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        <title>Frontiers in Sleep | Insomnia section | New and Recent Articles</title>
        <link>https://www.frontiersin.org/journals/sleep/sections/insomnia</link>
        <description>RSS Feed for Insomnia section in the Frontiers in Sleep journal | New and Recent Articles</description>
        <language>en-us</language>
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        <pubDate>2026-04-15T17:20:05.97+00:00</pubDate>
        <ttl>60</ttl>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2025.1707162</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2025.1707162</link>
        <title><![CDATA[Elements of music that work to improve sleep, a narrative review]]></title>
        <pubdate>2025-12-02T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Ethan Y. Pan</author><author>Wei Wang</author>
        <description><![CDATA[Sleep health is essential for overall wellbeing; however, millions of people worldwide experience poor sleep quality due to insomnia, stress, or lifestyle-related disturbances. Pharmacological and behavioral treatments, while effective, remain limited by side effects, accessibility barriers, or patient adherence. In contrast, music is an accessible, low-cost, and non-invasive intervention that is increasingly used by individuals to improve sleep. This narrative review synthesizes findings from randomized controlled trials and meta-analyses to identify the musical elements and delivery methods that are most effective in enhancing sleep quality. Across studies, listening to music consistently reduced sleep-onset latency, improved sleep efficiency, and increased total sleep time. Music that was slow in tempo (60–80 bpm), soft and smooth in melodies, instrumental, and simple in structure, often classical or new age, was most effective. Cultural familiarity, nature sounds, and religious music also demonstrated benefits in specific contexts. Innovative approaches, such as brain-wave music and binaural beats, show promise but require further validation. Optimal dosing included 30–45 min of daily listening before bedtime at comfortable volume levels. Despite strong evidence of short-term benefits, gaps remain in our understanding of the long-term effects, mechanisms of action, and impacts on youth populations. Future research should explore how personalized music interventions and artificial intelligence-generated compositions may advance sleep health. Overall, this review highlights the elements at work that make music a safe, scalable, and culturally adaptable adjunct to traditional sleep therapies.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2025.1635434</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2025.1635434</link>
        <title><![CDATA[Evaluating the Insomnia Severity Index among South African first responders: evidence from classical test theory, Rasch, and Mokken analyses]]></title>
        <pubdate>2025-09-23T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Tyrone B. Pretorius</author><author>Anita Padmanabhanunni</author>
        <description><![CDATA[BackgroundSleep is essential for physical health and psychological wellbeing, and insomnia is strongly associated with mental health difficulties, including depression, anxiety, and fatigue. Among first responders, the prevalence of insomnia is particularly high due to chronic exposure to stress, trauma, and irregular work hours.AimAs part of a broader study focusing on the mental health of first responders in South Africa, the current study examined the psychometric properties of the Insomnia Severity Index from three different psychometric perspectives: classical test theory, Rasch analysis and Mokken scale analysis.MethodsParticipants were first responders (n = 429) in the Western Cape province of South Africa and they included police officers (n = 309) and paramedics (n = 120). They completed the Insomnia Severity Index (ISI), the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, and the Chalder Fatigue Questionnaire.ResultsThe three psychometric paradigms converged to confirm that the ISI measures a unidimensional scale. Furthermore, all three paradigms provided evidence for the construct validity of the ISI. In addition, classical test theory indices provided evidence for convergent and discriminant validity. Lastly, the correlations between insomnia as measured by the ISI and depression, anxiety, and fatigue provided evidence for concurrent validity.ConclusionThese findings affirm that the ISI is a stable and sound tool for assessing insomnia severity within the first responder population. The absence of measurement bias across gender and professional roles also enhances the practical utility of the ISI, as it ensures equitable assessment across subgroups within the first responder workforce. The ISI emerges from this study as a valuable resource for clinicians, researchers, and occupational health professionals working with South African first responders.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2025.1587801</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2025.1587801</link>
        <title><![CDATA[A non-randomized pre-post pilot study of cooling bed sheets in hot sleeping people]]></title>
        <pubdate>2025-09-16T00:00:00Z</pubdate>
        <category>Brief Research Report</category>
        <author>Matthew D. Weaver</author><author>Salim Qadri</author><author>Chidera Ejikeme</author><author>Stuart F. Quan</author><author>Charles A. Czeisler</author><author>Rebecca Robbins</author>
        <description><![CDATA[IntroductionSleeping hot is a common barrier to good sleep. Characteristics of the sleep environment may impact temperature regulation and sleep. We tested the effectiveness of one brand of bed sheets that advertise cooling properties on sleep and vasomotor symptoms.MethodsParticipants were recruited through multiple channels that included potential customers of the intervention sheets and targeted online advertisements. Participants completed a baseline questionnaire, daily electronic diary for 6 weeks, and an end-of-study questionnaire. Assessments included the Pittsburgh Sleep Quality Index and Restorative Sleep Questionnaire. Daily diaries assessed sleep, mood, and perceived temperature during sleep. Within-person responses were compared before and after use of the intervention bed sheets.Results64 participants provided 2,627 total days of data. The study sample was 89% female, mean age 48 (SD 12). Sixty-nine percent of participants reported improved sleep quality after implementing the intervention. Mean improvement on the Pittsburgh Sleep Quality Index was 1.9 (95% CI 1.3–2.6), from 8.0 (SD 3.0) to 6.1 (SD 2.5) at end-of-study. The proportion of participants reporting trouble sleeping due to feeling too hot was reduced from 82.5 to 39.7%. Reported sleep duration increased 26 min (95% CI 14–38 min), from 6.5 h (SD 1.0) to 7.0 h (SD 0.8). Participants also reported improvements in night sweats, restorative sleep, mood, and alertness.ConclusionIndividuals reported improvements on several dimensions of sleep health, reductions in night sweats, and less sleep disruption due to sleeping too hot after implementing the intervention bed sheets. These findings warrant replication in a randomized, placebo-controlled design.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2025.1683978</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2025.1683978</link>
        <title><![CDATA[Editorial: Women in insomnia]]></title>
        <pubdate>2025-09-03T00:00:00Z</pubdate>
        <category>Editorial</category>
        <author>Darlynn M. Rojo-Wissar</author><author>Jessica M. Meers</author><author>Patricia L. Haynes</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2025.1452213</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2025.1452213</link>
        <title><![CDATA[Novel active-feedback device improves sleep quality in insomnia disorder: a randomized placebo-controlled trial]]></title>
        <pubdate>2025-05-16T00:00:00Z</pubdate>
        <category>Clinical Trial</category>
        <author>Antonia Ypsilanti</author><author>Maan van de Werken</author><author>Anna Robson</author><author>Petra Examilioti</author><author>Lambros Lazuras</author>
        <description><![CDATA[ObjectivesInsomnia disorder is a public health challenge associated with impaired cognitive functioning, reduced quality of life, and adverse mental health outcomes. This study examined the effectiveness of SleepCogni, an active-feedback device, in reducing insomnia symptom severity and improving perceived sleep quality in individuals with insomnia disorder.MethodA two-arm, parallel-group trial design was used, with 80 participants randomized to either the experimental group or the placebo control group. Participants provided self-reported measures of insomnia severity, sleep continuity, and user experience as main outcome variables.ResultsRepeated measures analysis of variance showed that participants in the experimental group reported significantly greater improvements in insomnia symptom severity than the control group (Time × Treatment). Although the mean difference did not reach the threshold for clinical significance, 37.5% of the participants achieved this threshold within 1 week of treatment. Mixed-effects models showed significant improvements in sleep efficiency and total sleep time, based on sleep diary records. Finally, an independent samples t-test and content analysis indicated a more positive user experience in the experimental group.ConclusionThe SleepCogni device appears to be a useful tool for improving sleep outcomes in individuals with insomnia disorder, showing effects on both insomnia severity and subjectively evaluated sleep. The SleepCogni device presents a useful intervention that might be used alone or as a complement to increase the effectiveness of existing treatments, such as cognitive behavioral therapy for insomnia.Clinical trial registrationhttps://osf.io/rswcb, identifier: osf-registrations-rswcb-v1.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2025.1459854</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2025.1459854</link>
        <title><![CDATA[Gratitude and sleep disturbance in primary care patients: the mediating roles of health self-efficacy, health behaviors, and psychological distress]]></title>
        <pubdate>2025-04-17T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Heather R. Altier</author><author>Jameson K. Hirsch</author><author>Annemarie Weber</author><author>Niko Kohls</author><author>Jörg Schelling</author><author>Loren L. Toussaint</author><author>Fuschia M. Sirois</author><author>Martin Offenbächer</author>
        <description><![CDATA[IntroductionSleep disturbances are prevalent among primary care patients, and psychological dysfunction, including stress, anxiety, and depression, are robust contributors to poor sleep health. Yet, the presence of potential protective characteristics, such as health self-efficacy and engaging in adaptive health behaviors, may mitigate such outcomes. Gratitude (i.e., recognition and appreciation of experiences, relationships, and surroundings), a positive psychological cognitive-emotional characteristic, may serve as a catalyst of these beneficial downstream effects, given its association with improved health functioning and sleep.MethodsIn a sample of primary care patients (N = 869, M age = 53; 60.7% female) from 50 urban and 30 rural practices in Germany, health self-efficacy (i.e., belief in ability to perform necessary actions to manage health) and constructive health behaviors (i.e., actions taken to modify health positively), separately and together as parallel first-order mediators, and stress, anxiety, and depression, as parallel second-order mediators, were investigated as potential serial mediators of the association between gratitude and sleep disturbances. Participants completed self-report measures in person and online.ResultsSignificant serial mediation was observed across models, although effects varied. In the first model, gratitude was associated with greater health self-efficacy and, in turn, to less stress (a1d21b4 = −0.019, 95% CI [−0.039, −0.002], SE = 0.010), anxiety (a1d31b5 = −0.026, 95% CI [−0.045, −0.008], SE = 0.009), and depression (a1d41b6 = −0.020, 95% CI [−0.040, −0.003], SE = 0.009), and fewer consequent sleep disturbances. In the second model, health behaviors, and anxiety (a1d31b5 = −0.009, 95% CI [−0.019, −0.002], SE = 0.004) and depression (a1d41b6 = −0.007, 95% CI [−0.016, −0.001], SE = 0.004), were serial mediators, but health behaviors and stress were not. In a final combined model, serial mediation occurred on two pathways, health self-efficacy and anxiety (a1d41b6 = −0.026, 95% CI [−0.046, −0.009], SE = 0.009), and health self-efficacy and depression (a1d51b7 = −0.019, 95% CI [−0.037, −0.003], SE = 0.009), and a specific indirect effect was found for health behaviors (a2b4= −0.086, 95% CI [−0.140, −0.030], SE = 0.026), but not self-efficacy.DiscussionOverall, gratitude was associated with reduced sleep disturbances through positive health behavior engagement, and via the serial mediation effects of greater health self-efficacy and lower psychological distress. Clinical interventions that enhance gratitude (e.g., gratitude listing or diaries), self-efficacy (e.g., disease self-management programs), or health behavior engagement (e.g., weight management programs) may promote favorable downstream effects on psychological distress and sleep disturbances among primary care patients.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2025.1557003</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2025.1557003</link>
        <title><![CDATA[Editorial: Online cognitive behavioral therapy for insomnia]]></title>
        <pubdate>2025-03-10T00:00:00Z</pubdate>
        <category>Editorial</category>
        <author>Stuart F. Quan</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2024.1405398</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2024.1405398</link>
        <title><![CDATA[The role of sleep disturbances in associations between early life adversity and subsequent brain and language development during childhood]]></title>
        <pubdate>2024-12-04T00:00:00Z</pubdate>
        <category>Mini Review</category>
        <author>Hatty Lara</author><author>Melissa Nevarez-Brewster</author><author>Cori Manning</author><author>Matthew J. Reid</author><author>Stephanie H. Parade</author><author>Gina M. Mason</author><author>Darlynn M. Rojo-Wissar</author>
        <description><![CDATA[Sleep disturbances are posited to play a key role in the development of poor mental and physical health outcomes related to early life adversity (ELA), in part through effects on brain development. Language development is critically important for health and developmental outcomes across the lifespan, including academic achievement and emotion regulation. Yet, very little research has focused on the dynamic contributions of ELA, sleep, and brain development on language outcomes. In this mini review, we summarize the current pediatric literature independently connecting ELA and sleep to language development, as well as the effects of ELA and sleep on language-relevant aspects of brain structure and function. We then propose a framework suggesting that sleep disturbances and subsequent effects on brain structure and function may act as key mechanisms linking ELA and language development. Future research investigating the associations among ELA, sleep, brain, and language development will refine our proposed framework and identify whether sleep should be included as an intervention target to mitigate the effects of early life adversity on language development.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2024.1424083</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2024.1424083</link>
        <title><![CDATA[Polysomnographically mediated cognitive improvements in individuals with insomnia symptoms following continuous theta-burst stimulation of the default mode network]]></title>
        <pubdate>2024-10-02T00:00:00Z</pubdate>
        <category>Clinical Trial</category>
        <author>Alisa Huskey</author><author>Julia M. Fisher</author><author>Lindsey Hildebrand</author><author>David Negelspach</author><author>Kymberly Henderson-Arredondo</author><author>Samantha Jankowski</author><author>Salma I. Patel</author><author>Ying-Hui Chou</author><author>Natalie S. Dailey</author><author>William D. S. Killgore</author>
        <description><![CDATA[IntroductionInsomnia is associated with mild cognitive impairment, although the mechanisms of this impairment are not well-understood. Timing of slow-wave and rapid eye movement sleep may help explain cognitive impairments common in insomnia. This investigation aimed to determine whether cognitive changes following continuous theta-burst stimulation (cTBS) are attributable to active stimulation, polysomnographic parameters of sleep, or both.MethodData presented here are part of a pilot clinical trial aiming to treat insomnia by targeting a node in the default mode network using an inhibitory 40-s (cTBS). A double-blind counterbalanced sham-controlled crossover design was conducted. Participants (N = 20) served as their own controls on two separate in-laboratory visits—one with active cTBS and the other with sham cTBS. Each visit included cognitive assessments before and after stimulation and following a night of sleep in the lab monitored with polysomnography.ResultsSlow wave sleep duration influenced working memory in the active cTBS condition, with shorter duration predicting improvements in working memory post sleep (B = −0.003, p = 0.095). Onset latency to rapid eye movement sleep predicted subsequent working memory, regardless of treatment condition (B = −0.001, p = 0.040). Results suggest that changes in attention and processing speed were primarily due to slow wave sleep onset (B = −0.001, p = 0.017) and marginally predicted by slow wave sleep duration (B = 0.002, p = 0.081) and sleep efficiency (B = 0.006, p = 0.090).ConclusionsFindings emphasize the important role that timing of slow-wave and rapid eye movement sleep have on information processing. Future work using larger sample sizes and more stimulation sessions is needed to determine optimal interactions between timing and duration of slow wave and rapid eye movement throughout the sleep period.Clinical trial registrationThis study is registered on ClinicalTrials.gov (NCT04953559). https://clinicaltrials.gov/study/NCT04953559?locStr=Arizona&country=United%20States&state=Arizona&cond=insomnia&intr=tms%20&rank=1]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2024.1456045</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2024.1456045</link>
        <title><![CDATA[Exploring the social context of insomnia: a thematic content analysis of the lived experiences of insomnia of Latinx women and men]]></title>
        <pubdate>2024-09-11T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Luciana Giorgio Cosenzo</author><author>Darwin Arias</author><author>Carmela Alcántara</author>
        <description><![CDATA[IntroductionAlthough social ties have detrimental and beneficial effects on sleep health, the social processes through which social ties affect sleep remain understudied, particularly among Latinx adults. These processes include social support, social stress, social control, personal control, and symbolic meaning. Importantly, some studies suggest there are gender differences in how social ties influence Latinx health. This study explores how Latinx women and men with insomnia describe the social processes through which social ties shape their lived experience of insomnia.MethodsQualitative data from six focus groups conducted in 2017 were analyzed using thematic content analysis. These focus groups were comprised of 35 Spanish- and English-speaking Latinx adults with insomnia. Participants were majority women (62.86%), had a mean age of 65.43 years (SD = 12.63), and an average insomnia severity score of 20.6 (SD = 3.44). Major and minor themes were deductively and inductively identified in the transcripts. These themes were compared between Latinx women and men. The methods and results of this study are reported using the Consolidated Criteria for Qualitative Research (COREQ).ResultsThe influence of social processes on the lived experience of insomnia centered on three major themes. The first theme identified social stress and social control as precipitating and perpetuating factors of insomnia. The second theme related to how social support, through receiving advice from others, shaped participants' coping behaviors. Lastly, participants described their insomnia symptoms as negatively affecting their social relationships through social conflict. Latina women attributed their insomnia to the symbolic meaning of their gender identities, while men did not.DiscussionThese findings suggest that among Latinx adults, it may be important for psychological treatments for insomnia to address the ways in which social processes contribute to insomnia symptoms. Additionally, Latina women's discussion of the influence of gender identities on their insomnia symptoms highlights the need to tailor psychological treatments for Latina women that acknowledge and address the challenges presented by traditional gender roles and expectations. Future studies should investigate the potential reciprocal relationship between social processes, mainly social stress and social control, and insomnia symptoms.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2024.1432919</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2024.1432919</link>
        <title><![CDATA[The influence of service dog partnerships on perceived and objective sleep quality for military veterans with PTSD]]></title>
        <pubdate>2024-09-04T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Stephanie Bristol</author><author>Sarah C. Leighton</author><author>A. J. Schwichtenberg</author><author>Rebecca L. Campbell</author><author>Erin L. Ashbeck</author><author>Daniel J. Taylor</author><author>Edward J. Bedrick</author><author>Marguerite E. O'Haire</author>
        <description><![CDATA[IntroductionSleep disturbances, fear of sleep, and nightmares are among the most reported symptoms for military service members and veterans (henceforth “veterans”) with posttraumatic stress disorder (PTSD), potentially contributing to treatment resistance and heightened suicidality. Despite available evidence-based interventions, many veterans still report difficulties. The complementary intervention of a psychiatric service dog may contribute to improvements in sleep quality for veterans with PTSD.MethodsThis preregistered, non-randomized clinical trial evaluated the association between service dog partnership and sleep at 3 month follow-up. Participants were N = 155 veterans with PTSD (81 in the service dog group and 74 waitlisted controls). Measures included self-report surveys measuring PTSD severity (PTSD Checklist for DSM-5, PCL-5) sleep quality (Pittsburgh Sleep Quality Index, PSQI), sleep disturbance (PROMIS Sleep Disturbance), and fear of sleep (Fear of Sleep Inventory-Short Form, FoSI-SF); morning sleep diaries measuring nightmares; and wrist-worn actigraphy. Regression models and mediation analyses were performed.ResultsService dog partnership was significantly associated with better subjective sleep [PSQI: mean difference −2.2, 95% CI (−3.4, −1.1), p < 0.001; PROMIS Sleep Disturbance: −3.6, 95% CI (−6.3, −0.9), p = 0.004; FoSI-SF: −6.6, 95% CI (−9.7, −3.5), p < 0.001] and odds of nightmares [OR = 0.45, 95% CI (0.26, 0.76), p = 0.003]. Service dog partnership was not associated with a change in actigraphy-based measures of sleep [sleep onset: −4.5, 95% CI (−12.2, 3.2); sleep duration: −4.7, 95% CI (−25.9, 16.6); wake after sleep onset: 6.0, 95% CI (−2.1,14.1); sleep efficiency: −0.4, 95% CI (−3.4, 2.5)]. The estimated proportion of the effect of service dogs on PTSD severity mediated by fear of sleep was 0.26 [95% CI (0.10, 0.48)].DiscussionCompared to the control group, veterans with service dogs for PTSD reported better sleep quality, less sleep disturbance, and less fear of sleep after 3 months. However, service dog partnership was not associated with differences in actigraphy-measured sleep. These findings demonstrate the impact of psychiatric service dog partnerships on sleep quality for veterans with PTSD.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2024.1401023</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2024.1401023</link>
        <title><![CDATA[Efficacy of a telehealth cognitive behavioral therapy for improving sleep and nightmares in children aged 6–17]]></title>
        <pubdate>2024-07-11T00:00:00Z</pubdate>
        <category>Clinical Trial</category>
        <author>Lisa DeMarni Cromer</author><author>Sarah Beth Bell</author><author>Lauren E. Prince</author><author>Nicholas Hollman</author><author>Elissar El Sabbagh</author><author>Tara R. Buck</author>
        <description><![CDATA[IntroductionThis study examined the efficacy of a five-module cognitive behavioral therapy for nightmares in children (CBT-NC) and improving sleep.Materials and methodsForty-six youth aged 6–17 years with sleep problems and at least weekly chronic and distressing nightmares were randomized to treatment (n = 23) or waiting list (n = 23) using a block four randomized design. Among participants, 65% (n = 30) were White, 4% (n = 2) were Black/African American, 2% (n = 1) were Asian American, 13% (n = 6) were Native American or Pacific Islander, and 15% (n = 7) were multiracial. Fifty percent of participants (n = 23) were cisgender girls, 35% were cisgender boys (n = 16), 7% were transgender boys (n = 3), and 9% were gender non-binary (n = 4). The baseline nightmare persistence ranged from 6 months to 13.5 years. The treatment adapted exposure, relaxation, and rescription therapy for trauma-related nightmares in adults and added elements of cognitive behavioral therapy for insomnia in children. Psychoeducation included topics of sleep and nightmares, relaxation, anxiety management, and sleep hygiene; the youth were guided through nightmare exposure and rescription.ResultsThere was a statistically significant improvement in the number of nights with awakening (Cohen's d = 1.08), the number of weekly nightmares (Cohen's d = 0.82), and nightmare distress (Cohen's d = 1.05) for the treatment group compared to the wait-list group. Parent-reported youth sleep improved for the entire group from pretreatment to posttreatment (p < 0.001) but did not reach statistical significance for between-subjects analyses of the treatment group compared to the wait-list group (p = 0.05). Between-subjects analyses saw improvement for the treatment group compared to the wait-list group on internalizing and externalizing problems and suicidal thoughts and behaviors.DiscussionThis study supports the efficacy of CBT-NC for improving sleep maintenance, nightmare frequency and distress, and other mental health difficulties in youth. Preliminary evidence of possibly improving suicidal thinking and behavior is also presented.Clinical trial registrationhttps://clinicaltrials.gov/study/NCT05588739, identifier: NCT05588739.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2024.1404684</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2024.1404684</link>
        <title><![CDATA[Insomnia severity and daytime sleepiness in caregivers of advanced age]]></title>
        <pubdate>2024-07-11T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Lucy A. Webster</author><author>Talha Ali</author><author>Jody Sharninghausen</author><author>Alexandra M. Hajduk</author><author>Thomas M. Gill</author><author>Brienne Miner</author>
        <description><![CDATA[ObjectiveAging-related changes and caregiver burden may increase the risk for sleep disturbances among older caregivers, yet few studies have examined the prevalence of insomnia and daytime sleepiness in this group. We examined the relationship of caregiver status with insomnia and daytime sleepiness among persons of advanced age (>75 years of age).DesignCross-sectional.SettingCommunity.ParticipantsYale Precipitating Events Project participants (n=383, mean age 84.4 years, 67% female, 12% African American, 25% caregivers).MeasurementsCaregivers were persons who reported caring for another person in the past week or caring for/helping a friend or relative >4 times in the past month. We examined the correlates of caregiver status, including demographic (age, sex, race/ethnicity, education, marital status), psychosocial (living alone, Medicaid eligibility, depressive symptoms, social support, hours volunteered), and physical (obesity, chronic conditions, medication use, self-rated health status, physical activity, functional disability, cognitive impairment) factors. We used the Insomnia Severity Index (ISI) to establish insomnia severity (ISI score 0–28) or clinically significant insomnia symptoms (ISI ≥8). We used the Epworth Sleepiness Scale to establish daytime sleepiness (ESS score 0–24) or hypersomnia (ESS ≥10). In nonparametric multivariable regression analyses, we examined the relationship of caregiver status with insomnia or daytime sleepiness.ResultsCompared to non-caregivers, caregivers were younger, more educated, less likely to be Medicaid eligible and had lower rates of depression, obesity, poor self-rated health, low physical activity, functional disability, and cognitive impairment. Mean ISI and ESS scores were in the normal range and similar among non-caregivers and caregivers (ISI scores of 6.9±5.6 and 6.9±5.4, and ESS scores of 6.4±4.7 and 6.1±4.3, in non-caregivers and caregivers, respectively). Multivariable-adjusted models demonstrated no significant differences in ISI and ESS scores between non-caregivers and caregivers (regression coefficients for ISI and ESS scores of −0.01 [95% CI = −1.58, 1.21] and −0.10 [−1.05, 1.21], respectively).ConclusionWhen compared to older non-caregivers, older caregivers had more advantageous demographic, psychosocial, and physical profiles and had similar levels of insomnia and daytime sleepiness on standardized questionnaires. Future research is needed to elucidate contextual factors (e.g., caregiving intensity and care partner disease) that may increase the risk of sleep disturbances among caregivers of advanced age.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2024.1383552</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2024.1383552</link>
        <title><![CDATA[Emotion dysregulation in insomnia disorder: the possible role of psychiatric comorbidity]]></title>
        <pubdate>2024-05-30T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Markus Jansson-Fröjmark</author><author>Samiul Hossain</author>
        <description><![CDATA[AimThe purpose of this study was to investigate the link between emotion dysregulation and insomnia disorder as well as the possible role of psychiatric comorbidity on the association. More specifically, the aim was to examine whether the elevations in emotion dysregulation in insomnia are dependent on co-occurring psychiatric comorbidity, in this study defined as anxiety disorders and/or major depression.MethodsFour diagnostically differing groups with 25 participants in each were recruited: normal sleep, normal sleep with psychiatric comorbidity, insomnia disorder, and insomnia disorder with psychiatric comorbidity. The 100 study participants completed self-report scales and items assessing socio-demographic parameters, symptoms of insomnia, anxiety, and depression, generic emotion regulation, and insomnia-specific emotion regulation.ResultsConcerning generic emotion regulation, the results showed that psychiatric comorbidity, but not insomnia, was associated with elevations in generic emotion dysregulation. Psychiatric comorbidity was distinctly related to elevations in non-acceptance, goals, and impulse domains (d = 1.09–1.22). Regarding insomnia-specific emotion regulation, the findings demonstrated that insomnia, with or without psychiatric comorbidity, was related to heightened use of insomnia-associated emotion dysregulation strategies. Insomnia was uniquely associated with elevated unhelpful beliefs about sleep and safety behaviors (d = 1.00–1.04).ConclusionThe current findings support the notion that insomnia is associated with specific, but not generic, emotion dysregulation strategies. These results have relevance for the conceptualization of the role of emotion dysregulation in insomnia and the clinical management of insomnia.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2024.1323967</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2024.1323967</link>
        <title><![CDATA[Effectiveness of applying auricular acupressure to treat insomnia: a systematic review and meta-analysis]]></title>
        <pubdate>2024-04-11T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Li Jun</author><author>Li Xiong</author><author>Yu Wen</author><author>Wang Yongxiang</author>
        <description><![CDATA[BackgroundInsomnia affects the quality of life of a significant number of individuals worldwide. Despite the fact that pharmaceutical sleep treatments have shown brief enhancements in sleep quality, these are still not recommended for the long-term management of sleep issues. To deal with this problem, our study aims to assess the effectiveness of auricular acupressure for treating insomnia by conducting a systematic review and meta-analysis.MethodData from randomized controlled trials (RCTs) of auricular acupressure for insomnia was collected from five English-language databases (Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, AMED, and CINAHL) and four Chinese databases (CBM, CNKI, CQVIP, and Wanfang). Relevant data were extracted by two reviewers. I2 statistics were adopted to appraise heterogeneity. A network meta-analysis was applied to compare the effect of auricular acupressure with other methods.ResultIn all, 23 RCTs involving a total of 1,689 patients were included. The results demonstrated a significant decrease in the Pittsburgh Sleep Quality Index (PSQI) score for the intervention group compared to the control group [SMD = −1.30, 95% CI (−1.65, −0.96), I2 = 90%]. Furthermore, the group receiving auricular acupressure in addition to usual care showed a lower PSQI score compared to the usual care group [SMD = −1.13, 95% CI (−1.33, −0.93), I2 = 23%]. Auricular acupressure was found to enhance the effectiveness of estazolam in improving PSQI score, with the combination of auricular acupressure and estazolam resulting in a lower PSQI score [MD = −4.8, 95% CI (−7.4, −2.1)]. Importantly, no serious adverse events were reported. In patients with insomnia following stroke, the intervention group (which received auricular acupressure) exhibited a lower PSQI score compared to the control group [SMD = −0.74, 95% CI (−1.03, −0.46), I2 = 0%]. Similarly, in patients with insomnia related to cancer, the intervention group (receiving auricular acupressure) demonstrated a lower PSQI score compared to the control group [SMD = −0.99, 95% CI (−1.37, −0.61), I2 = 0%].ConclusionThe effects of auricular acupressure on insomnia are comparable to those of estazolam. Furthermore, auricular acupressure can serve as a complementary treatment to estazolam or other interventions, effectively improving symptoms of insomnia.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2024.1355468</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2024.1355468</link>
        <title><![CDATA[Effect of high-risk sleep apnea on treatment-response to a tailored digital cognitive behavioral therapy for insomnia program: a quasi-experimental trial]]></title>
        <pubdate>2024-03-13T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Alexander Sweetman</author><author>Chelsea Reynolds</author><author>Leon Lack</author><author>Andrew Vakulin</author><author>Ching Li Chai-Coetzer</author><author>Douglas M. Wallace</author><author>Megan Crawford</author><author>Cele Richardson</author>
        <description><![CDATA[IntroductionTherapist-delivered Cognitive Behavioral Therapy for Insomnia (CBTi) is an effective but largely inaccessible treatment for people with Co-Morbid Insomnia and Sleep Apnea (COMISA). To increase CBTi access for COMISA, we aimed to develop a self-guided interactive 5-session digital CBTi program that is appropriate for people with insomnia-alone and COMISA, and compare its effectiveness between people with insomnia-alone, vs. comorbid insomnia and high-risk sleep apnea.MethodsData from 62 adults with insomnia symptoms were used. High-risk sleep apnea was defined as a score of ≥5 on the OSA50. Participants self-reported symptoms of insomnia (ISI), depression, anxiety, sleepiness (ESS), fatigue, and maladaptive sleep-related beliefs (DBAS-16) at baseline, 8-week, and 16-week follow-up. ESS scores were additionally assessed during each CBTi session. Intent-to-treat mixed models and complete-case chi2 analyses were used.ResultsThere were more participants with insomnia-alone [n = 43, age M (sd) = 51.8 (17.0), 86.1% female] than suspected COMISA [n = 19, age = 54.0 (14.8), 73.7% female]. There were no between-group differences in baseline questionnaire data, or rates of missing follow-up data. There were no significant group by time interactions on any outcomes. Main effects of time indicated moderate-to-large and sustained improvements in insomnia (d = 3.3), depression (d = 1.2), anxiety (d = 0.6), ESS (d = 0.5), fatigue (d = 1.2), and DBAS-16 symptoms (d = 1.2) at 16-weeks. ESS scores did not increase significantly during any CBTi session.ConclusionThis interactive digital CBTi program is effective in people with insomnia-alone, and people with co-morbid insomnia and high-risk sleep apnea. Further research is required to determine the effectiveness, safety and acceptability of digital CBTi in people with insomnia and confirmed sleep apnea.Clinical Trial RegistrationThis trial was prospectively registered on the Australian and New Zealand Clinical Trials Registry (ANZCTR, ACTRN12621001395820).]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2024.1271167</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2024.1271167</link>
        <title><![CDATA[Machine learning data sources in pediatric sleep research: assessing racial/ethnic differences in electronic health record–based clinical notes prior to model training]]></title>
        <pubdate>2024-02-14T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Mattina A. Davenport</author><author>Joseph W. Sirrianni</author><author>Deena J. Chisolm</author>
        <description><![CDATA[IntroductionPediatric sleep problems can be detected across racial/ethnic subpopulations in primary care settings. However, the electronic health record (EHR) data documentation that describes patients' sleep problems may be inherently biased due to both historical biases and informed presence. This study assessed racial/ethnic differences in natural language processing (NLP) training data (e.g., pediatric sleep-related keywords in primary care clinical notes) prior to model training.MethodsWe used a predefined keyword features set containing 178 Peds B-SATED keywords. We then queried all the clinical notes from patients seen in pediatric primary care between the ages of 5 and 18 from January 2018 to December 2021. A least absolute shrinkage and selection operator (LASSO) regression model was used to investigate whether there were racial/ethnic differences in the documentation of Peds B-SATED keywords. Then, mixed-effects logistic regression was used to determine whether the odds of the presence of global Peds B-SATED dimensions also differed across racial/ethnic subpopulations.ResultsUsing both LASSO and multilevel modeling approaches, the current study found that there were racial/ethnic differences in providers' documentation of Peds B-SATED keywords and global dimensions. In addition, the most frequently documented Peds B-SATED keyword rankings qualitatively differed across racial/ethnic subpopulations.ConclusionThis study revealed providers' differential patterns of documenting Peds B-SATED keywords and global dimensions that may account for the under-detection of pediatric sleep problems among racial/ethnic subpopulations. In research, these findings have important implications for the equitable clinical documentation of sleep problems in pediatric primary care settings and extend prior retrospective work in pediatric sleep specialty settings.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2024.1322761</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2024.1322761</link>
        <title><![CDATA[Sleep health challenges among women: insomnia across the lifespan]]></title>
        <pubdate>2024-02-12T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Elizabeth Benge</author><author>Milena Pavlova</author><author>Sogol Javaheri</author>
        <description><![CDATA[The presentation of sleep disorders varies widely among women and men, and sleep disorders among women are frequently subject to under- and delayed diagnosis. Insomnia is a complex sleep disorder with a multifactorial etiology, and women face many sex-specific sleep health challenges that may contribute to and influence the presence of insomnia symptoms across their lifespan. These include sex differences in neurobiology, hormonal variation during menstruation, pregnancy and menopause, increased prevalence of mood disorders, increased vulnerability to adverse socioeconomic factors, and gender discrimination, among other psychosocial stressors, particularly among women of racial-ethnic minority. As the medical community continues to recognize the significance of sleep as a vital pillar of overall wellbeing, the integration of sex-specific considerations in research, diagnosis, and treatment strategies is essential to optimizing sleep health for women.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2024.1343393</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2024.1343393</link>
        <title><![CDATA[Current sleep interventions for shift workers: a mini review to shape a new preventative, multicomponent sleep management programme]]></title>
        <pubdate>2024-02-08T00:00:00Z</pubdate>
        <category>Mini Review</category>
        <author>Amber F. Tout</author><author>Nicole K. Y. Tang</author><author>Tracey L. Sletten</author><author>Carla T. Toro</author><author>Charlotte Kershaw</author><author>Caroline Meyer</author><author>Shantha M. W. Rajaratnam</author><author>Talar R. Moukhtarian</author>
        <description><![CDATA[IntroductionShift work can lead to sleep disturbances and insomnia during the sleeping period, as well as excessive sleepiness and fatigue during the waking period. While Cognitive Behavioral Therapy (CBT-i) is recommended as the first line of treatment for insomnia, key elements of CBT-i, such as maintaining a consistent sleep schedule, can be challenging for shift workers, highlighting the need for tailored sleep interventions. This mini review provides a narrative synthesis of non-pharmacological sleep interventions for shift workers and informs the development of a preventative, multicomponent sleep management programme.MethodAn informal review was conducted in line with Phase 1 of the Framework for the Development and Evaluation of Complex Interventions.ResultsA variety of strategies have been employed to help manage the impacts of shift work on sleep, including: CBT-i, adjusting shift schedules, controlled light exposure, sleep hygiene education, planned napping, caffeine consumption, and mind-body interventions (e.g., yogic relaxation).DiscussionRecommendations, limitations, and directions for future research are discussed; notably, the role of the family, the commute to and from the workplace, and the eating behaviors of employees appear to have been overlooked in current intervention efforts. Digital CBT-i platforms could help to provide an effective, scalable, and low-cost method of reducing insomnia in shift workers.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/frsle.2023.1261142</guid>
        <link>https://www.frontiersin.org/articles/10.3389/frsle.2023.1261142</link>
        <title><![CDATA[Outcomes of remotely delivered behavioral insomnia interventions for children and adolescents: systematic review of randomized controlled trials]]></title>
        <pubdate>2024-01-11T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Suncica Lah</author><author>Thanh Vinh Cao</author>
        <description><![CDATA[Pediatric insomnia is common and can be effectively treated with behavioral therapies delivered face-to face. Such treatments could also improve children's mood, cognition, and quality of life, and caregivers' wellbeing. There is a discrepancy between high needs and limited access to pediatric behavioral insomnia treatments, which could be improved by provision of technology enhanced interventions. No study reviewed outcomes of randomized controlled trials (RCTs) of remotely delivered psychological treatments for pediatric insomnia. The current study aimed to examine (i) the outcomes of remotely delivered RCTs for pediatric insomnia/insomnia symptoms and (ii) whether gains made in treatment extend to functional correlates. We conducted a systematic review according to Cochrane and PRISMA guidelines. PsychINFO, PubMed/Medline and Cochrane CENTRAL databases were searched for RCTs reporting on remotely delivered behavioral treatments for insomnia and insomnia symptoms. Data was abstracted and the risk of bias were assessed in November 2022 and November 2023. Seven RCTs (nine manuscripts) involving 786 participants, with the mean age from 19.3 months to 16.9 years, were identified. Four different treatments were used. Risk of bias ranged from low to high and was the highest for the randomization process. Across studies, significant improvements were found in some (but not all) sleep parameters, namely: sleep quality and sleep efficacy on questionnaires and on actigraphy, despite heterogeneity of the treatments used, age of participants and instruments employed to assess outcomes. Improvements gained in treatments delivered remotely was compared to treatments delivered face-to-face in 3 studies and were found to be comparable or slightly lower. No worsening was observed on either objective or subjective measures of sleep, except for sleep onset latency and wake after sleep onset that improved on questionnaires but worsened on actigraphy in one study each. Children's mood improved across studies on parent and self-report measures. Other possible functional gains were understudied. Our study provides preliminary evidence of improved sleep following remotely delivered behavioral treatments for pediatric insomnia, and improvements in children's mood. Further research is needed to develop individualized treatments that will cater for different developmental needs and types of insomnia symptoms and examine not only group but also individual outcomes.]]></description>
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