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。     

Correcting distorted perception of sleep in insomnia: a novel behavioural experiment?

Patients with primary insomnia overestimate their sleep onset latency (SOL) and underestimate their total sleep time (TST). The present study aimed to test the utility of a novel behavioural experiment designed to correct distorted perception of sleep among patients diagnosed with primary insomnia. Individuals with primary insomnia were asked to wear an actigraph and keep a sleep diary for three nights. On the following day, half were shown the discrepancy between the data recorded on the actigraph and their sleep diary (Shown-Discrepancy Group), the other half were not shown the discrepancy (No-Demonstration Group). Participants were then asked to wear the actigraph and keep a sleep diary for three further nights. Following the behavioural experiment, the Shown-Discrepancy Group estimated their SOL more accurately and reported less anxiety and preoccupation about sleep compared to the No-Demonstration Group. The theoretical and clinical implications of these findings are discussed.     

Predicting Treatment Response in Older Adults with Insomnia

This study examined potential predictors of treatment outcome in late-life insomnia. Fifty-four older adults with chronic insomnia were treated with cognitive–behavior therapy (CBT), pharmacotherapy (PCT), or combined CBT plus PCT. Pretreatment characteristics such as demographic, clinical, psychometric, and sleep variables were examined as correlates or potential predictors of treatment response. Treatment response was defined by posttreatment sleep efficiency as measured subjectively by daily sleep diary and objectively by polysomnography. The results indicate that age, insomnia duration, medical illness, and previous use of sleep medications can moderate subjective or objective treatment outcome or both of these in late-life insomnia. However, there are no reliable predictors of outcome across all treatment and assessment modalities. The implications of these findings for the treatment of insomnia in older adults seen in primary care settings are discussed.     

A diary after dinner: How the time of event recording influences later accessibility of diary events

Recording the events of a day in a diary may help improve their later accessibility. An interesting question is whether improvements in long-term accessibility will be greater if the diary is completed at the end of the day, or after a period of sleep, the following morning. We investigated this question using an internet-based diary method. On each of five days, participants (n?=?109) recorded autobiographical memories for that day or for the previous day. Recording took place either in the morning or in the evening. Following a 30-day retention interval, the diary events were free recalled. We found that participants who recorded their memories in the evening before sleep had best memory performance. These results suggest that the time of reactivation and recording of recent autobiographical events has a significant effect on the later accessibility of those diary events. We discuss our results in the light of related findings that show a beneficial effect of reduced interference during sleep on memory consolidation and reconsolidation.     

Recall of mental sleep experience with or without prior verbalization.

We investigated whether verbalization of contents of mental sleep experience (MSE), just after awakening provoked during rapid eye movement (REM) sleep, facilitates subsequent recall in the morning. Twelve subjects were awakened four times in each of two experimental nights and alternately asked to recall, with or without concurrent verbalization, MSE contents preceding the awakening. In the morning, the subjects were asked to report MSEs both verbalized and nonverbalized during the night. If subjects were unable to provide a spontaneous morning report, they were prompted using a probe, which was the title given by the subjects to each MSE at the end of its verbalization or covert recall at night. Frequencies of spontaneous reports were high, regardless of whether MSEs had been previously verbalized or not. The proportions of spontaneous and probed reports were similar for verbalized and nonverbalized MSEs, but spontaneous morning reports were longer than probed ones, regardless of their previous verbalization. Spontaneous and probed morning reports corresponding to night reports shared similar linguistic structures (i.e., length of sentences and proportions of waking-related utterances, which are indicative of difficulty of retrieval for MSE contents) and had similar percentages of contents common to night and morning reports. These findings support the hypothesis that verbalization does not directly influence the further accessibility of MSE contents.     

Self-experimentation as a source of new ideas: ten examples about sleep, mood, health, and weight

Little is known about how to generate plausible new scientific ideas. So it is noteworthy that 12 years of self-experimentation led to the discovery of several surprising cause-effect relationships and suggested a new theory of weight control, an unusually high rate of new ideas. The cause-effect relationships were: (1) Seeing faces in the morning on television decreased mood in the evening (> 10 hrs later) and improved mood the next day (> 24 hrs later), yet had no detectable effect before that (0-10 hrs later). The effect was strongest if the faces were life-sized and at a conversational distance. Travel across time zones reduced the effect for a few weeks. (2) Standing 8 hours per day reduced early awakening and made sleep more restorative, even though more standing was associated with less sleep. (3) Morning light (1 hr/day) reduced early awakening and made sleep more restorative. (4) Breakfast increased early awakening. (5) Standing and morning light together eliminated colds (upper respiratory tract infections) for more than 5 years. (6) Drinking lots of water, eating low-glycemic-index foods, and eating sushi each caused a modest weight loss. (7) Drinking unflavored fructose water caused a large weight loss that has lasted more than 1 year. While losing weight, hunger was much less than usual. Unflavored sucrose water had a similar effect. The new theory of weight control, which helped discover this effect, assumes that flavors associated with calories raise the body-fat set point: The stronger the association, the greater the increase. Between meals the set point declines. Self-experimentation lasting months or years seems to be a good way to generate plausible new ideas.     

Relationships Among Sleep Disturbance,Reward System Functioning,Anhedonia, and Depressive Symptoms

Recent models propose reward system dysfunction as a key mediator of the relationship between sleep and depression and anhedonia. This study explored interrelationships among sleep disturbance, depressive symptoms, anhedonia, and reward responsiveness. Two-hundred and sixty undergraduate students completed questionnaires and a daily diary paradigm assessing sleep, reward responsiveness, depression, anhedonia, and positive affect over 1 week. Baseline sleep disturbance was associated with depressive symptoms, anhedonia, and reward responsiveness. Daily diary sleep parameters showed differential associations with anticipatory versus consummatory reward responsiveness and positive affect. Poorer sleep quality, shorter sleep duration, and longer awakening after sleep onset predicted blunted anticipatory and consummatory reward responsiveness, while increased sleep onset latency and lower sleep efficiency predicted only decreased consummatory reward responsiveness. All sleep indices, except sleep onset latency, were associated with positive affect. Findings demonstrate unique associations between disparate sleep disturbance and reward responsiveness elements, highlighting new treatment mechanisms for anhedonia and depression.     

Brief Cognitive Behavioral Therapy for Insomnia in Parkinson's Disease: A Case Series Study1

Parkinson's disease (PD) patients frequently suffer from insomnia and insomnia can result in reduction of quality of life in PD. Although pharmacotherapy is most applicable for insomnia, it may cause side-effects in PD. The purpose of the study was to investigate the efficacy of brief cognitive behavioral therapy for insomnia (CBTI) in PD. A total of 11 PD patients aged 43–84 years with chronic insomnia received two sessions of CBTI. Patients reported a significant decrease in total score for the Insomnia Severity Index (ISI). The total score for the Parkinson's Disease Sleep Scale (PDSS) improved. Although objective sleep measured by actigraph did not improve, subjective sleep measured by sleep diary improved. Functional impairment measured by the Sheehan Disability Scale (SDS) significantly decreased. These results revealed that brief CBTI was effective in improving insomnia in PD, with improvements extending to functional impairments that had been affected by insomnia. Additionally, this non-pharmacotherapy treatment could be easily applied to PD patients who may have difficulty coming to the clinic frequently due to physical symptoms.     

Circadian typology and the Alternative Five‐Factor Model of personality

Two studies were carried out to explore the relationship between circadian typology and the Alternative Five‐Factor Model of personality. In the first study, 379 participants (232 females) were administered the reduced version of the Morningness‐Eveningness Questionnaire and the Zuckerman–Kuhlman Personality Questionnaire. Evening types reported higher impulsive sensation‐seeking scores than morning and intermediate types, whereas morning types scored higher than evening types on activity factor. In the second study, the association between morningness and activity personality factor was verified through the objective‐actigraphic monitoring of the rest‐activity cycle. Actigraphy allowed us to operationalise both circadian typology, through the computing of midpoint of sleep (early values, expressed in hours and minutes, correspond to an advanced phase of the sleep/wake cycle), and activity factor by the means of motor activity recording. Fifty‐one individuals (30 females) wore an actigraph on the nondominant wrist continuously for 1 week. A negative correlation was observed between midpoint of sleep and mean diurnal motor activity, demonstrating that an early phase of the sleep/wake cycle (i.e. morningness preference) was related to higher diurnal motor activity. Assessed both subjectively and objectively, the results of both studies highlight a significant relationship between morningness and activity personality factor.     

Interserial and intraserial interference processes in morning recall of mental sleep experience

This study investigated ways in which predictions from interference theory might explain partial or total failure in the morning recall of mental sleep experience (MSE) episodes reported after provoked night awakening. Interference could take place either between the contents of one MSE episode (intraserial interference) or between the contents of different MSE episodes (interserial interference) and would be more likely to affect morning recall where similar (i.e., interrelated) contents in MSEs are involved. If interference were mainly intraserial, in the morning there would be no change in the difficulty of retrieving interrelated contents, whereas, if it were mainly interserial, there would be increased difficulty in the retrieval of such contents. All the possible pairs of reports obtained by awakening 8 subjects four times in REM sleep during each of four experimental nights spaced at weekly intervals were scored for interrelated contents, using Clark's (1970) system of analysis of paired units, which operates by matching linguistic features. Results showed that interrelations in morning report pairs are as frequent as in night report pairs, maintaining the same linguistic characteristics and with little transfer of contents from one MSE to another. Overall these findings are compatible with the hypothesis that interference is primarily intraserial rather than interserial. It is consequently suggested that morning recall failure may be due to temporary blocking of retrieval.     

Sleep patterns of 7‐week‐old infants at familial risk for attention deficit hyperactivity disorder

Sleep patterns of 26 seven‐week‐old boys at familial risk for attention deficit hyperactivity disorder (ADHD) and 18 control infants were compared by objective (actigraph) and subjective (maternal sleep diary) measures, over five consecutive 24‐hr periods. Actigraph findings indicated that the groups differed on stability (SD) of quiet sleep only during the day. Reports in maternal sleep diaries indicated that they also differed on stability of waking and stability of sleep duration, again only during the day. No group differences were found in terms of average scores, whether calculated for the entire 24‐hr periods, for nights, or for days. Mothers in the risk group reported that fathers were less involved in infant care than did those in the control group. These findings suggest that as early as 7 weeks of age, infants at risk for ADHD differ from controls only on stability of their sleep patterns during the day, when environmental regulatory factors are more intensive.     

Relationships between two dimensions of employee perfectionism,postwork cognitive processing,and work day functioning

This daily diary study examined relations between two distinct perfectionism dimensions and work-related cognitions experienced by employees during evening leisure time. Drawing from perseverative cognitive processing theory, we hypothesized that perfectionistic concerns would be related to work-related worry and rumination during post-work evenings. In contrast, we hypothesized that a theoretically more adaptive perfectionist dimension (perfectionistic strivings) would be associated with positively valenced self-reflections about work across consecutive evenings. A sample of 148 full-time workers completed an initial survey, which included a trait perfectionism measure, reported their work-related cognitions across four consecutive evenings of a working week, rated their sleep quality immediately upon awakening on each subsequent morning, and their daily levels of emotional exhaustion and work engagement at the end of each work day. Results showed that perfectionistic concerns were indirectly negatively associated with sleep quality and work day functioning via the tendency to worry and ruminate about work. In contrast, perfectionistic strivings were indirectly positively associated with work day engagement via the propensity to experience positive thoughts about work during evening leisure time. The theoretical and practical implications of these findings are discussed.     

The cortisol awakening response and the big five personality dimensions

The present study investigated the association between the big five personality dimensions and the cortisol awakening response (CAR), a physiological parameter reflective of HPA axis activity. One hundred and seven participants completed the big five inventory (BFI; John, Donahue, & Kentle, 1991) and collected salivary cortisol samples at 0, 30, and 60 min after awakening on a weekday morning. The cortisol awakening response under the curve (CARauc) and the cortisol awakening response with respect to increase (CARi) were used as outcome variables in the statistical analyses. Hierarchical linear regression analyses were conducted using the data of 92 participants. Gender and age were included as covariates in block one of the regressions, followed by the personality dimensions in block two. Extraversion emerged as a significant predictor of CARauc. No other personality dimensions were significantly predictive of CARauc or CARi. Interestingly, gender emerged as the strongest predictor in the CARauc, with females exhibiting greater cortisol release across the awakening period than males. Our results suggest that extraversion and gender may be particularly important variables to consider in the regulation of the HPA axis.     

Light therapy for seasonal and nonseasonal depression: efficacy, protocol, safety, and side effects

Bright light therapy for seasonal affective disorder (SAD) has been investigated and applied for over 20 years. Physicians and clinicians are increasingly confident that bright light therapy is a potent, specifically active, nonpharmaceutical treatment modality. Indeed, the domain of light treatment is moving beyond SAD, to nonseasonal depression (unipolar and bipolar), seasonal flare-ups of bulimia nervosa, circadian sleep phase disorders, and more. Light therapy is simple to deliver to outpatients and inpatients alike, although the optimum dosing of light and treatment time of day requires individual adjustment. The side-effect profile is favorable in comparison with medications, although the clinician must remain vigilant about emergent hypomania and autonomic hyperactivation, especially during the first few days of treatment. Importantly, light therapy provides a compatible adjunct to antidepressant medication, which can result in accelerated improvement and fewer residual symptoms.     

Culture and the organization of infant sleep: A study in the Netherlands and the U.S.A.

This study investigates differences in the amount and structure of infant sleep in two cultural places with previously documented, divergent parental beliefs and practices. Eight-month-old infants (n = 24 per site) were recruited from towns in the Netherlands and the eastern U.S.A. To evaluate sleep, infants’ physical activity was recorded at home for 24 h using a miniature actigraph, while parents kept a diary of infant activities. Measures derived from actigraphy include total sleep, longest sleep episode, longest wake episode, number of sleep episodes, and percent of sleep during nighttime, as well as time in the stages of Quiet and Active Sleep. Measures based on the parental diaries include most of these aspects as well, except those related to sleep stages. Results based on the more precise actigraphy method indicate that (1) the Dutch infants averaged 13.65 h of sleep per 24 h, 1.67 h more than the U.S. infants; this difference was mostly due to daytime sleep; (2) The Dutch infants’ longest wake episode averaged less than that of the U.S. infants, while their longest sleep episode appeared slightly longer. (3) The Dutch infants, compared to the U.S. sample, spent more time in the Quiet, rather than the Active phase of sleep; (4) They began their Quiet sleep earlier in the evening than did their U.S. counterparts. Measures derived from parental diaries are largely in agreement with the actigraph findings. These results are consistent with reported and observed practices and beliefs in the two communities. The pattern of differences – less apparent maturity among the Dutch in the amount of sleep, but greater apparent maturity in the structure of sleep -- illustrates that behavioral and neurological maturity can be assessed only in the context of the developing child’s adaptation to the specific demands and affordances of the culturally structured developmental niche.     

Prolonged exposure in patients with chronic PTSD: predictors of treatment outcome and dropout

The present study investigated predictors of treatment outcome and dropout in two samples of PTSD-patients with mixed traumas treated using prolonged imaginal exposure. Possible predictors were analysed in both samples separately, in order to replicate in one sample findings found in the other. The only stable finding across the two groups was that patients who showed more PTSD-symptoms at pre-treatment, showed more PTSD-symptoms at post-treatment and follow-up. Indications were found that benzodiazepine use was related to both treatment outcome and dropout, and alcohol use to dropout. Demographic variables, depression and general anxiety, personality, trauma characteristics, feelings of anger, guilt, and shame and nonspecific variables regarding therapy were not related to either treatment outcome or dropout, disconfirming generally held beliefs about these factors as contra-indications for exposure therapy. It is concluded that it is difficult to use pre-treatment variables as a powerful and reliable tool for predicting treatment outcome or dropout. Clinically seen, it is therefore argued that exclusion of PTSD-patients from prolonged exposure treatment on the basis of pre-treatment characteristics is not justified.     

Relationships between early and final reports of treatment outcome in long-term group psychotherapy

A study of the report of treatment outcome in three long-term therapy groups focused on two questions: 1) Are early reports of treatment outcome significantly related to final reports, i.e., is there substantial consistency in outcome reports over the course of therapy? 2) Are final reports of treatment outcome significantly more favorable than early reports, i.e., do patients experience significant improvement after the early part of therapy? Affirmative answers to these two questions for a number of outcome variables led to a consideration of a number of clinical and research implications.     

Pilot study of light therapy and neurocognitive performance of attention and memory in healthy subjects

The aim of this pilot study was to investigate whether light therapy improves healthy subjects' neurocognitive performance of attention, memory, and language. Ten subjects were treated with white bright light for 5 days and a control group of 10 with no treatment were assessed with a battery of neurocognitive tests which included the Stroop Colour Word Interference Test, the Verbal Fluency Test, the Story Recall Test, and the Word Pairs Recall Test. Analysis showed improvements in cognitive scores in both groups, although on all the cognitive tests the mean difference scores between baseline and endpoint were significantly larger in the light-treated group. These preliminary results suggest that short-term bright light may exert beneficial effects on cognitive functions.     

Cortisol response to behavior problems in FMR1 premutation mothers of adolescents and adults with fragile X syndrome: A diathesis-stress model

Mothers of adolescents and adults with fragile X syndrome (FXS) are faced with high levels of parenting stress. The extent to which mothers are negatively impacted by this stress, however, may be influenced by their own genetic status. The present study uses a diathesis-stress model to examine the ways in which a genetic vulnerability in mothers with the premutation of the FMR1 gene interacts with child-related environmental stress to predict their morning cortisol levels. Seventy-six mothers of an adolescent or adult with FXS participated in an 8-day telephone diary study in which they reported on the behavior problems of their son or daughter with FXS each day. We analyzed salivary cortisol collected from mothers at awakening and 30 minutes after awakening on 4 of these days. The results indicated that mothers with greater genetic vulnerability had a lower level of cortisol on mornings following days when their son or daughter with FXS manifested more episodes of behavior problems, whereas mothers with less genetic risk evinced the opposite pattern of higher morning cortisol in response to their child's behavior problems. This finding contributes to our understanding of gene-by-environment interactions and highlights the importance of interventions to alleviate parenting stress in mothers raising children with FXS.     

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”.