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Järnefelt, Heli, Mikko Härmä, Mikael Sallinen, Jussi Virkkala, Teemu Paajanen, Kari-Pekka Martimo, and Christer Hublin. "Cognitive behavioural therapy interventions for insomnia among shift workers: RCT in an occupational health setting." International Archives of Occupational and Environmental Health 93, no. 5 (December 18, 2019): 535–50. http://dx.doi.org/10.1007/s00420-019-01504-6.
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Abstract Introduction The aim of the study was to compare the effectiveness of cognitive behavioural therapy interventions for insomnia (CBT-I) to that of a sleep hygiene intervention in a randomized controlled design among shift workers. We also studied whether the features of shift work disorder (SWD) affected the results. Methods A total of 83 shift workers with insomnia disorder were partially randomized into a group-based CBT-I, self-help CBT-I, or sleep hygiene control intervention. The outcomes were assessed before and after the interventions and at 6-month follow-up using questionnaires, a sleep diary, and actigraphy. Results Perceived severity of insomnia, sleep-related dysfunctional beliefs, burnout symptoms, restedness, recovery after a shift, and actigraphy-based total sleep time improved after the interventions, but we found no significant differences between the interventions. Mood symptoms improved only among the group-based CBT-I intervention participants. Non-SWD participants had more mental diseases and symptoms, used more sleep-promoting medication, and had pronounced insomnia severity and more dysfunctional beliefs than those with SWD. After the interventions, non-SWD participants showed more prominent improvements than those with SWD. Conclusions Our results showed no significant differences between the sleep improvements of the shift workers in the CBT-I interventions and of those in the sleep hygiene control intervention. Alleviation of mood symptoms seemed to be the main added value of the group-based CBT-I intervention compared to the control intervention. The clinical condition of the non-SWD participants was more severe and these participants benefitted more from the interventions than the SWD participants did. Trial registration ClinicalTrials.gov, NCT02523079.
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Gadam, S., C. Pattinson, S. Soleimanloo, K. Rossa, J. Moore, T. Begum, A. Srinivasan, and S. Smith. "P039 Interventions used to increase sleep duration in young people: A systematic review." SLEEP Advances 2, Supplement_1 (October 1, 2021): A34. http://dx.doi.org/10.1093/sleepadvances/zpab014.087.
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Abstract Introduction Habitual short sleep duration affects a substantial proportion of young people, which is problematic due to its association with various adverse consequences. The aim of this systematic review was to identify the effectiveness of current interventions to increase sleep duration in healthy young people (14–25 years). Methods A systematic literature search, following PRISMA guidelines was conducted across multiple databases including PubMed, Ovid MEDLINE, CENTRAL, Embase, CINAHL (via EBSCOhost), PsycINFO, Scopus, Web of Science, ProQuest Dissertations and Theses, and Trove. Eligible studies were required to report sleep duration before and after exposure to the intervention, published from 2005 onwards, and participants 14–25 years of age. The Newcastle-Ottawa scale and Cochrane Risk of Bias were used to evaluate quality of studies. Results 2695 citation were screened, and 29 studies met the eligibility criteria for this review. The included studies implemented differing methodologies, including behavioural (48.3%), educational (24.1%), and combination (24.1%) of behavioural, educational and other methods, such as mindfulness, light therapy, and naturalistic observation (3.4%). Initial findings indicate that educational interventions on their own are not effective at increasing sleep duration as behavioural or combination of both. Discussion These results indicate that behavioural interventions which prescribe new sleep schedules show positive treatment effects on sleep duration. Hence, provide promise for mitigating sleep difficulties and improving health in young people aged 14–25 years.
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Hendricks, Melissa C., Cynthia M. Ward, Lauren K. Grodin, and Keith J. Slifer. "Multicomponent Cognitive-Behavioural Intervention to Improve Sleep in Adolescents: A Multiple Baseline Design." Behavioural and Cognitive Psychotherapy 42, no. 3 (September 4, 2013): 368–73. http://dx.doi.org/10.1017/s1352465813000623.
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Background: Adolescents are prone to sleep problems that have unique developmental aspects and contribute to physical, emotional, and behavioural problems. Aims: This study evaluated an individualized, multicomponent intervention that considered developmental factors, and promoted age-appropriate autonomy in three adolescent females with disrupted sleep. Method: Adolescents recorded sleep data on daily logs. A nonconcurrent multiple baseline design was used to evaluate a cognitive-behavioural intervention including sleep hygiene training, bedtime routine development, cognitive restructuring, relaxation training, stimulus control, sleep restriction, bedtime fading, and problem-solving, along with clinically indicated individualization. Results: Outcomes demonstrated clinically meaningful improvements and decreased variability in sleep parameters following intervention. Each participant's sleep log data indicated improvement in, or maintenance of, adequate total sleep time (TST), decreased sleep onset latency (SOL), improved sleep efficiency (SE), improvement in time of sleep onset, and decreased or continued low frequency of night awakenings (NA). Anecdotally, adolescents and parents reported improvement in daytime functioning, coping, and sense of wellbeing. Conclusions: These cases highlight the potential for cognitive-behavioural interventions to facilitate healthy sleep in adolescents with challenging sleep problems.
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Speedy, Kathryn, Lokesh Nukalapati, Kathryn Speedy, and Megan Davies-Kabir. "Melatonin prescribing practices and the provision of sleep hygiene/parent-led sleep behavioural Interventions in S-CAMHS, Aneurin Bevan University Health Board (ABUHB)- Service evaluation as part of quality improvement project." BJPsych Open 7, S1 (June 2021): S351—S352. http://dx.doi.org/10.1192/bjo.2021.920.
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AimsTo identify the number of patients currently on melatoninTo determine the average duration of use of melatonin in patients under the care of S-CAMHS in ABUHBTo investigate whether behaviour interventions were tried and reinforced from time to timeTo identify any areas of improvementMethodData were collected at St. Cadoc's hospital, in January, 2021. S-CAMHS database was used. Out of total 346 patient currently being managed with pharmacological therapies, 115 (33.2%) are currently on melatonin. 57/115 were randomly selected as a sample for this this project. Patient notes and EPEX software were also used to collect information regarding the sleep management practices.ResultDuring analysis, it was noticed that within the sample, only 46 patients were actively on melatonin. Melatonin is prescribed for sleep related issues in ASD (8/46), ADHD (15/46), ASD and ADHD (10/46), ADHD and mood disorder (0/46), ASD and mood disorder (6/46), ADHD and behaviour difficulties (2/46), ASD with behaviour difficulties (1/46), mood disorder (4/46).39/46 patients are currently on melatonin for more than a year (85%). These patients also include 10 patients who have been using melatonin for 5 years or more.35 patients (76%) reported improved sleep or some benefit from melatonin.Evidence for implementation of parent-led sleep behavioural interventions:Prior to commencing melatonin- Clear evidence available for 35 patients only (76%). These interventions were however not deemed helpful by most of the service users.While prescribing melatonin- Clear evidence available for 39(85%) patients. Evidence base for melatonin was also discussed during this visit.During last follow-up visit- Evidence available for 31 patients only (67%).ConclusionMajority of patients under S-CAMHS ABUHB remain on melatonin therapy for longer than one year. Most of these patients have reported benefit from this therapy and preferred to remain on it despite being informed about evidence base for melatonin. Also, there is evidence for implementation of sleep behavioural interventions prior to prescribing melatonin, however their benefit remains unclear.Recommendations:The quality of education on sleep hygiene offered should be assessed and improved if neededFormal group sessions/workshops on sleep hygiene/parent-led sleep behavioural interventions at regular intervals might be useful in reducing the chances of long term polypharmacy or unlicensed drugsUse of outcome measures such as Child Sleep Habits Questionnaire at intervals can be helpful in identifying any improvement from educational/pharmacological interventionsS-CAMHS database (for patients actively on medications) needs a review and update
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Escañuela Sanchez, Tamara, Molly Byrne, Sarah Meaney, Keelin O'Donoghue, and Karen Matvienko-Sikar. "A protocol for a systematic review of behaviour change techniques used in the context of stillbirth prevention." HRB Open Research 4 (August 19, 2021): 92. http://dx.doi.org/10.12688/hrbopenres.13375.1.
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Background: Stillbirth is a devastating pregnancy outcome that affects approximately 3.5 per 1000 births in high-income countries. Previous research has highlighted the importance of focusing prevention efforts on targeting risk factors and vulnerable groups. A wide range of risk factors has been associated with stillbirth before, including maternal behaviours such as back sleep position, smoking, alcohol intake, illicit drug use, and inadequate attendance at antenatal care. Given the modifiable nature of these risk factors, there has been an increase in the design of behaviour change interventions targeting such behaviours to reduce the risk of stillbirth. Objectives: The aim of this study is to identify all behavioural interventions with a behavioural component designed and trialled for the prevention of stillbirth in high-income countries, and to identify the behaviour change techniques (BCTs) used in such interventions using the Behaviour Change Techniques Taxonomy V1 (BCTTv1). Inclusion criteria: Interventions will be included in this review if they (1) have the objective of reducing stillbirth rates with a focus on behavioural risk factors; (2) are implemented in high-income countries; (3) target pregnant women or women of childbearing age; and (4) are published in research articles. Methods: A systematic search of the literature will be conducted. The results of the search will be screened against our inclusion criteria by two authors. The following data items will be extracted from the selected papers: general information, study characteristics, participant and intervention/approach details. The Cochrane Effective Practice and Organization of Care (EPOC) risk of bias criteria will be used to assess the methodological quality of included studies. Intervention content will be coded for BCTs as present (+) or absent (-) by two authors using the BCTTv1, discrepancies will be discussed with a third author. A narrative synthesis approach will be used to present the results of this systematic review.
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Escañuela Sánchez, Tamara, Molly Byrne, Sarah Meaney, Keelin O'Donoghue, and Karen Matvienko-Sikar. "A protocol for a systematic review of behaviour change techniques used in the context of stillbirth prevention." HRB Open Research 4 (March 11, 2022): 92. http://dx.doi.org/10.12688/hrbopenres.13375.2.
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Background: Stillbirth is a devastating pregnancy outcome that affects approximately 3.5 per 1000 births in high-income countries. Previous research has highlighted the importance of focusing prevention efforts on targeting risk factors and vulnerable groups. A wide range of risk factors has been associated with stillbirth before, including maternal behaviours such as back sleep position, smoking, alcohol intake, illicit drug use, and inadequate attendance at antenatal care. Given the modifiable nature of these risk factors, there has been an increase in the design of behaviour change interventions targeting such behaviours to reduce the risk of stillbirth. Objectives: The aim of this study is to identify all behavioural interventions with a behavioural component designed and trialled for the prevention of stillbirth in high-income countries, and to identify the behaviour change techniques (BCTs) used in such interventions using the Behaviour Change Techniques Taxonomy V1 (BCTTv1). Inclusion criteria: Interventions will be included in this review if they (1) have the objective of reducing stillbirth rates with a focus on behavioural risk factors; (2) are implemented in high-income countries; (3) target pregnant women or women of childbearing age; and (4) are published in research articles. Methods: A systematic search of the literature will be conducted. The results of the search will be screened against our inclusion criteria by two authors. The following data items will be extracted from the selected papers: general information, study characteristics, participant and intervention/approach details. The Cochrane Effective Practice and Organization of Care (EPOC) risk of bias criteria will be used to assess the methodological quality of included studies. Intervention content will be coded for BCTs as present (+) or absent (-) by two authors using the BCTTv1, discrepancies will be discussed with a third author. A narrative synthesis approach will be used to present the results of this systematic review.
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Crowther, M., S. Ferguson, C. Gupta, and A. Reynolds. "P032 The Health Belief Model for Shift Workers Scale: The development and validation of a novel metric for use in shift working populations." SLEEP Advances 3, Supplement_1 (October 1, 2022): A41—A42. http://dx.doi.org/10.1093/sleepadvances/zpac029.105.
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Abstract Introduction Shift work is associated with circadian misalignment, sleep loss and suboptimal health behaviours, which may contribute to longer term negative health outcomes. interventions based on behavioural models may improve health behaviours in shift workers. To implement and evaluate these interventions, a validated metric based on behavioural theory specifically for use with shift workers would be beneficial. The present study aimed to develop and evaluate the Health Belief Model for Shift Workers (HBM-SW) scale. Methods The HBM-SW development involved a seven-step process, including a literature review, expert panel analysis, cognitive interviews with shift workers, and administration to pilot sample of shift workers (n=153). Validation of the HBM-SW was compared to Pittsburgh Sleep Quality Index, International Physical Activity Questionnaire and Food Frequency Questionnaire. Results Utilising exploratory factor analysis for factor identification and item reduction, the developed scale loaded on seven factors in line with the theoretical framework of the Health Belief Model Perceived Threat, Perceived Severity, Perceived Benefits, Perceived Barriers, Cues to Action, Self-Efficacy and Health Motivation. The HBM-SW showed good – excellent (α =0.74-0.93) internal consistency and moderate – good (ICC =0.64-0.89) test re-test reliability. Using health behaviour outcome measures, the HBM-SW scale showed meaningful correlations with sleep quality, sleep duration, diet quality and leisure time physical activity, and acceptable validity and reliability. Conclusion Further testing should be conducted in a larger sample to facilitate confirmatory factor analysis. The Health Belief Model for Shift Workers scale is likely to be beneficial for in future studies of interventions for shift workers.
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Edley, Ruth. "Can non-pharmacological interventions improve sleep quality for haemodialysis patients?" Journal of Kidney Care 5, no. 1 (January 2, 2020): 6–12. http://dx.doi.org/10.12968/jokc.2020.5.1.6.
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Poor sleep quality is a major issue for haemodialysis (HD) patients, with as many as 80% reporting problems with sleep. Poor sleep has a negative impact on HD patients' mental health, quality of life and day-to-day functioning, along with increasing morbidity and mortality risks. Non-pharmacological interventions have fewer side-effects compared to hypnotic medications and have been shown to be effective in research studies. Ruth Edley examines acupressure, massage, aerobic and non-aerobic exercise and cognitive behavioural therapy. All have been shown in small-scale studies to improve sleep quality in HD patients, although no intervention has been found to improve sleep quality to normal levels. It is recommended that further research using larger, randomised controlled trials is undertaken to increase confidence in the benefits of these interventions.
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Aparício, Carlos, and Francesca Panin. "Interventions to improve inpatients' sleep quality in intensive care units and acute wards: a literature review." British Journal of Nursing 29, no. 13 (July 9, 2020): 770–76. http://dx.doi.org/10.12968/bjon.2020.29.13.770.
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Background: Sleep is essential for the physical and psychological restoration of inpatients, and lack of sleep results in sleep deprivation and poor sleep quality, with potentially harmful consequences. Aim: To summarise sleep-promoting interventions in the Intensive care unit (ICU) and acute ward setting. Method and results: Six databases were searched to obtain studies for review and eight studies were selected, appraised, analysed and produced two themes: sleep-disturbing factors and sleep-promoting strategies. Sleep-disturbing factors included environmental factors (such as light and noise), illness-related factors (such as pain, anxiety and discomfort), clinical care and diagnostics. Sleep-promoting strategies included using pharmacological aids (medication) and non-pharmacological aids (reducing noise and disturbances, eye masks, earplugs and educational and behavioural changes). Conclusion: The literature review showed that both ICU and acute ward settings affect patients' sleep and both use similar strategies to improve this. Nevertheless, noise and sleep disturbances remain the most critical sleep-inhibiting factors in both settings. The review recommended future research should focus on behavioural changes among health professionals to reduce noise and improve patients' sleep.
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Tse, Andy C. Y., Paul H. Lee, Jihui Zhang, and Elvis W. H. Lai. "Study protocol for a randomised controlled trial examining the association between physical activity and sleep quality in children with autism spectrum disorder based on the melatonin-mediated mechanism model." BMJ Open 8, no. 4 (April 2018): e020944. http://dx.doi.org/10.1136/bmjopen-2017-020944.
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IntroductionSleep disturbance is commonly observed in children with autism spectrum disorders (ASD). Disturbed sleep may exacerbate the core symptoms of ASD. Behavioural interventions and supplemental melatonin medication are traditionally used to improve sleep quality, but poor sustainability of behavioural intervention effects and use of other medications that metabolise melatonin may degrade the effectiveness of these interventions. However, several studies have suggested that physical activity may provide an effective intervention for treating sleep disturbance in typically developing children. Thus, we designed a study to examine whether such an intervention is also effective in children with ASD. We present a protocol (4 December 2017) for a jogging intervention with a parallel and two-group randomised controlled trial design using objective actigraphic assessment and 6-sulfatoxymelatonin measurement to determine whether a 12-week physical activity intervention elicits changes in sleep quality or melatonin levels.Methods and analysisAll eligible participants will be randomly allocated to either a jogging intervention group or a control group receiving standard care. Changes in sleep quality will be monitored through actigraphic assessment and parental sleep logs. All participants will also be instructed to collect a 24-hour urine sample. 6-sulfatoxymelatonin, a creatinine-adjusted morning urinary melatonin representative of the participant’s melatonin levels, will be measured from the sample. All assessments will be carried out before the intervention (T1), immediately after the 12-week intervention or regular treatment (T2), 6 weeks after the intervention (T3) and 12 weeks after the intervention (T4) to examine the sustainability of the intervention effects. The first enrolment began in February 2018.Ethics and disseminationEthical approval was obtained through the Human Research Ethics Committee, Education University of Hong Kong. The results of this trial will be submitted for publication in peer-reviewed journals.Trial registration numberNCT03348982.
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El Kazzi, M., C. De Pasquale, G. Vincent, A. Shriane, and Y. Bin. "P024 Defining sleep hygiene: A scoping review of intervention studies." SLEEP Advances 3, Supplement_1 (October 1, 2022): A39. http://dx.doi.org/10.1093/sleepadvances/zpac029.097.
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Abstract Background Inadequate sleep is common in the community. For those with subclinical sleep problems there are few interventions for improving their sleep. Sleep hygiene advice has received interest as a possible intervention, however, studies using sleep hygiene as an intervention have been inconclusive. A possible explanation is the inconsistency in sleep hygiene advice in these studies. This scoping review aimed to systematically review studies which used sleep hygiene as an intervention to clarify what individual components comprise “sleep hygiene”. Methods Search of 4 databases (EMBASE, MEDLINE, CINAHL, PsychINFO) revealed 298 intervention studies. Information pertaining to the use of sleep hygiene as an intervention was extracted. Results 49% of papers defined sleep hygiene. 66% of papers used sleep hygiene as an active intervention while 34% used it as a control intervention. Sleep hygiene advice included caffeine (mentioned in 36% of papers), alcohol (31%), exercise (31%), food intake (29%), sleep time regularity (26%), light (25%), napping (23%), noise (22%), nicotine (18%), bed restriction (18%), stimulus control (18%), room temperature control (18%), stress (15%), and wind down routine (11%). The specific advice provided about each behaviour varied between studies. Advice also varied depending on the methodology used. Papers using cognitive behavioural therapy for insomnia were more likely to include advice about stimulus control and bed restriction and less likely to include advice about light, noise, and room temperature. Conclusion Research incorporating sleep hygiene as an intervention provide different sets of advice hence reducing study replicability. Consensus on what constitutes sleep hygiene is required.
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de Sousa, Daniela, Adriana Fogel, José Azevedo, and Patrícia Padrão. "The Effectiveness of Web-Based Interventions to Promote Health Behaviour Change in Adolescents: A Systematic Review." Nutrients 14, no. 6 (March 16, 2022): 1258. http://dx.doi.org/10.3390/nu14061258.
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Although web-based interventions are attractive to researchers and users, the evidence about their effectiveness in the promotion of health behaviour change is still limited. Our aim was to review the effectiveness of web-based interventions used in health behavioural change in adolescents regarding physical activity, eating habits, tobacco and alcohol use, sexual behaviour, and quality of sleep. Studies published from 2016 till the search was run (May-to-June 2021) were included if they were experimental or quasi-experimental studies, pre-post-test studies, clinical trials, or randomized controlled trials evaluating the effectiveness of web-based intervention in promoting behaviour change in adolescents regarding those health behaviours. The risk of bias assessment was performed by using the Effective Public Health Practice Project (EPHPP)—Quality Assessment Tool for Quantitative Studies. Fourteen studies were included. Most were in a school setting, non-probabilistic and relatively small samples. All had a short length of follow-up and were theory driven. Thirteen showed significant positive findings to support web-based interventions’ effectiveness in promoting health behaviour change among adolescents but were classified as low evidence quality. Although this review shows that web-based interventions may contribute to health behaviour change among adolescents, these findings rely on low-quality evidence, so it is urgent to test these interventions in larger controlled trials with long-term maintenance.
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Semsarian, Caitlin R., Gabrielle Rigney, Peter A. Cistulli, and Yu Sun Bin. "Impact of an Online Sleep and Circadian Education Program on University Students’ Sleep Knowledge, Attitudes, and Behaviours." International Journal of Environmental Research and Public Health 18, no. 19 (September 28, 2021): 10180. http://dx.doi.org/10.3390/ijerph181910180.
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University students consistently report poor sleep. We conducted a before-and-after study to evaluate the impact of an online 10-week course on undergraduate students’ sleep knowledge, attitudes, and behaviours at 6-month follow-up. Data were collected via baseline course surveys (August–September 2020) and follow-up surveys distributed via email (February–March 2021). n = 212 students completed baseline surveys and n = 75 (35%) completed follow-up. Students retained to follow-up possessed higher baseline sleep knowledge and received higher course grades. At the 6-month follow-up, sleep knowledge had increased (mean score out of 5: 3.0 vs. 4.2, p < 0.001). At baseline, 85% of students aimed to increase their sleep knowledge and 83% aimed to improve their sleep. At follow-up, 91% reported being more knowledgeable and 37% reported improved sleep. A novel Stages of Change item revealed that 53% of students’ attitudes towards their sleep behaviours had changed from baseline. There was a reduction in sleep latency at follow-up (mean 33.3 vs. 25.6 min, p = 0.015), but no change in the total Pittsburgh Sleep Quality Index score. In summary, completion of an online course led to increased sleep and circadian knowledge and changed sleep attitudes, with no meaningful change in sleep behaviours. Future interventions should consider components of behavioural change that go beyond the knowledge–attitudes–behaviour continuum.
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Basheti, M., J. Bussing, R. Grunstein, C. Gordon, and B. Saini. "P016 Evaluating the effectiveness of an interactive educational intervention on sleep health for second-year pharmacy students." SLEEP Advances 3, Supplement_1 (October 1, 2022): A36—A37. http://dx.doi.org/10.1093/sleepadvances/zpac029.089.
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Abstract Background Pharmacists are usually the most frequently consulted professionals in primary care for health concerns, such as sleep disturbances. However, conventionally, curricular space devoted to sleep health has been insufficient and this eventuates in suboptimal care provision. For example, pharmacists often provide over the counter/complementary medicines rather than the recommended behavioural counselling for insomnia management. Clearly, pedagogically informed learning experiences about sleep health/insomnia management are important to improve practice. Objectives To develop, implement and evaluate an interactive sleep health educational intervention for 2nd year pharmacy students. Methods An educational intervention utilising a flipped classroom approach, with interactive lectures, self-reflection around personal sleep habits, and role-playing behavioural treatment provision was designed and implemented. A questionnaire assessing pre- and post-intervention changes in knowledge about and attitudes towards sleep as well as post-intervention learning satisfaction, was administered to students. Results Mean total knowledge scores for participating students (n=125, 70.4% females) improved significantly post-intervention from a baseline of 11.1 ± 3.8 to 17.1 ± 3.5 post-intervention, p <0.05 (Score range= 0-25). The mean total attitudes scores also improved from 28.8 ± 3.2 at baseline to 29.4 ± 3.8 (Score range= 10-50), p=0.07; however, this change was insignificant. Conclusion Carefully crafted educational interventions for pharmacy students can help improve sleep health knowledge. Whilst a trend to improved sleep health attitudes was evident, it was not significant, possibly because of positive sleep health attitudes even at baseline. Such programs should be incorporated into pharmacy pre-registration curricula to potentially enhance future pharmacists’ skills in sleep health provision.
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Pizova, N. V., A. V. Pizov, and I. N. Solovyov. "Insomnia: risk factors, sex- and age-specific features, and therapeutic approaches." Meditsinskiy sovet = Medical Council, no. 11 (July 6, 2022): 62–70. http://dx.doi.org/10.21518/2079-701x-2022-16-11-62-70.
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Insomnia is a common clinical condition characterized by difficulty initiating or maintaining sleep, accompanied by symptoms such as irritability or fatigue during wakefulness. Insomnia is often divided into subtypes based on the prevailing symptom. Insomnia is a risk factor for developing other somatic and mental disorders such as cerebrovascular diseases, hypertension, diabetes mellitus, depression, and causes increased healthcare costs. Given the bidirectional association of insomnia with the development of other somatic and mental diseases, the term “comorbid insomnia” may be used. The etiology and pathophysiology of insomnia involve genetic, environmental, behavioural, and physiological factors. The goals of insomnia treatment are to improve quantitative and qualitative aspects of sleep, to reduce the distress and anxiety associated with poor sleep, and to improve daytime function. Efficacious treatments for insomnia include behavioural, cognitive, and pharmacological interventions. Simple behavioural interventions may be provided in primary care facilities, but lack of training in these techniques limits their use. Among pharmacological interventions, the most evidence exists for benzodiazepine receptor agonist drugs, although on-going concerns focus on their safety as compared to modest efficacy. Different “natural” and OTC drugs are used as sleeping medications, for instance melatonin-based drugs. Behavioural treatments should be used whenever possible, and drugs should be limited to the lowest necessary dose and shortest necessary duration.
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Whittall, Hannah, Michal Kahn, Meg Pillion, and Michael Gradisar. "Parents matter: barriers and solutions when implementing behavioural sleep interventions for infant sleep problems." Sleep Medicine 84 (August 2021): 244–52. http://dx.doi.org/10.1016/j.sleep.2021.05.042.
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Gauthier-Gagne, G., J. Dimakos, G. Somerville, J. Boursier, and R. Gruber. "0217 Adolescents’ Evening Preference is Associated with Specific Sleep Hygiene Behaviours." Sleep 43, Supplement_1 (April 2020): A84. http://dx.doi.org/10.1093/sleep/zsaa056.215.
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Abstract Introduction Circadian tendencies are associated with individual differences in preferred timing of behaviour. Sleep hygiene encompasses a variety of habits that are necessary for healthy. Given the later bedtimes of individuals with evening circadian preferences, more time is spent being awake in the evening and this could be associated with increased or longer engagement in poor sleep hygiene. Specific sleep hygiene practices that are common in adolescents with high evening preferences may therefore be a target to improve sleep. However, the relationship between specific sleep hygiene behaviours and circadian preferences in adolescents has not been examined. The objective of this study was to examine the associations between circadian preference and specific domains of sleep hygiene behavior. Methods 127 adolescents (86 female) between 13 and 18 years old (M = 14.83, SD = 1.20) participated in the study. Circadian preferences were measured by the Morningness-Eveningness subscale of the School Sleep Habits Survey. Sleep hygiene was measured using the Adolescent Sleep Hygiene Scale (ASHS). Results Higher eveningness scores were significantly negatively associated with the ASHS physiological, behavioural arousal, cognitive emotional arousal, sleep environment, sleep stability, daytime sleep, substances use factors (r = -.20, p = <.05, r = -.27, p = <.01, r = -.32, p = <.01, r = -.18, p = <.05, r = -.41, p = <.01, r = -.28, p = <.01, r = 0.20, p = <.05 respectively) and with total sleep hygiene score (r = -.45, p = <.01). Conclusion Higher eveningness preferences in adolescents is significantly associated with poorer sleep hygiene in all domains with the exception of bedtime routine. Behavioural arousal, cognitive emotional, and sleep stability domains show the strongest inverse correlations. These findings could be used to inform the development of tailored sleep health interventions for adolescents with strong evening tendencies Support Social Sciences and Humanities Research Council (SSHRC) support for Dr. Reut Gruber.
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DATTA, KARUNA, MANJARI TRIPATHI, MANSI VERMA, DEEPIKA MASIWAL, and HRUDA NANDA MALLICK. "Yoga nidra practice shows improvement in sleep in patients with chronic insomnia: A randomized controlled trial." National Medical Journal of India 34 (October 22, 2021): 143–50. http://dx.doi.org/10.25259/nmji_63_19.
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Background Yoga nidra is practised by sages for sleep. The practice is simple to use and has been clearly laid out, but its role in the treatment of chronic insomnia has not been well studied. Methods In this randomized parallel-design study conducted during 2012–16, we enrolled 41 patients with chronic insomnia to receive conventional intervention of cognitive behavioural therapy for insomnia (n=20) or yoga nidra (n=21). Outcome measures were both subjective using a sleep diary and objective using polysomnography (PSG). Salivary cortisol levels were also measured. PSG was done before the intervention in all patients and repeated only in those who volunteered for the same. Results Both interventions showed an improvement in subjective total sleep time (TST), sleep efficiency, wake after sleep onset, reduction in total wake duration and enhancement in subjective sleep quality. Objectively, both the interventions improved TST and total wake duration and increased N1% of TST. Yoga nidra showed marked improvement in N2% and N3% in TST. Salivary cortisol reduced statistically significantly after yoga nidra (p=0.041). Conclusion Improvement of N3 sleep, total wake duration and subjective sleep quality occurred following yoga nidra practice. Yoga nidra practice can be used for treatment of chronic insomnia after supervised practice sessions.
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Elphick, Heather E., Candi Lawson, Ann Ives, Sue Siddall, Ruth N. Kingshott, Janine Reynolds, Victoria Dawson, and Lorraine Hall. "Pilot study of an integrated model of sleep support for children: a before and after evaluation." BMJ Paediatrics Open 3, no. 1 (November 2019): e000551. http://dx.doi.org/10.1136/bmjpo-2019-000551.
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ObjectiveDespite the success of behavioural sleep support interventions in the third sector, sleep support is not universally available for families in the UK. The aim of the study was to provide evidence of efficacy and to propose a delivery model for integrated sleep support for families of vulnerable children.Design and settingA sleep support intervention was carried out in Sheffield Local Authority evaluated using a preintervention and postintervention study design by Sheffield Children’s National Health Service (NHS) Trust.ParticipantsFifty-six children aged 6–16 years with significant sleep problems were recruited; 39 completed the intervention and evaluation.InterventionsBasic sleep education and an individualised programme was delivered by a sleep practitioner. Follow-on telephone support was provided to empower the parent (and/or young person) to carry out the sleep programme at home. An integrated NHS and Local Authority delivery model was designed and implemented.ResultsParents’ ratings of their child’s ability to self-settle improved from 1.1/10 to 6.4/10 (p<0.05). Mean Warwick-Edinburgh Mental Well-being Scale scores improved significantly for parents/carers (MD 5.16, 95%CIs 2.62 to 7.69, p<0.05). Children who completed the intervention gained on average an extra 2.4 hours sleep a night. There was reduction in healthcare utilisation, illnesses and medication use.ConclusionsThe behavioural approach to sleep support for these vulnerable groups of children is highly effective. Follow-on individual support to empower parents is key to achieving success. Sleep support can be implemented in NHS and Local Authority services by integration into the existing workforce using a cross-agency model.
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Manea, Vlad, and Katarzyna Wac. "Co-Calibrating Physical and Psychological Outcomes and Consumer Wearable Activity Outcomes in Older Adults: An Evaluation of the coQoL Method." Journal of Personalized Medicine 10, no. 4 (October 31, 2020): 203. http://dx.doi.org/10.3390/jpm10040203.
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Inactivity, lack of sleep, and poor nutrition predispose individuals to health risks. Patient-Reported Outcomes (PROs) assess physical behaviours and psychological states but are subject of self-reporting biases. Conversely, wearables are an increasingly accurate source of behavioural Technology-Reported Outcomes (TechROs). However, the extent to which PROs and TechROs provide convergent information is unknown. We propose the coQoL PRO-TechRO co-calibration method and report its feasibility, reliability, and human factors influencing data quality. Thirty-nine seniors provided 7.4 ± 4.4 PROs for physical activity (IPAQ), social support (MSPSS), anxiety/depression (GADS), nutrition (PREDIMED, SelfMNA), memory (MFE), sleep (PSQI), Quality of Life (EQ-5D-3L), and 295 ± 238 days of TechROs (Fitbit Charge 2) along two years. We co-calibrated PROs and TechROs by Spearman rank and reported human factors guiding coQoL use. We report high PRO—TechRO correlations (rS ≥ 0.8) for physical activity (moderate domestic activity—light+fair active duration), social support (family help—fair activity), anxiety/depression (numeric score—sleep duration), or sleep (duration to sleep—sleep duration) at various durations (7–120 days). coQoL feasibly co-calibrates constructs within physical behaviours and psychological states in seniors. Our results can inform designs of longitudinal observations and, whenever appropriate, personalized behavioural interventions.
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Chawla, Jasneek K., Anne Bernard, Helen Heussler, and Scott Burgess. "Sleep, Function, Behaviour and Cognition in a Cohort of Children with Down Syndrome." Brain Sciences 11, no. 10 (October 4, 2021): 1317. http://dx.doi.org/10.3390/brainsci11101317.
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Objective: To describe the sleep problems experienced by children with Down syndrome attending a tertiary sleep clinic and relationship with behaviour, function and cognition. Methods: Data were collected from children with Down syndrome aged 3–18 years old. Carers completed the Abbreviated Child Sleep Habits Questionnaire, Child Behaviour Checklist and Life-Habits Questionnaire at enrolment. Cognitive assessment (Stanford-Binet 5) was undertaken by a trained psychologist. Children received management for their sleep problem as clinically indicated. Results: Forty-two subjects with a median age of 6.8 years (Interquartile Range-IQR 4.5, 9.8) were enrolled. A total of 92% were referred with snoring or symptoms of Obstructive Sleep Apnoea (OSA), with 79% of those referred having had previous ENT surgery. Thus, 85% of all participants underwent a sleep study and 61% were diagnosed with OSA (OAHI ≥ 1/h). Based on questionnaires, 86% of respondents indicated that their child had a significant sleep disorder and non-respiratory sleep problems were common. Non-respiratory problems included: trouble going to sleep independently (45%), restless sleep (76%), night-time waking (24%) and bedtime resistance (22%). No significant correlations were found between sleep measures (behavioural and medical sleep problems) and the behavioural, functional or cognitive parameters. Conclusion: Sleep disorders were very common, especially non-respiratory sleep problems. OSA was common despite previous surgery. No association was found between sleep-related problems (snoring, sleep-study-confirmed OSA or non-respiratory sleep problem) and parent-reported behavioural problems, functional impairments or intellectual performance. This may reflect limitations of the measures used in this study, that in this population ongoing problems with daytime function are not sleep related or that a cross-sectional assessment does not adequately take into account the impacts of past disease/treatments. Further research is required to further evaluate the tools used to evaluate sleep disorders, the impact of those disorder on children with Down syndrome and interventions which improve both sleep and daytime function.
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Rapaport, Penny, Lucy Webster, Rossana Horsley, Simon D. Kyle, Kirsi M. Kinnunen, Brendan Hallam, James Pickett, Claudia Cooper, Colin A. Espie, and Gill Livingston. "An intervention to improve sleep for people living with dementia: Reflections on the development and co-production of DREAMS:START (Dementia RElAted Manual for Sleep: STrAtegies for RelaTives)." Dementia 17, no. 8 (October 29, 2018): 976–89. http://dx.doi.org/10.1177/1471301218789559.
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Many people living with dementia experience sleep disturbances yet there are currently no known effective, safe and acceptable treatments. Working with those affected by dementia to co-produce interventions is increasingly promoted to ensure that approaches are fit for purpose and meet the specific needs of target groups. Our aim here is to outline and reflect upon the co-production of Dementia RElAted Manual for Sleep; STrAtegies for RelaTives (DREAMS:START), an intervention to improve sleep for people living with dementia. Our co-production team brought together experts in the development and testing of manualised interventions in dementia care and cognitive behavioural interventions for sleep disorders, with Alzheimer’s Society research network volunteers (ASRNVs) whose lives had been affected by dementia. Here we present the process of intervention development. We worked with (ASRNVs) at each stage of the process bringing together ‘experts by training’ and ‘experts by experience’. (ASRNVs)shared their experiences of sleep disturbances in dementia and how they had managed these difficulties, as well as suggestions for how to overcome barriers to putting the intervention into practice; making (DREAMS:START) more accessible and usable for those in need. In this paper we discuss both the benefits and challenges to this process and what we can learn for future work. Collaborating with ‘experts by experience’ caring for a relative with sleep difficulties helped us to develop a complex intervention in an accessible and engaging way which we have tested and found to be feasible and acceptable in a randomised controlled trial.
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Semsarian, C., G. Rigney, P. Cistulli, and Y. Bin. "P131 The impact of an online sleep education program on university students’ sleep knowledge, attitudes, and behaviours." SLEEP Advances 2, Supplement_1 (October 1, 2021): A64. http://dx.doi.org/10.1093/sleepadvances/zpab014.172.
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Abstract Introduction Sleep is essential for optimising health and academic performance, yet university students consistently report poor sleep quality. We conducted a before-and-after study to determine if an interactive, online sleep course improved sleep (1) knowledge, (2) attitudes, and (3) behaviours among university students. Methods Undergraduate students completed the course from August-November 2020. The course involved activities that encouraged students to reflect on their own sleep behaviours and goals. Baseline data was collected through course surveys and students were invited to complete a 6-month follow-up survey via email. Results N=212 students completed the baseline questionnaires and n=75 (35%) completed the follow-up survey. Students retained at follow-up possessed higher baseline sleep knowledge and received higher grades. At 6-months follow-up, sleep knowledge increased from baseline (mean quiz score: 60 vs 84%, p<0.001). 85% of students aimed to increase their sleep knowledge at baseline and 91% reported that they were more knowledgeable at follow-up. 83% of students aimed to improve their sleep at baseline and 37% reported improvement at follow-up. 53% of students’ attitudes towards their sleep behaviours had changed from baseline. There was reduction in sleep latency (mean 33.3 vs 25.6min, p=0.015), but no change in total Pittsburgh Sleep Quality Index score at follow-up. Discussion Completion of an interactive sleep education course led to increased sleep knowledge and changes in sleep attitudes, with no meaningful change in sleep behaviours. Future interventions require careful design and evaluation, and should consider components of behavioural change (e.g. motivation, triggers) that go beyond the knowledge-attitudes-behaviour continuum.
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Olsen, Anna, and Georgina Charlesworth. "Obstructive Sleep Apnoea (OSA) as a potentially modifiable risk factor for Mild Cognitive Impairment (MCI): A role for old age psychology?" FPOP Bulletin: Psychology of Older People 1, no. 161 (February 2023): 17–23. http://dx.doi.org/10.53841/bpsfpop.2023.1.161.17.
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It is estimated that just under a third of people with mild cognitive impairment (MCI) also have obstructive sleep apnoea (OSA; a form of sleep disordered breathing distinguished by repeated upper airway collapse during sleep), and disordered sleep is a potential risk factor for dementia. In this paper, we consider the potential role for the old age psychologist in (1) identifying OSA for onward referral and treatment, (2) assessing neurocognitive profiles in people with comorbid OSA and cognitive decline, (3) providing behavioural interventions to improve OSA treatment adherence, and (4) providing health psychology (lifestyle change) interventions relevant to both MCI and OSA.
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Hill, Vanessa, Sally Ferguson, Amanda Rebar, Alexandra Shriane, and Grace Vincent. "0002 Go to bed! A systematic review and meta-analysis of bedtime procrastination determinants and sleep outcomes." Sleep 45, Supplement_1 (May 25, 2022): A1. http://dx.doi.org/10.1093/sleep/zsac079.001.
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Abstract Introduction Bedtime procrastination, the volitional delay of going to bed without any external circumstances causing the delay, is associated with poor sleep outcomes. Alleviating bedtime procrastination is an important target for interventions to promote adequate sleep, yet the social cognitive, biological, and behavioural determinants of bedtime procrastination are poorly understood. The present study aimed to conduct a systematic review, narrative synthesis, and meta-analysis of (1) the underlying determinants of bedtime procrastination, and (2) the strength and direction of the relationship between bedtime procrastination and sleep outcomes. Methods A database search was conducted through CINAHL, EMBASE, PsychINFO, PubMed, Scopus and Web of Science, using keywords related to procrastination, delay, bedtime and sleep. Results A total of 2087 records were identified, and 38 publications met the inclusion criteria. Random-effects meta-analysis for bedtime procrastination and sleep outcomes is ongoing. Preliminary findings suggest self-regulation, self-control and chronotype are the most prominent determinants. Conclusion Future research should expand focus to identify a broader range of determinants. Given that there are multiple benefits to a theory-based approach to behaviour change interventions, further research exploring determinants will be able to guide the development of interventions targeting bedtime procrastination. Support (If Any):
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Partonen, T. "Review: cognitive behavioural interventions improve some sleep outcomes in older adults." Evidence-Based Mental Health 5, no. 4 (November 1, 2002): 118. http://dx.doi.org/10.1136/ebmh.5.4.118.
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Waite, Felicity, Elissa Myers, Allison G. Harvey, Colin A. Espie, Helen Startup, Bryony Sheaves, and Daniel Freeman. "Treating Sleep Problems in Patients with Schizophrenia." Behavioural and Cognitive Psychotherapy 44, no. 3 (July 30, 2015): 273–87. http://dx.doi.org/10.1017/s1352465815000430.
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Background: Sleep disturbance is increasingly recognized as a major problem for patients with schizophrenia but it is rarely the direct focus of treatment. The main recommended treatment for insomnia is cognitive behavioural therapy, which we have been evaluating for patients with current delusions and hallucinations in the context of non-affective psychosis. Aims: In this article we describe the lessons we have learned about clinical presentations of sleep problems in schizophrenia and the adaptations to intervention that we recommend for patients with current delusions and hallucinations. Method: Twelve factors that may particularly contribute to sleep problems in schizophrenia are identified. These include delusions and hallucinations interfering with sleep, attempts to use sleep as an escape from voices, circadian rhythm disruption, insufficient daytime activity, and fear of the bed, based upon past adverse experiences. Specific adaptations for psychological treatment related to each factor are described. Conclusions: Our experience is that patients want help to improve their sleep; sleep problems in schizophrenia should be treated with evidence-based interventions, and that the interventions may have the added benefit of lessening the psychotic experiences. A treatment technique hierarchy is proposed for ease of translation to clinical practice.
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Blunden, S., and J. Osborne. "P012 Maternal and infant stress during a bedtime separation: a pilot RCT." SLEEP Advances 2, Supplement_1 (October 1, 2021): A25. http://dx.doi.org/10.1093/sleepadvances/zpab014.060.
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Abstract Background Behavioural sleep interventions to improve infant sleep disturbance commonly include extinction where an unwanted behaviour (night time crying) is periodically ignored. There have been conflicting findings regarding the impact of extinction methods on infant stress levels as measured with cortisol and as perceived by mothers and only one that measured cortisol at the time of the separation. This study aimed to compare a responsive method to extinction (controlled crying) and a control group evaluating subjective and objective stress for mother/infant dyads at the time of bedtime separation. Methods Mother/infant dyads were randomly allocated to behavioural sleep interventions (Responsive - n= 7, Controlled Crying - n=6 or Controls - n=4). Cortisol (two oral swabs on two nights at T2), maternal self-reported stress (Subjective Units of Distress - SUDS), and perceived infant distress (PIS) were compared over eight weeks. Correlations tested relationships between PIS, SUDS and infant cortisol levels. Mixed models analysis were used for cortisol analyses. Results There were no significant differences in cortisol levels between groups across time points but significant inter and intra-individual variability. Maternal stress was positively correlated with infant cortisol and PIS (p<0.05) and mothers in the Responsive group were significantly less stressed (p=0.02). Conclusion In this small sample, infant cortisol during bedtime separation was variable, elevated in all sleep interventions and not significantly different. Mothers were less stressed in the Responsive group. Findings indicate responsive methods are comparable to extinction and less stressful for mothers offering a possible gentler choice at bedtime separation.
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Prins, Angela Joanna, Erik J. Anton Scherder, Annemieke van Straten, Yvonne Zwaagstra, and Maarten Valentijn Milders. "Sensory Stimulation for Nursing-Home Residents: Systematic Review and Meta-Analysis of Its Effects on Sleep Quality and Rest-Activity Rhythm in Dementia." Dementia and Geriatric Cognitive Disorders 49, no. 3 (2020): 219–34. http://dx.doi.org/10.1159/000509433.
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<b><i>Introduction:</i></b> Disrupted sleep-wake cycles might be associated with an exacerbation of behavioural disturbances and accelerate disease progression in dementia. The effect of sensory stimulation for improving sleep quality is unclear. <b><i>Methods:</i></b> A systematic literature search was performed and all studies examining the effects of a sensory stimulation intervention (i.e. bright light, massage, acupuncture, animal-assisted interventions) on rest-activity rhythm (RAR) and/or nocturnal restlessness in nursing-home residents with dementia were included. <b><i>Results:</i></b> Sensory stimulation was shown to improve nocturnal behavioural restlessness as well as sleep duration and continuation, but the effect on the number of awakenings, RAR, and daytime sleep was negligible. Notable was the high heterogeneity between studies regarding treatments and patients’ characteristics and sleep parameters. <b><i>Conclusion:</i></b> Sleep quality and nocturnal restlessness in nursing-home residents with dementia may benefit from sensory stimulation. An environment with sensory stimulation may prevent or improve sleep disturbances in nursing homes, and thereby contribute to a better quality of life for their patients.
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Soreq, Eyal, Magdalena Kolanko, Kiran Kumar Guruswamy Ravindran, Ciro Della Monica, Victoria Revell, Helen Lai, Payam Barnaghi, Paresh Malhotra, Deerk-Jan Dijk, and David Sharp. "042 Longitudinal assessment of sleep/wake behaviour in dementia patients living at home." Journal of Neurology, Neurosurgery & Psychiatry 93, no. 9 (August 12, 2022): e2.237. http://dx.doi.org/10.1136/jnnp-2022-abn2.86.
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IntroductionDisturbances of sleep/wake behaviour are amongst the most disabling symptoms of dementia, leading to increased carers’ burden and institutionalisation. The lack of unobtrusive, low- burden technologies validated to monitor sleep in patients living with dementia (PLWD) has prevented longitudinal studies of nocturnal disturbances and their correlates.AimsTo examine the effect of medication changes and clinical status on the intraindividual variation in sleep/wake behaviour in PLWD.MethodsUsing under-mattress pressure-sensing mat in 46 PLWD, we monitored sleep/wake behavioural metrics for 13,711 nights between 2019-2021. Machine learning and >3.6million nightly summaries from 13,671 individuals from the general population were used to detect abnormalities in PLWD’s nightly sleep/wake metrics and convert them to risk scores. Additionally, GP records were reviewed for each patient to determine whether medication changes and clinical events affected sleep parameters.ResultsPLWD’s went to bed earlier and rose later than sex- and age-matched controls. They had more nocturnal awakenings with longer out-of-bed durations. Notably, at the individual patient level, increased metric-specific risk scores were temporally related to changes in antipsychotics and antidepressants, and acute illness, including UTI, cardiac events, and depressive episodes.ConclusionsPassive monitoring of sleep/wake behaviours is a promising way to identify novel markers of disease progression and evaluate the effectiveness of pharmaceutical interventions in patients with dementia.
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Conway-Jones, Rebecca, Ella Dunlop, Simon Kyle, David Ray, Nia Roberts, and Andrew Farmer. "A scoping review of the evidence for the impact of pharmacological and non-pharmacological interventions on shift work related sleep disturbance in an occupational setting." Wellcome Open Research 6 (August 3, 2021): 198. http://dx.doi.org/10.12688/wellcomeopenres.17002.1.
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Background: Shift work is essential in society but can be detrimental to health and quality of life and is associated with decreased productivity and increased risk of accidents. Interventions to reduce these consequences are needed, but the extent and range of trial evidence for interventions for those most affected by their shift-work schedules is unclear. We therefore carried out a scoping review to assess the availability of evidence to inform the development and evaluation of future interventions. Methods: We aimed to identify clinical trials of any intervention for shift work-related sleep disturbance that included a comparator group, where the intervention was delivered in an occupational setting. We searched Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, CINAHL, EMBASE, Medline and Science Citation Index from inception to 30th March 2020 for relevant citations. Citations were screened by two independent reviewers, a third reviewer resolved disagreements. Data were extracted by two independent reviewers. Results: From 1250 unique citations, 14 studies met inclusion criteria for comparative trials of treatment in an occupational setting. There were five trials of hypnotics, five trials of stimulants, and four trials of non-pharmacological therapies (cognitive behavioural therapy, light therapy, aromatherapy and herbal medicine). Outcomes included sleep parameters, day-time sleepiness, and quality of life. There were no consistently reported outcomes across trials. Conclusions: Interventions fell into three distinct groups investigated in distinct time periods without progression from efficacy trials to wider-scale interventions. The lack of consistent patient-reported outcome measures limits synthesising findings. Some trials focussed on optimising sleep, others on reducing wake-time sleepiness. Adequately powered trials of existing interventions are needed, with the development and testing of novel combination treatments in patients with well-defined shift work sleep disorder. A core set of clinically relevant outcomes will develop and standardise the evidence-base for shift work sleep disorder.
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Conway-Jones, Rebecca, Ella Dunlop, Simon Kyle, David Ray, Nia Roberts, and Andrew Farmer. "A scoping review of the evidence for the impact of pharmacological and non-pharmacological interventions on shift work related sleep disturbance in an occupational setting." Wellcome Open Research 6 (January 6, 2023): 198. http://dx.doi.org/10.12688/wellcomeopenres.17002.2.
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Background: Shift work is essential in society but can be detrimental to health and quality of life and is associated with decreased productivity and increased risk of accidents. Interventions to reduce these consequences are needed, but the extent and range of trial evidence for interventions for those most affected by their shift-work schedules is unclear. We therefore carried out a scoping review to assess the availability of evidence to inform the development and evaluation of future interventions. Methods: We aimed to identify clinical trials of any intervention for shift work-related sleep disturbance that included a comparator group, where the intervention was delivered in an occupational setting. We searched Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, CINAHL, EMBASE, Medline and Science Citation Index from inception to 30th March 2020 for relevant citations. Citations were screened by two independent reviewers, a third reviewer resolved disagreements. Data were extracted by two independent reviewers. Results: From 1250 unique citations, 14 studies met inclusion criteria for comparative trials of treatment in an occupational setting. There were five trials of hypnotics, five trials of stimulants, and four trials of non-pharmacological therapies (cognitive behavioural therapy, light therapy, aromatherapy and herbal medicine). Outcomes included sleep parameters, day-time sleepiness, and quality of life. There were no consistently reported outcomes across trials. Conclusions: Interventions fell into three distinct groups investigated in distinct time periods without progression from efficacy trials to wider-scale interventions. The lack of consistent patient-reported outcome measures limits synthesising findings. Some trials focussed on optimising sleep, others on reducing wake-time sleepiness. Adequately powered trials of existing interventions are needed, with the development and testing of novel combination treatments in patients with well-defined shift work sleep disorder. A core set of clinically relevant outcomes will develop and standardise the evidence-base for shift work sleep disorder.
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Verma, S., N. Quin, L. Astbury, C. Wellecke, J. Wiley, M. Davey, S. Rajaratnam, and B. Bei. "O005 Cognitive behavioural therapy and light dark therapy for postpartum insomnia symptoms: a randomised controlled trial." SLEEP Advances 2, Supplement_1 (October 1, 2021): A2—A3. http://dx.doi.org/10.1093/sleepadvances/zpab014.004.
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Abstract Introduction Symptoms of postpartum insomnia are common however interventions remain scarce. Cognitive Behavioural Therapy (CBT) and Light Dark Therapy (LDT) target distinct mechanisms to improve sleep. This randomised controlled superiority trial compared CBT and LDT against treatment-as-usual (TAU) in reducing maternal postpartum insomnia symptoms. Methods Nulliparous females 4–12 months postpartum with self-reported symptoms of insomnia (Insomnia Severity Index scores >7) were included; excluded were those at risk or with high medical/psychiatric needs. Eligible participants were randomised 1:1:1 to 6 weeks of CBT, LDT (gaining light upon awakening, night-time light avoidance) or TAU. Interventions were therapist-assisted through two telephone calls and included automated self-help emails over six weeks. Symptoms of insomnia (ISI; primary outcome), sleep disturbance, fatigue, sleepiness, depression, and anxiety were assessed at baseline, mid-intervention, post-intervention, and 1-month post-intervention. Latent growth models were used. Results 114 participants (mean age=32.2±4.6 years) were randomised. There were significantly greater reductions in insomnia and sleep disturbance in both intervention groups with very large effect sizes (d>1·4, p<0·0001) from baseline to post-intervention compared to TAU; improvements were maintained at one-month follow-up. There were greater reductions in fatigue symptoms in the CBT group (d=0.85, p<.0001) but not LDT (p=0.11) compared to TAU; gains were maintained for CBT at follow-up. Changes in sleepiness, depression and anxiety over time were non-significant compared to TAU (p-values>0.08). Conclusion Therapist-assisted CBT and LDT are both efficacious for reducing postpartum insomnia symptoms. Findings were mixed for fatigue, sleepiness and mood. Future research is needed on predictors of treatment response.
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Owens, Laurence J., Karyn G. France, and Luci Wiggs. "REVIEW ARTICLE: Behavioural and cognitive-behavioural interventions for sleep disorders in infants and children: A review." Sleep Medicine Reviews 3, no. 4 (December 1999): 281–302. http://dx.doi.org/10.1053/smrv.1999.0082.
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Preyde, Michèle, Shrenik Parekh, Nicole Karki-Niejadlik, Lynn Vanderbrug, Graham Ashbourne, Karen MacLeod, and John Heintzman. "Calling on All Child and Family Practitioners to Help Mitigate the Impacts of the Poor Behavioural Health of Children with Psychiatric Illness." Adolescents 2, no. 4 (December 16, 2022): 508–13. http://dx.doi.org/10.3390/adolescents2040040.
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Adolescents and children (aged 6 to 17+ years) admitted to inpatient psychiatry or intensive out-of-home mental health programs (formerly called residential mental health treatment centres) are among those with the most severe psychiatric illnesses. Moreover, these children also have very poor behavioural and biopsychosocial health including sleep deprivation, difficult relationships, problematic use of electronic devices, academic difficulty, poor school engagement, insufficient exercise and poor diets; all of these were noted before the pandemic. The pandemic has only increased the social isolation, poor health behaviours and mental health challenges for many children and adolescents. The poor behavioural and psychosocial health of those in their youth with psychiatric illnesses can exacerbate symptoms and can interfere with academic performance, development and good decision making; these biopsychosocial health behaviours are modifiable. All child and family practitioners including pediatricians, family physicians, nurses, social workers, psychologists and psychotherapists have an important role in fostering the behavioural and biopsychosocial health (i.e., sleep, positive relationships, electronic device use, exercise and diet) of all family members and especially children with psychiatric illness. Enacting biopsychosocial lifestyle interventions before or during childhood and adolescence may reduce the burden of mental illness.
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Al-Najjar, Nadia, Lucy Bray, Bernie Carter, Advisory Panel CASTLE, Amber Collingwood, Georgia Cook, Holly Crudgington, et al. "Changing Agendas on Sleep, Treatment and Learning in Epilepsy (CASTLE) Sleep-E: a protocol for a randomised controlled trial comparing an online behavioural sleep intervention with standard care in children with Rolandic epilepsy." BMJ Open 13, no. 3 (March 2023): e065769. http://dx.doi.org/10.1136/bmjopen-2022-065769.
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IntroductionSleep and epilepsy have an established bidirectional relationship yet only one randomised controlled clinical trial has assessed the effectiveness of behavioural sleep interventions for children with epilepsy. The intervention was successful, but was delivered via face-to-face educational sessions with parents, which are costly and non-scalable to population level. The Changing Agendas on Sleep, Treatment and Learning in Epilepsy (CASTLE) Sleep-E trial addresses this problem by comparing clinical and cost-effectiveness in children with Rolandic epilepsy between standard care (SC) and SC augmented with a novel, tailored parent-led CASTLE Online Sleep Intervention (COSI) that incorporates evidence-based behavioural components.Methods and analysesCASTLE Sleep-E is a UK-based, multicentre, open-label, active concurrent control, randomised, parallel-group, pragmatic superiority trial. A total of 110 children with Rolandic epilepsy will be recruited in outpatient clinics and allocated 1:1 to SC or SC augmented with COSI (SC+COSI). Primary clinical outcome is parent-reported sleep problem score (Children’s Sleep Habits Questionnaire). Primary health economic outcome is the incremental cost-effectiveness ratio (National Health Service and Personal Social Services perspective, Child Health Utility 9D Instrument). Parents and children (≥7 years) can opt into qualitative interviews and activities to share their experiences and perceptions of trial participation and managing sleep with Rolandic epilepsy.Ethics and disseminationThe CASTLE Sleep-E protocol was approved by the Health Research Authority East Midlands (HRA)–Nottingham 1 Research Ethics Committee (reference: 21/EM/0205). Trial results will be disseminated to scientific audiences, families, professional groups, managers, commissioners and policymakers. Pseudo-anonymised individual patient data will be made available after dissemination on reasonable request.Trial registration numberISRCTN13202325.
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Pizova, N. V. "Insomnia: definition, prevalence, health risks and therapy approaches." Meditsinskiy sovet = Medical Council, no. 3 (April 11, 2023): 85–91. http://dx.doi.org/10.21518/ms2023-034.
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Insomnia is a common disorder among the general population, which has a chronic course and a heavy burden on patients and the health care system. Epidemiological papers on sleep disorders show that a large number of people complain of sleep disorders. Today, there are several classifications and definitions for sleep disorders, and first of all for insomnia. Insufficient sleep can contribute to the occurrence of rapid fatigue during the daytime, reduced activity, attention and efficiency. Studies have shown that long-term and severe sleep disorders can lead to and/or exacerbate various somatic, neurological and mental diseases. Insomnia can contribute to cognitive impairment. Although both non-pharmacological and pharmacological interventions are available, drugs are more often prescribed due to greater availability. Cognitive behavioural therapy for insomnia is recommended as the first line treatment for adults of any age. Pharmacological intervention may be offered, if cognitive behavioural therapy for insomnia is not enough effective or not available. At the same time, the pharmacotherapy for sleep disorders remains problematic despite a large number of sleeping pills. Sleeping agents that are widely used in medical practice both in terms of their mechanisms of action and final results such as their effect on sleep do not always contribute to the development of natural (or at least close to physiological) sleep. Benzodiazepines, benzodiazepine receptor agonists, antidepressants, antihistamines, antipsychotics, melatonin, and phytotherapeutic medicines can be used to treat insomnia.
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Gosling, John A., Phil Batterham, Lee Ritterband, Nick Glozier, Frances Thorndike, Kathleen M. Griffiths, Andrew Mackinnon, and Helen M. Christensen. "Online insomnia treatment and the reduction of anxiety symptoms as a secondary outcome in a randomised controlled trial: The role of cognitive-behavioural factors." Australian & New Zealand Journal of Psychiatry 52, no. 12 (May 2, 2018): 1183–93. http://dx.doi.org/10.1177/0004867418772338.
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Objective: Insomnia and anxiety commonly co-occur, yet the mechanisms underlying this remain unclear. The current paper describes the impact of an Internet-based intervention for insomnia on anxiety, and explores the influence of two cognitive-behavioural constructs – dysfunctional beliefs about sleep and sleep-threat monitoring. Methods: A large-scale, 9-week, two-arm randomised controlled trial ( N = 1149) of community-dwelling Australian adults with insomnia and elevated yet subclinical depression symptoms was conducted, comparing a cognitive behavioural therapy–based online intervention for insomnia (Sleep Healthy Using The Internet) with an attention-matched online control intervention (HealthWatch). Symptoms of anxiety were assessed at pretest, posttest, and 6-month follow-up. Dysfunctional beliefs about sleep and sleep threat monitoring were assessed only at pretest. Results: Sleep Healthy Using The Internet led to a greater reduction in anxiety symptoms at both posttest ( t724.27 = –6.77, p < 0.001) and at 6-month follow-up ( t700.67 = –4.27, p < 0.001) than HealthWatch. At posttest and follow-up, this effect was found to moderated by sleep-threat monitoring ( t713.69 = –2.39, p < 0.05 and t694.77 = –2.98, p < 0.01 respectively) but not by dysfunctional beliefs about sleep at either posttest or follow-up ( t717.53 = –0.61, p = 0.55 and t683.79 = 0.22, p = 0.83 respectively). Participants in the Sleep Healthy Using The Internet condition with higher levels of sleep-threat monitoring showed a greater reduction in anxiety than those with lower levels from pretest to posttest, ( t724.27 = –6.77, p < 0.001) and through to 6-month follow-up ( t700.67 = –4.27, p < 0.001). This result remained after controlling for baseline anxiety levels. Conclusion: The findings suggest that online cognitive behavioral therapy interventions for insomnia are beneficial for reducing anxiety regardless of people’s beliefs about their sleep and insomnia, and this is particularly the case for those with high sleep-threat monitoring. This study also provides further evidence for cognitive models of insomnia.
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Gomes, Ana Allen. "A Course on Cognitive and Behavioural Interventions for Sleep Disorders within a Master Degree Programme in Clinical and Health Psychology." Psychologica 63, no. 2 (December 28, 2020): 159–77. http://dx.doi.org/10.14195/1647-8606_63-2_8.
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Given the prevalence of sleep disorders, the efficacy and effectiveness of behavioural/cognitive interventions, mainly CBT for insomnia, we consider that a course on the topic should be introduced within the psychology master degree programmes. Since 2017/18 we are offering the optional course: Psychological Interventions on Sleep Disorders. The present work summarizes the course syllabus and analyses the students' perceptions regarding the first three editions. One hundred and twenty psychology master degree students have voluntarily registered at the course. End-of-semester online institutional anonymous questionnaires were voluntarily completed. Participants were asked to rate the course in a variety of parameters using a 5-point scale (1=minimum; 5=maximum). Ninety questionnaires were completed. Mean scores on each item (addressing: bibliography/other learning materials; quality of learnings; learning results; non-redundancy concerning other courses; theoretical-practical articulation; students’ active participation in the learning processes; development of analytical and critical reflection/thinking skills; overall self-assessment) ranged between 4.23 and 4.46, items’ mean score = 4.35. Students' perceptions on the first three semesters of the course were clearly encouraging. By offering a course on behavioural interventions for sleep disorders at master degree level, we hope to contribute to increase its delivery in health contexts in the near future.
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Knudsen, Ann Kristin, Max Henderson, Samuel B. Harvey, and Trudie Chalder. "Long-term sickness absence among patients with chronic fatigue syndrome." British Journal of Psychiatry 199, no. 5 (November 2011): 430–31. http://dx.doi.org/10.1192/bjp.bp.110.082974.
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SummaryChronic fatigue syndrome is associated with high levels of occupational disability. Consecutive out-patients at a chronic fatigue syndrome treatment service were studied for associations between occupational status, symptom severity and cognitive and behavioural responses to symptoms. All patients had high symptom levels; however, those on long-term sickness absence had significantly more physical fatigue (β = 0.098, P<0.05) and worse sleep (β = 0.075, P<0.05). Patients with long-term sickness absence also demonstrated more embarrassment avoidance cognitions (β = 0.086, P<0.05) and avoidance resting behavioural responses (β = 0.078, P<0.05). Identifying and addressing avoidance behaviours and cognitions regarding embarrassment in interventions may enhance the chances of individuals returning to work.
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Coe, S., M. Franssen, J. Collett, D. Boyle, A. Meaney, R. Chantry, P. Esser, H. Izadi, and H. Dawes. "Physical Activity, Fatigue, and Sleep in People with Parkinson’s Disease: A Secondary per Protocol Analysis from an Intervention Trial." Parkinson's Disease 2018 (September 6, 2018): 1–6. http://dx.doi.org/10.1155/2018/1517807.
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Symptoms of Parkinson’s can result in low physical activity and poor sleep patterns which can have a detrimental effect on a person’s quality of life. To date, studies looking into exercise interventions for people with Parkinson’s (PwP) for symptom management are promising but inconclusive. The aim of this study is to estimate the effect of a clearly defined exercise prescription on general physical activity levels, fatigue, sleep, and quality of life in PwP. Method. PwP randomised into either an exercise group (29; 16 males, 13 females; mean age 67 years (7.12)) or a control handwriting group (36; 19 males; 17 females; mean age 67 years (5.88)) as part of a larger trial were included in this substudy if they had completed a 6-month weekly exercise programme (intervention group) and had complete objective physical activity data (intervention and control group). Sleep and fatigue were recorded from self-reported measures, and physical activity levels measured through the use of accelerometers worn 24 hours/day over a seven-day testing period at baseline and following the 24-week intervention. A Wilcoxon’s test followed by a Mann–Whitney post hoc analysis was used, and effect sizes were calculated. Results. Participants showed a significant increase in time spent in sedentary and light activities during the overnight period postintervention in both exercise and handwriting groups (p<0.05) with a moderate effect found for the change in sedentary and light activities in the overnight hours for both groups, over time (0.32 and 0.37-0.38, resp.). There was no impact on self-reported fatigue or sleep. Conclusion. The observed moderate effect on sedentary and light activities overnight could suggest an objective improvement in sleep patterns for individuals participating in both exercise and handwriting interventions. This supports the need for further studies to investigate the role of behavioural interventions for nonmotor symptoms.
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Glozier, Nick, Helen Christensen, Kathleen M. Griffiths, Ian B. Hickie, Sharon L. Naismith, Daniel Biddle, Simon Overland, Frances Thorndike, and Lee Ritterband. "Adjunctive Internet-delivered cognitive behavioural therapy for insomnia in men with depression: A randomised controlled trial." Australian & New Zealand Journal of Psychiatry 53, no. 4 (September 7, 2018): 350–60. http://dx.doi.org/10.1177/0004867418797432.
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Objective: Internet-delivered cognitive behavioural therapy for insomnia is efficacious for insomnia, and post hoc analyses suggest mood improvements. We undertook the first clinical trial evaluating the efficacy of Internet-delivered cognitive behavioural therapy for insomnia on depressive symptoms as an adjunct to guideline-based treatment of depressive disorders. Methods: Older men undergoing psychiatrist-coordinated treatment for major depressive disorder or dysthymia and who had significant insomnia symptoms were randomised to either adjunctive Internet-delivered cognitive behavioural therapy for insomnia (Sleep Healthy Using The Internet) or online sleep psychoeducation. The primary outcome was change in depressive symptoms (Centre for Epidemiological Studies Depression scale) from baseline to week 12 (post intervention). Secondary outcomes were insomnia and anxiety symptoms. Results: In all, 87 men were randomised (Internet-delivered cognitive behavioural therapy for insomnia = 45; psychoeducation = 42). The mean observed Centre for Epidemiological Studies Depression scale changes by week 12 were 8.2 (standard deviation = 11.5) and 3.9 (standard deviation = 12.8) for Internet-delivered cognitive behavioural therapy for insomnia and psychoeducation, respectively. The adjunctive effect size of 0.35 in favour of Sleep Healthy Using The Internet programme was not statistically significant (group × time difference in the Mixed effect Model Repeat Measurement analysis difference 4.3; 95% confidence interval = [−1.2, 9.8]; p = 0.15). There was a statistically significant effect on insomnia symptoms (group × time p = 0.02, difference 2.7; 95% confidence interval = [0.2, 5.3]; effect size = 0.62). There were no differences in insomnia or depression at 6 months or differential effects on anxiety at any time point. There were no reported adverse trial-related events in the intervention arm. Conclusion: Adjunctive Internet-delivered cognitive behavioural therapy for insomnia for older men being treated for depression can improve insomnia in the short term, without apparent harm. The short-term depressive symptom effect size in this pilot trial was comparable to other adjunctive interventions and may warrant a larger, definitive trial.
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Belmon, Laura, Vincent Busch, Maartje van Stralen, Dominique Stijnman, Lisan Hidding, Irene Harmsen, and Mai Chinapaw. "Child and Parent Perceived Determinants of Children’s Inadequate Sleep Health. A Concept Mapping Study." International Journal of Environmental Research and Public Health 17, no. 5 (February 29, 2020): 1583. http://dx.doi.org/10.3390/ijerph17051583.
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Many children do not meet the recommendations for healthy sleep, which is concerning given the potential negative effects on children’s health. To promote healthy sleep, it is crucial to understand its determinants. This concept mapping study therefore explores perspectives of children and parents on potential determinants of children’s inadequate sleep. The focus lies on 9–12 year old children (n = 45), and their parents (n = 33), from low socioeconomic neighbourhoods, as these children run a higher risk of living in a sleep-disturbing environment (e.g., worries, noise). All participants generated potential reasons (i.e., ideas) for children’s inadequate sleep. Next, participants sorted all ideas by relatedness and rated their importance. Subsequently, multidimensional scaling and hierarchical cluster analyses were performed to create clusters of ideas for children and parents separately. Children and parents both identified psychological (i.e., fear, affective state, stressful situation), social environmental (i.e., sleep schedule, family sleep habits), behavioural (i.e., screen behaviour, physical activity, diet), physical environmental (i.e., sleep environment such as temperature, noise, light), and physiological (i.e., physical well-being) determinants. These insights may be valuable for the development of future healthy sleep interventions.
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Davidson, Judith R., Ciara Dickson, and Han Han. "Cognitive behavioural treatment for insomnia in primary care: a systematic review of sleep outcomes." British Journal of General Practice 69, no. 686 (July 29, 2019): e657-e664. http://dx.doi.org/10.3399/bjgp19x705065.
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BackgroundPractice guidelines recommend that chronic insomnia be treated first with cognitive behavioural therapy for insomnia (CBT-I), and that hypnotic medication be considered only when CBT-I is unsuccessful. Although there is evidence of CBT-I’s efficacy in research studies, systematic reviews of its effects in primary care are lacking.AimTo review the effects on sleep outcomes of CBT-I delivered in primary care.Design and settingSystematic review of articles published worldwide.MethodMedline, PsycINFO, EMBASE, and CINAHL were searched for articles published from January 1987 until August 2018 that reported sleep results and on the use of CBT-I in general primary care settings. Two researchers independently assessed and then reached agreement on the included studies and the extracted data. Cohen’s d was used to measure effects on sleep diary outcomes and the Insomnia Severity Index.ResultsIn total, 13 studies were included. Medium-to-large positive effects on self-reported sleep were found for CBT-I provided over 4–6 sessions. Improvements were generally well maintained for 3–12 months post-treatment. Studies of interventions in which the format or content veered substantially from conventional CBT-I were less conclusive. In only three studies was CBT-I delivered by a GP; usually, it was provided by nurses, psychologists, nurse practitioners, social workers, or counsellors. Six studies included advice on withdrawal from hypnotics.ConclusionThe findings support the effectiveness of multicomponent CBT-I in general primary care. Future studies should use standard sleep measures, examine daytime symptoms, and investigate the impact of hypnotic tapering interventions delivered in conjunction with CBT-I.
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SELIM, CHERIN ABDELAAL, KARYN G. FRANCE, NEVILLE M. BLAMPIED, and KATHLEEN A. LIBERTY. "Treating treatment-resistant infant sleep disturbance with combination pharmacotherapy and behavioural family interventions." Australian Psychologist 41, no. 3 (November 2006): 193–204. http://dx.doi.org/10.1080/00050060500545044.
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Edney, Sarah Martine, Su Hyun Park, Linda Tan, Xin Hui Chua, Borame Sue Lee Dickens, Salome A. Rebello, Nick Petrunoff, et al. "Advancing understanding of dietary and movement behaviours in an Asian population through real-time monitoring: Protocol of the Continuous Observations of Behavioural Risk Factors in Asia study (COBRA)." DIGITAL HEALTH 8 (January 2022): 205520762211105. http://dx.doi.org/10.1177/20552076221110534.
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Background Modifiable risk factors for non-communicable diseases, including eating an unhealthy diet and being physically inactive, are influenced by complex and dynamic interactions between people and their social and physical environment. Therefore, understanding patterns and determinants of these risk factors as they occur in real life is essential to enable the design of precision public health interventions. Objective This paper describes the protocol for the Continuous Observations of Behavioural Risk Factors in Asia study (COBRA). The study uses real-time data capture methods to gain a comprehensive understanding of eating and movement behaviours, including how these differ by socio-demographic characteristics and are shaped by people's interaction with their social and physical environment. Methods COBRA is an observational study in free-living conditions. We will recruit 1500 adults aged 21–69 years from a large prospective cohort study. Real-time data capture methods will be used for nine consecutive days: an ecological momentary assessment app with a global positioning system enabled to collect location data, accelerometers to measure movement, and wearable sensors to monitor blood glucose levels. Participants receive six EMA surveys per day between 8 a.m. and 9.30 p.m. to capture information on behavioural risk factors including eating behaviours and diet composition movement behaviours (physical activity, sedentary behaviour, sleep), and related contextual factors. The second wave of ecological momentary assessment surveys with a global positioning system enabled will be sent 6 months later. Data will be analysed using generalised linear models to examine associations between behavioural risk factors and contextual determinants. Discussion Findings from this study will advance our understanding of dietary and movement behaviours as they occur in real-life and inform the development of personalised interventions to prevent chronic diseases.
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Fucito, Lisa M., Nancy S. Redeker, Samuel A. Ball, Benjamin A. Toll, Jolomi T. Ikomi, and Kathleen M. Carroll. "Integrating a Behavioural Sleep Intervention into Smoking Cessation Treatment for Smokers with Insomnia: A Randomised Pilot Study." Journal of Smoking Cessation 9, no. 1 (August 16, 2013): 31–38. http://dx.doi.org/10.1017/jsc.2013.19.
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Introduction: Sleep disturbance is common among cigarette smokers and predicts smoking cessation failure. Aims: The purpose of this study was to conduct a pilot test of whether provision of a sleep intervention might bolster smoking cessation outcomes among this vulnerable group. Methods: Smokers with insomnia (N = 19) seeking smoking cessation treatment were randomly assigned to receive 8 sessions over 10 weeks of either: (1) cognitive-behavioural therapy for insomnia + smoking cessation counselling (CBT-I+SC; n = 9) or (2) smoking cessation counselling alone (SC; n = 10). Counselling commenced 4 weeks prior to a scheduled quit date, and nicotine patch therapy was also provided for 6 weeks starting on the quit date. Results: There was no significant effect of counselling condition on smoking cessation outcomes. Most participants had difficulty initiating and maintaining smoking abstinence in that 7-day point prevalence abstinence rates at end of treatment (CBT-I+SC: 1/7, 14%; SC: 2/10, 20%) and follow-up (CBT-I+SC: 1/7, 14%; SC: 0/10, 0%) were low for both conditions. CBT-I+SC participants reported improvements in sleep efficiency, quality, duration and insomnia symptoms. Sleep changes were not associated with the likelihood of achieving smoking abstinence. Conclusions: This randomised pilot study suggests that behavioural interventions may improve sleep among smokers with insomnia, but a larger sample is needed to replicate this finding and evaluate whether these changes facilitate smoking cessation.
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Doherty, Madigan, Warrington, and Ellis. "Sleep and Nutrition Interactions: Implications for Athletes." Nutrients 11, no. 4 (April 11, 2019): 822. http://dx.doi.org/10.3390/nu11040822.
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This narrative review explores the relationship between sleep and nutrition. Various nutritional interventions have been shown to improve sleep including high carbohydrate, high glycaemic index evening meals, melatonin, tryptophan rich protein, tart cherry juice, kiwifruit and micronutrients. Sleep disturbances and short sleep duration are behavioural risk factors for inflammation, associated with increased risk of illness and disease, which can be modified to promote sleep health. For sleep to have a restorative effect on the body, it must be of adequate duration and quality; particularly for athletes whose physical and mental recovery needs may be greater due to the high physiological and psychological demands placed on them during training and competition. Sleep has been shown to have a restorative effect on the immune system, the endocrine system, facilitate the recovery of the nervous system and metabolic cost of the waking state and has an integral role in learning, memory and synaptic plasticity, all of which can impact both athletic recovery and performance. Functional food-based interventions designed to enhance sleep quality and quantity or promote general health, sleep health, training adaptations and/or recovery warrant further investigation.
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Crowther, Meagan E., Sally A. Ferguson, Grace E. Vincent, and Amy C. Reynolds. "Non-Pharmacological Interventions to Improve Chronic Disease Risk Factors and Sleep in Shift Workers: A Systematic Review and Meta-Analysis." Clocks & Sleep 3, no. 1 (January 28, 2021): 132–78. http://dx.doi.org/10.3390/clockssleep3010009.
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Shift work is associated with adverse chronic health outcomes. Addressing chronic disease risk factors including biomedical risk factors, behavioural risk factors, as well as sleep and perceived health status, affords an opportunity to improve health outcomes in shift workers. The present study aimed to conduct a systematic review, qualitative synthesis, and meta-analysis of non-pharmacological interventions targeting chronic disease risk factors, including sleep, in shift workers. A total of 8465 records were retrieved; 65 publications were eligible for inclusion in qualitative analysis. Random-effects meta-analysis were conducted for eight eligible health outcomes, including a total of thirty-nine studies. Interventions resulted in increased objective sleep duration (Hedges’ g = 0.73; CI: 0.36, 1.10, k = 16), improved objective sleep efficiency (Hedges’ g = 0.48; CI: 0.20, 0.76, k = 10) and a small increase in both subjective sleep duration (Hedges’ g = 0.11; CI: −0.04, 0.27, k = 19) and sleep quality (Hedges’ g = 0.11; CI: −0.11, 0.33, k = 21). Interventions also improved perceived health status (Hedges’ g = 0.20; CI: −0.05, 0.46, k = 8), decreased systolic (Hedges’ g = 0.26; CI: −0.54, 0.02, k = 7) and diastolic (Hedges’ g = 0.06; CI: −0.23, 0.36, k = 7) blood pressure, and reduced body mass index (Hedges’ g = −0.04; CI: −0.37, 0.29, k = 9). The current study suggests interventions may improve chronic disease risk factors and sleep in shift workers; however, this could only be objectively assessed for a limited number of risk factor endpoints. Future interventions could explore the impact of non-pharmacological interventions on a broader range of chronic disease risk factors to better characterise targets for improved health outcomes in shift workers.
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Costello, M., C. McCarthy, J. Bosch, S. Robinson, M. Canavan, and M. O'Donnell. "33 ARE CLINICAL TRIALS RANDOMISING HOUSEHOLDS TO LIFESTYLE INTERVENTIONS FOR THE PREVENTION OF COGNITIVE DECLINE FEASIBLE?" Age and Ageing 50, Supplement_3 (November 2021): ii9—ii41. http://dx.doi.org/10.1093/ageing/afab219.33.
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Abstract Background Dementia is increasing in prevalence worldwide. Several lifestyle factors have been identified as targets for dementia prevention, which may be more effective if targeted at households instead of an individual. To date there have been no clinical trials randomising households to lifestyle interventions of sleep, diet and/or physical activity to prevent cognitive decline. To inform future studies, qualitative approaches can give valuable in-depth insights into the values and beliefs of all household members towards behavioural change. Methods Semi structured interviews were carried out among eight households affected by cognitive impairment. Interview content was analysed, and important themes identified. Results Eighteen participants were interviewed within household pods. Among those, eight had cognitive impairment and the remainder were spouses or first-degree relatives living in the same home. Several themes of interest emerged including household members without dementia were more likely to report poor sleep habits; sleep was perceived the hardest behaviour to change; although most participants had healthy diets, most were interested in making a change and felt there was a strong link with nutrition and cognition; physical activity is challenging to adapt due to lack of motivation and focus when individuals are cognitively impaired and motivation to pursue physical activity in households centred on relaxation and social interaction. Conclusion This study identified beliefs and preferences of households towards lifestyle intervention trials. Barriers to study participation including risk of harm, complexity of intervention and deviation from routine emerged during discussions. Findings from this study should be used to inform future clinical trial protocols and future qualitative studies should explore acceptability and feasibility of digital intervention applications.