Search

The Chronic Sleep Reduction Questionnaire is a validated questionnaire that measures symptoms of prolonged insufficient and/or poor sleep and therefore accounts for individuals' sleep need and sleep debt. This study extends its psychometric properties by providing cut-off scores, using a matched sample of 298 healthy adolescents (15.38 ± 1.63 years, 37.9% male, mean Chronic Sleep Reduction Questionnaire score: 32.98 ± 6.51) and 298 adolescents with insomnia/delayed sleep-wake phase disorder (15.48 ± 1.62 years; 37.9% male, mean Chronic Sleep Reduction Questionnaire score: 42.59 ± 7.06). We found an area under the curve of 0.84 (95% confidence interval: 0.81-0.87). Cut-off scores for optimal sensitivity, optimal specificity and based on Youden's criterion are provided. These cut-off scores are highly relevant for use of the Chronic Sleep Reduction Questionnaire in future studies and clinical practice. [ABSTRACT FROM AUTHOR]

Background: Adolescent insomnia can be treated effectively with cognitive behavioural therapy for insomnia (CBTI). However, little is known about effects of CBTI on psychopathology in adolescents. This study aimed to investigate whether (a) CBTI improves psychopathology in Internet‐ (IT) and face‐to‐face group treatment (GT) compared to waitlist (WL), (b) improvement in psychopathology can be attributed to reduced insomnia, (c) improvement in psychopathology remains stable for up to 1 year. Methods: One hundred and sixteen participants (age = 15.6 years, 25% males) with DSM‐5 insomnia, were randomly assigned to IT, GT or WL. Clinical trial registration: http://www.controlledtrials.com (ISRCTN33922163). Assessments of psychopathology, insomnia and objectively and subjectively measured sleep occurred at baseline, post‐treatment, and at 2‐, 6‐ and 12‐month follow‐up. Multilevel and mediation analyses were run to test hypotheses. The CBTI protocol, ‘Sleeping Smart’ for both IT and GT consisted of six weekly sessions and a booster session after 2 months. Results: Psychopathology symptoms, insomnia and sleep problems as measured by actigraphy and sleep logs decreased substantially in IT and GT compared with WL at 2‐month follow‐up with medium to large effect sizes (ESs). Psychopathology symptoms remained stable or further improved for up to 12‐month follow‐up. ESs at 12‐month follow‐up for IT and GT were respectively: affective (d = −0.87 and −0.97), anxiety (d = −0.81 for IT), somatic (d = −0.38 and d = −0.52), oppositional (d = −0.42 for GT) and attention deficit hyperactivity disorder (ADHD) problems (d = −0.47 and −0.46). Mediation analyses indicated that reduction of insomnia symptoms after CBTI fully mediated the effects of CBTI on affective and anxiety problems, and partially mediated the effect on ADHD problems. Conclusions: This is the first study demonstrating that Internet and face‐to‐face CBT for insomnia achieves long‐term reduction in adolescent psychopathology and does so by improving insomnia. This finding can have profound implications for youth mental health care. [ABSTRACT FROM AUTHOR]

Background: Guided Internet cognitive behavioral therapy for insomnia (CBTI) offers an effective treatment for adolescents, but little is known about the active ingredients of therapeutic feedback on outcomes.Objective: This study aims to identify which factors can be distinguished in written therapeutic feedback in Internet CBTI, and examine whether these factors and participation in a chat session contribute to sleep outcomes.Methods: Internet CBTI was applied to 57 adolescents (mean age 15.43 years, SD 1.74, 82.5% girls). Symptoms of insomnia and chronic sleep reduction, and total sleep time, time in bed, and sleep efficiency from seven day sleep logs were measured at baseline, post-treatment, and at two month follow-up. With a coding instrument developed for this study, two independent researchers coded transcripts of the written therapeutic feedback of the Internet CBTI sessions with an event sampling method.Results: Principal component analysis of the initial 17 items from the coding instrument yielded four distinct factors of therapeutic feedback, of which only Sleep expertise seemed to contribute to improvements after Internet CBTI. The other factors, indicating forms of encouragement, and participation in a chat session seemed counterproductive.Conclusions: This first longitudinal study into effects of therapeutic feedback in adolescent Internet CBTI indicated that emphasizing knowledge about sleep might contribute to insomnia improvement. The structured nature of the preprogrammed treatment content, delay of therapeutic feedback due to standardized timing, and unintentional reinforcement of undesirable behavior by giving attention to failures might explain the negative results of encouraging behavior. Further research to identify effective therapeutic factors in Internet therapy is warranted. [ABSTRACT FROM AUTHOR]

Although bright light therapy seems a promising treatment for sleep problems, research shows inconclusive results. This meta-analysis is the first to systematically review the effect of light therapy on sleep problems in general and on specific types of sleep problems in particular (circadian rhythm sleep disorders, insomnia, sleep problems related to Alzheimer's disease and dementia). Fifty-three studies with a total of 1154 participants were included. Overall effects and effects on separate circadian and sleep outcomes were examined. We calculated Hedges' g effect sizes and we investigated the effects of twelve moderators (design-related, treatment-related, participant-related). Light therapy was found effective in the treatment of sleep problems in general (g = 0.39), and for circadian rhythm sleep disorders (g = 0.41), insomnia (g = 0.47), and sleep problems related to Alzheimer's disease/dementia (g = 0.30) specifically. For circadian rhythm sleep disorders, effects were smaller for randomised controlled trials. For insomnia, we found larger effects for studies using a higher light intensity, and for sleep problems related to Alzheimer's disease/dementia larger effects were found for studies with more female participants. There was indication of publication bias. To conclude, light therapy is effective for sleep problems in general, particularly for circadian outcomes and insomnia symptoms. However, most effect sizes are small to medium. [ABSTRACT FROM AUTHOR]

In children with sleep-onset insomnia and delayed dim-light melatonin onset, melatonin treatment not only improves sleep but also health, behavior and parenting stress. The aim of the present study was to see whether the latter effects are dependent on the direct effects on sleep. Data come from 41 children (24 boys, 17 girls; mean age = 9.43 years). They entered melatonin treatment (1-5 mg per day) for three weeks, then discontinued treatment by first taking a half dose for one week, and then stopped completely for another week. Sleep was measured with sleep diaries filled in by parents and with actometers. We found a positive effect of actual sleep duration on health but this disappeared after discontinuing treatment. We also found that melatonin treatment decreased behavior problems, which effect appeared to be stronger for children with an earlier dim-light melatonin onset. These results show that the melatonin effects on health and behavior problems may partly be dependent on sleep. [ABSTRACT FROM AUTHOR]

This study investigated the influence of infants' sleep and crying on marital relationship in first-time parent couples (N = 107) during the 1st year after birth. Control variables are parents' insomnia and parental self-efficacy in handling the baby. Questionnaires were administered to both parents before birth, at 2 and 7 weeks after birth, and at 1 year after birth. Results show that marital problem-solving ability did not change but that marital satisfaction diminished significantly over time. Crying was the main child variable that affected marital satisfaction. Fathers' self-efficacy contributed positively to marital problem solving and negatively to paternal insomnia. Both maternal and paternal insomnia affected spouses' insomnia. As infant sleep problems may worsen preexisting parental insomnia, it is recommended that first-time parents be informed about treatments of insomnia. [ABSTRACT FROM AUTHOR]

Objective To examine the effects of online Cognitive Behavior Therapy for Insomnia (CBTI) on adolescents' sleep and cognitive functioning. Methods 32 adolescents (13–19 years, M = 15.9, SD = 1.6) with DSM-5 insomnia disorder, were randomly assigned to a treatment group (n = 18) or a waiting list (n = 14). Treatment consisted of six guided self-help online CBTI sessions. Both groups were assessed at baseline and post-treatment. Sleep was measured with actigraphy, sleep logs, and questionnaires. Cognitive functioning was assessed with a battery of standard cognitive tests. Results After CBTI the treatment group showed significant improvements compared to the waiting list group in sleep efficiency from actigraphy and sleep logs. This finding was confirmed by improvements in other sleep variables from sleep logs, and in symptoms of chronic sleep reduction and insomnia. Most participants from the treatment group improved to sub clinical levels of insomnia. Cognitive functioning of the treatment group showed more improvement compared to the waiting list in visuospatial processing, selective attention and phonological working memory, and a trend of improvement in response inhibition and set shifting, letter fluency and sustained attention, but not in declarative memory, visuospatial working memory, category fluency, and general cognitive speed. Changes in sleep appeared to be related to changes in cognitive functioning. Conclusions These results indicate that CBTI can have positive effects on cognitive functions in adolescents, with notable improvements in visuospatial processing and phonological working memory but not in visuospatial working memory. [ABSTRACT FROM AUTHOR]

Abstract: Objective: This study investigated reliability, validity, and clinical relevance of the Adolescent Sleep Hygiene Scale (ASHS) in Dutch adolescents. Methods: The Dutch translation of the ASHS was administered to 186 normal-sleeping adolescents and 112 adolescents with insomnia. Their sleep variables were measured using sleep logs and questionnaires. From the insomnia group, scores were also obtained after six weeks of cognitive behavioral therapy for insomnia (n =58) or waiting list (n =22). Results: The full scale of the ASHS had acceptable internal consistency. The results showed moderate to strong correlations of the ASHS (domains) with sleep quality, sleep duration and chronic sleep reduction. Furthermore, the Dutch ASHS was able to discriminate between normal sleepers and adolescents with insomnia, and scores of adolescents with insomnia improved after treatment. Conclusions: These findings confirm the importance of sleep hygiene in adolescent sleep, and contribute to the validity of the ASHS and its applicability in research and clinical practice. [Copyright &y& Elsevier]

Objective: To investigate the effect of melatonin treatment on health status and sleep in children with idiopathic sleep-onset insomnia. Method: A randomized, double-blind, placebo-controlled trial was conducted in a Dutch sleep cantar, involving 62 children, 6 to 12 years of age, who suffered more than 1 year from idiopathic chronic sleep-onset insomnia. Patients received either 5 mg melatonin or placebo at 7 PM. The study consisted of a 1-week baseline period, followed by a 4-week treatment. Health status was measured with the RAND General Health Rating Index (RAND-GHRI) and Functional Status II (FS-II) questionnaires. Lights-off time, sleep onset, and wake-up time were recorded in a diary, and andogenous dim light melatonin onset was measured in saliva. Results: The total scores of the RAND-GHRI and FS-II improved significantly more during melatonin treatment compared to placebo. The magnitude of change was much higher in the melatonin group than in the placebo group, with standardized response means for the RAND-GHRI of 0.69 versus 0.07 and for the FS-II of 1.61 versus 0.64. Melatonin treatment also significantly advanced sleep onset by 57 minutes, sleep offset by 9 minutes, and melatonin onset by 82 minutes, and decreased sleep latency by 17 minutes. Lights-off time and total sleep rime did not change. Conclusions: Melatonin improves health status and advances the sleep-wake rhythm in children with idiopathic chronic sleep-onset insomnia. Key Words: melatonin; insomnia; Functional Status II; RAND General Health Rating Index; health status. [ABSTRACT FROM AUTHOR]