Accept Anxiety to Improve Sleep: The Impact of the COVID-19 Lockdown on the Relationships between Mindfulness, Distress, and Sleep Quality.
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ABSTRACT:
SUBMITTER: Mirolli M
PROVIDER: S-EPMC8701850 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Objective/backgroundPoor sleep quality is common in pregnancy and associated with increased psychological distress, which has adverse consequences for families. Emerging theory suggests that mindfulness-based interventions may help reduce cognitive and emotional reactivity to stressful events. The current study examines the effects of a mindfulness-based intervention on the relationship between poor sleep quality and increased depression symptom severity and perceived stress during pregnancy. Additionally, we explored the prevalence of poor sleep quality in this unique sample and the impact of intervention on sleep quality.ParticipantsParticipants were 215 ethnically diverse, overweight and obese, predominantly low-income pregnant women drawn from a study examining the impact of an 8-week mindfulness-based program (Mindful Moms Training; MMT) to reduce excessive gestational weight gain, stress, and depression compared to treatment as usual (TAU).MethodsParticipants reported global sleep quality, depressive symptoms, and perceived stress at baseline and postintervention.ResultsMost participants (63%) were categorized as poor sleepers at baseline. MMT participants did not experience significantly greater improvement in sleep quality compared to TAU participants. Baseline poor global sleep quality predicted increased depression symptom severity for all participants. Baseline poor global sleep quality predicted increased perceived stress for the TAU group only; this association was not evident in the MMT group.ConclusionsPoor sleep quality is prevalent in overweight and obese predominantly low-income pregnant women. Poor sleep quality was associated with worsening psychological distress, but mindfulness training significantly attenuated the influence of poor sleep on perceived stress.
| S-EPMC5522361 | biostudies-literature
Project description:The mechanisms of mindfulness-improved sleep quality are not extensively studied. Recently, attention monitoring/awareness and acceptance in mindfulness have been proposed to be the underlying mechanisms that tackle distress and related disorders. The current study tested if acceptance moderated the relationship of awareness with psychological distress and sleep quality, and verified that psychological distress mediated the relationship between mindfulness and sleep quality in a group of community-dwelling healthy adults. Three hundred and sixty-four healthy Chinese non-meditators (age 18-65, 59% female) completed a set of online self-reported questionnaires in Chinese via SurveyMonkey. Awareness and acceptance were measured by Observe and Nonreact facets in the Five Facet Mindfulness Questionnaire (FFMQ), respectively. General psychological distress levels and sleep quality were reflected in the global score of the Depression Anxiety and Stress Scales (DASS) and the Pittsburgh Sleep Quality Index (PSQI), respectively. Model 1 and model 8 in the PROCESS macro for SPSS were used to assess the moderation and moderated mediation effects. Increased level of acceptance (Nonreact) weakened the positive relationship between awareness (Observe) and poor sleep quality (? = -0.0154, p = 0.0123), which was partially mediated through perceived psychological distress (? = -0.0065, 95% bias-corrected bootstrap CI = -0.0128, -0.0004) in a group of community-dwelling healthy adults. Our findings suggested that awareness and acceptance could be the mechanisms of mindfulness interventions in improving sleep quality, partly via reducing psychological stress.
| S-EPMC5866834 | biostudies-other
Project description:ObjectiveAnxiety is associated with sleep disturbance and insomnia. Mindfulness-based interventions, such as mindfulness-based stress reduction, have shown consistent anxiety reduction. Mindfulness training has been theorized to affect reinforcement learning, affecting habitual behaviors such as smoking and overeating, but a direct mechanistic link between the use of mindfulness training for anxiety reduction and improvement in sleep has not been studied. Moreover, the mechanisms by which mindfulness might affect worry and subsequent sleep disturbances have not been elucidated. This study protocol evaluates the impact an app-based mindfulness training program for anxiety might have on decreasing worry and improvement in sleep.MethodA randomized controlled study will be conducted in approximately 80 adults with worry that interferes with their sleep. Participants will be randomly allocated (1:1) to two groups: treatment-as-usual (TAU) or TAU + App-Based Mindfulness Training (Unwinding Anxiety app). The primary outcomes will be the non-reactivity subscale of the Five Facet Mindfulness Questionnaire and Patient-Reported Outcomes Measurement Information System sleep quality measures (Baer et al., 2008; Yu et al., 2011). Secondary outcomes will include the Penn State Worry Questionnaire, Generalized Anxiety Disorder-7, and Multidimensional Assessment of Interoceptive Awareness Scale (Mehling et al., 2012; Meyer, Miller, Metzger, & Borkovec, 1990; Spitzer, Kroenke, Williams, & Löwe, 2006).DiscussionThis study will be the first to test the mechanism of app-based mindfulness training on worry and sleep disturbance. Testing the mechanistic effects of mindfulness training using the science of behavior change framework will help move the field forward both in further elucidation of potential mechanisms of mindfulness (e.g., targeting reinforcement learning) and determining whether such a platform might be a viable method for delivering high-fidelity treatment at scale and for a low cost. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
| S-EPMC8345003 | biostudies-literature
Project description:(1) Background: Given that the most effective dose, optimal type, and most beneficial population for improving sleep with mindfulness-based movement (MBM) remains unknown, we conducted a systematic review and meta-analysis with moderator analysis of randomized controlled trials (RCTs) to assess these effects. (2) Methods: Three electronic databases (PubMed, Web of Science, and EBSCO) were systematically searched for RCTs published through August 2021 for analysis. The risk of bias of the included studies was assessed with Review Manager 5.3, and the meta-analysis was performed in Stata 16.0. (3) Results: A meta-analysis of 61 RCTs with 2697 participants showed that MBM significantly improved sleep quality compared to controls (SMD = -0.794; 95% CI: -0.794 to -0.994, p < 0.001, I2 = 90.7%). Moderator analysis showed that a long-term MBM (SMD = -0.829; 95% CI: 0.945 to 0.712; p < 0.001) had a larger effect size on sleep than a short-term MBM (SMD = -0.714; 95% CI: 0.784 to 0.644; p < 0.001). Practicing at least twice per week (SMD = -0.793; 95% CI: -0.868 to -0.718; p < 0.001) was more effective compared to practicing once per week (SMD = -0.687; 95% CI: -0.804 to -0.570; p < 0.001). Studies with a total intervention time of more than 24 h also revealed better sleep quality improvement (SMD = -0.759; 95% CI: -0.865 to -0.653; p < 0.001). In addition, the healthy population and older adults gained more from MBM than the patients and younger adults. (4) Conclusions: MBM can effectively improve subjective sleep quality, and the optimal intervention dose of MBM can be utilized in future intervention studies to treat or improve sleep disturbance (MBM more than twice a week for more than three months, with a total intervention time of more than 24 h).
| S-EPMC9408303 | biostudies-literature
Project description:BackgroundBetter caregiver contribution to self-care in heart failure is associated with better patient outcomes. However, caregiver contribution to self-care is also associated with high anxiety and depression, poor quality of life, and poor sleep in caregivers. It is still unclear whether interventions that encourage caregivers to contribute more to patient self-care might increase caregivers' anxiety and depression and decrease their quality of life and sleep.ObjectiveThe aim of this study was to assess the impact of a motivational interview intervention aimed at improving caregiver contribution to self-care in heart failure on caregivers' anxiety, depression, quality of life, and sleep.MethodsThis is a secondary outcome analysis of the MOTIVATE-HF trial. Patients with heart failure and their caregivers were randomized into arm 1 (motivational interview to patients), arm 2 (motivational interview to patients and caregivers), and arm 3 (standard care). Data were collected between June 2014 and October 2018. The article has been prepared following the Consolidated Standards of Reporting Trials checklist.ResultsA sample of 510 patient-caregiver dyads was enrolled. Over the year of the study, the levels of anxiety, depression, quality of life, and sleep in caregivers did not significantly change among the 3 arms.ConclusionsMotivational interview aimed at improving caregiver contribution to self-care does not seem to increase caregiver anxiety and depression, nor decrease their quality of life and sleep. Thus, such an intervention might be safely delivered to caregivers of patients with heart failure, although further studies are needed to confirm our findings.
| S-EPMC10259208 | biostudies-literature
Project description:Sleep paralysis is the unusual experience of waking up in the night without the ability to move. Currently little is known about the experience, despite the fact that the vast majority of episodes are associated with extreme fear and in a minority of cases can lead to clinically significant levels of distress. The aim of this work was to review the existing literature pertaining to the relationship sleep paralysis has to sleep more generally, measured both with subjective questionnaires and objective laboratory recordings. In terms of subjective sleep variables, worse sleep quality has been found in multiple studies to be associated with increased odds of sleep paralysis occurrence. In addition, insomnia symptoms (but not a diagnosed insomnia disorder) have also been found to predict sleep paralysis. Associations between sleep paralysis and other unusual and/or threatening sleep experiences such as nightmares, exploding head syndrome, and lucid dreaming have been reported. In terms of objective measurements, the limited literature to date shows sleep paralysis to be a "mixed" state of consciousness, combining elements of rapid eye movement sleep with elements of wakefulness. Future research needs to focus on longitudinal designs to disentangle the direction of effects and more typically employ a broader assessment of sleep paralysis that better captures associated features such as hallucinations, fear, and distress.
| S-EPMC6220434 | biostudies-literature
Project description:Internet gaming and social media use are prevalent and integral to many people's lives. However, excessive engagement in either could lead to negative health impacts. This study aimed to investigate relationships between severities of internet gaming disorder (IGD) and problematic social media use (operationalized as social media addiction; SMA) with sleep quality and psychological distress among young adults. A cross-sectional study with snowball sampling was conducted among Hong Kong university students in 2019. All participants (n = 300; mean (SD) age = 20.89 (1.48); 122 males (40.67%)) responded to an online survey that included Chinese versions of the Internet Gaming Disorder Scale-Short Form (IGDS9-SF), Bergen Social Media Addiction Scale (BSMAS), Pittsburgh Sleep Quality Index (PSQI), and Depression Anxiety Stress Scales (DASS-21). Multiple linear regressions demonstrated that IGDS-SF9 scores demonstrated associations with psychological distress measures (standardized coefficient (?) = 0.295 for depression, 0.325 for anxiety, 0.339 for stress, all p < 0.001). BSMAS scores showed similar albeit numerically less robust associations (? = 0.235 for depression, p < 0.001; 0.219 for anxiety, p = 0.001; 0.262 for stress, p < 0.001). BSMAS scores demonstrated associations with poorer sleep quality (? = 0.292; p < 0.001) and IGDS9-SF scores (? = 0.157; p = 0.024) showed a significantly less robust association (p = 0.01 for comparing the two ?s). These findings suggest that both severities of IGD and SMA associate with more psychological distress and poorer sleep quality, although the strengths of associations may differ.
| S-EPMC7143464 | biostudies-literature
Project description:ObjectivesTo assess the benefits of training in mindfulness-based stress reduction (MBSR) or moderate intensity exercise (EX) for improving sleep quality.DesignRandomized controlled trial.SettingOutpatient, community-based.ParticipantsHealthy adults (n = 413) aged 30-69 who did not regularly exercise or practice meditation, and who had no known prior sleep problems.Interventions1) 8-weeks of MBSR training; 2) matched EX training; or 3) wait-list control.MeasurementsThe Pittsburgh Sleep Quality Index (PSQI) was administered at baseline and at 1, 3, 5, and 7-month follow-up visits.AnalysisTotal PSQI scores and three PSQI factors (perceived sleep quality; daily disturbance, sleep efficiency) were assessed using linear mixed effects regression models for longitudinal data.ResultsCompared to controls, PSQI global scores improved significantly for EX (mean change -0.98 points [95% CI -1.56, -0.41] p = 0.001) and marginally for MBSR (-0.53 [-1.10, 0.04] p = 0.07). The perceived sleep quality factor improved for both EX (-0.18 [-0.30, -0.07] p = 0.002) and MBSR (-0.12 [-0.24, -0.01] p = 0.035). The daily disturbance factor improved slightly more for MBSR (-0.13 [-0.22, -0.033] p = 0.008) than EX (-0.09 [-0.19, 0.004] p = 0.06). The sleep efficiency factor did not improve after MBSR (0.08 [-0.045, 0.21] p = 0.2) or EX (-0.07 [-0.20, 0.06] p = 0.3). Improvements in the sleep quality were sustained over 7 months for both groups.ConclusionsTraining in MBSR and EX produced small but statistically significant and sustained improvements in sleep quality. For EX participants, this improvement was due primarily to improvements in perceived sleep quality. For MBSR, the decrease in daily disturbance was more important.
| S-EPMC8157793 | biostudies-literature
Project description:ObjectivesPain can have a negative impact on sleep and emotional well-being. This study investigated whether this may be partly explained by maladaptive sleep-related cognitive and behavioural responses to pain, including heightened anxiety about sleep and suboptimal sleep hygiene.MethodsThis cross-sectional study used data from an online survey that collected information about pain (Brief Pain Inventory), sleep (Pittsburgh Sleep Quality Index; Sleep Hygiene Index; Anxiety and Preoccupation about Sleep Questionnaire) and emotional distress (PROMIS measures; Perceived Stress Scale). Structural equation modelling examined the tenability of a framework linking these factors.ResultsOf 468 survey respondents (mean age 39 years, 60% female), 29% reported pain (mean severity 1.12), most commonly in the spine or low back (28%). Pain severity correlated with poor sleep quality, poor sleep hygiene, anxiety about sleep and emotional distress. In the first structural equation model, indirect effects were identified between pain severity and sleep quality through anxiety about sleep (β = .08, p < .001) and sleep hygiene (β = .12, p < .001). In the second model, an indirect effect was identified between pain severity and emotional distress through sleep quality (β = .19, p < .01). Combining these models, indirect effects were identified between pain severity and emotional distress through anxiety about sleep, sleep hygiene and sleep quality.ConclusionsThis study provides data to support the tenability of a theoretically guided framework linking pain, sleep and emotional distress. If upheld by experimental and/or longitudinal study, this framework holds the potential to inform public health initiatives and more comprehensive pain assessment.
| S-EPMC8782309 | biostudies-literature
Project description:ObjectiveThe COVID-19 pandemic has strongly affected daily habits and psychological wellbeing, and many studies point to large modifications in several sleep and sleep-related domains. Nevertheless, pre-sleep arousal during the pandemic has been substantially overlooked. Since hyperarousal represents one of the main factors for the development and the perpetuation of chronic insomnia disorder, the assessment of variables associated with high levels of pre-sleep arousal during the pandemic is clinically relevant. The study aimed to assess the prevalence and predictors of perceived sleep quality and pre-sleep arousal in an Italian sample during the COVID-19 lockdown.MethodsWe used an online survey to collect self-reported sociodemographic, environmental, clinical, sleep, and sleep-related data. Our final sample included 761 participants.ResultsBeyond a high frequency of poor sleep quality, depressive and stress symptoms, our results show that almost half of the sample suffered from clinically relevant levels of at least one component (ie, cognitive, somatic) of pre-sleep arousal. Subjects with greater pre-sleep arousal exhibited poorer sleep quality. Also, sleep quality was strongly associated with somatic and cognitive pre-sleep arousal. Regarding the predictors of sleep and sleep-related measures, depressive and event-related stress symptoms were the main factors associated with both poor sleep quality and pre-sleep arousal components. Moreover, specific sociodemographic and environmental variables were uniquely related to sleep quality, cognitive or somatic pre-sleep arousal.ConclusionsThese findings suggest that the assessment of specific sleep-related factors (ie, pre-sleep arousal), together with more global measures of sleep quality, may be crucial to depict the complex impact of the pandemic on sleep, and to help prevent and counteract the spread of insomnia symptoms.
| S-EPMC8577578 | biostudies-literature