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

Exercise, energy balance and the shift worker.

Shift work is now common in society and is not restricted to heavy industry or emergency services, but is increasingly found amongst 'white collar' occupations and the growing number of service industries. Participation in shift work is associated with increased body mass index, prevalence of obesity and other health problems. We review the behavioural and biological disturbances that occur during shift work and discuss their impact on leisure-time physical activity and energy balance. Shift work generally decreases opportunities for physical activity and participation in sports. For those shift workers who are able to exercise, subjective and biological responses can be altered if the exercise is taken at unusual times of day and/or if the shift worker is sleep deprived. These altered responses may in turn impact on the longer-term adherence to an exercise programme. The favourable effe…

matched on sleep duration (text), sleep quality (text)

Mediating effects of healthy lifestyle factors on associations between mental health and functional outcomes in early adolescence.

Background: Although mental health and healthy lifestyle interventions are associated with functional outcomes in adolescence, the extent to which particular lifestyle factors explain relationships between mental health and outcome are unclear. Here we examined mediating effects of lifestyle factors on relationships between mental health and two functional outcomes measured 2-3 years later, as well as moderating effects of environmental risk factors on mediation strength in early adolescence. Method: We analyzed data from three waves of the Adolescent Brain Cognitive Development Study (ages 10-11, 11-12, and 12-13 years). Mediating effects of sleep quality, screen time, physical activity, and Mediterranean diet on the relationships between depression, anxiety, psychotic-like experience (PLE) distress, and total problems with two subsequent functional outcomes (academic functioning and so…

matched on Sleep Quality (mesh), Sleep (keyword), sleep quality (text)

Trajectories of psychotic-like experiences in youth and associations with lifestyle factors.

Background: Persistent and/or distressing psychotic-like experiences (PLEs) during adolescence are associated with poorer subsequent psychiatric outcomes. Modifiable lifestyle factors (such as sleep quality or regular exercise) may improve mental health outcomes; however, it is unknown how lifestyle factors are linked to trajectories of PLEs. Methods: Using data from the Adolescent Brain Cognitive Development Study (N = 10,075, age 9-10 years at baseline), we characterized trajectories of PLEs using latent growth mixture models assessed using the Prodromal Questionnaire-Brief Child Version. We examined trajectories of Total and Distress scores. We used multinomial logistic regressions to examine associations between baseline lifestyle behaviors (including self-reported screen time, physical activity and caffeine intake, and parent-reported sleep disturbances and recreational activities) …

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

Younger people are more vulnerable to stress, anxiety and depression during COVID-19 pandemic: A global cross-sectional survey.

The COVID-19 pandemic has had far-ranging consequences for general physical and mental health. Country-specific research reveals a general reduction in mental and physical well-being, due to measures undertaken to stop the spread of COVID-19 disease. However, research is yet to examine the impact of the pandemic on global psychological distress and its effects upon vulnerable groups. Exploration of the factors that potentially mediate the relationship between stress and mental health during this period is needed, to assist in undertaking concrete measures to mitigate psychological distress and support vulnerable groups. Therefore, this study examined the impact of the COVID-19 pandemic on psychological distress globally, and identified factors that may exacerbate decline in mental health. N = 1653 participants (mean age 42.90 ± 13.63 years; 30.3% males) from 63 countries responded to the…

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

Sleep disturbance among Chinese breast cancer survivors living in the USA.

Purpose: Emerging evidence suggests Chinese breast cancer survivors, a largely understudied population, are at increased risk of sleep disturbance which can have significant impacts on quality of life and other important outcomes. This study aims to describe sleep disturbance among Chinese breast cancer survivors and to examine demographic and clinical correlates as well as psychosocial correlates of sleep disturbance. Methods: Data from 80 Chinese breast cancer survivors in the USA completed the Chinese version of the Pittsburgh Sleep Quality Index as well as measures of quality of life, depressive symptoms, and perceived stress. Participants also completed measures of demographic factors and acculturation. Results: Two thirds (66%) of survivors experienced elevated sleep disturbance. Approximately half (49%) reported sleep efficiency, the percentage of time in bed that is spent asleep,…

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

Caregiver burden and prevalence of depression, anxiety and sleep disturbances in Alzheimer's disease caregivers in China.

Aims and objectives: To evaluate caregiver burden and factors that influence this burden among caregivers and patients with Alzheimer's disease in China. Background: Long-term care can reduce the quality of life for caregivers and result in both mental and physical exhaustion. However, little is known about caregiver burden and associated factors in China. Design: The study had a quantitative cross-sectional design. Methods: A total of 309 caregivers and their patients were included in the study. The patients' cognitive, psychological and functional status and their caregivers' burden, sleep quality and mental state were evaluated. Descriptive analyses, single-factor regression and stepwise factor regression were used to determine the effects of various factors on caregiver burden. Results: Older females and spouses still play an important role in providing family care for those with dem…

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

Maternal Ube3a Loss Disrupts Sleep Homeostasis But Leaves Circadian Rhythmicity Largely Intact.

Individuals with Angelman syndrome (AS) suffer sleep disturbances that severely impair quality of life. Whether these disturbances arise from sleep or circadian clock dysfunction is currently unknown. Here, we explored the mechanistic basis for these sleep disorders in a mouse model of Angelman syndrome (Ube3a(m-/p+) mice). Genetic deletion of the maternal Ube3a allele practically eliminates UBE3A protein from the brain of Ube3a(m-/p+) mice, because the paternal allele is epigenetically silenced in most neurons. However, we found that UBE3A protein was present in many neurons of the suprachiasmatic nucleus--the site of the mammalian circadian clock--indicating that Ube3a can be expressed from both parental alleles in this brain region in adult mice. We found that while Ube3a(m-/p+) mice maintained relatively normal circadian rhythms of behavior and light-resetting, these mice exhibited c…

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

Challenging subjective excessive daytime sleepiness as an insomnia symptom: a retrospective study.

Diagnostic manuals describe insomnia disorder (ID) characterised by fatigue and sleepiness as diurnal consequences of nocturnal symptoms. However, patients with ID do not frequently report sleepiness in the clinical setting. The present study aimed to investigate subjective sleepiness in ID measured through the Epworth Sleepiness Scale (ESS) and its independence towards daytime functioning and fatigue, and to evaluate cognitive behavioural therapy for insomnia (CBT-I) improvement in daytime consequences and their relationship to sleepiness and fatigue. We retrospectively collected the ESS evaluation in a large sample of 105 healthy controls (HCs), 671 patients with ID, and 602 patients with sleep disorders characterised by excessive daytime sleepiness (EDS). Moreover, we conducted a pre-post evaluation of the ESS in a sub-sample of patients with ID who underwent CBT-I. Component 2 of the…

matched on Sleep Initiation and Maintenance Disorders (mesh), insomnia (text), Disorders of Excessive Somnolence (mesh)

Slow dissolving of emotional distress contributes to hyperarousal.

The mechanisms underlying hyperarousal, the key symptom of insomnia, have remained elusive, hampering cause-targeted treatment. Recently, restless rapid-eye-movement (REM) sleep emerged as a robust signature of sleep in insomnia. Given the role of REM sleep in emotion regulation, we hypothesized that restless REM sleep could interfere with the overnight resolution of emotional distress, thus contributing to accumulation of arousal. Participants (n = 1,199) completed questionnaires on insomnia severity, hyperarousal, self-conscious emotional distress, and thought-like nocturnal mentation that was validated to be a specific proxy for restless REM sleep (selective fragmentation: R = 0.57, P < 0.001; eye movement density: R = 0.46, P < 0.01) in 32 polysomnographically assessed participants. The experience of distress lasting overnight increased with insomnia severity (β = 0.29, P < 10(-23)),…

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

Nocturnal polysomnographic sleep across the menstrual cycle in premenstrual dysphoric disorder.

Objectives: Women with premenstrual dysphoric disorder (PMDD) experience disturbed mood, altered melatonin circadian rhythms, and frequent reports of insomnia during the luteal phase (LP) of their menstrual cycle. In this study we aimed to investigate nocturnal polysomnographic (PSG) sleep across the menstrual cycle in PMDD women and controls. Methods: Seven PMDD women who indicated insomnia during LP, and five controls, spent every third night throughout a complete menstrual cycle sleeping in the laboratory. Results: In PMDD and controls progesterone and core body temperature (BT(core)) were elevated during LP compared to the follicular phase (FP). Stage 2 sleep showed a significant main effect of menstrual phase and was significantly increased during mid-LP compared to early-FP in both groups. Rapid eye movement (REM) sleep for both groups was decreased during early-LP compared to earl…

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

Discontinuation of hypnotics during cognitive behavioural therapy for insomnia.

Background: In practical sleep medicine, therapists face the question of whether or not to discontinue the ongoing use of hypnotics in patients, as well as the possible effects of discontinuation. The aim of this study was to evaluate the effects of discontinuing third-generation hypnotics on the results of cognitive-behavioural therapy (CBT) for primary insomnia in patients after long-term abuse. Methods: Twenty-eight outpatients were treated by CBT for 8 weeks. The treatment outcome was estimated by means of differences among subjective clinical scales and polysomnography variables assessed before and after the treatment period. The therapeutic effect in a subgroup of 15 patients who had previously received hypnotics and were successively withdrawn during weeks 2-6 was compared to the effect achieved in patients who had not used hypnotics before CBT. Results: There were no significant …

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

Coordination of cortical and thalamic activity during non-REM sleep in humans.

Every night, the human brain produces thousands of downstates and spindles during non-REM sleep. Previous studies indicate that spindles originate thalamically and downstates cortically, loosely grouping spindle occurrence. However, the mechanisms whereby the thalamus and cortex interact in generating these sleep phenomena remain poorly understood. Using bipolar depth recordings, we report here a sequence wherein: (1) convergent cortical downstates lead thalamic downstates; (2) thalamic downstates hyperpolarize thalamic cells, thus triggering spindles; and (3) thalamic spindles are focally projected back to cortex, arriving during the down-to-upstate transition when the cortex replays memories. Thalamic intrinsic currents, therefore, may not be continuously available during non-REM sleep, permitting the cortex to control thalamic spindling by inducing downstates. This archetypical cortic…

matched on Sleep (mesh), Sleep Stages (mesh)

Improvement of a patient's circadian rhythm sleep disorders by aripiprazole was associated with stabilization of his bipolar illness.

Splitting of the behavioural activity phase has been found in nocturnal rodents with suprachiasmatic nucleus (SCN) coupling disorder. A similar phenomenon was observed in the sleep phase in the diurnal human discussed here, suggesting that there are so-called evening and morning oscillators in the SCN of humans. The present case suffered from bipolar disorder refractory to various treatments, and various circadian rhythm sleep disorders, such as delayed sleep phase, polyphasic sleep, separation of the sleep bout resembling splitting and circabidian rhythm (48 h), were found during prolonged depressive episodes with hypersomnia. Separation of sleep into evening and morning components and delayed sleep-offset (24.69-h cycle) developed when lowering and stopping the dose of aripiprazole (APZ). However, resumption of APZ improved these symptoms in 2 weeks, accompanied by improvement in the p…

matched on Sleep (mesh), Disorders of Excessive Somnolence (mesh)

Effects of the COVID-19 lockdown on human sleep and rest-activity rhythms.

In modern societies, human rest-activity rhythms and sleep result from the tensions and dynamics between the conflicting poles of external social time (e.g., work hours and leisure activities) and an individual's internal biological time. A mismatch between the two has been suggested to induce 'social jetlag' [1] and 'social sleep restriction', that is, shifts in sleep timing and differences in sleep duration between work days and free days. Social jetlag [2,3] and sleep restrictions [4] have repeatedly been associated with negative consequences on health, mental wellbeing, and performance. In a large-scale quasi-experimental design, we investigated the effects of the phase with the most rigorous COVID-19 restrictions on the relationship between social and biological rhythms as well as sleep during a six-week period (mid-March until end of April 2020) in three European societies (Austria…

matched on Sleep (mesh), sleep duration (text), sleep quality (text)

β-amyloid disrupts human NREM slow waves and related hippocampus-dependent memory consolidation.

Independent evidence associates β-amyloid pathology with both non-rapid eye movement (NREM) sleep disruption and memory impairment in older adults. However, whether the influence of β-amyloid pathology on hippocampus-dependent memory is, in part, driven by impairments of NREM slow wave activity (SWA) and associated overnight memory consolidation is unknown. Here we show that β-amyloid burden in medial prefrontal cortex (mPFC) correlates significantly with the severity of impairment in NREM SWA generation. Moreover, reduced NREM SWA generation was further associated with impaired overnight memory consolidation and impoverished hippocampal-neocortical memory transformation. Furthermore, structural equation models revealed that the association between mPFC β-amyloid pathology and impaired hippocampus-dependent memory consolidation was not direct, but instead statistically depended on the in…

matched on Sleep Wake Disorders (mesh), Polysomnography (mesh), Sleep Stages (mesh)

Essential role of dopamine D2 receptor in the maintenance of wakefulness, but not in homeostatic regulation of sleep, in mice.

Dopamine (DA) and its D(2) receptor (R) are involved in cognition, reward processing, and drug addiction. However, their roles in sleep-wake regulation remain unclear. Herein we investigated the role of D(2)R in sleep-wake regulation by using D(2)R knock-out (KO) mice and pharmacological manipulation. Compared with WT mice, D(2)R KO mice exhibited a significant decrease in wakefulness, with a concomitant increase in non-rapid eye movement (non-REM, NREM) and REM sleep and a drastic decrease in the low-frequency (0.75-2 Hz) electroencephalogram delta power of NREM sleep, especially during the first 4 h after lights off. The KO mice had decreased mean episode duration and increased episode numbers of wake and NREM sleep, many stage transitions between wakefulness and NREM sleep during the dark period, suggesting the instability of the wake stage in these D(2)R KO mice. When the KO mice wer…

matched on Sleep Deprivation (mesh), Sleep Stages (mesh), Wakefulness (mesh)

Status and risk factors for depression, anxiety, and insomnia symptoms among adolescents in the post-pandemic era.

Background: Owing to their vulnerability to public health crises, adolescents' mental health status, and related risk factors in the post-pandemic era in China require examination. This study aimed to lay a foundation for subsequent interventions and mental disorder prevention among adolescents. Methods: An anonymous online survey was conducted January 8-18, 2023. The survey comprised two parts. The first part collected personal information. The second part included the nine-item Patient Health Questionnaire, seven-item Generalized Anxiety Disorder Scale, and Pittsburgh Sleep Quality Index. Results: Of 50,666 adolescent participants, 46.8% displayed depressive symptoms, 31.5% showed anxiety symptoms, and 47.9% experienced difficulties initiating sleep within 30 min, while 4.9% manifested depressive, anxiety, and insomnia symptoms simultaneously. Chi-square tests revealed significant vari…

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

Network meta-analysis examining efficacy of components of cognitive behavioural therapy for insomnia.

Cognitive behavioural therapy for insomnia (CBTI) is recommended as first-line treatment for insomnia. CBT-I is a multi-component intervention comprising psychoeducation, sleep restriction, stimulus control, cognitive, and relaxation therapy. The relative efficacy of its components has yet to be investigated with state-of-the-art meta-analytic methods. PubMed, MEDLINE, PsycINFO, PsycARTICLES, and CINAHL were searched according to a pre-registered protocol using search terms indicative of insomnia and CBTI. Baseline-to-post-treatment effect sizes (Cohen's d) were calculated in a component network meta-analysis. Eighty studies representing 15,351 participants (mean age 44.9 years, 70.1 % female) were included. For the primary outcome insomnia severity, a significant positive effect for sleep restriction therapy (d = -0.45; 95 % CI: [-0.63; -0.36]) was found. Overall, the results suggest th…

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

Does treating insomnia with digital cognitive behavioural therapy (Sleepio) mediate improvements in anxiety for those with insomnia and comorbid anxiety? An analysis using individual participant data from two large randomised controlled trials.

Background: Considerable comorbidity exists between insomnia and anxiety, and evidence shows that the benefits of CBT for insomnia extend to anxiety. Using data from two large trials of digital CBT (dCBT) for insomnia, we evaluated whether improving sleep is an effective treatment target to reduce both insomnia and anxiety symptoms in individuals with insomnia and clinically significant anxiety. Methods: This was a controlled sub-analysis combining individual participant data from two previous randomised controlled trials of dCBT for insomnia (Sleepio). Participants (N = 2172) with insomnia disorder and clinically significant anxiety symptoms were included in this sub-analysis and received either dCBT or control (usual care or sleep hygiene education). Assessments were evaluated at baseline, post-intervention (week 8 or 10), and follow-up (week 22 or 24). Mediation was evaluated using st…

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

Telehealth-delivered CBT-I programme enhanced by acceptance and commitment therapy for insomnia and hypnotic dependence: A pilot randomized controlled trial.

Cognitive behavioural therapy for insomnia is the recommended treatment for chronic insomnia. However, up to a quarter of patients dropout from cognitive behavioural therapy for insomnia programmes. Acceptance, mindfulness and values-based actions may constitute complementary therapeutic tools to cognitive behavioural therapy for insomnia. The current study sought to evaluate the efficacy of a remotely delivered programme combining the main components of cognitive behavioural therapy for insomnia (sleep restriction and stimulus control) with the third-wave cognitive behavioural therapy acceptance and commitment therapy in adults with chronic insomnia and hypnotic dependence on insomnia symptoms and quality of life. Thirty-two participants were enrolled in a pilot randomized controlled trial: half of them were assigned to a 3-month waiting list before receiving the four "acceptance and co…

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

Treating insomnia in Swiss primary care practices: A survey study based on case vignettes.

Guidelines recommend cognitive behavioural therapy for insomnia (CBT-I) as first-line treatment for chronic insomnia, but it is not clear how many primary care physicians (PCPs) in Switzerland prescribe this treatment. We created a survey that asked PCPs how they would treat chronic insomnia and how much they knew about CBT-I. The survey included two case vignettes that described patients with chronic insomnia, one with and one without comorbid depression. PCPs also answered general questions about treating chronic insomnia and about CBT-I and CBT-I providers. Of the 820 Swiss PCPs we invited, 395 (48%) completed the survey (mean age 54 years; 70% male); 87% of PCPs prescribed sleep hygiene and 65% phytopharmaceuticals for the patient who had only chronic insomnia; 95% prescribed antidepressants for the patient who had comorbid depression. In each case, 20% of PCPs prescribed benzodiazep…

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

Photoplethysmography in Normal and Pathological Sleep.

This article presents an overview of the advancements that have been made in the use of photoplethysmography (PPG) for unobtrusive sleep studies. PPG is included in the quickly evolving and very popular landscape of wearables but has specific interesting properties, particularly the ability to capture the modulation of the autonomic nervous system during sleep. Recent advances have been made in PPG signal acquisition and processing, including coupling it with accelerometry in order to construct hypnograms in normal and pathologic sleep and also to detect sleep-disordered breathing (SDB). The limitations of PPG (e.g., oxymetry signal failure, motion artefacts, signal processing) are reviewed as well as technical solutions to overcome these issues. The potential medical applications of PPG are numerous, including home-based detection of SDB (for triage purposes), and long-term monitoring o…

matched on Sleep (mesh), insomnia (text), Polysomnography (mesh), Polysomnography (keyword)

Sleep disorders as primary and secondary factors in relation with daily functioning in medical students.

Background: College students experience various types of sleep disorders that impact daily functioning. Previous studies have focused on the effect of one sleep disorder. Objective: Examine factors that might relate to several sleep disorders and the impacts of sleep disorders on the daily functioning in medical students. Design: Cross-sectional study. Setting: Medical college. Subjects and methods: A random sample of medical students from a public university was invited to participate in a cross-sectional study using the structured SLEEP-50 self-reported questionnaire. The sleep disorders covered by the questionnaire were insomnia, sleep apnea, restless legs syndrome, sleep walking, circadian rhythm sleep disorder, nightmares, narcolepsy, and factors impacting sleep, effects of sleep complaints on daily functioning, and sleeping duration. Main outcome measure: Sleep duration, sleep diso…

matched on Sleep Wake Disorders (mesh), insomnia (text), sleep duration (text)

[Attitudes to insomnia by Primary Care physicians of Majorca (Spain)].

Objectives: To describe the current clinical management of insomnia by family physicians. Design: Cross-sectional study. Setting: Majorca Health Area, 2011-2012. Participants: Family physicians (FP). Paediatricians, resident physicians and emergency physicians were excluded. Measurements: Using a self-administered questionnaire, the following variables were collected: social, demographic, professional, training in insomnia, prescription preferences, and its clinical management. Results: A total of 322 of 435 physicians answered (74%), of whom 55% were female. The mean age was 48 years with a mean of 21 years in the profession. Most of them consider insomnia as a major health problem, and refer to asking patients about sleep habits and its impact on daily life. About one third have been trained in insomnia in the last 5 years. Very few (0.6%) refers patients to a psychiatrist, and 1.9% to…

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

Patients' and clinicians' experiences and perceptions of the primary care management of insomnia: qualitative study.

Background: Insomnia is common leading to patients with sleep problems often presenting to primary care services including general practice, community pharmacies and community mental health teams. Little is known about how health professionals in primary care respond to patients with insomnia. Aim: We aimed to explore health professionals' and patients' experiences and perceptions of the management of insomnia in primary care. Design: We used a qualitative design and thematic approach. Setting: Primary care in Nottinghamshire and Lincolnshire. Method: We undertook focus groups and one-to-one interviews with a purposive sample of health professionals and adults with insomnia. Results: We interviewed 28 patients and 23 health professionals. Practitioners focused on treating the cause of insomnia rather than the insomnia itself. They described providing stepped care for insomnia, but this f…

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