Sleep and insomnia النوم

وَهُوَ ٱلَّذِي جَعَلَ لَكُمُ ٱلَّيۡلَ لِبَاسࣰ ا وَٱلنَّوۡمَ سُبَاتࣰ ا وَجَعَلَ ٱلنَّهَارَ نُشُورࣰ ا

It is He who made the night a garment for you, and sleep a rest, and made the day like a resurrection

ٱللَّهُ لَآ إِلَٰهَ إِلَّا هُوَ ٱلۡحَيُّ ٱلۡقَيُّومُۚ لَا تَأۡخُذُهُۥ سِنَةࣱ وَلَا نَوۡمࣱۚ لَّهُۥ مَا فِي ٱلسَّمَٰوَٰتِ وَمَا فِي ٱلۡأَرۡضِۗ مَن ذَا ٱلَّذِي يَشۡفَعُ عِندَهُۥٓ إِلَّا بِإِذۡنِهِۦۚ يَعۡلَمُ مَا بَيۡنَ أَيۡدِيهِمۡ وَمَا خَلۡفَهُمۡۖ وَلَا يُحِيطُونَ بِشَيۡءࣲ مِّنۡ عِلۡمِهِۦٓ إِلَّا بِمَا شَآءَۚ وَسِعَ كُرۡسِيُّهُ ٱلسَّمَٰوَٰتِ وَٱلۡأَرۡضَۖ وَلَا يَـُٔودُهُۥ حِفۡظُهُمَاۚ وَهُوَ ٱلۡعَلِيُّ ٱلۡعَظِيمُ

God: there is no god but Him, the Ever Living, the Ever Watchful.Neither slumber nor sleep overtakes Him. All that is in the heavens and in the earth belongs to Him. Who is there that can intercede with Him except by His leave? He knows what is before them and what is behind them, but they do not comprehend any of His knowledge except what He wills. His throne extends over the heavens and the earth; it does not weary Him to preserve them both. He is the Most High, the Tremendous

وَجَعَلۡنَا نَوۡمَكُمۡ سُبَاتࣰ ا

give you sleep for rest

ثُمَّ أَنزَلَ عَلَيۡكُم مِّنۢ بَعۡدِ ٱلۡغَمِّ أَمَنَةࣰ نُّعَاسࣰ ا يَغۡشَىٰ طَآئِفَةࣰ مِّنكُمۡۖ وَطَآئِفَةࣱ قَدۡ أَهَمَّتۡهُمۡ أَنفُسُهُمۡ يَظُنُّونَ بِٱللَّهِ غَيۡرَ ٱلۡحَقِّ ظَنَّ ٱلۡجَٰهِلِيَّةِۖ يَقُولُونَ هَل لَّنَا مِنَ ٱلۡأَمۡرِ مِن شَيۡءࣲۗ قُلۡ إِنَّ ٱلۡأَمۡرَ كُلَّهُۥ لِلَّهِۗ يُخۡفُونَ فِيٓ أَنفُسِهِم مَّا لَا يُبۡدُونَ لَكَۖ يَقُولُونَ لَوۡ كَانَ لَنَا مِنَ ٱلۡأَمۡرِ شَيۡءࣱ مَّا قُتِلۡنَا هَٰهُنَاۗ قُل لَّوۡ كُنتُمۡ فِي بُيُوتِكُمۡ لَبَرَزَ ٱلَّذِينَ كُتِبَ عَلَيۡهِمُ ٱلۡقَتۡلُ إِلَىٰ مَضَاجِعِهِمۡۖ وَلِيَبۡتَلِيَ ٱللَّهُ مَا فِي صُدُورِكُمۡ وَلِيُمَحِّصَ مَا فِي قُلُوبِكُمۡۚ وَٱللَّهُ عَلِيمُۢ بِذَاتِ ٱلصُّدُورِ

After sorrow, He caused calm to descend upon you, a sleep that overtook some of you. Another group, caring only for themselves, entertained false thoughts about God, thoughts more appropriate to pagan ignorance, and said, ‘Do we get a say in any of this?’ [Prophet], tell them, ‘Everything to do with this affair is in God’s hands.’ They conceal in their hearts things they will not reveal to you. They say, ‘If we had had our say in this, none of us would have been killed here.’ Tell them, ‘Even if you had resolved to stay at home, those who were destined to be killed would still have gone out to meet their deaths.’ God did this in order to test everything within you and in order to prove what is in your hearts. God knows your innermost thoughts very well

فَالِقُ ٱلۡإِصۡبَاحِ وَجَعَلَ ٱلَّيۡلَ سَكَنࣰ ا وَٱلشَّمۡسَ وَٱلۡقَمَرَ حُسۡبَانࣰ اۚ ذَٰلِكَ تَقۡدِيرُ ٱلۡعَزِيزِ ٱلۡعَلِيمِ

He makes the dawn break; He makes the night for rest; and He made the sun and the moon to a precise measure. That is the design of the Almighty, the All Knowing

إِذۡ يُغَشِّيكُمُ ٱلنُّعَاسَ أَمَنَةࣰ مِّنۡهُ وَيُنَزِّلُ عَلَيۡكُم مِّنَ ٱلسَّمَآءِ مَآءࣰ لِّيُطَهِّرَكُم بِهِۦ وَيُذۡهِبَ عَنكُمۡ رِجۡزَ ٱلشَّيۡطَٰنِ وَلِيَرۡبِطَ عَلَىٰ قُلُوبِكُمۡ وَيُثَبِّتَ بِهِ ٱلۡأَقۡدَامَ

Remember when He gave you sleep as a reassurance from Him, and sent down water from the sky to cleanse you, to remove Satan’s pollution from you, to make your hearts strong and your feet firm

And He it is Who made for you the night as a garment veiling you like a garment and sleep for repose rest for bodies through the temporary cessation of labour and He made the day for rising a time in which all rise to seek their livelihood and so on.

Have you not seen how your Lord spread the shadow. If He willed, He could have made it still – but We have made the sun its guide (45)Then We withdraw it towards Ourselves – a gradual withdrawal (46)And it is He Who makes the night a covering for you, and the sleep (as) a repose, and makes the day Nushur (47) Evidence of the Existence of the Creator and the Extent of His Power Here Allah begins explaining the evidence for His existence and His perfect power to create various things and pairs of opposites. Allah says: أَلَمْ تَرَ إِلَىٰ رَبِّكَ كَيْفَ مَدَّ الظِّلَّ (Have you not seen how your Lord spread the shadow.) Ibn 'Abbas, Ibn 'Umar, Abu Al-'Aliyah, Abu Malik, Masruq, Mujahid, Sa'id bin Jubayr, An-Nakha'i, Ad-Dahhak, Al-Hasan, Qatadah, As-Suddi and others said, "This refers to the period from the beginning of the dawn until the sun rises." وَلَوْ شَاءَ لَجَعَلَهُ سَاكِنًا (If

God there is no god that is there is none worthy of being worshipped in all existence except Him the Living the Everlasting the Eternal Sustainer the One constantly engaged in the management of His creation. Slumber does not seize Him neither sleep; to Him belongs all that is in the heavens and the earth as possessions creatures and servants; who is there that is to say none is there that shall intercede with Him save by His leave? in this for him. He knows what lies before them that is creation and what is after them of the affairs of this world and the Hereafter; and they encompass nothing of His knowledge that is they know nothing of what He knows save such as He wills to inform of it by way of His messengers. His throne subsumes the heavens and the earth it is said that His knowledge encompasses them both; it is also said that the kursī ‘throne’ itself subsumes them on account of its

and made your sleep for rest? repose for your bodies

Allah! None has the right to be worshipped but He, the Ever Living, the One Who sustains and protects all that exists. Neither slumber nor sleep overtakes Him. To Him belongs whatever is in the heavens and whatever is on the earth. Who is he that can intercede with Him except with His permission? He knows what happens to them (His creatures) in this world, and what will happen to them in the Hereafter. And they will never compass anything of His Knowledge except that which He wills. His Kursi extends over the heavens and the earth, and He feels no fatigue in guarding and preserving them. And He is the Most High, the Most Great (255) The Virtue of Ayat Al-Kursi This is Ayat Al-Kursi and tremendous virtues have been associated with it, for the authentic Hadith describes it as 'the greatest Ayah in the Book of Allah.' Imam Ahmad recorded that 'Ubayy bin Ka'b said that the Prophet ﷺ asked

بِسْمِ اللَّهِ الرَّحْمَٰنِ الرَّحِيمِ In the Name of Allah, the Most Beneficent, the Most Merciful. عَمَّ يَتَسَاءَلُونَ - عَنِ النَّبَإِ الْعَظِيمِ - الَّذِي هُمْ فِيهِ مُخْتَلِفُونَ - كَلَّا سَيَعْلَمُونَ - ثُمَّ كَلَّا سَيَعْلَمُونَ - أَلَمْ نَجْعَلِ الْأَرْضَ مِهَادًا - وَالْجِبَالَ أَوْتَادًا - وَخَلَقْنَاكُمْ أَزْوَاجًا - وَجَعَلْنَا نَوْمَكُمْ سُبَاتًا - وَجَعَلْنَا اللَّيْلَ لِبَاسًا - وَجَعَلْنَا النَّهَارَ مَعَاشًا - وَبَنَيْنَا فَوْقَكُمْ سَبْعًا شِدَادًا - وَجَعَلْنَا سِرَاجًا وَهَّاجًا - وَأَنزَلْنَا مِنَ الْمُعْصِرَاتِ مَاءً ثَجَّاجًا - لِّنُخْرِجَ بِهِ حَبًّا وَنَبَاتًا - وَجَنَّاتٍ أَلْفَافًا (1. What are they asking about?)(2. About the great news,)(3. About which they are in disagreement.)(4. Nay, they will come to know!)(5. Nay, again, they will come to know!)(6. Have We not made the earth as a bed,)(7. And the mountains as pegs?)(8. And We have created you in pair

حَدَّثَنَا نَصْرُ بْنُ عَلِيٍّ، حَدَّثَنَا عَبْدُ الْوَهَّابِ الثَّقَفِيُّ، حَدَّثَنَا أَيُّوبُ، عَنْ مُحَمَّدِ بْنِ سِيرِينَ، عَنْ أَبِي هُرَيْرَةَ، قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ إِذَا اقْتَرَبَ الزَّمَانُ لَمْ تَكَدْ رُؤْيَا الْمُؤْمِنِ تَكْذِبُ وَأَصْدَقُهُمْ رُؤْيَا أَصْدَقُهُمْ حَدِيثًا وَرُؤْيَا الْمُسْلِمِ جُزْءٌ مِنْ سِتَّةٍ وَأَرْبَعِينَ جُزْءًا مِنَ النُّبُوَّةِ وَالرُّؤْيَا ثَلاَثٌ فَالرُّؤْيَا الصَّالِحَةُ بُشْرَى مِنَ اللَّهِ وَالرُّؤْيَا مِنْ تَحْزِينِ الشَّيْطَانِ وَالرُّؤْيَا مِمَّا يُحَدِّثُ بِهَا الرَّجُلُ نَفْسَهُ فَإِذَا رَأَى أَحَدُكُمْ مَا يَكْرَهُ فَلْيَقُمْ وَلْيَتْفُلْ وَلاَ يُحَدِّثْ بِهَا النَّاسَ قَالَ وَأُحِبُّ الْقَيْدَ فِي النَّوْمِ وَأَكْرَهُ الْغُلَّ الْقَيْدُ ثَبَاتٌ فِي الدِّينِ ‏"‏ ‏.‏ قَالَ وَهَذَا حَدِيثٌ حَسَنٌ صَحِيحٌ ‏.‏

Abu Hurairah narrated that the Messenger of Allah (s.a.w) said:"When time draws near, the dreams of a believer will hardly ever fail to come true, and the most truthful of them in dreams will be the truest in speech among them. The dream of a Muslim is a portion among the forty-six portions of Prophet-hood. And dreams are of three types: The righteous dream which is good news from Allah, dreams in which the Shaithan frightens someone, and dreams about something that has happened to the man himself. So when one of you sees what he dislikes, then he should get up and spit, and not tell any of the people- he said:- and I like the fetters in a dream while I dislike the iron collar." And the interpretation of fetters is being firm in the religion

حَدَّثَنَا مَحْمُودُ بْنُ غَيْلاَنَ، حَدَّثَنَا أَبُو دَاوُدَ، عَنْ شُعْبَةَ، عَنْ قَتَادَةَ، أَنَّهُ سَمِعَ أَنَسًا، عَنْ عُبَادَةَ بْنِ الصَّامِتِ، أَنَّ النَّبِيَّ صلى الله عليه وسلم قَالَ ‏ "‏ رُؤْيَا الْمُؤْمِنِ جُزْءٌ مِنْ سِتَّةٍ وَأَرْبَعِينَ جُزْءًا مِنَ النُّبُوَّةِ ‏"‏ ‏.‏ قَالَ وَفِي الْبَابِ عَنْ أَبِي هُرَيْرَةَ وَأَبِي رَزِينٍ الْعُقَيْلِيِّ وَأَبِي سَعِيدٍ وَعَبْدِ اللَّهِ بْنِ عَمْرٍو وَعَوْفِ بْنِ مَالِكٍ وَابْنِ عُمَرَ وَأَنَسٍ ‏.‏ قَالَ وَحَدِيثُ عُبَادَةَ حَدِيثٌ صَحِيحٌ ‏.‏

Ubadah bin As-Samit narrated that the Prophet (s.a.w) said:"The dreams of the believer are a portion of the forty-six portions of Prophet-hood

حَدَّثَنَا أَبُو نُعَيْمٍ، قَالَ حَدَّثَنَا سُفْيَانُ، عَنِ الأَسْوَدِ، قَالَ سَمِعْتُ جُنْدَبًا، يَقُولُ اشْتَكَى النَّبِيُّ صلى الله عليه وسلم فَلَمْ يَقُمْ لَيْلَةً أَوْ لَيْلَتَيْنِ‏.‏

Narrated Jundab:The Prophet (ﷺ) became sick and did not get up (for Tahajjud prayer) for a night or two

حَدَّثَنَا ابْنُ مُقَاتِلٍ، أَخْبَرَنَا عَبْدُ اللَّهِ، أَخْبَرَنَا مَعْمَرٌ، عَنِ الزُّهْرِيِّ، عَنْ هِنْدٍ بِنْتِ الْحَارِثِ، عَنْ أُمِّ سَلَمَةَ ـ رضى الله عنها ـ أَنَّ النَّبِيَّ صلى الله عليه وسلم اسْتَيْقَظَ لَيْلَةً فَقَالَ ‏ "‏ سُبْحَانَ اللَّهِ مَاذَا أُنْزِلَ اللَّيْلَةَ مِنَ الْفِتْنَةِ، مَاذَا أُنْزِلَ مِنَ الْخَزَائِنِ مَنْ يُوقِظُ صَوَاحِبَ الْحُجُرَاتِ، يَا رُبَّ كَاسِيَةٍ فِي الدُّنْيَا عَارِيَةٍ فِي الآخِرَةِ ‏"‏‏.‏

Narrated Um Salama:One night the Prophet (ﷺ) got up and said, "Subhan Allah! How many afflictions Allah has revealed tonight and how many treasures have been sent down (disclosed). Go and wake the sleeping lady occupants of these dwellings up (for prayers), perhaps a well dressed in this world may be naked in the Hereafter

حَدَّثَنَا عَبْدُ اللَّهِ بْنُ مَسْلَمَةَ، قَالَ قَرَأْتُ عَلَى مَالِكٍ عَنِ ابْنِ شِهَابٍ، أَنَّ عُمَرَ بْنَ عَبْدِ الْعَزِيزِ، أَخَّرَ الصَّلاَةَ يَوْمًا، فَدَخَلَ عَلَيْهِ عُرْوَةُ بْنُ الزُّبَيْرِ، فَأَخْبَرَهُ أَنَّ الْمُغِيرَةَ بْنَ شُعْبَةَ أَخَّرَ الصَّلاَةَ يَوْمًا وَهْوَ بِالْعِرَاقِ، فَدَخَلَ عَلَيْهِ أَبُو مَسْعُودٍ الأَنْصَارِيُّ فَقَالَ مَا هَذَا يَا مُغِيرَةُ أَلَيْسَ قَدْ عَلِمْتَ أَنَّ جِبْرِيلَ نَزَلَ فَصَلَّى، فَصَلَّى رَسُولُ اللَّهِ صلى الله عليه وسلم ثُمَّ صَلَّى فَصَلَّى رَسُولُ اللَّهِ صلى الله عليه وسلم ثُمَّ صَلَّى فَصَلَّى رَسُولُ اللَّهِ صلى الله عليه وسلم ثُمَّ صَلَّى فَصَلَّى رَسُولُ اللَّهِ صلى الله عليه وسلم ثُمَّ صَلَّى فَصَلَّى رَسُولُ اللَّهِ صلى الله عليه وسلم ثُمَّ قَالَ ‏ "‏ بِهَذَا أُمِرْتُ ‏"‏‏.‏ فَقَالَ عُمَرُ لِعُرْوَةَ اعْلَمْ مَا تُحَدِّثُ أَوَإِنَّ جِبْرِيلَ هُوَ أَقَامَ لِرَسُولِ اللَّهِ صلى الله عليه وسلم وَقْتَ الصَّلاَةِ‏.‏ قَالَ عُرْوَةُ كَذَلِكَ كَانَ بَشِيرُ بْنُ أَبِي مَسْعُودٍ يُحَدِّثُ عَنْ أَبِيهِ‏.‏ قَالَ عُرْوَةُ وَلَقَدْ حَدَّثَتْنِي عَائِشَةُ، أَنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم كَانَ يُصَلِّي الْعَصْرَ، وَالشَّمْسُ فِي حُجْرَتِهَا قَبْلَ أَنْ تَظْهَرَ‏.‏

Narrated Ibn Shihab:Once `Umar bin `Abdul `Aziz delayed the prayer and `Urwa bin Az-Zubair went to him and said, "Once in 'Iraq, Al-Mughira bin Shu`ba delayed his prayers and Abi Mas`ud Al-Ansari went to him and said, 'O Mughira! What is this? Don't you know that once Gabriel came and offered the prayer (Fajr prayer) and Allah's Messenger (ﷺ) prayed too, then he prayed again (Zuhr prayer) and so did Allah's Apostle and again he prayed (`Asr prayers and Allah's Messenger (ﷺ) did the same; again he prayed (Maghrib-prayer) and so did Allah's Messenger (ﷺ) and again prayed (`Isha prayer) and so did Allah's Apostle and (Gabriel) said, 'I was ordered to do so (to demonstrate the prayers prescribed to you)?'" `Umar (bin `Abdul `Aziz) said to `Urwa, "Be sure of what you Say. Did Gabriel lead Allah's Messenger (ﷺ) at the stated times of the prayers?" `Urwa replied, "Bashir bin Abi Mas`ud narrated like this on the authority of his father." `Urwa added, "Aisha told me that Allah's Messenger (ﷺ) used to pray `Asr prayer when the sunshine was still inside her residence (during the early time of `Asr)

حَدَّثَنَا قُتَيْبَةُ بْنُ سَعِيدٍ، قَالَ حَدَّثَنَا عَبَّادٌ ـ هُوَ ابْنُ عَبَّادٍ ـ عَنْ أَبِي جَمْرَةَ، عَنِ ابْنِ عَبَّاسٍ، قَالَ قَدِمَ وَفْدُ عَبْدِ الْقَيْسِ عَلَى رَسُولِ اللَّهِ صلى الله عليه وسلم فَقَالُوا إِنَّا مِنْ هَذَا الْحَىِّ مِنْ رَبِيعَةَ، وَلَسْنَا نَصِلُ إِلَيْكَ إِلاَّ فِي الشَّهْرِ الْحَرَامِ، فَمُرْنَا بِشَىْءٍ نَأْخُذْهُ عَنْكَ، وَنَدْعُو إِلَيْهِ مَنْ وَرَاءَنَا‏.‏ فَقَالَ ‏ "‏ آمُرُكُمْ بِأَرْبَعٍ، وَأَنْهَاكُمْ عَنْ أَرْبَعٍ الإِيمَانِ بِاللَّهِ ـ ثُمَّ فَسَّرَهَا لَهُمْ شَهَادَةُ أَنْ لاَ إِلَهَ إِلاَّ اللَّهُ، وَأَنِّي رَسُولُ اللَّهِ، وَإِقَامُ الصَّلاَةِ، وَإِيتَاءُ الزَّكَاةِ، وَأَنْ تُؤَدُّوا إِلَىَّ خُمُسَ مَا غَنِمْتُمْ، وَأَنْهَى عَنِ الدُّبَّاءِ وَالْحَنْتَمِ وَالْمُقَيَّرِ وَالنَّقِيرِ ‏"‏‏.‏

Narrated Ibn `Abbas:"Once a delegation of `Abdul Qais came to Allah's Messenger (ﷺ) and said, "We belong to such and such branch of the tribe of Rabi'ah and we can only come to you in the sacred months. Order us to do something good so that we may take it from you and also invite to it those whom we have left behind (at home)." So he said, "I order you to do four things and forbid you from four things: To believe in Allah" - and then he explained it to them "to testify that none has the right to be worshipped but Allah and that I am Allah's Messenger (ﷺ), to establish the prayers (at the stated times), to pay the Zakat (obligatory charity), to hand me the Khumus (fifth) if you acquire spoils of war. And I forbid from (using) Dubba, Hantam, Muqaiyyar, and Naqir (all these were utensils used for the preparation of alcoholic drinks)

يا طويل الرقاد والغفلات % كثرة النوم تورث الحسرات

وأما السهد فهو أيضا من آثار المحبة ولوازمها فالسهاد الأرق وقد سهد الرجل بالكسر يسهد سهدا والسهد بضم السين والهاء القليل النوم قال أبو كبير الهذلي

الثالث تعلقها به في حال النوم فلها به تعلق من وجه ومفارقة من وجه

1139 عن أبي هريرة رضي الله عنه قال أوصاني خليلي صلى الله عليه وسلم بصيام ثلاثة أيام من كل شهر وركعتي الضحى وأن أوتر قبل أن أرقد متفق عليه والإيتار قبل النوم إنما يستحب لمن لا يثق بالاستيقاظ آخر الليل فإن وثق فآخر الليل أفضل

وبدائع مصنوعاته ولهذا يعيد ذكرهما في القرآن ويبديه كقوله تعالى @QB@ ومن آياته الليل والنهار @QE@ وقوله وهو الذي جعل الليل لباسا والنوم سباتا وجعل النهار نشورا وقوله عز وجل @QB@ وهو الذي خلق الليل والنهار والشمس والقمر كل في فلك يسبحون @QE@ وقوله عز وجل @QB@ الله الذي جعل لكم الليل لتسكنوا فيه والنهار مبصرا @QE@ وهذا كثير في القرآن فانظر إلى هاتين الايتين وما تضمنتاه من العبر والدلالات على ربوبية الله وحكمته كيف جعل الليل سكنا ولباسا يغشى العالم فتسكن فيه الحركات وتأوى الحيوانات إلى بيوتها والطير إلى اوكارها وتستجم فيه النفوس وتستريح من كد السعي والتعب حتى إذا اخذت منه النفوس راحتها وسباتها وتطلعت إلى معايشها وتصرفها جاء فالق الاصباح سبحانه وتعالى بالنهار يقدم جيشه بشير الصباح فهزم تلك الظلمة ومزقها كل ممزق وكشفها عن العالم فإذا هم مبصرون فانتشر الحيوان وتصرف في معاشه ومصالحه وخرجت الطيور من اوكارها فياله من معاد ونشأة دال على قدرة الله سبحانه على المعاد الاكبر وتكرره ودوام مشاهدة النفوس

فأول مراتب هذا النائم اليقظة والإنتباه من النوم وقد ذكرنا أنها إنزعاج القلب لروعة الإنتباه

A sleep intervention study comparing effects of sleep restriction and fragmentation on sleep and vigilance and the need for recovery.: Purpose: Sleep deprivation is present not only in sleep disorders but also in numerous high demanding jobs and negatively affects cognition, performance and health. We developed a study design to distinguish the effects and need for recovery of two short-term disturbances - intermittent sleep fragmentation and partial sleep restriction. Methods: The randomized within-subjects design contained two weeks each with a baseline night, an intervention night of either sleep deprivation (5 h) or sleep f

The effect of group cognitive behavioural therapy for insomnia in postmenopausal women.: The menopausal period is associated with several complications in women. One of these complications is sleep disorders including insomnia disorder that can affect all aspects of personal life. The present study aimed to evaluate the effectiveness of cognitive behavioural therapy for insomnia (CBT-I) on insomnia severity and sleep quality among postmenopausal women. This was a randomised clinical trial in which 46 women were recruited and randomly allocated into two groups, one receiving CBT-I an

Investigating the subjective and objective efficacy of a cognitive behavioural therapy for insomnia (CBT-I)-based smartphone app on sleep: A randomised controlled trial.: Due to insufficient treatment options for insomnia, effective solutions are urgently needed. We evaluated the effects of a CBT-I-based app combining sleep training with subjective and objective sleep monitoring on (i) sleep and (ii) subjective-objective sleep discrepancies (SOSD). Fifty-seven volunteers (20-76 years; MAge = 45.67 ± 16.38; 39 female) suffering from sleep problems were randomly assigned to an experimental group (EG, n = 28) or a waitlist control group (CG, n = 29). During the 6-we

Let's talk about sleep: a systematic review of psychological interventions to improve sleep in college students.: Sleep problems are a common occurrence in college students. Insomnia, nightmares and impaired sleep quality lead to several mental health issues, as well as impaired academic performance. Although different sleep programmes exist, a systematic overview comparing their effectiveness is still missing. This systematic review aims to provide an overview of psychological interventions to improve sleep in college students. Seven databases were searched from November to December 2016 (MEDLINE, EMBASE,

The effects of a personalized sleep improvement app in subclinical poor sleepers: A randomized controlled trial.: The aim of this study was to determine the effects of a personalized smartphone application on subjective sleep quality, wellbeing and stress in participants with subclinical sleep problems. Healthy participants with subclinical threshold sleep issues that did not meet diagnostic criteria for insomnia were randomly assigned to use the app or be on a waiting list for app usage (control group). Subjective data on sleep quality (sleep quality component of Sleep Questionnaire B [primary endpoint] an

The effect of non-pharmacological sleep interventions on glycaemic measures in adults with sleep disturbances and behaviours: A systematic review and meta-analysis.: Background: Sleep insufficiency is known to negatively impact on glucose metabolism. Consequently, there is interest in determining the impact of improving sleep on glucose metabolism. We conducted a meta-analysis of studies that aimed at improving sleep using cognitive behavioural therapy for insomnia (CBT-I) and/or sleep hygiene or sleep extension on glucose metabolism. Methods: Searches were performed on MEDLINE, EMBASE, CINAHL and Cochrane. We included studies featuring adults≥18years, a sle

Functional consequences of inadequate sleep in adolescents: a systematic review.

During adolescence, changes in sleep patterns due to biological and environmental factors are well documented. Later bedtimes and inadequate sleep, i.e., short and disrupted sleep patterns, insomnia and daytime sleepiness, have become increasingly common. Accumulating evidence suggests that sleep plays a crucial role in healthy adolescent development. This review systematically explores descriptive evidence, based on prospective and cross sectional investigations, indicating that inadequate sleep is associated with negative outcomes in several areas of health and functioning, including somatic and psychosocial health, school performance and risk taking behavior. Findings highlight the need for longitudinal investigations aimed at establishing the underpinnings of these associations and for developing and implementing interventions designed to achieve healthier and more balanced sleep pat…

matched on Sleep Deprivation (mesh), Sleep Wake Disorders (mesh), Sleep (keyword), insomnia (text)

The effect of group-based cognitive behavioural therapy for insomnia in patients with rheumatoid arthritis: a randomized controlled trial.

Objectives: The primary objective was to compare the effect of cognitive behavioural therapy for insomnia (CBT-I) to usual care on sleep efficiency, measured by polysomnography (PSG) immediately after the intervention at week 7. Secondary objectives included comparing the longer-term effect on sleep- and RA-related outcomes at week 26. Methods: In a randomized controlled trial using a parallel group design, the experimental intervention was 6 weeks' nurse-led group-based CBT-I; the comparator was usual care. Analyses were based on the intention-to-treat (ITT) principle; missing data were statistically modelled using repeated-measures linear mixed effects models adjusted for the level at baseline. Results: The ITT population consisted of 62 patients (89% women), with an average age of 58 years and an average sleep efficiency of 83.1%. At primary end point, sleep efficiency was 88.7% in th…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), Sleep Quality (keyword), insomnia (text), Polysomnography (keyword)

Evaluation of a brief treatment program of cognitive behavior therapy for insomnia in older adults.

Objective: To evaluate the efficacy of a brief 4-w group-administered treatment program of cognitive behavior therapy for insomnia (CBT-I) for older adults with sleep maintenance insomnia. Design: Randomized controlled trial of CBT-I compared to waitlist control with comparisons at pretreatment, posttreatment, and 3-mo follow-up. Setting: Flinders University Sleep and Circadian Rhythm Research Laboratory, Adelaide, South Australia. Participants: One-hundred eighteen adults with sleep maintenance insomnia (mean age = 63.76 y, standard deviation = 6.45 y, male = 55). Interventions: A 4-w, group-based treatment program of CBT-I including bedtime restriction therapy, sleep education, and cognitive restructuring. Measurements: Seven-day sleep diaries, actigraphy, and several self-report measures to assess perceived insomnia severity, daytime functioning, and confidence in and beliefs about sl…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text), Actigraphy (mesh), Sleep Stages (mesh)

A randomised controlled trial of cognitive-behaviour therapy for behavioural insomnia of childhood in school-aged children.

Chronic sleep problems can lead to the development of Behavioural Insomnia of Childhood - a sleep disorder involving problematic sleep-onset associations (i.e., parental presence), and resulting in impairments for children and family members. The aim of the present paper was to perform a controlled evaluation of cognitive-behaviour therapy (CBT) for Behavioural Insomnia. 42 children (M = 9.3 ± 1.9 yrs, range 7-13 yrs, 18f, 24 m) were randomised to CBT (N = 21) or waitlist control (N = 21). CBT consisted of 6 sessions, and combined behavioural sleep medicine techniques (e.g., sleep restriction) with anxiety treatment techniques (e.g., cognitive restructuring). Compared to waitlist controls, children receiving CBT showed significant improvements in sleep latency, wake after sleep onset, and sleep efficiency (all p ≤ .003), but not total sleep time (p > .05). CBT was also associated with a …

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text), Actigraphy (mesh), Polysomnography (mesh)

Slow-wave sleep during a brief nap is related to reduced cognitive deficits during sleep deprivation.

Sleeping for a short period (i.e. napping) may help mitigate impairments in cognitive processing caused by sleep deprivation, but there is limited research on effects of brief naps in particular. Here, we tested the effect of a brief nap opportunity (30- or 60-min) during a period of sleep deprivation on two cognitive processes with broad scope, placekeeping and vigilant attention. In the evening, participants (N = 280) completed a placekeeping task (UNRAVEL) and a vigilant attention task (Psychomotor Vigilance Task [PVT]) and were randomly assigned to either stay awake overnight or sleep at home. Sleep-deprived participants were randomly assigned to receive either no nap opportunity, a 30-min opportunity, or a 60-min opportunity. Participants who napped were set up with polysomnography. The next morning, sleep participants returned, and all participants completed UNRAVEL and the PVT. Sl…

matched on Sleep Deprivation (mesh), Sleep (mesh), Sleep Deprivation (keyword), Wakefulness (mesh), Polysomnography (keyword)

Yoga nidra practice shows improvement in sleep in patients with chronic insomnia: A randomized controlled trial.

Background Yoga nidra is practised by sages for sleep. The practice is simple to use and has been clearly laid out, but its role in the treatment of chronic insomnia has not been well studied. Methods In this randomized parallel-design study conducted during 2012-16, we enrolled 41 patients with chronic insomnia to receive conventional intervention of cognitive behavioural therapy for insomnia (n=20) or yoga nidra (n=21). Outcome measures were both subjective using a sleep diary and objective using polysomnography (PSG). Salivary cortisol levels were also measured. PSG was done before the intervention in all patients and repeated only in those who volunteered for the same. Results Both interventions showed an improvement in subjective total sleep time (TST), sleep efficiency, wake after sleep onset, reduction in total wake duration and enhancement in subjective sleep quality. Objectively…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text), Polysomnography (mesh), sleep quality (text)

Effect of Transcranial Alternating Current Stimulation for the Treatment of Chronic Insomnia: A Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Clinical Trial.

Background: Not all adults with chronic insomnia respond to the recommended therapeutic options of cognitive behavioral therapy and approved hypnotic drugs. Transcranial alternating current stimulation (tACS) may offer a novel potential treatment modality for insomnia. Objectives: This study aimed to examine the efficacy and safety of tACS for treating adult patients with chronic insomnia. Methods: Sixty-two participants with chronic primary insomnia received 20 daily 40-min, 77.5-Hz, 15-mA sessions of active or sham tACS targeting the forehead and both mastoid areas in the laboratory on weekdays for 4 consecutive weeks, followed by a 4-week follow-up period. The primary outcome was response rate measured by the Pittsburgh Sleep Quality Index (PSQI) at week 8. Secondary outcomes were remission rate, insomnia severity, sleep onset latency (SOL), total sleep time (TST), sleep efficiency, s…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text), Polysomnography (mesh), sleep quality (text)

Efficacy of Cognitive Behavioral Therapy for Insomnia in Adolescents: A Randomized Controlled Trial with Internet Therapy, Group Therapy and A Waiting List Condition.

Study objectives: To investigate the efficacy of cognitive behavioral therapy for insomnia (CBTI) in adolescents. Design: A randomized controlled trial of CBTI in group therapy (GT), guided internet therapy (IT), and a waiting list (WL), with assessments at baseline, directly after treatment (post-test), and at 2 months follow-up. Setting: Diagnostic interviews were held at the laboratory of the Research Institute of Child Development and Education at the University of Amsterdam. Treatment for GT occurred at the mental health care center UvAMinds in Amsterdam, the Netherlands. Participants: One hundred sixteen adolescents (mean age = 15.6 y, SD = 1.6 y, 25% males) meeting DSM-IV criteria for insomnia, were randomized to IT, GT, or WL. Interventions: CBTI of 6 weekly sessions, consisted of psychoeducation, sleep hygiene, restriction of time in bed, stimulus control, cognitive therapy, and…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text), Actigraphy (mesh), sleep hygiene (text)

The impact of cognitive behavioural therapy for insomnia on objective sleep parameters: A meta-analysis and systematic review.

It is well-established that cognitive behavioural therapy for insomnia (CBT-I) improves self-reported sleep disturbance, however the impact on objective sleep is less clear. This meta-analysis aimed to quantify the impact of multi-component CBT-I on objective measures of sleep, indexed via polysomnography (PSG) and actigraphy. Fifteen studies met inclusion criteria. Following appraisal for risk of bias, extracted data were meta-analysed using random-effects models. The quality of the literature was generally high, although reporting of methodological detail varied markedly between studies. Meta-analyses found no evidence that CBT-I reliably improves PSG-defined sleep parameters. Actigraphy evidence was more mixed; with a small effect for reduction in sleep onset latency (Hedge's g = -0.28 [95% confidence interval (CI) -0.51 to -0.05], p = 0.018) and a moderate effect for reduction in tot…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text), Actigraphy (keyword), Polysomnography (keyword)

Treating postpartum insomnia: a three arm randomised controlled trial of cognitive behavioural therapy and light dark therapy.

Background: Insomnia symptoms are common during the postpartum period, yet interventions remain scarce. This trial aimed to simultaneously examine the efficacy of cognitive behavioural therapy (CBT) and light dark therapy (LDT), targeting different mechanisms, against treatment-as-usual (TAU), in reducing maternal postpartum insomnia symptoms. Methods: This three-arm randomised controlled trial recruited from the general community in Australia. Nulliparous females 4-12 months postpartum with self-reported insomnia symptoms [Insomnia Severity Index (ISI) scores >7] were included; severe medical/psychiatric conditions were excluded. Participants were randomised 1:1:1 to CBT, LDT, or TAU stratified by ISI (< or ⩾14) and infant age (< or ⩾8 months). Participants and principal investigators were unblinded. Six-week interventions were delivered via digital materials and telephone. The primary …

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep Wake Disorders (mesh), Sleep (keyword), insomnia (text)

A randomized controlled trial of digital cognitive behavioral therapy for insomnia in pregnant women.

Objective: Despite high rates of prenatal insomnia, efficacious treatment options for this population are quite limited. Early evidence from randomized controlled trials (RCTs) support the efficacy of face-to-face cognitive-behavioral therapy for insomnia (CBTI) for prenatal insomnia. Yet, as many patients are unable to access this specialist-driven care, a critical need exists to increase its accessibility. This RCT examined the efficacy internet-based digital CBTI in pregnant women with insomnia. Methods: Single-site RCT. A total of 91 pregnant women (29.03 ± 4.16 years) nearing/entering the third trimester who screened positive for clinical insomnia on the Insomnia Severity Index (ISI) were randomized to digital CBTI or digital sleep education control. The ISI, Pittsburgh Sleep Quality Index (PSQI), Edinburgh Postnatal Depression Scale (EPDS), and Pre-Sleep Arousal Scale's Cognitive f…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text), sleep duration (text), sleep quality (text)

Treating chronic insomnia in postmenopausal women: a randomized clinical trial comparing cognitive-behavioral therapy for insomnia, sleep restriction therapy, and sleep hygiene education.

Study objectives: Insomnia is a leading cause of disability in postmenopausal women. Multicomponent cognitive-behavioral therapy for insomnia (CBTI) is a first-line treatment for chronic insomnia, but support for its efficacy in treating menopause-related insomnia is scarce. The present study evaluated whether CBTI is an efficacious treatment for menopause-related chronic insomnia, and whether sleep restriction therapy (SRT)-a single component of CBTI-is equally efficacious compared with CBTI. Methods: In a single-site, randomized controlled trial, 150 postmenopausal women (56.44 ± 5.64 years) with chronic DSM-5 insomnia disorder related to menopause were randomized to three treatment conditions: sleep hygiene education (SHE), SRT, or CBTI. Blinded assessments were performed at baseline, posttreatment, and 6 months after treatment. The Insomnia Severity Index (ISI) and sleep diaries serv…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text), sleep duration (text), sleep hygiene (text)

Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: a randomized clinical trial.

Importance: Sleep disturbances are most prevalent among older adults and often go untreated. Treatment options for sleep disturbances remain limited, and there is a need for community-accessible programs that can improve sleep. Objective: To determine the efficacy of a mind-body medicine intervention, called mindfulness meditation, to promote sleep quality in older adults with moderate sleep disturbances. Design, setting, and participants: Randomized clinical trial with 2 parallel groups conducted from January 1 to December 31, 2012, at a medical research center among an older adult sample (mean [SD] age, 66.3 [7.4] years) with moderate sleep disturbances (Pittsburgh Sleep Quality Index [PSQI] >5). Interventions: A standardized mindful awareness practices (MAPs) intervention (n = 24) or a sleep hygiene education (SHE) intervention (n = 25) was randomized to participants, who received a 6…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text), sleep hygiene (text), sleep quality (text)

Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment.

Introduction: The purpose of this systematic review is to provide supporting evidence for a clinical practice guideline on the use of behavioral and psychological treatments for chronic insomnia disorder in adult populations. Methods: The American Academy of Sleep Medicine commissioned a task force of 9 experts in sleep medicine and sleep psychology. A systematic review was conducted to identify randomized controlled trials that addressed behavioral and psychological interventions for the treatment of chronic insomnia disorder in adults. Statistical analyses were performed to determine if the treatments produced clinically significant improvements in a range of critical and important outcomes. Finally, the Grading of Recommendations Assessment, Development, and Evaluation process was used to evaluate the evidence for making specific treatment recommendations. Results: The literature sear…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text), sleep hygiene (text)

Cognitive Behavioural Therapy for Insomnia Monotherapy in Patients with Medical or Psychiatric Comorbidities: a Meta-Analysis of Randomized Controlled Trials.

This is a meta-analysis of randomized controlled trials (RCTs) comparing cognitive behaviour therapy for insomnia (CBT-I) monotherapy with active control treatment for insomnia in patients with medical or psychiatric comorbidities. Both international (PubMed, EMBASE, PsycINFO, Cochrane Library) and Chinese (WanFang, and CNKI) databases were systematically searched. The random effects model was used. Thirteen RCTs comparing CBT-I (n = 441) and active controls (n = 412) groups were included. CBT-I group showed significant advantage over active controls at post-treatment assessment in terms of Insomnia Severity Index (ISI; SMD = -0.74), sleep onset latency (SMD = -0.36), wake after sleep onset (SMD = -0.21), sleep quality (SMD = 0.56), Pittsburgh sleep quality index total scores (PSQI; SMD = -0.76) and the total score of dysfunctional beliefs and attitudes about sleep scale (DBAS; SMD = -1.…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text), sleep quality (text)

Genome-wide analysis of insomnia in 1,331,010 individuals identifies new risk loci and functional pathways.

Insomnia is the second most prevalent mental disorder, with no sufficient treatment available. Despite substantial heritability, insight into the associated genes and neurobiological pathways remains limited. Here, we use a large genetic association sample (n = 1,331,010) to detect novel loci and gain insight into the pathways, tissue and cell types involved in insomnia complaints. We identify 202 loci implicating 956 genes through positional, expression quantitative trait loci, and chromatin mapping. The meta-analysis explained 2.6% of the variance. We show gene set enrichments for the axonal part of neurons, cortical and subcortical tissues, and specific cell types, including striatal, hypothalamic, and claustrum neurons. We found considerable genetic correlations with psychiatric traits and sleep duration, and modest correlations with other sleep-related traits. Mendelian randomizatio…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text), sleep duration (text)

Insomnia treatment in the context of alcohol use disorder: A systematic review and meta-analysis.

Purpose: To determine the efficacy of behavioral and pharmacological interventions for insomnia among individuals with alcohol use disorder (AUD). Procedures: Comprehensive literature searches of psychological, medical, and educational databases were conducted through October 2016. Eligible studies evaluated the efficacy of an insomnia intervention, included a comparison condition, sampled individuals with AUD and either insomnia disorder or complaints of insomnia, assessed sleep-related outcomes, and provided relevant statistics to calculate between-group effect sizes. Effect sizes were estimated for sleep quality, days of alcohol abstinence, and symptoms of depression. Type of intervention (behavioral versus pharmacological) was tested as a moderator of intervention efficacy. Main findings: Nine studies met eligibility criteria and were included in the final review and meta-analysis. R…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text), sleep quality (text)

Nonpharmacological Treatments of Insomnia for Long-Term Painful Conditions: A Systematic Review and Meta-analysis of Patient-Reported Outcomes in Randomized Controlled Trials.

Study objectives: Insomnia is a debilitating comorbidity of chronic pain. This study evaluated the effect of nonpharmacological sleep treatments on patient-reported sleep quality, pain, and well-being in people with long-term cancer and non-cancer (e.g., back pain, arthritis, fibromyalgia) pain conditions. Design: We systematically searched Cochrane CENTRAL, MEDLINE, Embase, and PsychINFO for relevant studies. Search period was set to inception of these databases to March 2014. Studies were included if they were: original randomized controlled trials (RCTs); testing a nonpharmacological intervention; that targets sleep; in adults; with painful health conditions; that has a control group; includes a measure of sleep quality; and at least one other health and well-being outcome. Measurement and findings: Means and standard deviations of sleep quality, pain, fatigue, depression, anxiety, ph…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text), sleep quality (text)

Cognitive Behavioral Therapy for Insomnia Comorbid With Psychiatric and Medical Conditions: A Meta-analysis.

Importance: Cognitive behavioral therapy for insomnia (CBT-I) is the most prominent nonpharmacologic treatment for insomnia disorders. Although meta-analyses have examined primary insomnia, less is known about the comparative efficacy of CBT-I on comorbid insomnia. Objective: To examine the efficacy of CBT-I for insomnia comorbid with psychiatric and/or medical conditions for (1) remission from insomnia; (2) self-reported sleep efficiency, sleep onset latency, wake after sleep onset, total sleep time, and subjective sleep quality; and (3) comorbid symptoms. Data sources: A systematic search was conducted on June 2, 2014, through PubMed, PsycINFO, the Cochrane Library, and manual searches. Search terms included (1) CBT-I or CBT or cognitive behavioral [and its variations] or behavioral therapy [and its variations] or behavioral sleep medicine or stimulus control or sleep restriction or re…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text), sleep quality (text)

Computerised cognitive behavioural therapy for insomnia: a systematic review and meta-analysis.

Background: Computerised cognitive behavioural therapy (CCBT) is an innovative mode of delivering services to patients with psychological disorders. The present paper uses a meta-analysis to systematically review and evaluate the effectiveness of CCBT for insomnia (CCBT-I). Method: A comprehensive search was conducted on 7 databases including MEDLINE, PsycINFO, EMBASE, CINAHL, Cochrane Library, Social Sciences Citation Index and PubMed (up to March 2011). Search terms covered 3 concepts: (1) [internet, web, online, computer-aided, computer-assisted, computer-guided, computerized OR computerised] AND (2) [CBT, cognitive therapy, behavio(u)ral therapy OR behavio(u)r therapy] AND (3) [insomnia, sleep disorders OR sleeping problem]. Results: 533 potentially relevant papers were identified, and 6 randomised controlled trials (RCTs) that met the selection criteria were included in the review a…

matched on Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text), sleep quality (text)

One-year outcomes of a behavioral therapy intervention trial on sleep quality and cancer-related fatigue.

Purpose: To determine 1-year outcomes of a four-component behavioral therapy (BT) sleep intervention (Individualized Sleep Promotion Plan [ISPP]) versus a healthy eating control (HEC) on cancer-related fatigue in women receiving breast cancer adjuvant chemotherapy treatment (CTX). Patients and methods: A total of 219 participants from 12 oncology clinics were randomly assigned in a clinical trial. Before CTX, research nurses coached intervention participants to develop a BT plan including stimulus control, modified sleep restriction, relaxation therapy, and sleep hygiene. BT plans were revised before each CTX and 30, 60, and 90 days after the last CTX and reinforced 7 to 9 days later. HEC participants received nutritional information and equal attention. Pittsburgh Sleep Quality Index (PSQI), Daily Diary, Wrist Actigraph, and Piper Fatigue Scale measures and Repeated Linear Mixed Model a…

matched on Sleep Wake Disorders (mesh), Sleep (mesh), Actigraphy (mesh), sleep hygiene (text), sleep quality (text)

The cortisol awakening response--applications and implications for sleep medicine.

The stress hormone cortisol is the end product of the hypothalamic-pituitary-adrenal (HPA) axis, and the cortisol awakening response (CAR) refers to the rapid rise in cortisol levels observed immediately following awakening. During the CAR period, cortisol levels typically increase by 38%-75%, peaking approximately 30 min after awakening. Evidence suggests the function of the CAR may be related to arousal, energy boost and/or anticipation, although its precise function is still unknown. The CAR has been investigated in a range of clinical populations including the assessment of daytime dysfunction in insomnia; however little research, if any, has specifically examined its relation to sleep architecture, or night-time difficulties associated with insomnia. The aim of this review is to provide an overview of the CAR, a description of the factors which can affect it, and to outline the CAR …

matched on Sleep Deprivation (mesh), Sleep Initiation and Maintenance Disorders (mesh), Sleep (mesh), insomnia (text), Polysomnography (mesh), Wakefulness (mesh)

Cognitive Behavioral Therapy for Insomnia in Older Veterans Using Nonclinician Sleep Coaches: Randomized Controlled Trial.

Objectives: To test a new cognitive behavioral therapy for insomnia (CBT-I) program designed for use by nonclinicians. Design: Randomized controlled trial. Setting: Department of Veterans Affairs healthcare system. Participants: Community-dwelling veterans aged 60 and older who met diagnostic criteria for insomnia of 3 months duration or longer (N = 159). Intervention: Nonclinician "sleep coaches" delivered a five-session manual-based CBT-I program including stimulus control, sleep restriction, sleep hygiene, and cognitive therapy (individually or in small groups), with weekly telephone behavioral sleep medicine supervision. Controls received five sessions of general sleep education. Measurements: Primary outcomes, including self-reported (7-day sleep diary) sleep onset latency (SOL-D), wake after sleep onset (WASO-D), total wake time (TWT-D), and sleep efficiency (SE-D); Pittsburgh Slee…

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Sleep loss affects vigilance: effects of chronic insomnia and sleep therapy.

Although complaints of impaired daytime functioning are essential to the diagnosis of primary insomnia, objective evidence for cognitive dysfunction has been hard to establish. A prerequisite for understanding the neurocognitive consequences of primary insomnia is to establish task paradigms that robustly differentiate insomniacs from well-sleeping subjects. We hypothesized that the decline in performance that typically occurs with an increasing cognitive demand would provide a more sensitive measure than performance on a single task version. The hypothesis was tested, first, by assessing the performance on two vigilance tasks with different cognitive demands in 25 elderly patients with primary insomnia and 13 healthy well-sleeping age-matched subjects. Secondly, we investigated the performance response to sleep therapy using a waiting-list controlled design. Sleep therapy consisted of a…

matched on Sleep Deprivation (mesh), Sleep Initiation and Maintenance Disorders (mesh), insomnia (text), Polysomnography (mesh)

Common Sleep Disorders Affecting Older Adults.

Sleep disorders in older adults increase with aging, likely due to increased sleep latency, decreased sleep efficiency, and total sleep time. Common sleep issues include chronic insomnia, circadian rhythm sleep-wake disorders, sleep-related movement disorders, and sleep-disordered breathing. Diagnostic tools, such as a comprehensive sleep history and questionnaires, or a sleep log for more specific complaints, are commonly used. Polysomnography is not recommended as a routine test; however, it can be used for abnormal behaviors during sleep or if treatment fails. Sleep disorder management is based on the etiology and may include nonpharmacological and pharmacological alternative treatments. For example, nonpharmacological management for chronic insomnia and some sleep disorders may consist of cognitive behavioral therapy, sleep hygiene education, relaxation therapy, sleep restriction, li…

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