Sleep Quality and the Stress‐Buffering Role of Religious Involvement: A Mediated Moderation Analysis

Although several studies have documented an inverse association between stressful events and sleep quality, much less is known about the factors that might moderate or buffer against the adverse effects of psychosocial stress on sleep. Building on previous research, we employ national cross‐sectional survey data from the 2017 Baylor Religion Survey (n= 1,410) to test whether the association between recent stressful events and sleep quality varies according to several dimensions of religious involvement. We also formally assess whether any attenuation of the association between stressful events and sleep quality is at least partially mediated or explained by lower levels of depressive symptoms (mediated moderation). Our moderation analyses indicate that the inverse association between stressful events and sleep quality is in fact attenuated by religious cognitions (secure attachment to God and assurance of salvation), but not religious attendance or private religiousness. We also observe direct evidence of mediated moderation through depressive symptoms for both religious cognitions. Taken together, our results demonstrate that religious cognitions may buffer against stress‐related sleep disturbance by helping people avoid symptoms of depression.     

Evaluating motion detection to score sleep disturbance for children: A translational approach to developing a measurement system

Information obtained via direct observation of children's sleep disturbance throughout the night in their home can guide the assessment and treatment process, but watching live or via recorded video might be impractical in terms of time expenditures. In Experiment 1, we assessed the accuracy and reliability of a motion‐detection camera with human motor movements. In Experiment 2, we tested the system's generality by using it to obtain in‐home measures of sleep disturbance for three children with autism spectrum disorder and compared the accuracy to a continuous measurement system. We also measured scoring efficiency and assessed parents' acceptability of the camera. Results provide preliminary support for motion detection in measuring sleep disturbance, but further evaluation of motion detection to improve accuracy is warranted.     

Rapid eye movement sleep dreaming is characterized by uncoupled EEG activity between frontal and perceptual cortical regions

EEG coherent activity is involved in the binding of spatially separated but temporally correlated stimuli into whole events. Cognitive features of rapid eye movement sleep (REM) dreaming resemble frontal lobe dysfunction. Therefore, temporal coupling of EEG activity between frontal and perceptual regions was analyzed from 10 min prior to dream reports (8 adults) from stage-2 and REM sleep. EEG correlation between frontal and perceptual regions decreased and, among perceptual regions increased during REM. The temporal dissociation of EEG activity between executive and perceptual regions supplies an inadequate mechanism for the binding and interpretation of ongoing perceptual activity resulting in dream bizarreness.     

The utility of the Pittsburgh Sleep Quality Index in US military personnel

Sleep disturbances are endemic in military personnel with nonclinical populations averaging 6 hours of sleep. The Pittsburgh Sleep Quality Index (PSQI), however, has not been validated in this population. It is thus unknown if the PSQI can differentiate clinically significant sleep disorders from sleep disturbances resulting from military duties with restricted sleep periods. After a clinical evaluation and polysomnogram, participants (N = 148) were classified as having insomnia only, obstructive sleep apnea (OSA) only, comorbid insomnia and OSA (CIO), service-related illnesses only (SRI–; pain, depression, posttraumatic stress disorder, traumatic brain injury), and controls. Military personnel in the insomnia only, and the CIO groups had higher PSQI scores (13.5 ± 2.8 and 14.7 ± 3.5, respectively) compared to the controls (8.9 ± 3.9). A cut-off score of ≥10 was optimal (90% sensitivity and 69% specificity) for determining clinically significant insomnia (≥12 for CIO; 84% sensitivity, 77% specificity). In military personnel, a PSQI score >5 is not necessarily indicative of a clinically significant sleep disorder. The use of elevated cut-off PSQI scores are likely better suited to differentiate military personnel who require further clinical evaluation versus a more conservative sleep improvement protocol.     

Positive emotional attention bias in young children with symptoms of ADHD

Children with attention-deficit/hyperactivity disorder (ADHD) often experience emotional dysregulation. Dysregulation can arise from heightened attention to emotional stimuli. Emotional attention biases are associated with a number of adverse socioemotional outcomes including reward sensitivity and externalizing behaviors. As reward sensitivity and externalizing behaviors are common in children with ADHD, the aim of the current study was to determine whether emotional attention biases are evident in young children with clinically significant ADHD symptoms. To test this, children with (n = 18) and without (n = 15) symptoms of ADHD were tested on a Dot Probe task. Provided recent evidence that emotional attention biases are attenuated by sleep, the task was performed before and after overnight sleep. Children with ADHD symptoms displayed positive, but not negative, attention biases at both time points, whereas typically developing children did not preferentially attend toward or away from positive or negative stimuli. Sleep did not alter attention biases in either group. Collectively, these results indicate that children with ADHD symptoms have stable, positive attention biases.     

IGNORING CHILDREN'S BEDTIME CRYING: THE POWER OF WESTERN‐ORIENTED BELIEFS

Ignoring children's bedtime crying (ICBC) is an issue that polarizes parents as well as pediatricians. While most studies have focused on the effectiveness of sleep interventions, no study has yet questioned which parents use ICBC. Parents often find children's sleep difficulties to be very challenging, but factors such as the influence of Western approaches to infant care, stress, and sensitivity have not been analyzed in terms of ICBC. A sample of 586 parents completed a questionnaire to investigate the relationships between parental factors and the method of ICBC. Data were analyzed using structural equation modeling. Latent variables were used to measure parental stress (Parental Stress Scale; J.O. Berry & W.H. Jones, 1995), sensitivity (Situation‐Reaction‐Questionnaire; Y. Hänggi, K. Schweinberger, N. Gugger, & M. Perrez, 2010), Western‐oriented parental beliefs (Rigidity), and children's temperament (Parenting Stress Index; H. Tröster & R.R. Abidin). ICBC was used by 32.6% (n = 191) of parents in this study. Parents’ Western‐oriented beliefs predicted ICBC. Attitudes such as feeding a child on a time schedule and not carrying it out to prevent dependence were associated with letting the child cry to fall asleep. Low‐sensitivity parents as well as parents of children with a difficult temperament used ICBC more frequently. Path analysis shows that parental stress did not predict ICBC. The results suggest that ICBC has become part of Western childrearing tradition.     

The impact of pre-sleep arousal state and strategy to control unwanted thoughts on sleep quality

Objective: It has been questioned whether elevated pre-sleep cognitive arousal contributes to poor sleep or whether it is the use of maladaptive thought control strategies, used to manage this cognitive arousal, that are responsible. The study aimed to examine how these factors – cognitive arousal (with and without anxiety) and maladaptive thought control strategies contribute to perceived sleep quality (SQ). Design: 129 “healthy adults” (46 males, 83 females) were exposed to picture-stimuli eliciting either anxious cognitive arousal or non-anxious cognitive arousal at bedtime. The groups were then randomly split and briefed to use either a cognitive distraction or cognitive suppression thought control strategy or no instructions were given (controls). Subjective SQ was measured immediately on waking. Results: Induced anxious cognitive arousal was associated with lower SQ compared to non-anxious cognitive arousal. Analyses revealed a significant interaction between arousal and the strategies used to control unwanted thoughts on SQ. When experiencing anxious cognitive arousal, the strategy of distraction was associated with poorer sleep outcomes. Conclusion: The findings suggest that the efficacy of differing thought control strategies vary depending upon whether cognitive arousal elicits anxiety or not. With that in mind, clinical implications in terms of augmenting the treatment of insomnia are discussed.     

A population-based 2-year longitudinal study of insomnia disorder in a Chinese population in Hong Kong

There is a paucity of literature examining the longitudinal course of insomnia using standardized diagnostic criteria. This study aims to evaluate the persistence, remission, relapse, and incidence rates of insomnia symptoms and insomnia disorders according to the Diagnostic and Statistical Manual of Mental Disorders, 4th and 5th edition (DSM-IV and DSM-5). A total of 398 community dwellers were interviewed annually over two years using the Brief Insomnia Questionnaire, a validated questionnaire for deriving insomnia diagnoses. Normal sleepers were defined according to the DSM-5 quantitative criteria as having insomnia symptoms at most twice per week. Estimates were weighted against population age and sex distribution. Persistence for two consecutive years was 26.3, 26.4, and 23.0% for insomnia symptoms, DSM-IV, and DSM-5 insomnia disorders; remission rate was 55.8, 22.9, and 26.1%, relapse rate was 21.8, 1.3, and 0%, while incidence rate was 62.4, 19.6, and 4.5%. The common trajectories for DSM-IV insomnia disorder were to remain the same (26.4%), followed by a change to insomnia symptoms at the second year (25.7%), and at the third year (17.3%). For DSM-5 insomnia disorder, a change to insomnia symptoms at the second year was the commonest (28.3%), followed by continuing the same (23.0%), and a change to insomnia symptoms at the third year (14.0%). Over a two-year naturalistic follow-up, persistence of insomnia disorder was roughly 25%. Changes from insomnia disorder to insomnia symptoms were common; however, remission only occurred in about 25%, highlighting the chronic course of insomnia, perhaps due to a lack of treatment, under-treatment, or resistance to treatment. Incidence of insomnia symptoms was 62.4%, suggesting a high risk of developing insomnia in the general population.     

Insomnia and eating expectancies among college students: the role of emotion dysregulation

There is limited understanding of the relation between insomnia and aspects of eating among college students though available data suggest salient clinical relationships. The present study explored a potential transdiagnostic mechanism in the relation between insomnia symptoms and eating expectancies. Participants were a racially/ethnically diverse sample of 1589 college students (80.4% females; Mage = 22.2 years, SD = 5.27) from an urban university. Primary analysis included three regression-based models of eating expectancies. Insomnia symptoms served as the predictor, and emotion dysregulation served as the indirect (mediator) variable in all models. Results indicated that insomnia symptoms yielded a significant indirect effect through emotion dysregulation on expectancies of eating to help manage negative affect, alleviate boredom, and lead to feeling out of control. Students experiencing insomnia symptoms may be at higher risk for experiencing dysregulated emotions and consequently maladaptive eating expectancies compared to good sleepers.