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Pilot study of a mindfulness‐based, multi‐component, in‐school group sleep intervention in adolescent girls

Existing literature links poor sleep and anxiety symptoms in adolescents. This pilot study aimed to develop a practical method through which a program to improve sleep could reach adolescents in need and to examine the feasibility of a mindfulness‐based, multi‐component group sleep intervention using sleep and anxiety as outcome measures.

The relationship between attitudes to aging and physical and mental health in older adults

BACKGROUND Attitudes are known to exert a powerful influence on a range of behaviors. The objective of this study was to investigate the contribution of attitudes toward ones own aging to satisfaction with life and physical and mental health measured in a sample of community-dwelling older adults. METHODS Adults who were part of a larger study of health and well-being in rural and regional Australia aged ≥60 years (N = 421) completed a cross-sectional postal survey comprising the Attitudes to Aging Questionnaire, the 12-Item Short Form Health Survey (SF-12), the Satisfaction with Life Scale, the Geriatric Anxiety Inventory, and the Center for Epidemiological Studies Depression Scale. RESULTS Overall, attitudes to aging were positive in this sample. More positive attitudes to aging were associated with higher levels of satisfaction with life, better self-report physical and mental health on the SF-12, and lower levels of anxiety and depression, after controlling for confounding variables. Better financial status and being employed were both associated with more positive attitudes to aging and better self-reported physical health. Relationship status was also significantly associated with mental health and satisfaction with life, but not physical health. CONCLUSION The promotion of successful aging is increasingly becoming important in aging societies. Having positive attitudes to aging may contribute to healthier mental and physical outcomes in older adults. Overcoming negative stereotypes of aging through change at the societal and individual level may help to promote more successful aging.

Beyond the mean: A systematic review on the correlates of daily intraindividual variability of sleep/wake patterns.

Features of an individuals sleep/wake patterns across multiple days are governed by two dimensions, the mean and the intraindividual variability (IIV). The existing literature focuses on the means, while the nature and correlates of sleep/wake IIV are not well understood. A systematic search of records in five major databases from inception to November 2014 identified 53 peer-reviewed empirical publications that examined correlates of sleep/wake IIV in adults. Overall, this literature appeared unsystematic and post hoc, with under-developed theoretical frameworks and inconsistent methodologies. Correlates most consistently associated with greater IIV in one or more aspects of sleep/wake patterns were: younger age, non-White race/ethnicity, living alone, physical health conditions, higher body mass index, weight gain, bipolar and unipolar depression symptomatology, stress, and evening chronotype; symptoms of insomnia and poor sleep were associated with higher sleep/wake IIV, which was reduced following sleep interventions. The effects of experimentally reduced sleep/wake IIV on daytime functioning were inconclusive. In extending current understanding of sleep/wake patterns beyond the mean values, IIV should be incorporated as an additional dimension when sleep is examined across multiple days. Theoretical and methodological shortcomings in the existing literature, and opportunities for future research are discussed.

A prospective study of the impact of floods on the mental and physical health of older adults.

Objectives: With a longitudinal prospective design, we examined the impact of floods on the mental and physical health of older adults and explored risk and protective factors. Method: Two hundred and seventy four older adults (age ≥60) completed surveys before and after a flood event. Both the surveys included measures of anxiety, depression, self-reported health, and satisfaction with life; the post-flood survey also included questionnaires on flood experience, symptoms of post-traumatic stress disorder (PTSD), stoicism, and psychological coping with floods. Results: Compared to those not personally affected (78.8%), personally affected individuals (21.2%) reported significantly higher PTSD symptoms, with about one in six reporting PTSD symptoms that might require clinical attention. Personally affected individuals also reported a greater increase in anxiety post-flood, but changes in their depressive symptoms and self-reported health were not significantly different from those not personally affected. Greater flood exposure and the lack of social support were the risk factors for poorer mental and physical health. Higher stoicism was associated with higher post-flood depression and poorer self-reported mental health. The use of maladaptive coping, such as venting and distraction, was associated with greater deterioration in mental health after floods, whilst emotion-focused coping such as acceptance, positive reframing, and humour, was protective against such deterioration. Conclusion: Floods had adverse psychological impacts on some older adults who were personally affected. Despite the evidence of resilience, a small proportion of older adults experienced significant difficulties after the floods. The findings in this study help understand older adults’ psychological responses to disasters and have practical implications for service planning and delivery.

Actigraphy-assessed sleep during school and vacation periods: a naturalistic study of restricted and extended sleep opportunities in adolescents

School‐related sleep restriction in adolescents has been identified by studies comparing weekday and weekend sleep. This study compared weekday and vacation sleep to assess restricted and extended sleep opportunities. One‐hundred and forty‐six adolescents (47.3% male) aged 16.2 ± 1.0 years (M ± SD) from the general community wore an actigraph continuously for 4 weeks: the last week of a school term (Time‐E), the following 2‐week vacation, and the first week of the next term. Self‐reported sleep was assessed for each of the three time intervals, and chronotype was assessed using the Morningness–Eveningness Questionnaire at Time‐E. Daily actigraphy bedtime, rise‐time, time‐in‐bed, total sleep time, sleep onset latency, sleep efficiency, and % wake after sleep onset were analysed using latent growth curve modelling. The removal of school‐related sleep restriction was associated with an abrupt delay in sleep timing and increase in sleep duration. Subsequently, bedtime and rise‐time showed further linear delays throughout the vacation, while changes in time‐in‐bed were non‐significant. Sleep onset latency increased linearly, peaking in the middle of the second vacation week. Across the first vacation week, total sleep time and sleep efficiency linearly decreased, while % wake after sleep onset increased. These changes stabilized during the second vacation week. Older age and eveningness were associated with later bedtime and rise‐time, whilst females had longer time‐in‐bed, total sleep time and sleep onset latency. Compared with school days, sleep during the vacation was characterized by later timing, longer duration, lower quality and greater variability. Recovery from school‐related sleep restriction appeared to be completed within the 2 weeks of naturalistic extended sleep.

Sleep and Mood During Pregnancy and the Postpartum Period

During the perinatal period, compromises in sleep duration and quality are commonly reported by women and confirmed by objective measurements of sleep. Self-reported poor sleep has been associated with concurrent mood disturbance and with increased risk for future mood problems during pregnancy and the postpartum period. Findings on the relationship between objectively measured sleep and mood in perinatal women have been mixed. This article reviews the literature on the nature of and contributing factors to perinatal sleep disturbance, the relationship between sleep and mood, and intervention studies that aim to improve maternal sleep.

The Relationship Between Sleep and Mood in First-Time and Experienced Mothers

Sleep disruption has been suggested to contribute to postpartum mood, but few studies have explored differences in this relationship between nulliparous and multiparous mothers. This study compared the interaction of sleep and mood as a function of parity. Thirty-five nulliparous and 34 multiparous mothers completed questionnaires on mood and sleep, and wore actigraphs for 7 days during the third trimester of pregnancy and within 2 weeks postpartum. Mood and objective sleep were better in multiparas than in nulliparas after delivery. However, other than a stronger association between subjective sleep and stress in nulliparous mothers, the relationship between sleep and mood did not differ significantly between the two groups. This suggests that parity might play only a limited role in the interaction between sleep and mood during the immediate postpartum period.

Antecedents of Attitudes to Aging: A Study of the Roles of Personality and Well-being

PURPOSE OF THE STUDY Little research has examined factors that contribute to the formation of attitudes toward ones own aging. The current study aimed to examine personality as defined by the Five-Factor model of personality as an antecedent of attitudes, while taking into account demographic and health factors known to be relevant to such attitudes. DESIGN AND METHODS Participants aged 60 years or older (N = 421) were part of a longitudinal study of health and well-being in Australia, and completed a postal survey comprising measures of personality, the Attitudes to Ageing Questionnaire, the SF-12 health survey, and the Satisfaction with Life Scale. RESULTS Higher levels of neuroticism were associated with less positive attitudes toward old age as a time of psychological growth, and higher extraversion and agreeableness were significant predictors of less negative attitudes toward psychosocial loss. Baseline measures of self-reported mental and physical health, as well as change in those scores, also made significant contributions to attitudes toward aging. IMPLICATIONS Personality was a significant antecedent of attitudes towards aging, as were mental and physical health. The data highlight the role of potentially modifiable factors, such as mental and physical health. If these factors act as resources that shape an individuals attitudes during the aging process, then one potential foundation for holding positive attitudes to aging is to maintain physical and mental health. This requires interventions and policies that are effective in encouraging health-promoting behaviors.

Chronotype and improved sleep efficiency independently predict depressive symptom reduction after group cognitive behavioral therapy for insomnia

STUDY OBJECTIVES Cognitive behavioral therapy for insomnia (CBT-I) has been shown to improve both sleep and depressive symptoms, but predictors of depression outcome following CBT-I have not been well examined. This study investigated how chronotype (i.e., morningness-eveningness trait) and changes in sleep efficiency (SE) were related to changes in depressive symptoms among recipients of CBT-I. METHODS Included were 419 adult insomnia outpatients from a sleep disorders clinic (43.20% males, age mean ± standard deviation = 48.14 ± 14.02). All participants completed the Composite Scale of Morningness and attended at least 4 sessions of a 6-session group CBT-I. SE was extracted from sleep diary; depressive symptoms were assessed using the Beck Depression Inventory (BDI) prior to (Baseline), and at the end (End) of intervention. RESULTS Multilevel structural equation modeling revealed that from Baseline to End, SE increased and BDI decreased significantly. Controlling for age, sex, BDI, and SE at Baseline, stronger evening chronotype and less improvement in SE significantly and uniquely predicted less reduction in BDI from Baseline to End. Chronotype did not predict improvement in SE. CONCLUSIONS In an insomnia outpatient sample, SE and depressive symptoms improved significantly after a CBT-I group intervention. All chronotypes benefited from sleep improvement, but those with greater eveningness and/or less sleep improvement experienced less reduction in depressive symptom severity. This suggests that evening preference and insomnia symptoms may have distinct relationships with mood, raising the possibility that the effect of CBT-I on depressive symptoms could be enhanced by assessing and addressing circadian factors.

Discharge patterns of human tensor palatini motor units during sleep onset.

STUDY OBJECTIVES Upper airway muscles such as genioglossus (GG) and tensor palatini (TP) reduce activity at sleep onset. In GG reduced muscle activity is primarily due to inspiratory modulated motor units becoming silent, suggesting reduced respiratory pattern generator (RPG) output. However, unlike GG, TP shows minimal respiratory modulation and presumably has few inspiratory modulated motor units and minimal input from the RPG. Thus, we investigated the mechanism by which TP reduces activity at sleep onset. DESIGN The activity of TP motor units were studied during relaxed wakefulness and over the transition from wakefulness to sleep. SETTING Sleep laboratory. PARTICIPANTS Nine young (21.4 ± 3.4 years) males were studied on a total of 11 nights. INTERVENTION Sleep onset. MEASUREMENTS AND RESULTS Two TP EMGs (thin, hooked wire electrodes), and sleep and respiratory measures were recorded. One hundred twenty-one sleep onsets were identified (13.4 ± 7.2/subject), resulting in 128 motor units (14.3 ± 13.0/subject); 29% of units were tonic, 43% inspiratory modulated (inspiratory phasic 18%, inspiratory tonic 25%), and 28% expiratory modulated (expiratory phasic 21%, expiratory tonic 7%). There was a reduction in both expiratory and inspiratory modulated units, but not tonic units, at sleep onset. Reduced TP activity was almost entirely due to de-recruitment. CONCLUSIONS TP showed a similar distribution of motor units as other airway muscles. However, a greater proportion of expiratory modulated motor units were active in TP and these expiratory units, along with inspiratory units, tended to become silent over sleep onset. The data suggest that both expiratory and inspiratory drive components from the RPG are reduced at sleep onset in TP.