Summary
Although patients with insomnia often show a discrepancy between self‐reported and objective sleep parameters, the role of and change in this phenomenon during treatment remain unclear. The ...present study aimed to assess the effect of cognitive behavioural therapy for insomnia on subjective and objective sleep discrepancy of total sleep time, sleep‐onset latency and wake after sleep onset. The total sleep time discrepancy was also assessed across the entire therapy. The second aim was to examine the treatment outcome of two insomnia groups differing in sleep perception. Thirty‐six adults with insomnia (mean age = 46.7 years, SD = 13.9; 22 females) were enrolled in the final analyses. Patients underwent a 6‐week group cognitive behavioural therapy for insomnia programme. Sleep diary and actigraphy measurements were obtained during the therapy. Patients who underestimated total sleep time (n = 16; underestimating group) were compared with patients who accurately perceived or overestimated total sleep time (n = 20; accurate/overestimating group). After cognitive behavioural therapy for insomnia, a significant decrease of total sleep time and sleep‐onset latency discrepancy was observed without a change in wake after sleep onset discrepancy in the total sample. Only the underestimating group reported decreased sleep‐onset latency discrepancy after the treatment, whereas total sleep time discrepancy significantly changed in both groups. The underestimating group showed a significant decrease of total sleep time discrepancy from Week 1 to Week 2 when the sleep restriction was implemented, whereas the accurate/overestimating group showed the first significant change at Week 4. In conclusion, both groups differing in sleep perception responded similarly to cognitive behavioural therapy for insomnia, although different In conclusion, both groups differing in sleep perception responded similarly to cognitive behavioural therapy for insomnia, although different therapeutic components could play important roles in each group. components could play important roles in each group.
Abstract
Study Objectives
Recurrent isolated sleep paralysis (RISP) is a rapid eye movement (REM) parasomnia characterized by a dissociative state with characteristics of REM sleep and wakefulness. ...Pathophysiology has not yet been clarified and very little research has been performed using objective polysomnographic measures with inconsistent results. The main aim of our study was to find whether higher REM sleep fragmentation is consistent with the theory of state dissociation or whether signs of dissociation can be detected by spectral analysis.
Methods
A total of 19 participants in the RISP group and 19 age- and gender-matched participants in the control group underwent two consecutive full-night video-polysomnography recordings with 19-channel electroencephalography. Apart from sleep macrostructure, other REM sleep characteristics such as REM sleep arousal index, percentage of wakefulness and stage shifts within REM sleep period were analyzed, as well as power spectral analysis during REM sleep.
Results
No difference was found in the macrostructural parameters of REM sleep (percentage of REM sleep and REM latency). Similarly, no significant difference was detected in REM sleep fragmentation (assessed by REM sleep arousal index, percentage of wakefulness and stage shifts within REM sleep). Power spectral analysis showed higher bifrontal beta activity in the RISP group during REM sleep.
Conclusions
The results showed an underlying persistent trait of higher cortical activity that may predispose patients with sleep paralysis to be more likely to experience recurrent episodes, without any apparent macrostructural features including higher REM sleep fragmentation.
The objective of the present study was to assess the effect of combining CBT-I with wearing blue-light blocking glasses 90 min prior to bedtime on subjective and objective sleep parameters and daily ...symptoms (anxiety, depression, hyperarousal). Thirty patients (mean age 48.1 ± 16.13 years, range 21-71, 15 men/15 women) completed a CBT-I group therapy program, with groups randomly assigned to either "active" (blue-light filtering glasses) condition or "placebo" (glasses without filtering properties) condition. Patients were continually monitored by wristwatch actigraphy, kept their sleep diaries and completed a standard questionnaire battery at admission and after the end of the program. Statistical analyses showed a greater reduction of BAI score in "active" (4.33 ± 4.58) versus "placebo" (-0.92 ± 3.68) groups of patients F = 6.389,
= .019, Cohen's d = 1.26 and significant prolongation of subjective total sleep time in "active" (-36.88 ± 48.68 min.) versus "placebo" (7.04 ± 47.50 min.) F = 8.56, p < .01, d = 0.91 group. When pre- and post-treatment results were compared in both groups separately, using paired-samples t-tests, significant differences were observed also in the active group for BDI-II score (t = 3.66,
= .003, Cohen's d = 0.95) and HAS score (t = 2.90,
= .012, Cohen's d = 0.75). No significant differences were found in the placebo group. In active group, there was also a significant reduction of subjective sleep latency (t = 2.65,
= .021, d = 0.73) and an increase of subjective total sleep time (t = -2.73,
= .018, d = -0.76) without change in objective sleep duration which was significantly shortened in the placebo group. We provide further evidence that blocking short-wavelength light in the evening hours may be beneficial for patients suffering from insomnia.
Serotonergic agonist psilocybin is a psychedelic with antidepressant potential. Sleep may interact with psilocybin's antidepressant properties like other antidepressant drugs via induction of ...neuroplasticity. The main aim of the study was to evaluate the effect of psilocybin on sleep architecture on the night after psilocybin administration. Regarding the potential antidepressant properties, we hypothesized that psilocybin, similar to other classical antidepressants, would reduce rapid eye movement (REM) sleep and prolong REM sleep latency. Moreover, we also hypothesized that psilocybin would promote slow-wave activity (SWA) expression in the first sleep cycle, a marker of sleep-related neuroplasticity. Twenty healthy volunteers (10 women, age 28-53) underwent two drug administration sessions, psilocybin or placebo, in a randomized, double-blinded design. Changes in sleep macrostructure, SWA during the first sleep cycle, whole night EEG spectral power across frequencies in non-rapid eye movement (NREM) and REM sleep, and changes in subjective sleep measures were analyzed. The results revealed prolonged REM sleep latency after psilocybin administration and a trend toward a decrease in overall REM sleep duration. No changes in NREM sleep were observed. Psilocybin did not affect EEG power spectra in NREM or REM sleep when examined across the whole night. However, psilocybin suppressed SWA in the first sleep cycle. No evidence was found for sleep-related neuroplasticity, however, a different dosage, timing, effect on homeostatic regulation of sleep, or other mechanisms related to antidepressant effects may play a role. Overall, this study suggests that potential antidepressant properties of psilocybin might be related to changes in sleep.
Insomnia is a prevalent and disabling condition whose treatment is not always effective. This pilot study explores the feasibility and effects of closed-loop auditory stimulation (CLAS) as a ...potential non-invasive intervention to improve sleep, its subjective quality, and memory consolidation in patients with insomnia. A total of 27 patients with chronic insomnia underwent a crossover, sham-controlled study with 2 nights of either CLAS or sham stimulation. Polysomnography was used to record sleep parameters, while questionnaires and a word-pair memory task were administered to assess subjective sleep quality and memory consolidation. The initial analyses included 17 patients who completed the study, met the inclusion criteria, and received CLAS. From those, 10 (58%) received only a small number of stimuli. In the remaining seven (41%) patients with sufficient CLAS, we evaluated the acute and whole-night effect on sleep. CLAS led to a significant immediate increase in slow oscillation (0.5-1 Hz) amplitude and activity, and reduced delta (1-4 Hz) and sigma/sleep spindle (12-15 Hz) activity during slow-wave sleep across the whole night. All these fundamental sleep rhythms are implicated in sleep-dependent memory consolidation. Yet, CLAS did not change sleep-dependent memory consolidation or sleep macrostructure characteristics, number of arousals, or subjective perception of sleep quality. Results showed CLAS to be feasible in patients with insomnia. However, a high variance in the efficacy of our automated stimulation approach suggests that further research is needed to optimise stimulation protocols to better unlock potential CLAS benefits for sleep structure and subjective sleep quality in such clinical settings.
Objectives. Psychometric properties of the Czech version of the Pittsburgh Sleep Quality Index (PSQI-CZ) have been evaluated only in patients with chronic insomnia, and thus, it is unclear whether ...PSQI-CZ is suitable for use in other clinical and nonclinical populations. This study was aimed at examining the validity and reliability of the PSQI-CZ and at assessing whether the unidimensional or multidimensional scoring of the instrument would be recommended. Methods. A total of 524 adult subjects from the Czech population participated in the study. The internal consistency of PSQI was evaluated using Cronbach’s alpha. The known-group validity was tested using the Kruskal-Wallis H test to verify the difference between patients with sleep disorders and healthy control sample. For testing the structural validity, a cross-validation approach was used with both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). For EFA, the maximum likelihood method with direct oblimin rotation and parallel analysis was used. Results. The internal consistency of PSQI-CZ items was moderate (α=0.75). Receiver operating characteristic (ROC) curve analysis showed high specificity (0.79) and moderate sensitivity (0.64) using an optimal cut-off score of 10. The EFA revealed a 3-factor structure with factors labelled as “sleep duration and efficiency,” “sleep disturbances and quality,” and “sleep latency.” The CFA showed that the emerged 3-factor model had a partly acceptable fit, which was better than other previously supported models. Conclusions. A high cut-off score of 10 is recommended to define poor sleep quality. Given the inconsistency of structural analyses, alternative scoring was not recommended. However, the individual components in addition to a total score should be interpreted when assessing sleep quality. We recommend editing and verifying the PSQI-CZ translation.
Study Objectives: Recurrent isolated sleep paralysis (RISP) is a rapid eye movement (REM) parasomnia characterized by a dissociative state with characteristics of REM sleep and wakefulness. ...Pathophysiology has not yet been clarified and very little research has been performed using objective polysomnographic measures with inconsistent results. The main aim of our study was to find whether higher REM sleep fragmentation is consistent with the theory of state dissociation or whether signs of dissociation can be detected by spectral analysis. Methods: A total of 19 participants in the RISP group and 19 age- and gender-matched participants in the control group underwent two consecutive full-night video-polysomnography recordings with 19-channel electroencephalography. Apart from sleep macrostructure, other REM sleep characteristics such as REM sleep arousal index, percentage of wakefulness and stage shifts within REM sleep period were analyzed, as well as power spectral analysis during REM sleep. Results: No difference was found in the macrostructural parameters of REM sleep (percentage of REM sleep and REM latency). Similarly, no significant difference was detected in REM sleep fragmentation (assessed by REM sleep arousal index, percentage of wakefulness and stage shifts within REM sleep). Power spectral analysis showed higher bifrontal beta activity in the RISP group during REM sleep. Conclusions: The results showed an underlying persistent trait of higher cortical activity that may predispose patients with sleep paralysis to be more likely to experience recurrent episodes, without any apparent macrostructural features including higher REM sleep fragmentation. Key words: polysomnography; recurrent isolated sleep paralysis; REM fragmentation; REM pathophysiology; REM sleep; REM sleep arousal index; power spectral analysis
Psilocybin is investigated as a fast-acting antidepressant used in conjunction with psychotherapy. Intact cognitive functions, including memory, are one of the basic conditions of effective ...psychedelic-assisted therapy. While cognitive and memory processing is attenuated on various domains during psilocybin intoxication, the effect of psilocybin on the consolidation of memories learned outside of acute intoxication is not known. Thus the main aim of the current study was to test the effects of psilocybin on (A) memory consolidation of previously learned material just after the psilocybin session and (B) on overnight memory consolidation the night just after the psilocybin session. 20 healthy volunteers (10 M/10F) were enrolled in a placebo-controlled, double-blind, cross-over design. Effects on declarative memory consolidation in condition (A) The Groton Maze Learning Task and Rey Auditory Verbal Learning Test were used, and for (B) the Pair Associative Learning Test was used. We did not find psilocybin to improve memory consolidation. At the same time, we did not find psilocybin to negatively affect memory consolidation in any of the tests used. This evidence adds to the safety profile for the use of psilocybin.
Background: Insomnia is one of the most prevalent sleep disorders, negatively impacting the quality of life and increasing the risk of other health problems. Many patients with insomnia underestimate ...their sleep quantity compared to objective sleep measures. This objective and subjective sleep discrepancy (sleep misperception) occurs in different insomnia subtypes as well as in insomnia with a comorbid psychiatric disorder. Although previous research suggests that the sleep discrepancy reflects specific objective sleep alterations, the results of studies are inconsistent. Moreover, its relation to psychiatric comorbidities is not clear, as well as its role in the insomnia treatment. Aims: The theoretical part of the present thesis aimed to provide an overview of the recent research on sleep discrepancy in insomnia. The experimental part consists of four studies with the following goals: (1) to explore sleep electroencephalographic (EEG) correlates of sleep discrepancy in insomnia patients (Study 1); (2) to assess the association between sleep discrepancy and psychopathology (Study 2); (3) to examine changes of sleep discrepancy during and after the cognitive behavioural therapy for insomnia (CBT-I; Study 3); (4) to assess whether the additional chronotherapeutic tool can enhance the effect of CBT-I...
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