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Summary: The present study evaluates the efficacy of behavioural therapy adapted for shift work disorder with a randomised control design in a healthcare population. Forty‐three night shift workers (m. age: 34 years; 77% women) experiencing shift work disorder were randomised to either the behavioural therapy for shift work disorder (BT‐SWD) or a waiting‐list control group offered after the waiting period. Participants completed questionnaires on insomnia, sleepiness and mental health pre‐ and post‐treatment, pre‐ and post‐waiting, and at follow‐up, and a sleep diary. As night shift workers alternate between sleeping during the day after their night shifts and transitioning to nighttime sleep on days off, insomnia severity and sleep variables were analysed for daytime and nighttime sleep. The BT‐SWD involved sleep restriction therapy, stimulus control and fixed sleep periods in the dark. Statistical analyses were performed under intent‐to‐treat and per‐protocol approaches. Repeated‐measures two‐way ANCOVA analysis, controlling for age, sex and pre‐treatment daytime total sleep time, was performed with Bonferroni corrections, and between‐group effect sizes computed. Fourteen participants dropped out after randomisation. Under the intent‐to‐treat analysis, BT‐SWD participants had a significant greater decrease in daytime insomnia severity and an increase in daytime total sleep time at post‐treatment than the control group, with large between‐group effect sizes (−1.25 and 0.89). These corresponding results were also significant with large effect sizes under the per‐protocol analysis. Sleepiness, anxiety and depression levels improved at post‐treatment and maintained at follow‐up when the BT‐SWD treated controls were added to the BT‐SWD group. The behavioural therapy for shift work disorder can be used to improve the sleep and mental health of healthcare night workers. [ABSTRACT FROM AUTHOR]

Summary: Insomnia is a primary symptom of shift work disorder, yet it remains undertreated. This randomised‐controlled pilot trial examined the efficacy of a digital, guided cognitive behavioural therapy for insomnia adapted to shift work (SleepCare) in nurses with shift work disorder. The hypothesis was that SleepCare reduces insomnia severity compared with a waitlist control condition. A total of 46 unmedicated nurses suffering from shift work disorder with insomnia (age: 39.7 ± 12.1 years; 80.4% female) were randomised to the SleepCare group or the waitlist control group. The primary outcome measure was the Insomnia Severity Index. Other questionnaires on sleep, mental health and occupational functioning, sleep diary data and actigraphy data were analysed as secondary outcomes. Assessments were conducted before (T0), after the intervention/waitlist period (T1), and 6 months after treatment completion (T2). The SleepCare group showed a significant reduction in insomnia severity from T0 to T1 compared with the control condition (β = −4.73, SE = 1.12, p < 0.001). Significant improvements were observed in sleepiness, dysfunctional beliefs about sleep, pre‐sleep arousal, sleep effort, self‐reported sleep efficiency and sleep onset latency. No significant effect was found in actigraphy data. Depressive and anxiety symptoms, cognitive irritation and work ability improved significantly. Overall, satisfaction and engagement with the intervention was high. SleepCare improved insomnia severity, sleep, mental health and occupational functioning. This is the first randomised‐controlled trial investigating the efficacy of digital cognitive behavioural therapy for insomnia in a population suffering from shift work disorder with insomnia. Future research should further explore these effects with larger sample sizes and active control conditions. [ABSTRACT FROM AUTHOR]

Summary: Stimulus control is part of the widely used cognitive behavioural therapy for insomnia. However, there is a lack of knowledge about its mechanisms of action and effectiveness when used alone. This systematic review with network meta‐analysis aimed to evaluate stimulus control efficacy when used alone compared with cognitive behavioural therapy for insomnia or its components. The review also documented stimulus control mechanisms of action proposed by the authors. A search was conducted in several bibliographic databases (MEDLINE, PsycINFO, Embase, CINAHL, Psychology Behavioural Sciences Collection, Web of Science, and Cochrane Library) and in two registers from 1972 to June 2022. Randomised studies with adult participants presenting a diagnosis of insomnia and including at least one stimulus control instruction in a treatment group were included. Risk of bias was assessed with the Quality Assessment of Controlled Intervention Studies. Twenty‐three studies were included and three network meta‐analyses were conducted. The quality of included studies was generally poor. Results indicate that stimulus control is an effective intervention to improve insomnia compared with control conditions. Not all stimulus control instructions seem essential, especially those known to recondition the bedroom for sleep. The review challenges the classical conditioning hypothesis. Results should be interpreted cautiously given the small number of studies included, bias risk, and inconsistencies in the network meta‐analysis. Rigorous research is needed in evaluating stimulus control efficacy and mechanisms. [ABSTRACT FROM AUTHOR]

Epigenetic processes are important mechanisms for phenotypic changes that occur in response to the environment. As such, it is expected that the alteration of cytoplasmic composition (the immediate environment of nuclei) results in the modification of the methylome and the expression of the nuclear genome. Cytoplasmic hybrids (or cybrids) are an ideal model to study the influence of mitochondria on gene expression. In this study, we take advantage of the natural co-occurrence of two biotypes that have a similar nuclear genome type (Chrosomus eos), but harbor mitochondria from different species (C. eos in wild type or C. neogaeus in cybrids) to assess the effects of mitochondria on DNA methylation profiles and protein expression of the nuclear genome. Comparison between these biotypes is particularly relevant given their recent divergence and their low level of genetic differentiation. Variations of DNA methylation assessed on tissues from different embryonic origins revealed the distinct profiles of cybrid and wild type populations. Differences are more pronounced between wild type and cybrids than between populations of a given biotype. The proteome is also more different between biotypes than within a given biotype. These results indicate a strong influence of mitochondria on the nuclear genome, which remains detectable in different genetic and environmental contexts. These changes in the methylome and proteome of cybrids are expected to reflect the adjustments imposed by the coexistence of nuclear and mitochondrial genomes from different species [Current Zoology 58 (1): 138–145, 2012].

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The objective of the present study is to explore lucid dream control strategies (LDCSs) facilitating the production of outcomes that are impossible in the real world. Participants are 107 adults who experienced at least one lucid dream per year. They completed an online survey including an open question on LDCSs. Responses were analyzed using a content analysis method with a consensus approach. The results revealed five categories of LDCSs used within the lucid dreams: verbal strategies, strategies based on the use of the dream's objects or environment, strategies based on the use of the oneiric body, strategies based on the management of emotions, and other strategies. Within these categories, 35 LDCSs were identified. These were used individually or in combination. Three additional LDCSs were used in waking. In conclusion, several LDCSs that were identified could be tested in the context of the lucid dream therapy for chronic nightmares. [ABSTRACT FROM AUTHOR]

This article explores the efficacy of sequential treatment involving medication and cognitive behavioral treatment (CBT) for insomnia. In a multiple baseline across-subjects design. 6 participants with primary chronic insomnia received 1 of the following treatment sequences: (a) concurrent combination of medication and CBT for the 10-week treatment duration (Combined): (b) medication for the first 5 weeks, with introduction of CBT at week 4 and medication withdrawal after the 5th week resulting in treatment overlap during weeks 4 and 5 (Overlapping: Medication → Combined → CBT): and (c) medication alone For the first 5 weeks followed by CBT alone for an additional 5 weeks (Medication → CBT). Each sequence led to significant sleep improvements, but these improvements occurred at different times during the intervention. Participants in the Combined and in the Overlapping sequences improved their sleep during the 1st phase of treatment, whereas those in the Medication → CBT sequence improved mostly during the 2nd phase of treatment. These preliminary results suggest that a sequential treatment is effective for chronic insomnia. In addition, the results suggest that sleep improvements are more likely to emerge when CBT is introduced. with an Overlapping sequence showing a slight advantage over the other sequence. Additional clinical trials should be conducted with larger samples to replicate these preliminary findings. [ABSTRACT FROM AUTHOR]

During the early days of the pandemic and in the context of a seemingly unknown global threat, several potential major sleep disruptors were identified by sleep researchers and practitioners across the globe. The COVID-19 pandemic combined several features that, individually, had been shown to negatively affect sleep health in the general population. Those features included state of crisis, restrictions on in-person social interactions, as well as financial adversity. To address the lack of a comprehensive summary of sleep research across these three distinctive domains, we undertook three parallel systematic reviews based on the following themes: 1) Sleep in times of crises; 2) Sleep and social isolation; and 3) Sleep and economic uncertainty. Using a scoping review framework, we systematically identified and summarized findings from these three separated bodies of works. Potential moderating factors such as age, sex, ethnicity, socioeconomic status, psychological predisposition, occupation and other personal circumstances are also discussed. To conclude, we propose novel lines of research necessary to alleviate the short- and long-term impacts of the COVID-19 crises and highlight the need to prepare the deployment of sleep solutions in future crises. [ABSTRACT FROM AUTHOR]

To better understand Shift Work Disorder (SWD), this study investigates insomnia, sleepiness, and psychosocial features of night workers. The study compares night workers with or without SWD to day workers with or without insomnia. Seventy-nine night workers and 40 day workers underwent diagnostic interviews for sleep disorders and for psychopathologies. They completed questionnaires and a sleep diary for 14 days. The design was observatory upon two factors: Work schedule (night, day work) and sleep (good sleep, SWD/insomnia). Two-way ANCOVAs were conducted on psychosocial variables, and effect size were calculated. The clinical approach chosen led to distinct groups of workers. Night workers slept several periods (main sleep period after work, naps, nights on days off). High total wake time and low total sleep time characterized sleep in SWD. Most night workers with SWD still complained of sleepiness after main sleep. Cognitive activation distinguished groups of night workers. All other differences in psychosocial variables between night workers groups were similar to, but smaller than, the ones between day workers. The evaluation of SWD should consider all sleep periods of night workers with particular attention to self-reported total wake time, state sleepiness, and level of cognitive activation. [ABSTRACT FROM AUTHOR]

Summary The present study aims at identifying sleep patterns in insomnia in a clinical sample using three strategies to define poor nights. Sleep diaries and self‐reported questionnaires were collected from 77 clinical patients with insomnia. The conditional probabilities of observing a poor night after 1, 2, or 3 consecutive poor nights were computed according to three strategies with same criteria for sleep onset latency, wake after sleep onset, and sleep efficiency, but varying criterion for total sleep time. Latent profile analyses were conducted to derive sleep patterns. Uni‐ and multivariate analyses were conducted to characterise the sleep patterns identified. A total of 1586 nights were analysed. The strategy used significantly influenced the average percentage of reported poor nights. Two to three sleep patterns were derived per strategy. Within each strategy, sleep patterns differed from each other on sleep variables and night‐to‐night variability. Results suggest the existence of sleep patterns in insomnia among individuals consulting in psychological clinics. Adding a total sleep time of 6‐h cut‐off as a criterion to define poor nights increases the accuracy of the strategy to define poor night and allows to identify sleep patterns of poor nights in insomnia. [ABSTRACT FROM AUTHOR]

The couple relationship (marriage/cohabitation) is, for most adults, the primary social context of sleep. Although there is a growing literature on couples' sleep, no qualitative cross-cultural study on this topic has yet been published. The aim of the present study was to explore the strategies used by adult couples with sleep difficulties from two different cultures, as well as the potential sociocultural variations related to these strategies. Six couples in Quebec City (Canada) and five couples in Fortaleza (Brazil), of which one or both partners experienced sleep difficulties, were recruited. Participants completed the Pittsburgh Sleep Quality Index, the Dyadic Adjustment Scale, and gave open-ended reports regarding their sleep every morning for a week. They also took part in an in-depth semistructured interview for couples. The interviews were transcribed verbatim and analyzed using the Critical Phenomenological Method. The participants' strategies in the face of sleep difficulties fell into three modalities: individual, common and shared, and common and independent. Within these modalities, seven strategies were identified in both research sites: body and mind relaxation before sleep, stress reduction in daily life, reduction of sleep performance anxiety, respect of the partner's sleep, intervention or drug use to induce sleep or to reduce diurnal sleepiness, diet monitoring, and naps. The present study reveals that the coping strategies used by partners are related not only to the individual, but can be shared, and are closely related to the sociocultural, economic and environmental contexts of their respective countries. [ABSTRACT FROM AUTHOR]

No review has specifically focused on the experience of nightmares in individuals with a mental disorder. With a better understanding of nightmares in this population, clinicians will be more inclined to investigate for the presence of chronic nightmares, to consider nightmares for prognosis, and to treat this sleep difficulty independently from other mental disorders. Therefore, this narrative review aims to summarize the most relevant literature on the experience of nightmares in posttraumatic stress disorder (PTSD), depressive disorders and bipolar disorders, anxiety disorders and obsessive-compulsive disorder, attention-deficit/hyperactivity disorder, schizophrenia spectrum disorders, substance use disorders, autism spectrum disorder, eating disorders, and personality disorders. Differences in the experience of nightmares between mental disorders are also addressed. Expectedly, the positive relationship between nightmares and PTSD is the most empirically supported. Empirical data generally support a positive relationship between nightmares and other mental disorders, with the autism spectrum disorder being an exception. Moreover, the presence of nightmares in individuals with a mental disorder is often associated with poorer mental health, poorer sleep, and a greater risk for suicide. In conclusion, this review highlights the importance for clinicians to investigate for the presence of chronic nightmares along with other sleep difficulties (most commonly, insomnia and sleep apnea), to consider the potential influence of nightmares on the course of the primary mental disorder, and to be prepared to grant access to treatments targeting nightmares. [ABSTRACT FROM AUTHOR]