The Holte Sleeping Technique: An experimental study

The Holte Sleeping Technique is an alternative to medication to facilitate sleep onset in situations of normal stress. The technique is based on a combination of conditioning within the theory of learning, simulation of natural bodily processes, and manipulation of naturally available sleep-releasing stimuli. The author describes the technique and reports on experimental testing of its efficacy. Fifty-six female subjects were selected according to criteria based on questionnaires and sleep logs. The subjects were randomly assigned to a treatment group, a placebo group, and a no-treatment group. A pre-test-post-test design was used. The author questions the generalizability of findings from modern electronic sleep laboratories to the bedrooms of everyday life. In order to optimize the combination of normal stress, objective criteria and generalizability, sleep onset was measured by behavioural criteria based on the "fog-horn procedure" developed by the author. At post-test 67% of the treatment group fell asleep, while only 17% of the placebo group and 25% of the no-treatment group fell asleep. The differences were significant. It is concluded that the Holte Sleeping Technique is highly effective. In a discussion of placebo trials the author argues that traditional medical trials do not take into consideration the differentiating psychological attribution effects occurring by giving the same experimental instruction under different experimental conditions. As a consequence the active treatment is given better conditions than the placebo in traditional clinical trials.     

Anticipatory attention during the sleep onset period

To examine whether anticipatory attention or expectancy is a cognitive process that is automatic or requires conscious control, we employed a paired-stimulus event-related potential (ERP) paradigm during the transition to sleep. The slow negative ERP wave observed between two successive stimuli, the Contingent Negative Variation (CNV), reflects attention and expectancy to the second stimulus. Thirteen good sleepers were instructed to respond to the second stimulus in a pair during waking sessions. In a non-response paradigm modified for sleep, participants then fell asleep while tones played. As expected, N1 decreased and P2 increased in amplitude systematically with the loss of consciousness at sleep onset; the CNV was increasingly more positive. Sleep onset latency was correlated with the amplitude of the CNV. The systematic attenuation of the CNV waveform at sleep onset and its absence in sleep indicates that anticipatory attention requires endogenous conscious control.     

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.     

Obstructive Sleep Apnea Syndrome in Prader-Willi Syndrome: An Unrecognized and Untreated Cause of Cognitive and Behavioral Deficits?

Prader-Willi Syndrome (PWS) is a rare genetic disorder characterized by a range of physical, psychological, and physiological abnormalities. It is also distinguished by the high prevalence of obstructive sleep apnea syndrome (OSAS), i.e., repetitive upper airway collapse during sleep resulting in hypoxia and sleep fragmentation. In non-PWS populations, OSAS is associated with a range of neurocognitive and psychosocial deficits. Importantly, these deficits are at least partly reversible following treatment. Given the findings in non-PWS populations, it is possible that OSAS may contribute to neurocognitive and psychosocial deficits in PWS. The present review examines this possibility. While acknowledging a primary contribution from the primary genetic abnormality to central neural dysfunction in PWS, we conclude that OSAS may be an important secondary contributing factor to reduced neurocognitive and psychosocial performance. Treatment of OSAS may have potential benefits in improving neurocognitive performance and behavior in PWS, but this awaits confirmatory investigation.     

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.     

Associations between sleep variables and ostensibly paranormal experiences and paranormal beliefs: A scoping review

Night-time is a period of great significance for many people who report paranormal experiences. However, there is limited understanding of the associations between sleep variables and seemingly paranormal experiences and/or beliefs. The aim of this review is to improve our understanding of these associations while unifying a currently fragmented literature-base into a structured, practical review. In this pre-registered scoping review, we searched for relevant studies in MEDLINE (PubMed), PsycINFO (EBSCO), Web of Science and EMBASE using terms related to sleep and ostensibly paranormal experiences and beliefs. Forty-four studies met all inclusion criteria. All were cross-sectional and most investigated sleep paralysis and/or lucid dreaming in relation to ostensibly paranormal experiences and paranormal beliefs. Overall, there were positive associations between many sleep variables (including sleep paralysis, lucid dreams, nightmares, and hypnagogic hallucinations) and ostensibly paranormal experiences and paranormal beliefs (including those of ghosts, spirits, and near-death experiences). The findings of this review have potential clinical implications such as reducing misdiagnosis and treatment development and provide foundations for further research. Our findings also highlight the importance of understanding why so many people report ‘things that go bump in the night’.     

The longitudinal associations between temperament and sleep during the first year of life

Temperament and sleep in infants are related but also distinct concepts. The longitudinal effects of temperament on sleep in infancy remain unclear, although this information is potentially important for the prevention and treatment of early sleep problems. We examined how various temperament features influence sleep development during the first year of life in a large birth cohort. This study comprised mother-infant dyads with complete longitudinal data on sleep, temperament and sociodemographic measurements at six and 12 months (N = 1436). We observed that higher infant Negative Affectivity was related to several sleep problems, and that many subscales of Negative Affectivity and Orienting/Regulation predicted worse sleep and deterioration in sleep problems from six to 12 months. Few associations between Surgency and sleep were found. Our findings highlight especially Negative Affectivity as a risk factor for persistent and increasing sleep problems, and also the specific importance of the fine-grained aspects of temperament in predicting infant sleep development.