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Alexithymia, a difficulty identifying and expressing emotions experienced by oneself or others, measurably harms quality of sleep. Research has observed the association between alexithymia and sleep problems; however, the cumulative effect of this association is still unknown. Therefore, this systematic review and meta-analysis was conducted to present scientific evidence regarding the relationship between alexithymia and sleep quality. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, and using relevant keywords, we searched six databases: Scopus, PubMed Central, ProQuest, ISI Web of Knowledge, EMBASE, and Science Direct. We selected observational studies on the association between alexithymia and sleep. We conducted meta-analysis using a random-effect model to calculate the effect size (ES) with Fishers z transformation. Eligible studies (N = 26) in 24 papers included 7546 participants from 12 countries. The entire ES for the association between alexithymia and sleep was 0.44 (95 % CI: 0.31, 0.56). Additionally, patient populations had a larger ES (ES = 0.55; 95 % CI: 0.30, 0.79) than healthy populations (ES = 0.30; 95 % CI: 0.20, 0.41). The results of the present systematic review and meta-analysis revealed a significant association between alexithymia and sleep problems, especially among people with any medical condition.

Background: Sleep hygiene is important for maintaining good sleep and reducing insomnia. Objective: This study examined the long-term efficacy of a theory-based app (including cognitive behavioral therapy [CBT], theory of planned behavior [TPB], health action process approach [HAPA], and control theory [CT]) on sleep hygiene among insomnia patients. Methods: The study was a 2-arm single-blind parallel-group randomized controlled trial (RCT). Insomnia patients were randomly assigned to a treatment group that used an app for 6 weeks (ie, CBT for insomnia [CBT-I], n=156) or a control group that received only patient education (PE, n=156) through the app. Outcomes were assessed at baseline and 1 month, 3 months, and 6 months postintervention. Primary outcomes were sleep hygiene, insomnia, and sleep quality. Secondary outcomes included attitudes toward sleep hygiene behavior, perceived behavioral control, behavioral intention, action and coping planning, self-monitoring, behavioral automaticity, and anxiety and depression. Linear mixed models were used to evaluate the magnitude of changes in outcomes between the two groups and across time. Results: Sleep hygiene was improved in the CBT-I group compared with the PE group (P=.02 at 1 month, P=.04 at 3 months, and P=.02 at 6 months) as were sleep quality and severity of insomnia. Mediation analyses suggested that perceived behavioral control on sleep hygiene as specified by TPB along with self-regulatory processes from HAPA and CT mediated the effect of the intervention on outcomes. Conclusions: Health care providers might consider using a CBT-I app to improve sleep among insomnia patients., Funding Agencies|Qazvin University of Medical Sciences

Objectives Rates of novel coronavirus disease 2019 (COVID-19) infections have rapidly increased worldwide and reached pandemic proportions. A suite of preventive behaviours have been recommended to minimize risk of COVID-19 infection in the general population. The present study utilized an integrated social cognition model to explain COVID-19 preventive behaviours in a sample from the Iranian general population. Design The study adopted a three-wave prospective correlational design. Methods Members of the general public (N = 1,718, Mage = 33.34, SD = 15.77, male = 796, female = 922) agreed to participate in the study. Participants completed self-report measures of demographic characteristics, intention, attitude, subjective norm, perceived behavioural control, and action self-efficacy at an initial data collection occasion. One week later, participants completed self-report measures of maintenance self-efficacy, action planning and coping planning, and, a further week later, measures of COVID-19 preventive behaviours. Hypothesized relationships among social cognition constructs and COVID-19 preventive behaviours according to the proposed integrated model were estimated using structural equation modelling. Results The proposed model fitted the data well according to multiple goodness-of-fit criteria. All proposed relationships among model constructs were statistically significant. The social cognition constructs with the largest effects on COVID-19 preventive behaviours were coping planning (? = .575, p < .001) and action planning (? = .267, p < .001). Conclusions Current findings may inform the development of behavioural interventions in health care contexts by identifying intervention targets. In particular, findings suggest targeting change in coping planning and action planning may be most effective in promoting participation in COVID-19 preventive behaviours. Statement of contribution What is already known on this subject? Curbing COVID-19 infections globa, Special Section Article.