TY - JOUR
T1 - The underestimation of sleep duration phenotype is associated with better treatment response to cognitive behavior therapy for insomnia in patients with chronic insomnia
T2 - a preliminary study
AU - Sun, Qimeng
AU - Dai, Yanyuan
AU - Chen, Baixin
AU - Vgontzas, Alexandros N.
AU - Basta, Maria
AU - Tang, Xiangdong
AU - Zhang, Sen
AU - Li, Yun
N1 - Funding Information:
All authors have seen and approved this manuscript. Work for this study was performed at the Department of Sleep Medicine, Shantou University Mental Health Center. This study was funded by the National Natural Science Foundation of China (No.81970087), Grant for Key Disciplinary Project of Clinical Medicine under the Guangdong High-level University Development Program, Guangdong Province science and technology special fund project (200115165870512), and 2020 Li Ka Shing Foundation Cross-Disciplinary Research Grant (2020LKSFG05B). The supporter had no role in the design, analysis, interpretation, or publication of this study. The authors report no conflicts of interest.
Funding Information:
The authors thank the sleep technicians and staff of the Department of Sleep Medicine at the Shantou University Medical College for their support.
Publisher Copyright:
Copyright 2022 American Academy of Sleep Medicine. All rights reserved.
PY - 2022/10/1
Y1 - 2022/10/1
N2 - Study Objectives: To examine treatment response to cognitive behavior therapy for insomnia (CBT-I) in patients with chronic insomnia with and without underestimation of sleep duration. Methods: We studied 41 patients with chronic insomnia who had received 5-week CBT-I. Self-reported and objective sleep were assessed with sleep diary and actigraphy, respectively. Sleep perception was calculated as self-reported total sleep time/objective total sleep time. The underestimation of sleep duration group was defined based on sleep perception less than the median of the overall sample (85%). Insomnia Severity Index was used to assess the severity of insomnia. Results: The total scores of Insomnia Severity Index decreased significantly after CBT-I in both groups with and without underestimation of sleep duration. Compared to pretreatment, self-reported sleep efficiency increased and total wake time decreased after CBT-I, while the magnitude of changes in sleep efficiency (d = 1.40 vs d=0.81, interaction P =.016) and total wake time (d = -1.82 vs d = -0.85, interaction P <.001) were larger in the underestimation of sleep duration group . Furthermore, self-reported sleep onset latency (interaction P =.520) and wake after sleep onset (interaction P = .052) decreased in the underestimation of sleep duration group (all P <.05), but not in patients without underestimation of sleep duration. Linear regressions showed that lower sleep perception at baseline predicted greater increase in self-reported sleep efficiency (β = -0.99, P <.001) and total sleep time (β = -0.51, P = .006) and greater decrease in self-reported total wake time (β=1.22, P = .023) after CBT-I after adjusting for confounders. Conclusions: The current preliminary study suggests that sleep perception moderates the self-reported CBT-I effects on chronic insomnia: the phenotype of underestimation of sleep duration is associated with a better response to CBT-I, especially in self-reported sleep parameters.
AB - Study Objectives: To examine treatment response to cognitive behavior therapy for insomnia (CBT-I) in patients with chronic insomnia with and without underestimation of sleep duration. Methods: We studied 41 patients with chronic insomnia who had received 5-week CBT-I. Self-reported and objective sleep were assessed with sleep diary and actigraphy, respectively. Sleep perception was calculated as self-reported total sleep time/objective total sleep time. The underestimation of sleep duration group was defined based on sleep perception less than the median of the overall sample (85%). Insomnia Severity Index was used to assess the severity of insomnia. Results: The total scores of Insomnia Severity Index decreased significantly after CBT-I in both groups with and without underestimation of sleep duration. Compared to pretreatment, self-reported sleep efficiency increased and total wake time decreased after CBT-I, while the magnitude of changes in sleep efficiency (d = 1.40 vs d=0.81, interaction P =.016) and total wake time (d = -1.82 vs d = -0.85, interaction P <.001) were larger in the underestimation of sleep duration group . Furthermore, self-reported sleep onset latency (interaction P =.520) and wake after sleep onset (interaction P = .052) decreased in the underestimation of sleep duration group (all P <.05), but not in patients without underestimation of sleep duration. Linear regressions showed that lower sleep perception at baseline predicted greater increase in self-reported sleep efficiency (β = -0.99, P <.001) and total sleep time (β = -0.51, P = .006) and greater decrease in self-reported total wake time (β=1.22, P = .023) after CBT-I after adjusting for confounders. Conclusions: The current preliminary study suggests that sleep perception moderates the self-reported CBT-I effects on chronic insomnia: the phenotype of underestimation of sleep duration is associated with a better response to CBT-I, especially in self-reported sleep parameters.
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U2 - 10.5664/jcsm.10130
DO - 10.5664/jcsm.10130
M3 - Article
C2 - 35818730
AN - SCOPUS:85139375336
SN - 1550-9389
VL - 18
SP - 2443
EP - 2450
JO - Journal of Clinical Sleep Medicine
JF - Journal of Clinical Sleep Medicine
IS - 10
ER -