Delayed Sleep Timing in Obsessive-Compulsive Disorder Is Associated With Diminished Response to Exposure and Ritual Prevention

Exposure and ritual prevention (ERP) and pharmacotherapy are typically associated with significant symptom reductions for individuals with obsessive-compulsive disorder (OCD). However, many patients are left with residual symptoms and other patients do not respond. There is increasing evidence that delays in sleep timing/circadian rhythms are associated with OCD but the potential effects of delays in sleep timing on ERP warrant attention. This paper presents data from 31 outpatients with OCD who participated in ERP. Results showed that delayed sleep timing was common and that individuals with delayed bedtimes benefited significantly less from treatment and were significantly more likely to be nonresponders compared to individuals with earlier bedtimes. Further, the effects of sleep timing remained statistically significant even after controlling for global sleep quality, negative affect, and several other variables. These findings add to a growing literature suggesting the utility of better understanding the role of disruptions in the timing of sleep in OCD.     

Effects of daily maladaptive coping on nightly sleep in mothers

Objective: We examined effects of daily rumination and suppression in response to stressors on objective and subjective sleep among mothers.

Design: Participants were 183 mothers, including chronically stressed mothers of children with an autism spectrum disorder (M-ASD; n = 92) and age-matched mothers of neurotypical children (M-NT; n = 91). In an intensive longitudinal design, participants provided reports of daily rumination and suppression, nightly objective actigraphy-defined sleep and nightly subjective sleep quality for seven consecutive days at baseline, 9 months and 18 months.

Main Outcome Measures: Total sleep time, sleep fragmentation, sleep onset latency, and subjective sleep quality.

Results: Among M-NT with above average depressive symptoms, higher daily rumination was associated with shorter total sleep time. Rumination was associated with more sleep fragmentation among M-NT at the trend level. Rumination was not associated with sleep onset latency among M-NT, or with any sleep outcomes among M-ASD. Suppression was not associated with any sleep outcomes.

Conclusion: We provide novel evidence of the effect of rumination on objectively measured sleep duration among M-NT. Coping was not related to sleep among M-ASD. Given the prevalence of poor sleep among mothers, future work should examine modifiable factors perpetuating sleep disturbance.     

No seasonality in cognitive performance among adolescents at a subarctic latitude (69°N)

Seasonal changes in daylight are substantial in subarctic areas and are known to affect circadian sleep rhythms. We examined whether seasonality in cognitive performance also exists and to what extent seasonality in sleep moderates this relationship. In the city of Tromsø (Norway) at 69°N, 182 adolescents (36% male; mean age 16.8 years) participated in a prospective study. The cognitive measures included verbal and visual memory, verbal learning, psychomotor speed, and problem solving, whereas sleep and sleep‐related problems were recorded via weekly sleep diaries and questionnaires. The results indicated no effect of season on any of the cognitive tests. Seasonality in sleep timing, insomnia, and fatigue were confirmed; however, these variables did not modify the null correlation between season and cognition. The lack of seasonality in cognition is a positive finding and serves to undermine myths about the burdens of living in subarctic areas with substantial seasonal changes in daylight.     

Prospective Associations Between Sleep Disturbance and Repetitive Negative Thinking: The Mediating Roles of Focusing and Shifting Attentional Control

Although considerable evidence has linked sleep disturbance to symptoms of psychopathology, including repetitive negative thinking, few studies have examined how sleep disturbance may predict repetitive negative thinking over time. Further, no study to date has examined specific mechanisms that may account for this relationship. The present study sought to address these gaps in the literature by testing focusing and shifting attentional control as two potential mediators of the relationship between sleep disturbance and repetitive negative thinking over a 6-month period. A final sample of 445 unselected community participants completed measures of sleep disturbance and repetitive negative thinking at Time 1, measures of focusing and shifting attentional control 3 months later, and measures of repetitive negative thinking again 6 months later. Results revealed that focusing, but not shifting, attentional control mediated the relationship between sleep disturbance and repetitive negative thinking, specifically, worry, rumination, and obsessions. These findings provide preliminary evidence for focusing attentional control as a candidate mechanism that may explain the causal role of sleep disturbance in the development of repetitive negative thinking observed in various disorders.     

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.     

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.     

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.