Appraisals of insomnia identity in a clinical sample.

Background: Insomnia identity, the conviction that one has insomnia, occurs independently of sleep quality or quantity, and is associated with numerous negative health outcomes. Little is known about factors influencing insomnia identity. This study planned to evaluate insomnia identity, perceived sleep experience, and sleep parameters.

Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline.

Introduction: This guideline establishes clinical practice recommendations for the use of behavioral and psychological treatments for chronic insomnia disorder in adults.

Methods: The American Academy of Sleep Medicine (AASM) commissioned a task force of experts in sleep medicine and sleep psychology to develop recommendations and assign strengths based on a systematic review of the literature and an assessment of the evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. The task force evaluated a summary of the relevant literature and the quality of evidence, the balance of clinically relevant benefits and harms, patient values and preferences, and resource use considerations that underpin the recommendations.

Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment.

Introduction: The purpose of this systematic review is to provide supporting evidence for a clinical practice guideline on the use of behavioral and psychological treatments for chronic insomnia disorder in adult populations.

Methods: The American Academy of Sleep Medicine commissioned a task force of 9 experts in sleep medicine and sleep psychology. A systematic review was conducted to identify randomized controlled trials that addressed behavioral and psychological interventions for the treatment of chronic insomnia disorder in adults.

Worry and Rumination Have Distinct Associations with Nighttime versus Daytime Sleep Symptomology.

: To assess whether worry and rumination differ in predicting nighttime sleep disturbance versus daytime sleep-related impairment, as assessed using short forms from the Patient Reported Outcomes Measurement Information System (PROMIS). : Adults recruited from the United States population ( = 459) via an online crowdsourcing service. : Factor analysis explored whether items comprising validated measures of worry and rumination loaded onto separate factors.

Repeated measures regression mixture models.

Regression mixture models are one increasingly utilized approach for developing theories about and exploring the heterogeneity of effects. In this study we aimed to extend the current use of regression mixtures to a repeated regression mixture method when repeated measures, such as diary-type and experience-sampling method, data are available. We hypothesized that additional information borrowed from the repeated measures would improve the model performance, in terms of class enumeration and accuracy of the parameter estimates.

Health and demographic discriminators of an insomnia identity and self-reported poor quantitative sleep.

Objectives: To identify factors that most saliently characterize the profile of individuals who complain of chronic insomnia, with or without quantitative sleep impairment.

Design: Community-dwelling adults reported on their demographics and functioning via questionnaires and completed 2 weeks of sleep diaries.

Setting: Shelby County in the Memphis, TN, area.

Intraindividual variability in sleep and comorbid medical and mental health conditions.

Study Objectives: Intraindividual variability (IIV) in sleep may be a risk factor for disease above the influence of mean sleep. Associations between IIV in sleep and risk for a comprehensive set of common medical and mental health conditions have not been assessed in a representative sample.

Methods: This study examined mean and IIV in total sleep time (TST), sleep quality (SQ), sleep efficiency (SE), and circadian midpoint (CM) in 771 adults recruited for an epidemiological study.

Intraindividual sleep variability and its association with insomnia identity and poor sleep.

Objective: Insomnia identity refers to the conviction that one has insomnia, which can occur independently of poor sleep. Night-to-night variability in sleep (termed intraindividual variability [IIV]) may contribute to insomnia identity yet remain undetected via conventional mean analyses. This study compared sleep IIV across four subgroups: noncomplaining good sleepers (NG), complaining poor sleepers (CP), complaining good sleepers (CG), and noncomplaining poor sleepers (NP).

Obsessive-compulsive personality disorder features and response to behavioral therapy for insomnia among patients with hypnotic-dependent insomnia.

: To compare therapeutic response to behavioral therapy for insomnia (BT-I) among hypnotic-dependent insomnia (HDI) patients with and without Cluster C personality disorders. : Twenty-three adults with HDI (17 females), aged between 33 and 68 (53; 9.9) were included in the study.

Multilevel modeling of chronotype and weekdays versus weekends to predict nonrestorative sleep.

Nonrestorative sleep, a form of subjective sleep disturbance that has been largely neglected in the literature, is newly accessible to researchers via the validated restorative sleep questionnaire (RSQ). The daily version of the RSQ allows for analysis of within-subjects variation in restorative sleep across repeated samplings, and such day-to-day regularity in sleep variables has been highlighted as an important new direction for research. The present study used a sophisticated statistical approach, multilevel modeling, to examine the contributions of circadian chronotype, calendar day of questionnaire completion (weekends versus weekdays), and their interaction in explaining both interindividual and intraindividual variance in restorative sleep.

Insomnia identity.

Insomnia identity refers to the conviction that one has insomnia, and this sleep complaint can be measured independently of sleep. Conventional wisdom predicts that sleep complaints are synchronous with poor sleep, but crossing the presence or absence of poor sleep with the presence or absence of insomnia identity reveals incongruity with expected patterns. This review of existing research on insomnia identity processes and influence finds that about one-fourth of the population are uncoupled sleepers, meaning there is an uncoupling of sleep and sleep appraisal, and daytime impairment accrues more strongly to those who endorse an insomnia identity.

The National Sleep Foundation's Sleep Health Index.

Objectives: A validated survey instrument to assess general sleep health would be a useful research tool, particularly when objective measures of sleep are not feasible. Thus, the National Sleep Foundation spearheaded the development of the Sleep Health Index (SHI).

Design: The development of the SHI began with a task force of experts who identified key sleep domains and questions.

The role of perceived sleep norms in subjective sleep appraisals and sleep-related illness behavior.

The present investigation sought to extend extant research on subjective sleep complaints by examining their relation to perceived sleep norms. Results from two studies showed that individuals' distress and illness behavior in response to symptoms of fatigue and non-restorative sleep was influenced by their perceptions of peer norms for those symptoms. Individuals who believed they experienced a greater degree of fatigue and non-restorative sleep than their peers reported more distress arising from those symptoms, and were also more likely to seek social support and medical treatment for them.

Association between chronotype and nonrestorative sleep in a college population.

Nonrestorative sleep (NRS), characterized by a lack of refreshment upon awakening, has received little attention in the sleep literature even though it can occur and cause impairment apart from other sleep difficulties associated with insomnia. The Restorative Sleep Questionnaire (RSQ) is one of the first validated self-report instruments for investigating NRS severity, presenting new opportunities to explore what factors predict and perhaps contribute to unrefreshing sleep. The present study sought to determine whether inherent circadian preference for morning or evening activity, known as chronotype, predicted restorative sleep in 164 college undergraduates who completed daily RSQs over 2 weeks.

Correlation of Disturbed Sleep and Cancer Stress.

To illuminate the course of insomnia in the presence of an acute comorbidity, we examined the association between insomnia severity and breast cancer symptom severity over time and determined if this association varies with insomnia history and presleep arousal. Twenty-nine newly diagnosed breast cancer patients, who also exhibited insomnia, completed sleep diary and cancer symptom severity questionnaires every other week (total of 28 days) over 7 weeks, as well as baseline and postobservation measures. Participants were defined as having insomnia prior to cancer (IPC) or insomnia secondary to cancer (ISC) based on precancer sleep status.

Cognitive processes in comorbid poor sleep and chronic pain.

We examined the unique and shared contributions of pain catastrophizing, cognitive pre-sleep arousal, and somatic pre-sleep arousal, to the prediction of insomnia severity in chronic pain. Forty-eight adults with chronic pain completed self-report measures of these study variables, health, and mood. Hierarchical regression showed that pain catastrophizing accounted for unique variance in insomnia severity, independent of pain intensity, depression, restless legs symptoms, and demographics.

Affective mediators of the association between pleasant events and global sleep quality in community-dwelling adults.

This study explored the association of engagement in pleasant events and global sleep quality, as well as examined the intermediary roles of positive affect and depressive symptoms in this association. Data were derived from the Midlife in the United States-II study. The sample consisted of 1054 community-dwelling adults.

Differences in sleep between black and white adults: an update and future directions.

Meta-analyses and other previous reviews have identified distinct ethnic/racial differences in the quantity, quality, and propensity for sleep disorders between black and white adults. The present article reviews the meta-analytic evidence along with recent epidemiological, community, and clinical studies to clarify what is known and not known about sleep differences between these two groups. Black individuals tend to have poorer sleep continuity and quality, excessively short or long sleep duration, greater sleep variability, and greater risk of sleep apnea than white individuals.

Prevalence of sleep disorders by sex and ethnicity among older adolescents and emerging adults: relations to daytime functioning, working memory and mental health.

The study determined the prevalence of sleep disorders by ethnicity and sex, and related daytime functioning, working memory, and mental health among older adolescent to emerging adult college students. Participants were U.S.

Variability in self-reported normal sleep across the adult age span.

Objectives: Illustrate the importance of examining within- and between-person differences in sleep across the adult age span.

Method: Two weeks of sleep diary data were analyzed for 592 normal sleepers ranging in age from 20 to 96 years. Variability in total sleep time (TST), number of nighttime awakenings (NWAK), sleep-onset latency (SOL), and wake-time after sleep onset (WASO) were examined overall and by age, sex, and race utilizing multilevel models and multiple regression.

Predictors of adherence to a brief behavioral insomnia intervention: daily process analysis.

Behavioral interventions for insomnia are effective in improving sleep, yet adherence is variable, and predictors of adherence have not been consistently replicated. The relationships between daily variations in state factors at the initiation of treatment and adherence have not been investigated. Using 2-week, self-report online logs, this study determined, among 53 college students with probable insomnia, the associations of pretreatment factors and daily factors during treatment on daily variations in adherence to one session of behavioral treatments for insomnia.