Effects of total sleep loss on sleep tendency.

Effects of two nights of sleep loss were assessed in six young adult (18--21 yr.) volunteers (2 women, 4 men). Performance on the Wilkinson Addition Test fell significantly below baseline values during the sleep-loss procedure and recovered after one or two full nights of sleep. Performance on a Serial Alternation Task also declined during sleep loss. Mood and sleepiness, assessed by subjective self-rating scales, showed a significantly less positive mood and a greater degree of sleepiness during sleep loss, with a recovery to baseline levels after one full night of sleep. Sleep tendency, measured at 2-hr. intervals during all waking periods, was assessed using an objective measure of latency to sleep onset, the Sleep Latency Test. The scores fell to about 1 min. at 0600 on the first night of sleep loss and remained at similarly low values throughout the sleep loss period. After one night of recovery sleep the scores remained significantly below baseline levels, which were not achieved until after the second recovery night. The multiple sleep latency test appears to be a valuable operationally defined tool for measuring daytime sleepiness.     

Agreement rates for sleep/wake judgments obtained via accelerometer and sleep diary: A comparison

Agreement rates for waking and sleeping obtained via sleep diary and accelerometer were evaluated, to compare the two methods. Sleep/wake data for consecutive days and nights were surveyed in 119 healthy university students. Accelerometer sleep/wake judgments obeyed the standard algorithm. Agreement rates for waking and sleeping according to accelerometer versus sleep diary, respectively, were calculated. Sleep diary data were set as a baseline. Seventy-six subjects (63.9%), 22 to 32 years of age, presented perfect data for the analysis. The mean sleep times, in minutes, judged by sleep diary and by accelerometer, were 482.3 and 629.6, respectively. The mean percentages and standard deviations of agreement on wake and sleep were 77.5% (SD=10.2) and 86.1% (SD=6.2), respectively. There was a significant negative relationship between the agreement rates for wake and sleep (r=−.482, p<.01). The accelerometer showed some measurement failure during waking, presumably because of the decrease in body movement. Sleep diary data during daytime appear to be more valid for detecting a sleep/wake cycle than are accelerometer data. In contrast, nocturnal sleep diary data might be supplemented by the use of an accelerometer as long as participants do not have insomnia.     

Effects of White Noise on Off-Task Behavior and Sleep for Elementary-Age Students with ADHD

Abstract

Children with ADHD were administered 75?dB of continuous white noise during independent seat work in the classroom and during bedtime in their homes. Compared to baseline all three students exhibited decreases in off-task behavior. Off-task behavior returned to original baseline levels when white noise was removed and decreased again when reintroduced in classrooms. White noise also decreased bedtime sleep latency and spontaneous night wakings at home. Both sleep latencies and night wakings increased during return-to-baseline conditions. Surprisingly, when white noise was reintroduced only in the classrooms sleep improved a second time. White noise in classrooms with or without simultaneous treatment during sleep at night resulted in lower levels of off-task classroom behavior as well as less disruptive sleep. Results were independent of whether children were on ADHD medication. Children, teachers, and parents all rated white noise favorably.     

Psychological treatment of hypnotic-dependent insomnia in a primarily older adult sample

Objective

This study tested cognitive behavior therapy (CBT) in hypnotic-dependent, late middle-age and older adults with insomnia.

Method

Seventy volunteers age 50 and older were randomized to CBT plus drug withdrawal, placebo biofeedback (PL) plus drug withdrawal, or drug withdrawal (MED) only. The CBT and PL groups received eight, 45 min weekly treatment sessions. The drug withdrawal protocol comprised slow tapering monitored with about six biweekly, 30 min sessions. Assessment including polysomnography (PSG), sleep diaries, hypnotic consumption, daytime functioning questionnaires, and drug screens collected at baseline, posttreatment, and 1-year follow-up.

Results

Only the CBT group showed significant sleep diary improvement, sleep onset latency significantly decreased at posttreatment. For all sleep diary measures for all groups, including MED, sleep trended to improvement from baseline to follow-up. Most PSG sleep variables did not significantly change. There were no significant between group differences in medication reduction. Compared to baseline, the three groups decreased hypnotic use at posttreatment, down 84%, and follow-up, down 66%. There was no evidence of withdrawal side-effects. Daytime functioning, including anxiety and depression, improved by posttreatment. Rigorous methodological features, including documentation of strong treatment implementation and the presence of a credible placebo, elevated the confidence due these findings.

Conclusions

Gradual drug withdrawal was associated with substantial hypnotic reduction at posttreatment and follow-up, and withdrawal side-effects were absent. When supplemented with CBT, participants accrued incremental self-reported, but not PSG, sleep benefits.     

A cross‐syndrome study of the differential effects of sleep on declarative memory consolidation in children with neurodevelopmental disorders

Sleep plays an active role in memory consolidation. Because children with Down syndrome (DS) and Williams syndrome (WS) experience significant problems with sleep and also with learning, we predicted that sleep‐dependent memory consolidation would be impaired in these children when compared to typically developing (TD) children. This is the first study to provide a cross‐syndrome comparison of sleep‐dependent learning in school‐aged children. Children with DS (n = 20) and WS (n = 22) and TD children (n = 33) were trained on the novel Animal Names task where they were taught pseudo‐words as the personal names of ten farm and domestic animals, e.g. Basco the cat, with the aid of animal picture flashcards. They were retested following counterbalanced retention intervals of wake and sleep. Overall, TD children remembered significantly more words than both the DS and WS groups. In addition, their performance improved following night‐time sleep, whereas performance over the wake retention interval remained stable, indicating an active role of sleep for memory consolidation. Task performance of children with DS did not significantly change following wake or sleep periods. However, children with DS who were initially trained in the morning continued to improve on the task at the following retests, so that performance on the final test was greater for children who had initially trained in the morning than those who trained in the evening. Children with WS improved on the task between training and the first retest, regardless of whether sleep or wake occurred during the retention interval. This suggests time‐dependent rather than sleep‐dependent learning in children with WS, or tiredness at the end of the first session and better performance once refreshed at the start of the second session, irrespective of the time of day. Contrary to expectations, sleep‐dependent learning was not related to baseline level of performance. The findings have significant implications for educational strategies, and suggest that children with DS should be taught more important or difficult information in the morning when they are better able to learn, whilst children with WS should be allowed a time delay between learning phases to allow for time‐dependent memory consolidation, and frequent breaks from learning so that they are refreshed and able to perform at their best.     

The behavioural treatment of sleep difficulties in children with an intellectual disability

Reinforcement, instruction giving, partner support strategies, bedtime routine, and standard extinction were taught to the parents of three boys (aged 5–10 years) with an intellectual disability and sleeping difficulties. Sleep was measured using sleep diaries and actigraphy, and daytime behaviour was monitored using diaries and direct observation. At referral, all children needed a parent present to fall asleep, two had co‐sleeping difficulties, and two had night waking difficulties. At post‐intervention, all children were falling asleep independently, co‐sleeping was eliminated for two children, and night waking was reduced in one child. An extinction burst was experienced by two children, with one family putting their child back to bed 259 times on the first night. Though one child still had night waking difficulties following intervention, actigraph recording demonstrated an improvement in his sleep quality. In addition to the children's independence, improvements were seen for sleep length, sleep latency, and morning wake time. However, improvements in daytime behaviour showed inconsistency across behaviours and settings. Improvement in sleep was maintained at a three month follow‐up. It was concluded that using extinction to address sleep problems in children with an intellectual disability is effective and approved of by parents, but any impact on daytime behaviour is equivocal. Copyright © 2002 John Wiley & Sons, Ltd.     

Recovery of performance during sleep following sleep deprivation in older normal and insomniac adult males

Groups of 12 normal and insomniac male subjects aged 55 to 71 yr. were sleep deprived for 64 hr. In both groups, the sleep loss was preceded by four baseline sleep nights and followed by four recovery nights. Reaction time, immediate recall, sleepiness, and body temperature were measured at approximately 2300, 0115, 0330, 0530, and 0800 during baseline, deprivation and recovery nights. Significant performance or mood differences were not found between the normal and insomniac males on any measure or at any testing period throughout the study. Performance of both groups declined characteristically during sleep loss while subjective sleepiness increased. As in young adults, degraded performance was restored by 8 hr. of recovery sleep. However, subjective sleepiness did not return to baseline levels until early in the second recovery night. It was concluded that chronic insomnia does not result in group performance deficits similar to those seen after chronic sleep loss; and the restorative function of sleep operates as efficiently in older insomniac subjects (who apparently have reduced need to sleep) as in older normal subjects.     

Longitudinal Assessment of Sleep–Wake Regulation and Attachment Security with Parents

The development of sleep–wake regulation occurs within the context of the infant–parent relationship. The present study investigated (1) patterns of change in night waking across infancy and attachment to parents and (2) if dependency, a characteristic of secure subgroup B4 and insecure‐resistant infants, accounted for differences in night waking. Forty‐six families reported on the number of infant night wakings at 7, 12, and 14 months of age. Attachment was measured at 12 (infant–mother) and 14 (infant–father) months. Findings suggest that infants with a secure (including the dependent‐secure, B4) pattern of attachment with mothers decreased in the number of night wakings over time, whereas infants with an insecure‐resistant pattern of attachment with mothers continued to wake at night into the second year. Attachment dependency did not account for differences in night waking. These findings are important to understanding the mechanism(s) underlying the relation between attachment and sleep–wake regulation. Copyright © 2012 John Wiley & Sons, Ltd.     

Effectiveness of an mHealth Intervention for Infant Sleep Disturbances

Bedtime problems and night wakings are highly prevalent in infants. This study assessed the real-world effectiveness of an mHealth behavioral sleep intervention (Customized Sleep Profile; CSP). Caregivers (83.9% mothers) of 404 infants (age 6 to 11.9 m, M = 8.32 m, 51.2% male) used the CSP (free and publicly available behavioral sleep intervention delivered via smartphone application, Johnson’s® Bedtime® Baby Sleep App). Caregivers completed the Brief Infant Sleep Questionnaire–Revised (BISQ-R) at baseline and again 4 to 28 days later. Changes in sleep patterns were analyzed, based on sleep problem status (problem versus no problem sleepers; PS; NPS). Sleep onset latency improved in both groups. Earlier bedtimes, longer continuous stretches of sleep, as well as decreased number and duration of night wakings, were evident in the PS group only. The BISQ-R Total score, total nighttime sleep, and total 24-hour sleep time improved for both groups, with a greater change for the PS group. Further, caregivers of infants in the PS group decreased feeding (bedtime and overnight) and picking up overnight, and perceived better sleep. Bedtime routine regularity, bedtime difficulty, sleep onset difficulty, and caregiver confidence improved for both groups, with the PS group showing a greater magnitude of change. Thus, a real-world, publicly available, mHealth behavioral sleep intervention was associated with improved outcomes for older infants. Intervention recommendations resulted in changes in caregivers’ behavior and improvements in caregiver-reported sleep outcomes in infants, in as few as 4 days.     

The Effect of Support on Internet-Delivered Treatment for Insomnia: Does Baseline Depression Severity Matter?

Internet-delivered cognitive-behavioral treatment is effective for insomnia. However, little is known about the beneficial effects of support. Recently we demonstrated that motivational support moderately improved the effects of Internet-delivered treatment for insomnia. In the present study, we tested whether depressive symptoms at baseline moderate the effect of support on Internet-delivered treatment for insomnia. We performed a multilevel intention-to-treat analysis on 262 participants in a randomized controlled trial. We found that baseline depressive symptoms moderated the effect of support on sleep efficiency, total sleep time, and sleep onset latency (but not on wake after sleep onset, number of nightly awakenings, or the Insomnia Severity Index). This means that for these variables, people with high levels of depressive symptoms benefit from support, whereas people with low levels of depressive symptoms improve regardless of support. The data show that baseline depression severity plays an important role in the way Internet treatments need to be delivered. These findings open up opportunities to personalize the support offered in Internet-delivered treatments.     

To Challenge the Morning Lark and the Night Owl: Using Smartphone Sensing Data to Investigate Day–Night Behaviour Patterns

For decades, day–night patterns in behaviour have been investigated by asking people about their sleep–wake timing, their diurnal activity patterns, and their sleep duration. We demonstrate that the increasing digitalization of lifestyle offers new possibilities for research to investigate day–night patterns and related traits with the help of behavioural data. Using smartphone sensing, we collected in vivo data from 597 participants across several weeks and extracted behavioural day–night pattern indicators. Using this data, we explored three popular research topics. First, we focused on individual differences in day–night patterns by investigating whether ‘morning larks’ and ‘night owls’ manifest in smartphone-sensed behavioural indicators. Second, we examined whether personality traits are related to day–night patterns. Finally, exploring social jetlag, we investigated whether traits and work weekly day–night behaviours influence day–night patterns on weekends. Our findings highlight that behavioural data play an essential role in understanding daily routines and their relations to personality traits. We discuss how psychological research can integrate new behavioural approaches to study personality.     

The effect of a delayed weekend sleep pattern on sleep and morning functioning

Abstract

It is a common practice for young adults to delay their weekend sleep schedule. The present study was designed to assess the effect of this sleep pattern on the sleep of Sunday night and the functioning of Monday morning. The sleep schedules of 30 young adults were manipulated for 2 consecutive weeks. In the Habitual-Sleep (HS) week, subjects followed their habitual sleep schedule throughout the week; in the Delayed-Sleep (DS) week, subjects' sleep schedule on Friday and Saturday nights were delayed by two hours. Compared to the HS week, subjects showed significantly lower subjective sleepiness near bedtime and trends of longer sleep onset latency on Sunday night in the DS week. In addition, there was both lowered cognitive performance and overall mood rating on Monday morning in the DS week. The delayed weekend sleep pattern contributes to Sunday night insomnia and the Monday morning “blues”.     

Measuring Daytime Drowsiness in Nursing Home Residents: The MSLT-NH

A standardized method of assessing daytime drowsiness in frail nursing home residents has not been previously available. We present here the development and test characteristics of an instrument to measure daytime drowsiness in nursing home residents with cognitive and functional impairment, the Multiple Sleep Latency Test-Nursing Home (MSLT-NH). In a standardized manner, the resident is tested three times in one day (at 9 a.m., 11 a.m., and 1 p.m.) to measure the amount of time until the subject falls asleep. The average sleep latency (minutes to fall asleep) is the measure of interest. We tested the MSLT-NH in 95 residents from six community nursing homes in the Los Angeles area (82% of subjects were female; 81% were white, mean age was 86.6 years and mean score on the Mini-Mental State Examination [MMSE] was 9.4). Interrater reliability of the MSLT-NH was quite good (correlations between raters ranged from 0.98 to 0.99; all p values were <.0001). Validity was assessed by comparing MSLT-NH results to simultaneous wrist activity estimation of sleep, and by comparing MSLT-NH findings to results from nighttime sleep estimation by wrist actigraphy the night prior to MSLT-NH. The percent agreement between MSLT-NH and wrist actigraph ranged from 77% to 79% MSLT-NH results were significantly associated with peak duration of nighttime sleep episodes the night prior to testing. The MSLT-NH was also quite acceptable for use in the NH setting. In conclusion, we have developed a promising measure of daytime drowsiness in NH residents. Further testing will help establish whether this test is a clinically useful measure of daytime drowsiness from medications or other conditions in the NH setting.     

The Emotional Impact of Ambivalent Sexism: Forecasts Versus Real Experiences

Research on affective forecasting indicates that people regularly mispredict the emotional impact of negative events. We extended this work by demonstrating several forecasting errors regarding women’s affective reactions to ambivalent sexism. In response to a survey about sexism against women, students at a university in the Central U.S. (N?=?188) overestimated the negative impact of hostile sexism, and underestimated the negative impact of benevolent sexism, relative to women’s reports of their actual experiences. Moreover, people mispredicted both the intensity of women’s initial affective reactions to, and the duration of women’s recovery following, ambivalent sexism. The data supported a model in which inaccurate estimates of initial intensity fully accounted for people’s inaccurate estimates of recovery duration following ambivalent sexism.     

黎明模拟光照对晨起睡眠惰性的影响

本研究采用单因素被试内设计对清晨唤醒后睡眠惰性对个体主观情绪、警觉性和认知加工的影响，以及利用动态黎明模拟光照能否对睡眠惰性产生有效的对抗作用进行了考察。结果发现：（1）被试的积极情绪、主观警觉性在刚唤醒时显著低于基线水平，之后随时间推移逐渐提升。（2）被试醒后立即进行测试的认知加工成绩最差，随后逐渐提高，且主要表现在加工速度的回升上。（3）黎明模拟光照对被试醒后在积极情绪、主观警觉性、持续性注意和抑制功能的缓解上产生了明显的促进作用。这表明睡眠惰性会对个体的主客观活动产生显著的负性影响，而使用黎明模拟光照可在一定程度上对抗睡眠惰性带来的负性影响。     

原发性失眠患者的主客观睡眠特征研究

目的：了解原发性失眠患者的睡眠特点,探讨其主客观睡眠的异同点。方法：对15例原发性失眠患者、20例正常人的主观睡眠（PSQI）和客观睡眠（PSG）特点进行比较,对原发性失眠患者进行主观睡眠（PSQI）和客观睡眠（PSG）的比较。结果：原发性失眠的PSG多项指标（睡眠总时间、睡后觉醒次数、觉醒总时间、睡眠潜伏期、睡眠效率、觉睡比、睡眠维持率、REM睡眠时间和REM百分比、REM睡眠潜伏期和REM活动密度）等方面与正常对照有显著差异（p〈0.05或p〈0.01）;原发性失眠的PSQI多项指标（PSQI总分、睡眠效率、睡眠时间、睡眠潜伏期）方面与正常组对照差异显著（p〈0.01）。原发性失眠的PSQI和PSG在睡眠效率、实际睡眠时间、睡眠潜伏期方面存在显著差异（p〈0.01）。结论：原发性失眠患者的PSQI和PSG均存在一定程度的异常,原发性失眠患者有高估自己睡眠障碍的倾向。     

Sleep after learning aids memory recall

In recent years, the effect of sleep on memory consolidation has received considerable attention. In humans, these studies concentrated mainly on procedural types of memory, which are considered to be hippocampus-independent. Here, we show that sleep also has a persisting effect on hippocampus-dependent declarative memory. In two experiments, we examined high school students' ability to remember vocabulary. We show that declarative memory is enhanced when sleep follows within a few hours of learning, independent of time of day, and with equal amounts of interference during retention intervals. Sleep deprivation has a detrimental effect on memory, which was significant after a night of recovery sleep. Thus, fatigue accumulating during wake intervals could be ruled out as a confound.     

Using a Behavioral Treatment Package for Sleep Problems in Children With Autism Spectrum Disorders

This study investigated the effectiveness of a behavioral treatment package for sleep problems in children diagnosed with Autism Spectrum Disorders. Treatment consisted of four behaviorally based components: circadian rhythm management, positive bedtime routines, white noise, and graduated extinction. A multiple-baseline design across three participants was used. Families completed a baseline of various lengths followed by 1 month of intervention. Results indicated the treatment package was effective in decreasing sleep onset latency and the frequency of night awakenings. A week of follow-up data showed continued improvement. Parents reported their children slept better and satisfaction with the four intervention components.     

How Do Mothers Help Their Children Sleep at Night? Night‐waking Strategy Use Among Mothers of Preschool‐aged Children

Night‐waking is common among preschool‐aged children. Little is known about night‐time parenting among parents of preschool‐aged children. To explore night‐waking strategy use in a community sample, 203 mothers (M age = 32 years, SD = 5.1; children's M age = 3.4 years, SD = 1.0) completed the Night‐waking Strategy Scale (NSS) and measures of general parenting, agreement with night‐waking strategies, and children's sleep. Children were grouped by age (2‐, 3‐, and 4‐to‐5‐year‐olds). Mothers endorsed using routines most frequently, followed by active comforting and rewards; limit‐setting and punishment were used less often. NSS punishment and routines were significantly associated with parenting (e.g. laxness was correlated with NSS routines, rs = ?.35 to .47, p < .001). Night‐waking strategy use was correlated with agreement with those strategies (e.g. active comforting was correlated with agreement with active comforting rs = .35 to .52, p < .001). Active comforting was correlated with the frequency of children's night‐waking for 2‐ and 3‐year‐olds (rs = .35 and .38, respectively, p < .01). Mothers of preschool‐aged children in the community engage in a range of parenting strategies to manage children's night‐waking. These strategies are largely consistent with general parenting and agreement with night‐waking strategy use. Copyright © 2014 John Wiley & Sons, Ltd.     

Clinical validation of a sleep assessment device

We have previously reported on the use of a sleep assessment device (SAD) with non-insomniac subjects. The SAD works by generating a brief, soft tone about every 10 min throughout the night and tape recording verbal responses to these cues. The sleep patterns reconstructed from the night's tape recordings proved highly concordant with EEG records. The present study tested the SAD against the EEG standard in 20 nights of monitoring chronic insomniacs. No significant differences were found between the SAD and EEG records with respect to sleep latency, duration of awakenings during the night, total sleep time and sleep efficiency percentage. The EEG detected many more very brief awakenings during the night than did the SAD due to the continuous monitoring by the former. The SAD proved to be a non-intrusive measure of sleep according to three independent measures. The usefulness of the SAD as a measure of sleep in the natural environment was discussed.