Do anxiety sensitivity cognitive concerns and/or depression symptoms independently explain sleep disturbances in a high anxiety sensitive treatment-seeking sample?

Cognitive models of insomnia posit a role for anxiety sensitivity (AS) in sleep difficulties. While sleep disturbances have been linked to AS, particularly AS cognitive concerns, prior studies have rarely accounted for the correlated construct of depression. We used pre-treatment intervention trial data from 128 high AS, treatment-seeking adults with a DSM-5 diagnosis of an anxiety, depressive, or posttraumatic stress disorder to determine whether AS cognitive concerns and/or depression are independently associated with sleep impairment domains (e.g., sleep quality, latency, daytime dysfunction). Participants provided data on AS, depressive symptoms, and sleep impairments. AS cognitive concerns (but not other AS dimensions) were correlated with four of five sleep impairment domains; depression was correlated with all five. Multiple regressions revealed four of five sleep impairment domains were predicted by depression with no independent contribution of AS cognitive concerns. In contrast, AS cognitive concerns and depression were independently associated with daytime dysfunction. Results suggest previous findings linking AS cognitive concerns to sleep impairments may have been largely secondary to the overlap of cognitive concerns with depression. Findings demonstrate the importance of incorporating depression into the cognitive model of insomnia. Both AS cognitive concerns and depression may be useful targets for reducing daytime dysfunction.

A bibliometric analysis of sleep in older adults

Background

Sleep problems severely affect the quality of life in the elderly and have gradually gained attention among scholars. As a major hot spot of current research, sleep in older adults is highly exploratory and of great significance for human health.

Objective

Therefore, in this study, the current state of the art of sleep research in older adults was analyzed through the visual mapping function of CiteSpace software. Using this software, we analyzed popular research questions and directions and revealed the development trends and research frontiers of this field.

Methods

In this paper, we searched the Web of Science database for sleep-related studies focusing on older adults and analyzed the number of publications, journals, authors, institutions, country regions, and keywords by using CiteSpace software.

Results

Our results revealed that the number of publications concerning sleep in older adults has gradually increased; after 2017, this field underwent rapid development. The journal Sleep has published the majority of the articles on sleep in older adults and has the highest citation frequency. The Journal of the American Geriatrics Society has the highest impact factor and CiteScore among the top 10 journals in terms of the number of published articles. The United States has the highest number of publications and most of the leading institutions in this field are located in the United States, with the University of California, Los Angeles, and the University of Pittsburgh having the highest number of publications. Dzierzewski JM is the most published author and has played an important role in guiding the development of this field. Research in this area is focused on insomnia, sleep quality, depression, and sleep duration.

Conclusion

The rapid development of sleep research in older adults, which shows a yearly growth trend, indicates that this field is receiving increasing attention from researchers. Insomnia in older adults is the most concerning problem in this field. At the same time, future research should continue to focus on the impact of sleep disorders on older adults to improve sleep and quality of life in older adults.

Dreams and nightmares during the pandemic

The pandemic caused by the coronavirus disease 2019 (COVID-19) had a huge impact on public mental health. This was also reflected in dreams. Not only did people start to remember more dreams, but dream content changed as themes like sickness, confinement, and-in the English-speaking world-even bugs began to dominate. This also led to an increase in nightmare frequency. There are various factors that contributed to this change in the dream landscape. Some people have started to sleep more and hereby spend more time in REM sleep, which is known to increase dream recall and further lead to bizarre and vivid dreams. On the other hand, stress and poor mental health had an impact on sleep, and sleep quality thus dropped in many individuals. Poor sleep quality can also lead to an increase in dream recall. Dreams are known to regulate mood, so the rise in dreams and the change in dream content could also reflect a reaction to the overall rise in stress and decline in mental health. Recent studies have shown that as the pandemic progresses, further changes in mental health, dream recall, and dream content arise, but data are still scarce. Further research could help understand the impact the pandemic still has on mental health and dreams, and how this impact is changing over the course of the pandemic.

The Concomitant Pattern of Association Between Subjective Global Sleep Quality and Daytime Dysfunction in Hypnotic-Treated Older Adults: The Yilan Study, Taiwan

OBJECTIVE

The relationship between improvements in subjective sleep quality and restoration of daytime function remains unclear. This study aimed to examine the concomitant pattern between subjective sleep quality and daytime dysfunction in hypnotic-treated older adults.

METHODS

This was a community-based, cross-sectional study. Participants comprised community-dwelling adults aged ≥ 65 years. Individual items from the Pittsburgh Sleep Quality Index (PSQI) were adopted to evaluate subjective global sleep quality and daytime dysfunction. Daytime dysfunction included composite scores of daytime dysfunction in the PSQI and its two sub-components: "staying awake" and "maintaining enthusiasm." Based on hypnotic use and status in subjective sleep quality, participants were categorized into four groups: "healthy control," "treated with good sleep quality (T+GSQ)," "treated with poor sleep quality (T+PSQ)," and "not treated with poor sleep quality (NT+PSQ)". The associations between these four groups and daytime dysfunction were analyzed using logistic regression.

RESULTS

In total, 2622 individuals participated in the study. After controlling for covariates, the T+PSQ group was more likely to have daytime dysfunction, including "composite daytime dysfunction" (OR: 6.41; 95% CI: 3.90-10.55), "poor at staying awake" (OR: 3.04; 95% CI: 1.45-6.37), and "poor at maintaining enthusiasm" (OR: 7.42; 95% CI: 4.33-12.70) compared to the T+GSQ group. However, the healthy control group was less likely than the T+GSQ group to present with daytime dysfunction, including "composite daytime dysfunction" (OR: 0.43; 95% CI: 0.26-0.72) and "poor at maintaining enthusiasm" (OR: 0.39; 95% CI: 0.22-0.68).

CONCLUSION

Subjective sleep quality attributed to hypnotic use did not necessarily indicate restoration of daytime dysfunction.

Case Report: Why Sleep and Dream Related Psychological Treatments, Such as Sleepcoaching (According to Holzinger&Klösch) and CBT-I Should Be Implemented in Treatment Concepts in the Public Health System-Description of the Nightmare Treatment Process in the Context of PTSD

In this case report, we explain the story of a woman diagnosed with severe PTSD, suffering from recurrent nightmares involving a traumatizing event. She participated in 6 week lucid dreaming training to help her reduce her nightmare frequency. Our descriptions include her dream reports as well as the results of the psychological assessment conducted. In only 6 weeks, she was able to begin to change her dream plots and to improve several of the psychological measures. In this case, we stated that paying more attention to sleep and, especially nightmares, not only in patients with PTSD, should be standard in treatment processes for psychiatric disorders. We, therefore, underpin our case with literature that explains the benefits of treatments, specifically for sleep problems that do not involve medication.