{"title":"老年慢性失眠症患者认知行为治疗前后睡眠-觉醒状态差异与临床特征的关系","authors":"D. Bensen-Boakes, H. Scott, L. Lack, N. Lovato","doi":"10.1093/sleepadvances/zpac029.049","DOIUrl":null,"url":null,"abstract":"Abstract Introduction Individuals with chronic insomnia often self-report more wakefulness and less sleep than is derived from objective measures, which is called sleep-wake state discrepancy (SWSD). This study investigated associations between SWSD and clinical characteristics in older adults with sleep maintenance insomnia before and after Cognitive Behaviour Therapy (CBTi). Method Seventy-three adults (female=53%, mean age=63.2, SD=6.3) were recruited. Participants completed sleep diaries and wore actigraphy for one week, as well as questionnaires related to sleep quality and daytime functioning immediately before and after CBTi. SWSD was calculated as the difference between subjective (sleep diary reported) and objective (actigraphy derived) total sleep time (TST) at pre- and post-treatment. Results Before treatment, SWSD was not associated with age or any clinical variables, ps > .05. Following treatment, SWSD significantly reduced (p<.001), despite no improvement in objective TST, and was significantly associated with improvements in insomnia severity (r=-.57), fatigue (r=-.26), sleep self-efficacy (r=.33), and beliefs about sleep (r=-.38), ps < .05. Discussion These findings suggest SWSD does not correlate with any other routinely-measured clinical characteristic prior to treatment. Given the associations with treatment outcomes, the need to incorporate objective measures, in conjunction with sleep diary assessments, to determine the degree of discrepancy and therapeutically address using CBTi is warranted. Following treatment, the reduction in discrepancy was driven by sleep diary reported TST that more closely matched objective TST, which remained relatively unchanged from pre-treatment. This has important implications for CBTi and suggests improvements in the accuracy of perceived sleep is a major therapeutic mechanism.","PeriodicalId":74808,"journal":{"name":"Sleep advances : a journal of the Sleep Research Society","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"O050 Associations between sleep-wake state discrepancy and clinical characteristics in older adults with chronic insomnia before and after Cognitive Behaviour Therapy (CBTi)\",\"authors\":\"D. Bensen-Boakes, H. Scott, L. Lack, N. Lovato\",\"doi\":\"10.1093/sleepadvances/zpac029.049\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Abstract Introduction Individuals with chronic insomnia often self-report more wakefulness and less sleep than is derived from objective measures, which is called sleep-wake state discrepancy (SWSD). This study investigated associations between SWSD and clinical characteristics in older adults with sleep maintenance insomnia before and after Cognitive Behaviour Therapy (CBTi). Method Seventy-three adults (female=53%, mean age=63.2, SD=6.3) were recruited. Participants completed sleep diaries and wore actigraphy for one week, as well as questionnaires related to sleep quality and daytime functioning immediately before and after CBTi. SWSD was calculated as the difference between subjective (sleep diary reported) and objective (actigraphy derived) total sleep time (TST) at pre- and post-treatment. Results Before treatment, SWSD was not associated with age or any clinical variables, ps > .05. Following treatment, SWSD significantly reduced (p<.001), despite no improvement in objective TST, and was significantly associated with improvements in insomnia severity (r=-.57), fatigue (r=-.26), sleep self-efficacy (r=.33), and beliefs about sleep (r=-.38), ps < .05. Discussion These findings suggest SWSD does not correlate with any other routinely-measured clinical characteristic prior to treatment. Given the associations with treatment outcomes, the need to incorporate objective measures, in conjunction with sleep diary assessments, to determine the degree of discrepancy and therapeutically address using CBTi is warranted. Following treatment, the reduction in discrepancy was driven by sleep diary reported TST that more closely matched objective TST, which remained relatively unchanged from pre-treatment. This has important implications for CBTi and suggests improvements in the accuracy of perceived sleep is a major therapeutic mechanism.\",\"PeriodicalId\":74808,\"journal\":{\"name\":\"Sleep advances : a journal of the Sleep Research Society\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sleep advances : a journal of the Sleep Research Society\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/sleepadvances/zpac029.049\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sleep advances : a journal of the Sleep Research Society","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/sleepadvances/zpac029.049","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
O050 Associations between sleep-wake state discrepancy and clinical characteristics in older adults with chronic insomnia before and after Cognitive Behaviour Therapy (CBTi)
Abstract Introduction Individuals with chronic insomnia often self-report more wakefulness and less sleep than is derived from objective measures, which is called sleep-wake state discrepancy (SWSD). This study investigated associations between SWSD and clinical characteristics in older adults with sleep maintenance insomnia before and after Cognitive Behaviour Therapy (CBTi). Method Seventy-three adults (female=53%, mean age=63.2, SD=6.3) were recruited. Participants completed sleep diaries and wore actigraphy for one week, as well as questionnaires related to sleep quality and daytime functioning immediately before and after CBTi. SWSD was calculated as the difference between subjective (sleep diary reported) and objective (actigraphy derived) total sleep time (TST) at pre- and post-treatment. Results Before treatment, SWSD was not associated with age or any clinical variables, ps > .05. Following treatment, SWSD significantly reduced (p<.001), despite no improvement in objective TST, and was significantly associated with improvements in insomnia severity (r=-.57), fatigue (r=-.26), sleep self-efficacy (r=.33), and beliefs about sleep (r=-.38), ps < .05. Discussion These findings suggest SWSD does not correlate with any other routinely-measured clinical characteristic prior to treatment. Given the associations with treatment outcomes, the need to incorporate objective measures, in conjunction with sleep diary assessments, to determine the degree of discrepancy and therapeutically address using CBTi is warranted. Following treatment, the reduction in discrepancy was driven by sleep diary reported TST that more closely matched objective TST, which remained relatively unchanged from pre-treatment. This has important implications for CBTi and suggests improvements in the accuracy of perceived sleep is a major therapeutic mechanism.