Methodological approach to sleep state misperception in insomnia disorder: Comparison between multiple nights of actigraphy recordings and a single night of polysomnography recording.

STUDY OBJECTIVE: To provide a comprehensive assessment of sleep state misperception in insomnia disorder (INS) and good sleepers (GS) by comparing recordings performed for one night in-lab (PSG and night review) and during several nights at-home (actigraphy and sleep diaries). METHODS: Fifty-seven INS and 29 GS wore an actigraphy device and filled a sleep diary for two weeks at-home. They subsequently completed a PSG recording and filled a night review in-lab. Sleep perception index (subjective/objective × 100) of sleep onset latency (SOL), sleep duration (TST) and wake duration (TST) were computed and compared between methods and groups. RESULTS: GS displayed a tendency to overestimate TST and WASO but correctly perceived SOL. The degree of misperception was similar across methods within the GS group. In contrast, INS underestimated their TST and overestimated their SOL both in-lab and at-home, yet the severity of misperception of SOL was larger at-home than in-lab. Finally, INS overestimated WASO only in-lab while correctly perceiving it at-home. While only the degree of TST misperception was stable across methods in INS, misperception of SOL and WASO were dependent on the method used. CONCLUSIONS: We found that GS and INS exhibit opposite patterns and severity of sleep misperception. While the degree of misperception in GS was similar across methods, only sleep duration misperception was reliably detected by both in-lab and at-home methods in INS. Our results highlight that, when assessing sleep misperception in insomnia disorder, the environment and method of data collection should be carefully considered.

Mindful larks and lonely owls: The relationship between chronotype, mental health, sleep quality, and social support in young adults.

Chronotype is related to mental health, with evening chronotypes being more susceptible to psychological disorders than intermediate and morning types. The present study investigated the relationship between chronotype, mental health, sleep quality, and social support in Canadian young adults. We surveyed 3160 university students aged 18-35 years. Participants completed the Morningness-Eveningness Questionnaire, the Hospital Anxiety and Depression Scale, the Mindful Attention Awareness Scale, the Pittsburgh Sleep Quality Index, and the Medical Outcomes Study - Social Support Survey. We conducted Bonferroni-corrected one-way analyses of covariance with post hoc paired comparisons to determine the relationship between the aforementioned variables, with age and sex as covariates. We further looked at the moderation of social support on the relationship between chronotype and sleep quality. Overall, 55%, 36% and 9% of participants were classified as intermediate, evening and morning types, respectively. There was a significant difference between chronotype on levels of depression, anxiety, and sleep quality, with evening types reporting more severe symptomology than morning-types and intermediate types. Morning types reported greater levels of overall social support and mindfulness. Evening types reported the lowest levels of all types of social support. Social support did not moderate the relationship between chronotype and sleep quality. This study further demonstrates the association between worse psychological well-being and eveningness and between more social support, and mindfulness in morning chronotype young adults. Education and intervention are warranted to help evening chronotypes manage the potential negative features of their circadian rhythm, as well as to cultivate a greater sense of social support and mindfulness.

Rationale and protocol for a randomized waitlist controlled trial of videoconference delivered cognitive behaviour therapy for insomnia (CBT-I) to improve perceived cognitive impairment (PCI) among cancer survivors.

Perceived cognitive impairment (PCI) and sleep disturbances (such as insomnia) are commonly reported barriers preventing cancer survivors from resuming normal functioning. Cognitive-behaviour therapy for insomnia (CBT-I) is the treatment of choice for insomnia among cancer survivors. Literature suggests that treatment with CBT-I may lead to an improvement in PCI, but this needs to be tested in a sample of patients with PCI at study entry with cognitive impairments as the primary study outcome. Here we describe the design of a clinical trial to evaluate the efficacy of videoconference-delivered CBT-I for the improvement of PCI among cancer survivors. This project is a randomized waitlist-controlled trial with a recruitment target of 124 adult cancer survivors (solid tumors and hematological malignancies) who have completed primary treatment at least 6 months prior, report PCI and meet criteria for insomnia disorder. Participants will complete assessments at baseline, 4 weeks (mid-treatment), 8 weeks (post treatment), and 3 and 6 months post-treatment. The primary outcome is the Functional Assessment of Cancer Therapy - Cognitive Function (FACT-Cog). Treatment of PCI in cancer patients is a priority for clinicians, researchers, and patients. This research will increase our understanding of the mechanisms of cognitive impairment associated with cancer, and potentially expand currently available treatment options.

Associations between device use before bed, mood disturbance, and insomnia symptoms in young adults.

OBJECTIVES: Young adults (YAs) are vulnerable to insomnia and mood disturbance. YAs also engage in back-lit device use which has been implicated in the development and maintenance of insomnia. This study explored the association between device use, mood disturbance, and insomnia symptoms in YAs. PARTICIPANTS: Two thousand three hundred and ninety students at a Canadian university, aged 18-35 years. DESIGN: Cross-sectional online survey MEASUREMENTS: Participants self-reported duration and frequency of back-lit device use before sleep and during the night. The Insomnia Severity Index and the Hospital Anxiety and Depression Scale were used to measure symptoms. Univariate and multivariate logistic regressions explored associations between device use behaviors and insomnia symptoms. A hierarchical regression analysis identified the unique contribution of back-lit device use on insomnia severity adjusting for mood disturbance, age, and sex. RESULTS: Using a back-lit device for 1-2 hours after lights out (adjusted odds ratio [AOR] = 1.50, p < 0.001), being awakened by a device (AOR = 1.34, p = 0.002), and believing that device use negatively impacts sleep (AOR = 2.27, p < 0.001) were associated with insomnia symptoms. Depression contributed to the greatest unique variance to insomnia (11.8%), followed by anxiety (7.2%). Duration of device use after lights out, being awakened by a device and a negative perception of device use on sleep accounted for an additional 3%. CONCLUSIONS: Device use contributed to insomnia symptoms over and above mood disturbance, age, and biological sex in YAs. Additional research is needed to determine the direction of effect and inform prevention/intervention programs specific to device use and insomnia symptomology in this population.