychology as well as neuroscience. Herein we evaluate 13 possible resolutions to the puzzle. Specifically, we consider the possible contribution, to misperception, of (1) features inherent to the context of sleep (e.g., darkness); (2) the definition of sleep onset, which may lack sensitivity for insomnia patients; (3) insomnia being an exaggerated sleep complaint; (4) psychological distress causing magnification; (5) a deficit in time estimation ability; (6) sleep being misperceived as wake; (7) worry and selective attention toward sleep-related threats; (8) a memory bias influenced by current symptoms and emotions, a confirmation bias/belief bias, or a recall bias linked to the intensity/recency of symptoms; (9) heightened physiological arousal; (10) elevated cortical arousal; (11) the presence of brief awakenings; (12) a fault in neuronal circuitry; and (13) there being 2 insomnia subtypes (one with and one without misperception). The best supported resolutions were misperception of sleep as wake, worry, and brief awakenings. A deficit in time estimation ability was not supported. We conclude by proposing several integrative solutions.

6 Review Cognitive consequences of sleep and sleep loss. 2008

Walker, Matthew P. ·Sleep and Neuroimaging Laboratory, Department of Psychology, University of California, Berkeley, CA 94720-1650, USA. mpwalker@berkeley.edu ·Sleep Med · Pubmed #18929316.

ABSTRACT: Although we still lack any consensus function(s) for sleep, accumulating evidence suggests it plays an important role in homeostatic restoration, thermoregulation, tissue repair, immune control and memory processing. In the last decade an increasing number of reports continue to support a bidirectional and symbiotic relationship between sleep and memory. Studies using procedural and declarative learning tasks have demonstrated the need for sleep after learning in the offline consolidation of new memories. Furthermore, these consolidation benefits appear to be mediated by an overnight neural reorganization of memory that may result in a more efficient storage of information, affording improved next-day recall. Sleep before learning also appears to be critical for brain functioning. Specifically, one night of sleep deprivation markedly impairs hippocampal function, imposing a deficit in the ability to commit new experiences to memory. Taken together, these observations are of particular ecologic importance from a professional and education perspective when considering that sleep time continues to decrease across all age ranges throughout industrialized nations.

7 Article Sleep loss causes social withdrawal and loneliness. 2018

Ben Simon, Eti / Walker, Matthew P. ·Center for Human Sleep Science, Department of Psychology, University of California, Berkeley, CA, 94720-1650, USA. etibens@berkeley.edu. · Center for Human Sleep Science, Department of Psychology, University of California, Berkeley, CA, 94720-1650, USA. mpwalker@berkeley.edu. · Helen Wills Neuroscience Institute, University of California, Berkeley, CA, 94720-1650, USA. mpwalker@berkeley.edu. ·Nat Commun · Pubmed #30108218.

ABSTRACT: Loneliness and social isolation markedly increase mortality risk, and are linked to numerous mental and physical comorbidities, including sleep disruption. But does sleep loss causally trigger loneliness? Here, we demonstrate that a lack of sleep leads to a neural and behavioral phenotype of social withdrawal and loneliness; one that can be perceived by other members of society, and reciprocally, makes those societal members lonelier in return. We propose a model in which sleep loss instigates a propagating, self-reinforcing cycle of social separation and withdrawal.

8 Article Adapted CBT to Stabilize Sleep on Psychiatric Wards: a Transdiagnostic Treatment Approach. 2018

Sheaves, Bryony / Isham, Louise / Bradley, Jonathan / Espie, Colin / Barrera, Alvaro / Waite, Felicity / Harvey, Allison G / Attard, Caroline / Freeman, Daniel. ·Sleep and Circadian Neuroscience Institute,Department of Psychiatry,University of Oxford,Oxford,UK. · Oxford Health NHS Foundation Trust,Oxford,UK. · Sleep and Circadian Neuroscience,Nuffield Department of Clinical Neurosciences,University of Oxford,Oxford,UK. · University of California,Berkeley,USA. · Berkshire Health NHS Foundation Trust,Berkshire,UK. ·Behav Cogn Psychother · Pubmed #29615140.

ABSTRACT: BACKGROUND: Almost all patients admitted at acute crisis to a psychiatric ward experience clinically significant symptoms of insomnia. Ward environments pose challenges to both sleep and the delivery of therapy. Despite this, there is no description of how to adapt cognitive behavioural therapy (CBT) for insomnia to overcome these challenges. AIMS: (i) To describe the key insomnia presentations observed in the Oxford Ward Sleep Solution (OWLS) trial and (ii) outline key adaptations aimed to increase accessibility and hence effectiveness of CBT for insomnia for a ward setting. METHODS: Trial therapists collaboratively agreed the key insomnia presentations and therapy adaptations based on their individual reflective logs used during the trial. RESULTS: Three key insomnia presentations are outlined. These are used to illustrate the application of 10 CBT for insomnia therapy adaptations. These include use of sleep monitoring watches to engage patients in treatment, stabilizing circadian rhythms, reducing the impact of night-time observations and managing discharge as a sleep challenge. CONCLUSIONS: Whilst inpatient wards bring challenges for sleep and therapy delivery, creative adaptations can increase the accessibility of evidence based CBT for insomnia techniques. This therapy has proven popular with patients.

9 Article Proinflammatory Cytokines, Mood, and Sleep in Interepisode Bipolar Disorder and Insomnia: A Pilot Study With Implications for Psychosocial Interventions. 2018

Dolsen, Michael R / Soehner, Adriane M / Harvey, Allison G. ·From the Department of Psychology (Dolsen, Harvey), University of California, Berkeley · and Department of Psychiatry (Soehner), University of Pittsburgh School of Medicine, Pennsylvania. ·Psychosom Med · Pubmed #28914726.

ABSTRACT: OBJECTIVE: Proinflammatory cytokines are associated with bipolar disorder (BD), but less is known about how cytokines function during the interepisode period. This study examined cytokines, mood symptoms, and sleep in individuals with interepisode BD with complaints of insomnia. We also investigated the effects of a BD-specific modification of cognitive behavior therapy for insomnia (CBTI-BP) on cytokine levels. METHODS: Twenty-two adults with interepisode BD type I and insomnia were drawn from a subset of a National Institute of Mental Health funded study. Participants were randomly allocated to CBTI-BP (n = 11) or psychoeducation (n = 11). Participants completed a sleep diary, rated self-report measures of mania and depression, and provided samples assayed for interleukin (IL)-6 and tumor necrosis factor soluble receptor 2 (sTNF-R2). RESULTS: IL-6 was associated with mania symptoms (rs = 0.44, p = .041) and total sleep time (rs = -0.49, p = .026). IL-6 was related to depression symptoms at the trend level (rs = 0.43, p = .052). sTNF-R2 was not significantly related to mood or sleep measures. From pretreatment to posttreatment, CBTI-BP compared with psychoeducation was associated with a nonsignificant, large effect size decrease in IL-6 (z = -1.61, p = .13, d = -0.78) and a nonsignificant, small-medium effect size decrease in sTNF-R2 (z = -0.79, p = .44, d = -0.38). CONCLUSIONS: These findings provide preliminary evidence that IL-6 is related to mania symptoms and shorter total sleep time in interepisode BD. A treatment that targets sleep in BD could potentially decrease IL-6 although replication is warranted.

10 Article Poor Sleep Quality, Psychological Distress, and the Buffering Effect of Mindfulness Training During Pregnancy. 2018

Felder, Jennifer N / Laraia, Barbara / Coleman-Phox, Kimberly / Bush, Nicole / Suresh, Madhuvanthi / Thomas, Melanie / Adler, Nancy / Epel, Elissa / Prather, Aric A. ·a Department of Psychiatry , University of California , San Francisco , California. · b Community Health Science , University of California , Berkeley , California. · c Center for Health and Community , University of California , San Francisco , California. · d Department of Pediatrics , University of California , San Francisco , California. ·Behav Sleep Med · Pubmed #28060531.

ABSTRACT: OBJECTIVE/BACKGROUND: Poor sleep quality is common in pregnancy and associated with increased psychological distress, which has adverse consequences for families. Emerging theory suggests that mindfulness-based interventions may help reduce cognitive and emotional reactivity to stressful events. The current study examines the effects of a mindfulness-based intervention on the relationship between poor sleep quality and increased depression symptom severity and perceived stress during pregnancy. Additionally, we explored the prevalence of poor sleep quality in this unique sample and the impact of intervention on sleep quality. PARTICIPANTS: Participants were 215 ethnically diverse, overweight and obese, predominantly low-income pregnant women drawn from a study examining the impact of an 8-week mindfulness-based program (Mindful Moms Training; MMT) to reduce excessive gestational weight gain, stress, and depression compared to treatment as usual (TAU). METHODS: Participants reported global sleep quality, depressive symptoms, and perceived stress at baseline and postintervention. RESULTS: Most participants (63%) were categorized as poor sleepers at baseline. MMT participants did not experience significantly greater improvement in sleep quality compared to TAU participants. Baseline poor global sleep quality predicted increased depression symptom severity for all participants. Baseline poor global sleep quality predicted increased perceived stress for the TAU group only; this association was not evident in the MMT group. CONCLUSIONS: Poor sleep quality is prevalent in overweight and obese predominantly low-income pregnant women. Poor sleep quality was associated with worsening psychological distress, but mindfulness training significantly attenuated the influence of poor sleep on perceived stress.

11 Article A cognitive-behavioral and mindfulness-based group sleep intervention improves behavior problems in at-risk adolescents by improving perceived sleep quality. 2017

Blake, Matthew J / Snoep, Lian / Raniti, Monika / Schwartz, Orli / Waloszek, Joanna M / Simmons, Julian G / Murray, Greg / Blake, Laura / Landau, Elizabeth R / Dahl, Ronald E / Bootzin, Richard / McMakin, Dana L / Dudgeon, Paul / Trinder, John / Allen, Nicholas B. ·Melbourne School of Psychological Sciences, The University of Melbourne, 12th Floor Redmond Barry Building, Parkville Campus, Melbourne, 3010, VIC Australia. Electronic address: mjblake3@gmail.com. · Melbourne School of Psychological Sciences, The University of Melbourne, 12th Floor Redmond Barry Building, Parkville Campus, Melbourne, 3010, VIC Australia. Electronic address: liansnoep@gmail.com. · Melbourne School of Psychological Sciences, The University of Melbourne, 12th Floor Redmond Barry Building, Parkville Campus, Melbourne, 3010, VIC Australia. Electronic address: m.raniti@student.unimelb.edu.au. · Melbourne School of Psychological Sciences, The University of Melbourne, 12th Floor Redmond Barry Building, Parkville Campus, Melbourne, 3010, VIC Australia. Electronic address: orli@unimelb.edu.au. · Melbourne School of Psychological Sciences, The University of Melbourne, 12th Floor Redmond Barry Building, Parkville Campus, Melbourne, 3010, VIC Australia. Electronic address: joannamw@unimelb.edu.au. · Melbourne School of Psychological Sciences, The University of Melbourne, 12th Floor Redmond Barry Building, Parkville Campus, Melbourne, 3010, VIC Australia. Electronic address: jgs@unimelb.edu.au. · Department Psychological Sciences, Swinburne University of Technology, Mail H24, PO Box 218, Hawthorn, 3122, VIC, Australia. Electronic address: gwmurray@swin.edu.au. · Melbourne School of Psychological Sciences, The University of Melbourne, 12th Floor Redmond Barry Building, Parkville Campus, Melbourne, 3010, VIC Australia. Electronic address: blake.laura.m@edumail.vic.gov.au. · Melbourne School of Psychological Sciences, The University of Melbourne, 12th Floor Redmond Barry Building, Parkville Campus, Melbourne, 3010, VIC Australia. Electronic address: elandau@student.unimelb.edu.au. · School of Public Health, University of California, Berkeley, 50 University Hall #7360, Berkeley, 94720, CA, USA. Electronic address: rondahl@berkeley.edu. · Departments of Psychology and Psychiatry, University of Arizona, Room 215C, Sleep Research Lab, 1503 E. University Blvd, Tucson, 85721, AZ, USA. Electronic address: bootzin@u.arizona.edu. · Department of Psychology, Florida International University, Modesto A. Maidique Campus, DM 256, 11200 S.W. 8th Street, Miami, 33199, FL, USA; Psychology Division, Nicklaus Children's Hospital, 3200 SW 60 Court #205, Miami, 33155, FL, USA. Electronic address: dmcmakin@fiu.edu. · Melbourne School of Psychological Sciences, The University of Melbourne, 12th Floor Redmond Barry Building, Parkville Campus, Melbourne, 3010, VIC Australia. Electronic address: dudgeon@unimelb.edu.au. · Melbourne School of Psychological Sciences, The University of Melbourne, 12th Floor Redmond Barry Building, Parkville Campus, Melbourne, 3010, VIC Australia. Electronic address: johnat@unimelb.edu.au. · Melbourne School of Psychological Sciences, The University of Melbourne, 12th Floor Redmond Barry Building, Parkville Campus, Melbourne, 3010, VIC Australia; Department of Psychology, University of Oregon, Eugene, 97403, OR, USA. Electronic address: nallen3@uoregon.edu. ·Behav Res Ther · Pubmed #29101843.

ABSTRACT: OBJECTIVE: The aim of this study was to test whether a cognitive-behavioral and mindfulness-based group sleep intervention would improve behavior problems in at-risk adolescents, and whether these improvements were specifically related to improvements in sleep. METHOD: Secondary analysis of a randomized controlled trial conducted with 123 adolescent participants (female = 60%; mean age = 14.48, range 12.04-16.31 years) who had high levels of sleep problems and anxiety symptoms. Participants were randomized into either a sleep improvement intervention (n = 63) or an active control "study skills" intervention (n = 60). Participants completed sleep and behavior problems questionnaires, wore an actiwatch and completed a sleep diary for five school nights, both before and after the intervention. RESULTS: Parallel multiple mediation models showed that postintervention improvements in social problems, attention problems, and aggressive behaviors were specifically mediated by moderate improvements in self-reported sleep quality on school nights, but were not mediated by moderate improvements in actigraphy-assessed sleep onset latency or sleep diary-measured sleep efficiency on school nights. CONCLUSION: This study provides evidence, using a methodologically rigorous design, that a cognitive-behavioral and mindfulness-based group sleep intervention improved behavior problems in at-risk adolescent by improving perceived sleep quality on school nights. These findings suggest that sleep interventions could be directed towards adolescents with behavior problems. CLINICAL TRIAL REGISTRATION: This study was part of The SENSE Study (Sleep and Education: learning New Skills Early). URL: ACTRN12612001177842; http://www.anzctr.org.au/TrialSearch.aspx?searchTxt=ACTRN12612001177842&isBasic=True.

12 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

13 Article Hypertension with unsatisfactory sleep health (HUSH): study protocol for a randomized controlled trial. 2017

Levenson, Jessica C / Rollman, Bruce L / Ritterband, Lee M / Strollo, Patrick J / Smith, Kenneth J / Yabes, Jonathan G / Moore, Charity G / Harvey, Allison G / Buysse, Daniel J. ·Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, E-1123 TDH, Pittsburgh, PA, 15213, USA. · Division of General Internal Medicine, Center for Behavioral Health and Smart Technology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. · Department of Psychiatry and Neurobehavioral Sciences and Center for Behavioral Health and Technology, University of Virginia School of Medicine, Charlottesville, VA, USA. · VA Pittsburgh Health System, Pittsburgh, PA, USA. · Department of Biostatistics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. · Carolinas HealthCare System, Charlotte, NC, USA. · Department of Psychology, University of California, Berkeley, CA, USA. · Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, E-1123 TDH, Pittsburgh, PA, 15213, USA. buyssedj@upmc.edu. ·Trials · Pubmed #28587609.

ABSTRACT: BACKGROUND: Insomnia is common in primary care medical practices. Although behavioral treatments for insomnia are safe, efficacious, and recommended in practice guidelines, they are not widely-available, and their effects on comorbid medical conditions remain uncertain. We are conducting a pragmatic clinical trial to test the efficacy of two cognitive behavioral treatments for insomnia (Brief Behavioral Treatment for Insomnia (BBTI) and Sleep Healthy Using the Internet (SHUTi)) versus an enhanced usual care condition (EUC). METHODS/DESIGN: The study is a three-arm, parallel group, randomized controlled trial. Participants include 625 adults with hypertension and insomnia, recruited via electronic health records from primary care practices affiliated with a large academic medical center. After screening and baseline assessments, participants are randomized to treatment. BBTI is delivered individually with a live therapist via web-interface/telehealth sessions, while SHUTi is a self-guided, automated, interactive, web-based form of cognitive behavioral therapy for insomnia. Participants in EUC receive an individualized sleep report, educational resources, and an online educational video. Treatment outcomes are measured at 9 weeks, 6 months, and 12 months. The primary outcome is patient-reported sleep disturbances. Secondary outcomes include other self-reported sleep measures, home blood pressure, body mass index, quality of life, health functioning, healthcare utilization, and side effects. DISCUSSION: This randomized clinical trial compares two efficacious insomnia interventions to EUC, and provides a cost-effective and efficient examination of their similarities and differences. The pragmatic orientation of this trial may impact sleep treatment delivery in real world clinical settings and advance the dissemination and implementation of behavioral sleep interventions. TRIAL REGISTRATION: ClinicalTrials.gov (Identifier: NCT02508129 ; Date Registered: July 21, 2015).

14 Article The SENSE Study: Treatment Mechanisms of a Cognitive Behavioral and Mindfulness-Based Group Sleep Improvement Intervention for At-Risk Adolescents. 2017

Blake, Matthew / Schwartz, Orli / Waloszek, Joanna M / Raniti, Monika / Simmons, Julian G / Murray, Greg / Blake, Laura / Dahl, Ronald E / Bootzin, Richard / McMakin, Dana L / Dudgeon, Paul / Trinder, John / Allen, Nicholas B. ·Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia. · Department of Psychological Sciences, Swinburne University of Technology, Melbourne, VIC, Australia. · School of Public Health, University of California, Berkeley, CA. · Departments of Psychology and Psychiatry, University of Arizona, Tucson, AZ. · Department of Psychology, Florida International University, Miami, FL. · Psychology Division, Nicklaus Children's Hospital, Miami, FL. · Department of Psychology, University of Oregon, Eugene, OR. ·Sleep · Pubmed #28431122.

ABSTRACT: Objectives: The aim of this study was to test whether a cognitive behavioral and mindfulness-based group sleep intervention would improve sleep and anxiety on school nights in a sample of at-risk adolescents. We also examined whether benefits to sleep and anxiety would be mediated by improvements in sleep hygiene awareness and presleep hyperarousal. Methods: Secondary analysis of a randomized controlled trial conducted with 123 adolescent participants (female = 60%; mean age = 14.48) who had high levels of sleep problems and anxiety symptoms. Participants were randomized into a sleep improvement intervention (n = 63) or active control "study skills" intervention (n = 60). Preintervention and postintervention, participants completed the Pittsburgh Sleep Quality Index (PSQI), Spence Children's Anxiety Scale (SCAS), Sleep Beliefs Scale (SBS), and Presleep Hyperarousal Scale (PSAS) and wore an actiwatch and completed a sleep diary for five school nights. Results: The sleep intervention condition was associated with significantly greater improvements in actigraphy-measured sleep onset latency (SOLobj), sleep diary measured sleep efficiency (SEsubj), PSQI, SCAS, SBS, and PSAS, with medium to large effect sizes. Improvements in the PSQI and SCAS were specifically mediated by the measured improvements in the PSAS that resulted from the intervention. Improvements in SOLobj and SEsubj were not specifically related to improvements in any of the putative treatment mechanisms. Conclusions: This study provides evidence that presleep arousal but not sleep hygiene awareness is important for adolescents' perceived sleep quality and could be a target for new treatments of adolescent sleep problems.

15 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

16 Article Life-time history of insomnia and hypersomnia symptoms as correlates of alcohol, cocaine and heroin use and relapse among adults seeking substance use treatment in the United States from 1991 to 1994. 2017

Dolsen, Michael R / Harvey, Allison G. ·Department of Psychology, University of California, Berkeley, USA. ·Addiction · Pubmed #28127809.

ABSTRACT: AIMS: To examine the association between a life-time history of insomnia and hypersomnia compared with no sleep disturbance and substance use patterns and amounts before and after a substance use treatment episode. DESIGN: Secondary analysis of data from the Drug Abuse Treatment Outcome Studies conducted from 1991 to 1994. SETTING: Data were collected at 96 substance use treatment programs in 11 United States cities, including short-term in-patient, long-term residential, methadone maintenance and out-patient drug-free treatment modalities. PARTICIPANTS: Study samples included 7168 adults at treatment entry and 2965 at 12 months post-treatment entry whose primary substance use at entry was alcohol (14.7%), cocaine (62.7%) or heroin (22.6%). MEASUREMENTS: Life-time history of insomnia and hypersomnia was assessed via self-report. Type and frequency of substance use were assessed at treatment entry. Substance use was also assessed 12 months following treatment completion. Associations were examined using linear and logistic regression with age, sex, race, education level, depression history, treatment modality and in-treatment substance use as covariates. FINDINGS: Life-time history of insomnia, hypersomnia, both or neither was reported by 26.3, 9.5, 28.0 and 36.2% of participants, respectively. Compared with no sleep disturbance, life-time insomnia and hypersomnia were associated at treatment entry with unique substance use patterns and a higher frequency of any substance use (P < 0.001). All types of sleep disturbance were associated with higher rates of cocaine use at 12-month post-entry (odds ratios: 1.30-1.57). CONCLUSIONS: There is evidence of an adverse association between substance use and sleep disturbance including higher frequency of all substance use before substance abuse treatment and higher rates of cocaine use after a treatment episode.

17 Article The association between insomnia-related sleep disruptions and cognitive dysfunction during the inter-episode phase of bipolar disorder. 2017

Kanady, Jennifer C / Soehner, Adriane M / Klein, Alexandra B / Harvey, Allison G. ·Department of Psychology, University of California, Berkeley, 3321 Tolman Hall, 94720 Berkeley, CA, USA. · Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 Ohara St, 15213 Pittsburgh, PA, USA. · VA Boston Healthcare System, 150 S. Huntington Ave. Boston, 02130 MA, USA. · Department of Psychology, University of California, Berkeley, 3321 Tolman Hall, 94720 Berkeley, CA, USA. Electronic address: aharvey@berkeley.edu. ·J Psychiatr Res · Pubmed #28088728.

ABSTRACT: Sleep disturbance and cognitive dysfunction are two domains of impairment during inter-episode bipolar disorder. Despite evidence demonstrating the importance of sleep for cognition in healthy and sleep-disordered samples, this link has been minimally examined in bipolar disorder. The present study tested the association between insomnia-related sleep disruptions and cognitive dysfunction during inter-episode bipolar disorder. Forty-seven participants with bipolar disorder and a comorbid insomnia diagnosis (BD-Insomnia) and 19 participants with bipolar disorder without sleep disturbance in the last six months (BD-Control) participated in the study. Two domains of cognition were assessed: working memory and verbal learning. Insomnia-related sleep disruptions were assessed both categorically (i.e., insomnia diagnosis) and dimensionally (i.e., total wake time, total sleep time, total wake time variability, and total sleep time variability). Hierarchical linear regressions, adjusting for participant age, demonstrated that insomnia diagnosis did not have an independent or interactive effect on cognition. However, regardless of insomnia diagnosis, greater total sleep time variability predicted poorer working memory and verbal learning performance. Further, following sleep treatment, a reduction in total wake time predicted improved working memory performance and a reduction in total sleep time variability predicted improved verbal learning performance. These findings raise the possibility that sleep disturbance may contribute to cognitive dysfunction in bipolar disorder and highlight the importance of treating sleep disturbance in bipolar disorder.

18 Article The association between sleep dysfunction and psychosis-like experiences among college students. 2017

Andorko, Nicole D / Mittal, Vijay / Thompson, Elizabeth / Denenny, Danielle / Epstein, Gregory / Demro, Caroline / Wilson, Camille / Sun, Shuyan / Klingaman, Elizabeth A / DeVylder, Jordan / Oh, Hans / Postolache, Teodor T / Reeves, Gloria M / Schiffman, Jason. ·Department of Psychology, University of Maryland Baltimore County, 1000 Hilltop Circle, Baltimore, MD, United States of America. · Department of Psychology, Northwestern University, Evanston, IL, United States of America. · VA Capitol Health Care Network, Mental Illness Research, Education, and Clinical Center (MIRECC), Baltimore, MD, United States of America; Department of Psychiatry, University of Maryland, School of Medicine, Baltimore, MD, United States of America. · University of Maryland, School of Social Work, Baltimore, MD, United States of America. · UC Berkeley School of Public Health, Berkeley, CA, United States of America; Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, CA, United States of America. · Department of Psychiatry, University of Maryland, School of Medicine, Baltimore, MD, United States of America; Capitol Health Care Networks MIRECC, Baltimore, MD, United States of America; Rocky Mountain MIRECC, Denver, CO, United States of America. · Department of Psychiatry, University of Maryland, School of Medicine, Baltimore, MD, United States of America. · Department of Psychology, University of Maryland Baltimore County, 1000 Hilltop Circle, Baltimore, MD, United States of America. Electronic address: schiffma@umbc.edu. ·Psychiatry Res · Pubmed #27988426.

ABSTRACT: Sleep problems are prominent and pervasive clinical issues experienced by many people with psychotic disorders, often causing distress and functional impairment. Sleep problems are also related to psychosis-like experiences (PLE; non-diagnosable phenomenon such as transient perceptual disturbances, unusual thoughts, periodic suspiciousness) in epidemiological studies. Prior studies in this field have used brief measures that precluded the ability to test (1) whether risk for psychosis-like experiences are related to specific sub-types of sleep disturbance, and (2) whether sleep disturbance is specifically related to clinically significant (i.e., distressing) psychosis-like experiences. The current project examined the relation between specific sleep issues, and PLEs and distress associated with PLEs, in a college sample. Participants (N=420) completed the Prodromal Questionnaire-Brief (PQ-B), which assesses PLEs and associated distress, and the Iowa Sleep Disturbances Inventory - extended version (ISDI-E), which assesses thirteen separate disturbed sleep domains. Symptoms of fragmented sleep, sleep hallucinations, and night anxiety significantly correlated with PLEs, and several sleep domains were significantly associated with PLE-related distress.

19 Article The SENSE study: Post intervention effects of a randomized controlled trial of a cognitive-behavioral and mindfulness-based group sleep improvement intervention among at-risk adolescents. 2016

Blake, Matthew / Waloszek, Joanna M / Schwartz, Orli / Raniti, Monika / Simmons, Julian G / Blake, Laura / Murray, Greg / Dahl, Ronald E / Bootzin, Richard / Dudgeon, Paul / Trinder, John / Allen, Nicholas B. ·Melbourne School of Psychological Sciences, The University of Melbourne. · Psychological Sciences and Statistics, Swinburne University of Technology. · School of Public Health, University of California, Berkeley. · Department of Psychology, University of Arizona. ·J Consult Clin Psychol · Pubmed #27775416.

ABSTRACT: OBJECTIVE: Sleep problems are a major risk factor for the emergence of mental health problems in adolescence. The aim of this study was to investigate the post intervention effects of a cognitive-behavioral/mindfulness-based group sleep intervention on sleep and mental health among at-risk adolescents. METHOD: A randomized controlled trial (RCT) was conducted across High schools in Melbourne, Australia. One hundred forty-four adolescents (aged 12-17 years) with high levels of anxiety and sleeping difficulties, but without past or current depressive disorder, were randomized into either a sleep improvement intervention or an active control 'study skills' intervention. Both programs consisted of 7 90-min-long group sessions delivered over 7 weeks. One hundred twenty-three participants began the interventions (female = 60%; mean age = 14.48, SD = 0.95), with 60 in the sleep condition and 63 in the control condition. All participants were required to complete a battery of mood and sleep questionnaires, 7 days of wrist actigraphy (an objective measure of sleep), and sleep diary entry at pre- and-post intervention. RESULTS: The sleep intervention condition was associated with significantly greater improvements in subjective sleep (global sleep quality [with a medium effect size], sleep onset latency, daytime sleepiness [with small effect sizes]), objective sleep (sleep onset latency [with a medium effect size]), and anxiety (with a small effect size) compared with the control intervention condition. CONCLUSION: The SENSE study provides evidence that a multicomponent group sleep intervention that includes cognitive-behavioral and mindfulness-based therapies can reduce sleep initiation problems and related daytime dysfunction, along with concomitant anxiety symptoms, among at-risk adolescents. (PsycINFO Database Record

20 Article Impact of comorbid anxiety and depressive disorders on treatment response to cognitive behavior therapy for insomnia. 2016

Bélanger, Lynda / Harvey, Allison G / Fortier-Brochu, Émilie / Beaulieu-Bonneau, Simon / Eidelman, Polina / Talbot, Lisa / Ivers, Hans / Hein, Kerrie / Lamy, Manon / Soehner, Adriane M / Mérette, Chantal / Morin, Charles M. ·École de psychologie, Université Laval and Centre Hospitalier Universitaire de Québec. · Department of Psychology, University of California, Berkeley. · École de psychologie, Université Laval and Institut Universitaire en Santé Mentale de Québec. · Department of Psychiatry, School of Medicine, University of Pittsburgh. · Département de psychiatrie et de neurosciences, Université Laval and Centre de recherche de l'Institut Universitaire en Santé Mentale de Québec. · École de psychologie, Université Laval and Centre de recherche de l'Institut Universitaire en Santé Mentale de Québec. ·J Consult Clin Psychol · Pubmed #26963600.

ABSTRACT: OBJECTIVE: To evaluate the impact of comorbid anxiety or depressive disorders on treatment response to cognitive-behavior therapy (CBT) for insomnia, behavior therapy (BT), or cognitive therapy (CT). METHOD: Participants were 188 adults (117 women; Mage = 47.4 years) with chronic insomnia, including 45 also presenting a comorbid anxiety or mild to moderate depressive disorder. They were randomized to BT (n = 63), CT (n = 65), or CBT (n = 60). Outcome measures were the proportion of treatment responders (decrease of ≥8 points on the Insomnia Severity Index; ISI) and remissions (ISI score < 8) and depression and anxiety symptoms. RESULTS: Proportion of treatment responders and remitters in the CBT condition was not significantly different between the subgroups with and without comorbidity. However, the proportion of responders was lower in the comorbidity subgroup compared to those without comorbidity in both the BT (34.4% vs. 81.6%; p = .007) and CT (23.6% vs. 57.6%; p = .02) alone conditions, although remission rates and prepost ISI change scores were not. Pre to post change scores on the depression (-10.6 vs. -3.9; p < .001) and anxiety measures (-9.2 vs. -2.5; p = .01) were significantly greater in the comorbidity subgroup relative to the subgroup without comorbidity but only for those treated with the full CBT; no difference was found for those treated with either BT or CT alone. CONCLUSIONS: The presence of a comorbid anxiety or mild to moderate depressive disorder did not reduce the efficacy of CBT for insomnia, but it did for its single BT and CT components when used alone. (PsycINFO Database Record

21 Article Slow dissolving of emotional distress contributes to hyperarousal. 2016

Wassing, Rick / Benjamins, Jeroen S / Dekker, Kim / Moens, Sarah / Spiegelhalder, Kai / Feige, Bernd / Riemann, Dieter / van der Sluis, Sophie / Van Der Werf, Ysbrand D / Talamini, Lucia M / Walker, Matthew P / Schalkwijk, Frans / Van Someren, Eus J W. ·Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Royal Academy of Arts and Sciences, 1105 BA, Amsterdam, The Netherlands; r.wassing@nin.knaw.nl. · Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Royal Academy of Arts and Sciences, 1105 BA, Amsterdam, The Netherlands; Department of Social, Health and Organizational Psychology, Experimental Psychology Section, Utrecht University, 3584 CS, Utrecht, The Netherlands; · Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Royal Academy of Arts and Sciences, 1105 BA, Amsterdam, The Netherlands; · Department of Clinical Psychology and Psychophysiology, University Medical Center Freiburg, 79104 Freiburg, Germany; · Department of Clinical Genetics, Complex Trait Genetics Section, Vrije Universiteit Medical Center, 1081 HV, Amsterdam, The Netherlands; · Department of Anatomy and Neurosciences, Vrije Universiteit Medical Center, 1007 MB, Amsterdam, The Netherlands; · Department of Psychology, University of Amsterdam, 1021 WX, Amsterdam, The Netherlands; · Department of Psychology, University of California, Berkeley, CA 94720-1650; · Institute for Psychotherapy, 1076 AP, Amsterdam, The Netherlands; · Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Royal Academy of Arts and Sciences, 1105 BA, Amsterdam, The Netherlands; Department of Medical Psychology, Vrije Universiteit Medical Center, 1081 HZ, Amsterdam, The Netherlands; Department of Integrative Neurophysiology, Neuroscience Campus, Vrije Universiteit, 1081 HV, Amsterdam, The Netherlands. ·Proc Natl Acad Sci U S A · Pubmed #26858434.

ABSTRACT: The mechanisms underlying hyperarousal, the key symptom of insomnia, have remained elusive, hampering cause-targeted treatment. Recently, restless rapid-eye-movement (REM) sleep emerged as a robust signature of sleep in insomnia. Given the role of REM sleep in emotion regulation, we hypothesized that restless REM sleep could interfere with the overnight resolution of emotional distress, thus contributing to accumulation of arousal. Participants (n = 1,199) completed questionnaires on insomnia severity, hyperarousal, self-conscious emotional distress, and thought-like nocturnal mentation that was validated to be a specific proxy for restless REM sleep (selective fragmentation: R = 0.57, P < 0.001; eye movement density: R = 0.46, P < 0.01) in 32 polysomnographically assessed participants. The experience of distress lasting overnight increased with insomnia severity (β = 0.29, P < 10(-23)), whereas short-lasting distress did not (β = -0.02, P = 0.41). Insomnia severity was associated with hyperarousal (β = 0.47, P < 10(-63)) and with the thought-like nocturnal mentation that is specifically associated with restless REM sleep (β = 0.31, P < 10(-26)). Structural equation modeling showed that 62.4% of the association between these key characteristics of insomnia was mediated specifically by reduced overnight resolution of emotional distress. The model outperformed all alternative mediation pathways. The findings suggest that restless REM sleep reflects a process that interferes with the overnight resolution of distress. Its accumulation may promote the development of chronic hyperarousal, giving clinical relevance to the role of REM sleep in emotion regulation in insomnia, depression, and posttraumatic stress disorder.

22 Article Change in Dysfunctional Beliefs About Sleep in Behavior Therapy, Cognitive Therapy, and Cognitive-Behavioral Therapy for Insomnia. 2016

Eidelman, Polina / Talbot, Lisa / Ivers, Hans / Bélanger, Lynda / Morin, Charles M / Harvey, Allison G. ·Cognitive Behavior Therapy and Science Center. · San Francisco VA Medical Center. · Université Laval. · University of California, Berkeley. Electronic address: aharvey@berkeley.edu. ·Behav Ther · Pubmed #26763501.

ABSTRACT: As part of a larger randomized controlled trial, 188 participants were randomized to behavior therapy (BT), cognitive therapy (CT), or cognitive-behavioral therapy (CBT) for insomnia. The aims of this study were threefold: (a) to determine whether change in dysfunctional beliefs about sleep was related to change in sleep, insomnia symptoms, and impairment following treatment; (b) to determine whether BT, CT, and CBT differ in their effects on dysfunctional beliefs; and (c) to determine whether the treatments differ in their effects on particular kinds of dysfunctional beliefs. Beliefs, sleep, insomnia symptoms, and sleep-related psychosocial impairment were assessed at pretreatment, posttreatment, and 6- and 12-month follow-up. Greater change in dysfunctional beliefs occurring over the course of BT, CT, or CBT was associated with greater improvement in insomnia symptoms and impairment at posttreatment and both follow-ups. All groups experienced a significant decrease in dysfunctional beliefs during treatment, which were sustained through 6- and 12-month follow-up. Compared with the BT group, a greater proportion of participants in the CT and/or CBT groups endorsed dysfunctional beliefs below a level considered clinically significant at posttreatment and 12-month follow-up. The results demonstrate the importance of targeting dysfunctional beliefs in insomnia treatment, suggest that beliefs may be significantly modified with BT alone, and indicate that cognitive interventions may be particularly powerful in enhancing belief change.

23 Article Cannabis species and cannabinoid concentration preference among sleep-disturbed medicinal cannabis users. 2015

Belendiuk, Katherine A / Babson, Kimberly A / Vandrey, Ryan / Bonn-Miller, Marcel O. ·University of California at Berkeley Institute of Human Development, 1127 Tolman Hall, Berkeley, CA, 94720-1690, USA. Electronic address: kab@berkeley.edu. · National Center for PTSD, VA Palo Alto Health Care System, 795 Willow Road (152-MPD), Menlo Park, CA, 94025, USA. Electronic address: Kimberly.Babson@va.gov. · Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine5510 Nathan Shock Drive, Baltimore, MD, 21224,USA. Electronic address: rvandrey@jhmi.edu. · National Center for PTSD, VA Palo Alto Health Care System, 795 Willow Road (152-MPD), Menlo Park, CA, 94025, USA; Center for Innovation to Implementation, VA Palo Alto Health Care System, 795 Willow Road (152-MPD), Menlo Park, CA 94025, USA; Center of Excellence in Substance Abuse Treatment and Education, Philadelphia VAMC, Philadelphia, PA, 19104, USA; Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA. Electronic address: Marcel.Bonn-Miller@va.gov. ·Addict Behav · Pubmed #26151582.

ABSTRACT: INTRODUCTION: Individuals report using cannabis for the promotion of sleep, and the effects of cannabis on sleep may vary by cannabis species. Little research has documented preferences for particular cannabis types or cannabinoid concentrations as a function of use for sleep disturbances. METHODS: 163 adults purchasing medical cannabis for a physical or mental health condition at a cannabis dispensary were recruited. They provided self-report of (a) whether cannabis use was intended to help with sleep problems (e.g. insomnia, nightmares), (b) sleep quality (PSQI), (c) cannabis use (including preferred type), and (d) symptoms of DSM-5 cannabis dependence. RESULTS: 81 participants reported using cannabis for the management of insomnia and 14 participants reported using cannabis to reduce nightmares. Individuals using cannabis to manage nightmares preferred sativa to indica strains (Fisher's exact test (2) = 6.83, p < 0.05), and sativa users were less likely to endorse DSM-5 cannabis dependence compared with those who preferred indica strains (χ(2)(2) = 4.09, p < 0.05). Individuals with current insomnia (t(9) = 3.30, p < 0.01) and greater sleep latency (F(3,6) = 46.7, p < 0.001) were more likely to report using strains of cannabis with significantly higher concentrations of CBD. Individuals who reported at least weekly use of hypnotic medications used cannabis with lower THC concentrations compared to those who used sleep medications less frequently than weekly (t(17) = 2.40, p < 0.05). CONCLUSIONS: Associations between sleep characteristics and the type of cannabis used were observed in this convenience sample of individuals using cannabis for the management of sleep disturbances. Controlled prospective studies are needed to better characterize the impact that specific components of cannabis have on sleep.

24 Article Cognitive-behavioral treatment of insomnia and depression in adolescents: A pilot randomized trial. 2015

Clarke, Greg / McGlinchey, Eleanor L / Hein, Kerrie / Gullion, Christina M / Dickerson, John F / Leo, Michael C / Harvey, Allison G. ·Kaiser Permanente Center for Health Research, 3800 N. Interstate Blvd, Portland, OR 97227, USA. Electronic address: greg.clarke@kpchr.org. · University of California at Berkeley (UCB) Golden Bear Sleep and Mood Research Clinic, Department of Psychology, University of California, 3210 Tolman Hall #1650, Berkeley, CA 94720-1650, USA. · Kaiser Permanente Center for Health Research, 3800 N. Interstate Blvd, Portland, OR 97227, USA. ·Behav Res Ther · Pubmed #25917009.

ABSTRACT: We tested whether augmenting conventional depression treatment in youth by treating sleep issues with cognitive behavioral therapy for insomnia (CBT-I) improved depression outcomes. We randomized youth 12-20 years of age to 10 weekly sessions of a sleep hygiene control condition (SH) combined with CBT for depression (CBT-D) (n = 20), or an experimental condition consisting of CBT-I combined with CBT-D (n = 21). We assessed outcomes through 26 weeks of follow-up and found medium-large effects favoring the experimental CBT-I arm on some sleep outcomes (actigraphy total sleep time and Insomnia Severity Index "caseness") and depression outcomes (higher percentage recovered, faster time to recovery), but little effect on other measures. Total sleep time improved by 99 min from baseline to week 12 in the CBT-I arm, but not in the SH arm. In addition, our pilot yielded important products to facilitate future studies: the youth-adapted CBT-I program; the study protocol; estimates of recruitment, retention, and attrition; and performance and parameters of candidate outcome measures. ClinicalTrials.gov Identifier NCT00949689.

25 Article Later emotional and behavioral problems associated with sleep problems in toddlers: a longitudinal study. 2015

Sivertsen, Børge / Harvey, Allison G / Reichborn-Kjennerud, Ted / Torgersen, Leila / Ystrom, Eivind / Hysing, Mari. ·Division of Mental Health, Norwegian Institute of Public Health, Bergen2Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway 3Department of Psychiatry, Helse Fonna HF, Haugesund, Norway. · Department of Psychology, University of California, Berkeley. · Division of Mental Health, Norwegian Institute of Public Health, Bergen5Institute of Psychiatry, University of Oslo, Oslo, Norway. · Division of Mental Health, Norwegian Institute of Public Health, Bergen. · Division of Mental Health, Norwegian Institute of Public Health, Bergen6Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway. · Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway. ·JAMA Pediatr · Pubmed #25867179.

ABSTRACT: IMPORTANCE: Childhood sleep problems have been linked to a range of adverse health outcomes, but there is limited knowledge as to the temporal association between sleep problems and subsequent emotional and behavioral problems in young children. OBJECTIVE: To examine whether sleep problems in toddlers aged 18 months are related to both concurrent and subsequent emotional and behavioral problems in preschool children aged 5 years. DESIGN, SETTING, AND PARTICIPANTS: A large population-based longitudinal study was conducted in September 2014 using data from the Norwegian Mother and Child Cohort Study conducted at the Norwegian Institute of Public Health from June 1, 1999, to December 31, 2008. A total of 32 662 children or pregnancies were included. EXPOSURES: Sleep was assessed by mother-reported child sleep duration and nocturnal awakenings. MAIN OUTCOMES AND MEASURES: Emotional and behavioral problems were measured with items from the Child Behavior Checklist and operationalized according to recommended clinical cutoffs, corresponding to T scores of greater than 65 (93rd percentile). Risk ratios (RRs) were calculated using negative binomial regression, controlling for emotional and behavioral problems at 18 months and other relevant covariates. RESULTS: Short sleep duration (≤10 hours) in 556 children (1.7%) and frequent nocturnal awakenings (≥3 times) in 1033 children (3.2%) at 18 months significantly predicted both concurrent and later incidence of emotional and behavioral problems at 5 years. The longitudinal RRs were generally larger for internalizing problems, with adjusted RRs of 1.59 (95% CI, 1.23-2.08) for both short sleep duration and 1.57 (95% CI, 1.28-1.93) for nocturnal awakenings; RRs for externalizing problems were 1.77 (95% CI, 1.37-2.30) and 1.25 (95% CI, 1.00-1.58), respectively. Additional adjustment for emotional and behavioral problems at 18 months slightly reduced the strength of these associations, and all RRs remained significant in the fully adjusted models. CONCLUSIONS AND RELEVANCE: Early sleep problems predict later development of emotional and behavioral problems. Intervention studies are needed to examine whether sleep programs targeting early childhood may avert the onset of later adverse outcomes.

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