The classical conditioning of sleep and wakefulness

Using a metronome beat as conditioned stimulus three cases are described in which this stimulus was presented in close temporal contiguity with experimentally-induced sleep or waking. Drugs or fatigue consequent upon sleep deprivation were used as unconditioned stimuli for sleep. One of the subjects was an anxiety neurotic, one had narcolepsy and the third was a student volunteer. No EEG indication of conditioned sleep was obtained but there was evidence of conditioned relaxation in the anxiety neurotic and conditioned arousal in the other two cases.     

中年人睡眠相关行为与高血压关系的病例对照研究

为探讨中年人睡眠相关行为与高血压发病风险之间的关系。本研究采用1：1匹配的病例对照研究法;资料收集方法采用问卷调查法;资料处理分析采用t检验及多元条件Logistic回归模型分析法。结果显示中年人病例组与对照组睡眠质量存在显著性差异（t=6．19,P〈0．05）。（1）睡眠相关行为（每日睡眠不足、夜间睡眠不足、睡眠时点延迟、睡眠质量差、入睡困难、每周入睡困难次数增加及打鼾等因素）多元条件Logistic回归模型的OR值和95％CI分别为[（OR=5．07,95％CI：3．12～8．21）;（OR=5．57,95％CI：3．43～9．04）;（OR=2．27,95％CI：1．49～3．47）;（OR=2．17,95％CI：1．60～2．94）;（OR=3．36,95％CI：1．47～7．69）;（OR=1．55,95％CI：1．08～2．24）;（OR=2．69,95％CI：1．86～3．88）]。（2）适当午睡为（OR=0．85,95％CI：0．74～0．98）。（3）早起与否（OR=1．40,95％CI：0．87～2．20）。因此（1）中年人睡眠相关行为与高血压发病密切相关,每日睡眠不足、夜间睡眠不足、睡眠时点延迟、睡眠质量差、入睡困难、每周入睡困难次数增加及打鼾等因素可能为高血压发病的危险因素;（2）中年人适当午睡可能是高血压发病的保护性因素;（3）是否早起与高血压发病关系尚不清晰。     

Sleep Quality and Quantity of Occupational Therapy and Other Allied Health Students

Abstract

We examined sleep behaviors in allied health students (N?=?77) with the following questionnaires: Caffeine Consumption, Pittsburgh Sleep Quality Index (PSQI), Profile of Mood States, and Mental and Physical State and Trait Energy and Fatigue Scales. Students averaged 6.56?hr of sleep per night. More than half of the students received borderline or poor sleep quality scores on the PSQI. Students with poor sleep quality had a significantly higher proportion of mood disturbances than students with optimal sleep quality. These results highlight the need for educational programs to emphasize the sleep hygiene practices of their students.     

Do lonely days invade the nights? Potential social modulation of sleep efficiency

Loneliness predicts morbidity and mortality from broad-based causes, but the reasons for this effect remain unclear. Few differences in traditional health behaviors (e.g., smoking, exercise, nutrition) have been found to differentiate lonely and nonlonely individuals. We present evidence that a prototypic restorative behavior—sleep—does make such a differentiation, not through differences in time in bed or in sleep duration, but through differences in efficacy: In the study we report here, lonely individuals evinced poorer sleep efficiency and more time awake after sleep onset than nonlonely individuals. These results, which were observed in controlled laboratory conditions and were found to generalize to the home, suggest that lonely individuals may be less resilient than nonlonely individuals in part because they sleep more poorly. These results also raise the possibility that social factors such as loneliness not only may influence the selection of health behaviors but also may modulate the salubrity of restorative behaviors.     

Prenatal Cocaine Exposure and Infant Sleep at 7 Months of age: The Influence of the Caregiving Environment

The primary goal of this study was to examine sleep problems in a sample of cocaine-exposed 7-month-old infants and to determine if maternal psychopathology mediated any existing association between substance exposure and sleep behaviors. We also examined the differences in sleep behaviors of cocaine-exposed infants in parental custody and cocaine-exposed infants in nonparental custody. Participants were 65 cocaine-exposed and 53 nonexposed infants and their primary caregivers who were recruited at delivery and assessed at 7 months of infant age. As expected, women who used cocaine during pregnancy had more psychiatric symptoms than nonusers. Prenatal exposure to heavier amounts of cocaine was significantly related to more severe sleep difficulties, and maternal anxiety mediated this association. Approximately 28% of cocaine mothers lost custody of their infants by 7 months of age. Nonmaternal caregivers had significantly fewer symptoms of psychopathology than the cocaine-using women who retained custody of their children. Infants who were in nonparental care at 7 months of age also had less severe sleep problems than did infants who remained in parental care.     

Sleep-Related Safety Behaviors and Dysfunctional Beliefs Mediate the Efficacy of Online CBT for Insomnia: A Randomized Controlled Trial

Several trials have demonstrated the efficacy of online cognitive behavioral therapy (CBT) for insomnia. However, few studies have examined putative mechanisms of change based on the cognitive model of insomnia. Identification of modifiable mechanisms by which the treatment works may guide efforts to further improve the efficacy of insomnia treatment. The current study therefore has two aims: (1) to replicate the finding that online CBT is effective for insomnia and (2) to test putative mechanism of change (i.e., safety behaviors and dysfunctional beliefs). Accordingly, we conducted a randomized controlled trial in which individuals with insomnia were randomized to either online CBT for insomnia (n = 36) or a waiting-list control group (n = 27). Baseline and posttest assessments included questionnaires assessing insomnia severity, safety behaviors, dysfunctional beliefs, anxiety and depression, and a sleep diary. Three- and six-month assessments were administered to the CBT group only. Results show moderate to large statistically significant effects of the online treatment compared to the waiting list on insomnia severity, sleep measures, sleep safety behaviors, and dysfunctional beliefs. Furthermore, dysfunctional beliefs and safety behaviors mediated the effects of treatment on insomnia severity and sleep efficiency. Together, these findings corroborate the efficacy of online CBT for insomnia, and suggest that these effects were produced by changing maladaptive beliefs, as well as safety behaviors. Treatment protocols for insomnia may specifically be enhanced by more focused attention on the comprehensive fading of sleep safety behaviors, for instance through behavioral experiments.     

Rethinking safety behaviors in insomnia: examining the perceived utility of sleep-related safety behaviors

Harvey's cognitive model of insomnia (2002a) proposes that sleep-related safety behaviors play a central role in the maintenance of insomnia because such maladaptive coping strategies are thought to reinforce threat-based appraisals of the likelihood and consequences of poor sleep. Research to date has assessed the frequency of safety behavior use in those with insomnia only; however, in addition to the frequency of occurrence, the function of safety behaviors (i.e., a belief that they will prevent a feared outcome from occurring), may be an important consideration. The purpose of this study was to examine sleep-related safety behaviors based on an expanded theoretical understanding of such behaviors across psychological disorders; that is, by examining both their frequency and perceived utility. Undergraduate students (N = 376) completed an online survey about their sleep, mood, and use of sleep-related safety behaviors. Insomnia severity was associated with a greater perceived need to use safety behaviors (i.e., utility) but not with frequency of safety behavior use. Higher perceived utility of safety behaviors was also associated with unhelpful beliefs about sleep, fear and avoidance of fatigue, and both general and sleep-specific helplessness. These results suggest that these behaviors and the associated underlying maladaptive beliefs may be important targets in cognitive behavioral therapy for insomnia. The current study extends the existing literature and refines the concept of safety behaviors in insomnia to include both the function and frequency of these behaviors.     

A RAPID METHOD FOR EVALUATING THE NECESSITY FOR BOTH A BEHAVIORAL INTERVENTION AND METHYLPHENIDATE

We examined the effects of a behavioral intervention and methylphenidate (MPH) on inappropriate behavior and sleep disturbance displayed by a 6-year-old boy who had been diagnosed with attention deficit hyperactivity disorder. Results showed that the behavioral intervention was effective in reducing inappropriate behaviors to near-zero levels regardless of the presence or absence of MPH.     

Exclusive breastfeeding at three months and infant sleep-wake behaviors at two weeks,three and six months

This study assessed infant sleep-wake behavior at two weeks, three and six months as function of feeding method at three months (exclusively breastfed, partially breastfed, and exclusively formula fed infants). Mothers of 163 first-born, full-term, normal birth weight, healthy infants completed socio-demographic, depression, anxiety, and infant sleep-wake behavior measures. No effects were found for sleep arrangements, depression or anxiety, on feeding methods and sleep-wake behavior at three months. At two weeks exclusively breastfed infants at three months spent more hours sleeping and less hours awake during the 24-h period than partially breastfed infants. At three months, exclusively breastfed infants had a shorter of the longest sleep period at night than exclusively formula fed infants. At six months, exclusively breastfed infants at three months spent more hours awake at night than partially breastfed infants, awake more at night than exclusively formula fed infants, and had a shorter sleep period at night than partially breastfed and exclusively formula fed infants. This study showed differences in sleep-wake behaviors at two weeks, three and six months, when exclusively breastfed infants are compared with partially breastfed and exclusively formula fed infants at three months, while no effects were found for sleep arrangements, depression or anxiety.     

Delayed Bedtimes Are Associated With More Severe Obsessive-Compulsive Symptoms in Intensive Residential Treatment

Delays in behavioral and biological circadian rhythms (e.g., sleep timing, melatonin secretion) are found more frequently in individuals with severe and treatment-resistant obsessive-compulsive disorder (OCD). In recent years, it has been documented that these delays in behavioral and biological circadian rhythms are associated with more severe OCD symptoms and poorer response to some OCD treatments. This study examined self-reported sleep behaviors in individuals taking part in an intensive treatment for OCD and the relations between these and OCD symptoms (both at admission to and discharge from the treatment program). Replicating previous findings in less severe populations, delayed sleep phases were relatively common in this group and later bedtimes were associated with more severe OCD symptoms at admission. Sleep onset latency and sleep duration were not associated with OCD symptom severity at admission. Later bedtimes were not associated with self-reported depression or worry symptom severity. There was no evidence of sleep behaviors affecting change in OCD symptoms from admission to discharge from treatment—however, later bedtimes at admission were associated with more severe OCD symptoms at admission and discharge from treatment. There was no evidence of sleep onset latency or sleep duration having a similar predictive effect. More severe OCD symptoms at admission were also associated with later bedtimes at admission and discharge from treatment. These bidirectional predictive relations between late bedtimes and OCD symptoms were of small effect size but support the potential value of evaluating sleep timing in individuals with severe and/or treatment-resistant OCD.     

睡眠不足对人际交互的影响及其认知神经机制

睡眠不足会对人的认知、情感和人际交互产生诸多影响。这种影响在社会情绪层面表现为个体情绪共情和认知共情的减少,易激惹性与愤怒情绪的增加;在社会行为层面则表现为亲社会行为的减少和攻击行为的增加。在睡眠不足状态下,情绪系统和认知系统功能连接的减弱可能是这些变化的潜在机制。未来应结合生态效度较高的睡眠操作手段,系统考察睡眠不足如何导致各种高级社会情绪的改变,以及这些社会情绪的变化如何导致社会行为的变化。     

Effects of acute sleep restriction on behavior, sustained attention, and response inhibition in children.

This study examined the effects of acute sleep restriction on the day-time behavior and performance of healthy children and adolescents. 82 participants (8 to 15 years of age) completed 5 nights of baseline sleep and were randomly assigned to Optimized (10 hr.) or Restricted (4 hr.) sleep for an overnight lab visit. Behavior, performance, and sleepiness were assessed the following day. Sleep restriction was associated with shorter daytime sleep latency, increased subjective sleepiness, and increased sleepy and inattentive behaviors but was not associated with increased hyperactive-impulsive behavior or impaired performance on tests of response inhibition and sustained attention. Results are discussed in terms of current theories regarding effects of inadequate or disturbed sleep among children and adolescents.     

A BEHAVIORAL MODEL OF INFANT SLEEP DISTURBANCE

Chronic sleep disturbance, such as bed refusal, sleep-onset delay, and night waking with crying, affects 15% to 35% of preschool children. Biological factors, particularly arousals associated with recurrent episodes of rapid-eye-movement sleep, render infants vulnerable to repeated awakenings. Parental failure to establish appropriate stimulus control of sleep-related behaviors and parent-mediated contingencies of reinforcement for sleep-incompatible behaviors may shape and maintain infant sleep disturbance. Treatment and prevention strategies are discussed, and research needs are identified.     

Evaluation of a Safe Sleep Training for Home Visitors and Their Clients

Sleep-related deaths are a common preventable cause of death, and such deaths occur disproportionately in families of color. Home visitors provide families with education about infant safe sleep guidelines; however, families face many barriers to engaging in safe sleep practices. This study evaluated the efficacy of a program to train home visitors to talk to clients about infant safe sleep using Motivational Interviewing and cultural sensitivity. We examined the effects of the intervention on home visitors’ (n?=?23) knowledge, MI skill use, and cultural sensitivity using a single group pre-post design. We also examined home visiting clients’ (n?=?78) knowledge, attitudes, and behaviors using a quasi-experimental design. Home visitors were primarily female (97%), had a college degree (86%), and were primarily white (50%) or African American (43%). The home visiting clients were all female and were primarily African American (43%) and Caucasian (36%). Most clients (59%) earned less than 30,000 dollars per year. Home visitors showed significant improvement in MI skill use and cultural sensitivity from pre- to post-test. Regarding client outcomes, our results indicate a significant group by time interaction when predicting changes in client knowledge such that the treatment group showed larger gains than the control group. There were no significant differences between groups when predicting changes in client attitudes or behavior. MI may be an effective technique for home visitors to help increase families’ safe sleep knowledge. Additional research is needed to examine whether such training can translate to changes in families’ safe sleep behavior.

     

睡眠时间参数对学前儿童问题行为的影响:消极情绪性的调节作用

本研究以338名学前儿童为被试,采用母亲报告法探究了学前儿童睡眠时间与问题行为之间的关系,以及儿童消极情绪性的调节作用。结果发现：（1）睡眠总时长对儿童内化和外化问题行为的主效应显著,而睡眠总时长与消极情绪性对儿童内化和外化问题行为的交互作用不显著;（2）夜间睡眠比对儿童内化问题行为的主效应显著,对儿童外化问题行为的主效应不显著;夜间睡眠比与消极情绪性对儿童内化问题行为的交互作用显著,即对高消极情绪性的儿童,夜间睡眠比能够显著负向预测其内化问题行为,而对低消极情绪性的儿童,夜间睡眠比对其内化问题行为的预测并不显著;夜间睡眠比与消极情绪性对儿童外化问题行为的交互作用不显著。     

Do animals dream?

The understanding of biological functions of sleep has improved recently, including an understanding of the deep evolutionary roots of sleep among animals. However, dreaming as an element of sleep may be particularly difficult to address in non-human animals because in humans dreaming involves a non-wakeful form of awareness typically identified through verbal report. Here, we argue that parallels that exist between the phenomenology, physiology, and sleep behaviors during human dreaming provide an avenue to investigate dreaming in non-human animals. We review three alternative measurements of human dreaming – neural correlates of dreaming, ‘replay’ of newly-acquired memories, and dream-enacting behaviors – and consider how these may be applied to non-human animal models. We suggest that while animals close in brain structure to humans (such as mammals and birds) may be optimal models for the first two of these measurements, cephalopods, especially octopuses, may be particularly good candidates for the third.     

Sleep Leadership in High-Risk Occupations: An Investigation of Soldiers on Peacekeeping and Combat Missions

Individuals in high-risk occupations (e.g., military service) often report physical, psychological, and organizational problems. Although leaders can partially buffer their subordinates against these problems, the impact of established leadership skills appears limited, especially in high-risk occupations. Thus, building on recent theories of domain-specific leadership, we examined whether leadership focused on the specific domain of sleep might be negatively associated with some specific problems facing individuals in high-risk occupations, beyond their relationship with general leadership. Studying military personnel on peacekeeping and combat deployments, we predicted that “sleep leadership” would be negatively associated with sleep problems (physical), depressive symptoms (psychological), and negative climate (organizational), and that sleep would mediate the relationship between sleep leadership and the psychological and organizational problems. Results were generally supportive, contributing to theories of domain-specific leadership by showing that sleep-focused leader behaviors may go beyond general leadership behaviors, relating directly to the problems facing individuals in high-risk occupations.     

电子媒体使用对睡眠的影响,机制及其干预

电子媒体设备日益流行的同时, 睡眠问题也日趋加重, 主客观研究均发现电子媒体使用会对睡眠产生消极影响.背后的加工机制涉及睡眠置换,唤醒,屏幕光和电磁辐射.可以通过睡眠卫生教育,限制电子媒体使用,屏蔽屏幕蓝光等方式进行干预.未来研究需要从理论机制的整合,因果关系的确定,测量方式的客观化和标准化,使用情况细化和本土化研究方面做努力.     

The Role of Sleep Disturbance in Suicidal and Nonsuicidal Self‐Injurious Behavior among Adolescents

The relationship between different sleep disturbances and self‐harm thoughts and behaviors was examined among 223 adolescents presenting to a community clinic for mood disorders and suicidal and nonsuicidal self‐injurious behaviors. Two‐thirds of the adolescents reported nightly, severe sleep complaints. Relative to adolescents without significant sleep complaints, patients with severe sleep complaints at the time of clinic entry endorsed significantly more engagement in nonsuicidal self‐injury. Middle insomnia and circadian reversal were both significant predictors of suicide attempts. Terminal insomnia was significantly associated with suicidal ideation. Results support the importance of assessing sleep difficulties among adolescents at risk for suicide.