抑郁症患者社会快感缺失与睡眠质量和睡眠信念的相关性

目的:探讨抑郁症患者社会快感缺失与睡眠质量及睡眠信念的关系。方法:收集42例抑郁症患者和43例健康者对照,采用社会快感缺失问卷(RSAS-C)、匹斯堡睡眠质量指数量表(PSQI)及睡眠个人信念和态度量表(DBAS)进行调查。结果:患者组RSAS-C(t=-3.18,P0.01)和PSQI总分(t=-8.84,P0.01)及各因子分均显著高于对照组,DBAS总分(t=4.52,P0.01)、失眠后果的估计(t=4.33,P0.01)和对睡眠的担心因子分(t=4.80,P0.01)均低于对照组,差异有显著性。Spearman相关分析显示,患者组RSAS-C评分与PSQI中睡眠障碍因子分呈正相关(r=0.327,P0.05),DBAS总分与PSQI总分呈负相关(r=-0.339,P0.05)。DBAS中对失眠后果的估计因子分与PSQI总分、睡眠质量、睡眠药物及睡眠效率因子分均呈负相关(r=-0.310,-0.337,-0.369,-0.326;P0.05)。余变量间的相关性均无统计学意义。结论 :抑郁症患者存在明显的社会快感缺失,睡眠质量变差以及存在较多错误的睡眠信念,并且患者睡眠质量与社会快感缺失存在相关。     

澳门特别行政区初三学生的睡眠质量、睡眠模式与抑郁、焦虑情绪

目的:了解澳门特别行政区初三年级学生的睡眠质量、模式与抑郁、焦虑情绪的关系。方法:抽取澳门535名初中三年级学生,用匹兹堡睡眠质量指数量表(PSQI)评估睡眠质量,爱泼沃斯思睡量表(ESS)以及清晨型和夜晚型量表(MEQ)调查白天思睡与睡眠模式,用贝克抑郁量表(BDI)、状态-特质焦虑量表(STAI)调查抑郁、焦虑状况。结果:PSQI和ESS得分分别为(5.2±2.6)和(8.4±4.7),女生PSQI[(5.5±2.5)vs.(4.8±2.6)]和ESS[(8.9±4.6)vs.(8.0±4.8)]得分高于男生(均P0.05)。MEQ平均得分(13.3±3.1),女生得分低于男生[(12.8±3.0)vs.(13.7±3.2),P0.01]。学生周末和假日的总睡眠时间长于平日总睡眠时间[(608±106)min,(605±109)min vs.(457±75)min],女生周末[(628±110)min vs.(590±97)min]和假期[(631±109)min vs.(581±103)min]平均睡眠时间长于男生(均P0.01)。BDI和STAI得分分别为(13.5±10.3)、(78.9±17)。睡眠质量差和白天思睡者MEQ得分、上学日睡眠时间低于睡眠质量好和无白天思睡者MEQ得分,而睡眠质量差和白天思睡者BDI得分高于睡眠质量好和无白天思睡者BDI得分(均P0.05)。PSQI分别与ESS、BDI,以及STAI中的TAI分呈正相关(r=0.27、0.37、0.12,均P0.05),而与M EQ和上学日总睡眠时间呈负相关(r=-0.30、-0.30,均P0.05)。结论:睡眠质量差和白天思睡在澳门初三学生中较为普遍,他们在上学日的平均睡眠时间不足,但在周末和假日则延长睡眠时间以作补充,其中女生更易出现上述睡眠模式。大部分学生有轻度抑郁,睡眠质量差可能与其抑郁、焦虑状况相关。     

失眠症患者状态-特质焦虑与睡眠结构的关系

目的:探讨失眠症患者睡眠结构改变与状态焦虑和特质焦虑的关系.方法:对31例失眠症患者和20例正常对照者进行状态-特质焦虑问卷调查和整夜多导睡眠图描记,失眠症组于症状缓解出院后3~4月回访时重复检查.结果:(1)在睡眠结构上,与对照组相比,失眠症组呈现睡眠时间减少[(333.71±84.33)min vs.(403.65±19.29)min]、睡眠效率下降[(70.41±17.35) % vs.(83.45±4.42) %]、睡眠潜伏期[(39.48±24.24) min vs.(19.65±8.57) min]和快速眼动睡眠潜伏期延长[(106.60±42.89) min vs.(86.80±12.25) min],S_1睡眠时间比例增加[( 25.36±14.22) %vs.(8.86±1.77) %]、觉醒次数增多[(4.45±2.51) vs.(1.75±1.07)].S_(3+4)睡眠[(7.38±9.70)% vs.(13.78±4.24)%]和快速眼动睡眠时间比例[( 14.54±5.61) %vs.(19.18±2.14) %]减少 (Ps<0.05).(2)在状态-特质焦虑问卷评分上,失眠症组状态焦虑[(47.94 ±8.96) vs.(39.15±4.51)]和特质焦虑[(49.94 ±8.90) vs.(42.05±7.13)]得分均高于对照组(Ps<0.05).状态焦虑与睡眠潜伏期、快眼动睡眠潜伏期、觉醒次数和S_1睡眠时间比例均呈正相关(r=0.25~0.44,Ps<0.05),而与快眼动睡眠时间比例呈负相关(r=-0.41,P<0.01);特质焦虑与睡眠潜伏期和觉醒次数正相关(r=0.37,0.29;均Ps<0.05).(3)回访时患者睡眠结构改善,状态焦虑得分下降,特质焦虑无明显变化.结论:失眠症患者有明显的睡眠结构改变和较高的状态焦虑和特质焦虑,其睡眠结构改变与状态焦虑和特质焦虑相关.     

大学生的睡眠质量与抑郁、焦虑的关系

目的:探讨大学生的睡眠质量与抑郁、焦虑症状严重程度的关系。方法:选取580名大学生,采用匹兹堡睡眠量表(PSQI)、抑郁自评量表(SDS)、焦虑自评量表测试(SAS)分别测查其睡眠质量以及抑郁、焦虑症状严重程度。SDS标准分≥53分为抑郁组,53分为无抑郁组;SAS标准分≥50分为焦虑组,50分为无焦虑组。结果:PSQI总分与SDS得分、SAS得分正相关(r=0.58、0.47,均P0.01)。得到抑郁组39例、无抑郁组488例,焦虑组147例、无焦虑组380例;其中抑郁症状的大学生PSQI总分高于无抑郁症状者[(9.2±2.2)vs.(5.5±2.2),P0.01],有焦虑症状的大学生PSQI总分高于无焦虑症状者[(7.2±2.6)vs.(5.3±2.1),P0.01];且PSQI总分对SDS得分和SAS得分的主效应均有统计学意义(F=22.64、14.00,均P0.01)。PSQI总分与SDS得分正向关联(β=0.58,P0.01),对SDS得分解释率为33.4%;PSQI总分与SAS得分正向关联(β=0.47,P0.01),对SAS得分的解释率为22.1%。结论:大学生睡眠质量是衡量抑郁、焦虑严重程度的重要指标。     

孤独症谱系障碍儿童的睡眠行为

目的:探讨学前期和学龄期孤独症谱系障碍(autism spectrum disorders,ASD)儿童的睡眠行为的特点和差异。方法:选取符合美国精神障碍诊断与统计手册第4版(DSM-IV)诊断标准的ASD儿童84名和年龄性别匹配的正常儿童91名,使用儿童睡眠习惯问卷(CSHQ)和一周睡眠日记,由儿童主要照顾者记录儿童的睡眠情况。依据CSHQ总分大于41分为睡眠不良,以具体条目中睡眠行为发生频率超过2晚/周的标准界定睡眠行为问题,分3～5岁和6～12岁两个年龄段比较ASD与对照组儿童在睡眠行为和习惯上的差异。结果:3～5岁ASD组儿童CSHQ的睡眠潜伏期[(2.1±0.8)vs.(1.6±0.7)]、睡眠持续情况[(5.4±1.7)vs.(4.8±1.3)]得分高于对照组,入睡困难(77.6%vs.49.0%)、睡眠量不足(63.3%vs.42.9%)、夜醒哭闹(34.7%vs.12.2%)及日间疲乏(36.7%vs.10.2%)的比例较对照组高(均P0.05)。6～12岁ASD儿童平时睡眠总时长短于对照组[(8.68±0.76)h vs.(9.33±1.00)h],CSHQ的入睡抵触[(10.1±2.8)vs.(8.6±2.5)]、睡眠潜伏期[(1.7±0.7)vs.(1.4±0.6)]与睡眠焦虑[(5.4±2.0)vs.(4.5±1.9)]得分高于对照组,入睡困难(54.3%vs.31.0%)、睡眠量不足(60.0%vs.35.7%)、与父母同睡(65.7%vs.38.1%)、入睡需陪伴(68.6%vs.35.7%)的比例较对照组高(均P0.05)。结论:ASD儿童普遍存在睡眠总量少、入睡困难等问题,学龄前期以夜醒后哭闹和白天疲倦较为突出,而学龄期则以睡眠焦虑较为明显。     

青少年的睡眠质量与负性生活事件、人格

目的:探讨青少年睡眠质量与负性生活事件、人格的关系,考察负性生活事件、人格特质与睡眠质量是否有交互作用.方法:本研究数据来自中国科学院心理研究所全国青少年心理健康数据库中2008年的调查数据,样本是用系统分层抽样方法抽取的4538名中小学生,采用匹兹堡睡眠质量指数(PSQI)、青少年负性生活事件自评问卷和艾森克人格问卷少年版(EPQ-Junior)评估青少年睡眠质量、负性生活事件和人格.结果:本样本PSQI总分为(5.1±2.8),26％的人有睡眠质量问题(PSQI≥7).11～14岁年龄组PSQI得分低于15 ～ 17岁年龄组,15～ 17岁年龄组PSQI得分低于18～20岁年龄组[(3.9±2.5)vs.(5.4±2.6)vs.(6.5±2.7),P＜0.01].PSQI总分与负性生活事件总分(r=0.32),EPQ-Jun-ior的神经质(r=0.54)、精神质维度(r=0.18)得分呈正相关(均P＜0.01),与内外倾维度得分呈负相关(r=-0.16,P＜0.01).二分logistic回归分析显示,负性生活事件得分(OR=1.56)与EPQ-Junior的神经质维度得分(OR=1.23)越高,PSQI得分可能越高(均P＜0.01).结论:同时存在神经质人格高分和经历负性生活事件多的青少年的睡眠质量可能更差.     

糖调节异常者认知行为团体心理治疗方案的编制及疗效

目的:编制一套针对糖调节异常者的认知行为团体心理治疗方案,并初步考察方案对糖调节异常者血糖控制及心理状况的影响。方法:在深度访谈、文献分析、专家论证基础上编制心理治疗方案。选取糖调节异常者38例,随机分为认知行为团体心理治疗组(简称团体治疗组)和对照组,两组均接受糖尿病健康教育,另外,对团体治疗组进行连续6次的认知行为团体治疗。通过血糖测试、焦虑自评量表(SAS)、抑郁自评量表(SDS)、特质应对方式问卷(CSQ)、社会支持评定量表(SSRS),评估两组在治疗前后生化指标及心理指标的变化。结果:团体治疗组治疗后空腹指尖血糖及餐后2小时血糖均低于治疗前[(5.8±0.7)mmol/L vs.(6.6±1.1)mmol/L,(8.9±2.3)mmol/L vs.(11.0±3.1)mmol/L;均P0.05];对照组治疗后空腹指尖血糖、餐后2小时血糖与治疗前比差异均无统计学意义[(6.1±0.8)mmol/L vs.(6.2±0.7)mmol/L,(9.2±2.8)mmol/L vs.(9.1±2.2)mmol/L;均P0.05];团体治疗组治疗后SAS和SDS得分均下降[(40.2±5.4)vs.(45.3±9.6),(32.5±4.2)vs.(37.9±8.3),均P0.05],SSRS总分及主观支持得分上升[(41.0±8.0)vs.(39.5±8.0),(22.8±3.9)vs.(19.6±3.9);P0.05或0.001],而对照组未发生显著变化(均P0.05)。结论:认知行为团体治疗对糖调节异常者的血糖水平及抑郁、焦虑情绪、社会支持等具有改善效果。     

乳腺癌患者的焦虑、抑郁、幸福感指数及社会支持

目的:调查不同治疗阶段乳腺癌患者的焦虑、抑郁、幸福感指数和社会支持情况,分析社会支持与情绪状况的关系.方法:收集术前组、术后组与康复组的乳腺癌患者各105例为病例组,以及年龄与教育年限匹配的健康对照105例,应用汉密顿焦虑量表(HAMA,≥8分为可疑焦虑)、汉密顿抑郁量表(HAMD, ≥8分为可疑抑郁)、幸福感指数量表(Index of Well-being)和领悟社会支持量表(PSSS)进行有关测评.结果:病例组的可疑焦虑、抑郁发生率均高于健康对照(42.9％,61.9％,59.0％ vs.9.5％;33.3％,60.0％,46.7％ vs.5.7％;均P＜0.01),病例组的HAMA、HAMD得分均高于健康对照[(7.2±4.3),(9.4±5.1),(9.2±5.6)vs.(3.9±3.1);(6.2±3.8),(9.2±4.8),(7.9±4.6) vs.(3.1±2.4),均P＜0.01];术前组与术后组的幸福感指数低于健康对照[(10.6±2.3),(10.5±2.6) vs.(11.5±2.2),均P＜0.01].病例组中,有可疑焦虑患者的幸福感指数、PSSS得分均低于无焦虑组[如,术后组PSSS得分(63.0±10.1)vs.(70.4±9.1),P＜0.01];有可疑抑郁患者的幸福感指数、PSSS得分低于无抑郁组[如,康复组PSSS得分(63.8±10.6) vs.(70.1±8.4),P＜0.01].结论:本研究提示,不同治疗阶段的乳腺癌患者的可疑焦虑、抑郁发生率和焦虑、抑郁得分均高于健康人群;有可疑焦虑、抑郁患者的幸福感指数和社会支持相对更低.     

神经性厌食少年的健康相关危险行为

目的:了解神经性厌食少年的健康危险行为特点.方法:选取符合国际疾病和相关健康问题分类第十版(ICD-10)神经性厌食诊断标准的少年33例及性别、年龄相匹配的正常对照66例,完成青少年健康相关危险行为问卷,由神经性厌食患儿家长完成青少年健康相关危险行为问卷父母版的评定.结果:两组青少年健康相关危险行为问卷总分的差异无统计学意义[(11.7±6.8)vs.(10.0±7.9),P＞0.05].神经性厌食组的破坏纪律与违法行为因子分[(2.1±1.6)vs.(2.7±1.7)]低于正常对照组,自杀与自伤行为因子分[(2.2±2.6)vs.(1.2±2.2)]高于正常对照组(均P ＜0.05).在所有条目中,神经性厌食组不吃早餐行为及对家庭成员撒谎行为的得分低于正常对照组,暴食行为或者暴食后再呕吐出来的行为、因为过度节食而出现头晕出冷汗及体力不支等躯体不适、存在自杀的想法、自杀的计划及自杀行为的得分高于正常对照组(均P＜0.05).神经性厌食组自评不健康饮食与缺乏体力活动因子分低于家长评定结果[(3.7±2.5)vs.(6.8±3.6),P＜0.01],神经性厌食组自评总分[(11.7±6.8)vs.(14.5±9.8)]及其他各因子分与家长评定结果差异无统计学意义(均P ＞0.05).在所有条目中,神经性厌食组自评不吃早餐行为[(0.2±0.5)vs.(1.4±1.3)]及不喝牛奶/豆浆行为的得分[(1.2±1.3)vs.(1.8±0.2)]低于家长评定结果,作弊或抄袭行为的得分[(0.6±0.9)vs.(0.2±0.4)]高于家长评定结果(均P＜0.05).结论:神经性厌食儿童少年存在较多的自伤自杀的观念和行为、暴食行为、暴食后呕吐行为及因过度节食而出现躯体不适,神经性厌食少年的破坏纪律行为、违法行为及对家庭成员撒谎等行为较少.     

失眠症与抑郁症患者的心理韧性与睡眠不良信念的比较及对睡眠质量的影响

目的:探讨失眠症、抑郁症失眠患者在心理韧性和睡眠信念的差异性及其对睡眠质量的影响。方法:选取符合国际疾病分类第十版(ICD-10)中相应诊断标准的27例非器质性失眠症患者(失眠症组)、40例伴有失眠症状的抑郁症患者(抑郁症失眠组)施测心理韧性量表(RIS)、睡眠个人信念和态度量表(DBAS)及匹兹堡睡眠质量指数量表(PSQI),并以汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)评定抑郁、焦虑症状。结果:失眠症组PSQI中的催眠药物分因子得分(t=2.221,P0.05)、心理韧性总分(t=2.048,P0.05)及主体性因子(t=2.169,P0.05)高于抑郁症失眠组,差异具有统计学意义;失眠症组在睡眠个人信念和态度分量表"对药物的认知"得分低于抑郁症失眠组(t=-2.393,P0.05),差异具有统计学意义;PSQI总分与HAMD、HAMA、DBAS总分及"对失眠引起的后果"和"对睡眠的担忧"分量表存在相关关系(P0.05);睡眠不良信念的回归系数β=-0.128(P=0.003);抑郁情绪在心理韧性和睡眠质量间的调节效应显著(P=0.009),引入交互项后新增解释量△R~2=0.095。结论:非器质性失眠患者与伴有失眠症状的抑郁症患者相比,有更好的心理韧性和更多的对药物的不良认知。睡眠不良信念越多,睡眠质量越差,且抑郁情绪对心理韧性和睡眠质量的关系有调节效应。     

Inter-identity amnesia in dissociative identity disorder: a simulated memory impairment?

BACKGROUND: Although included in the current edition of the DSM, there does not seem to be consensus among mental health professionals regarding the diagnostic status and scientific validity of dissociative identity disorder (DID). This study was aimed at the detection of simulation of inter-identity amnesia in DID. METHOD: A sample of 22 DID patients was included, together with a matched control sample of subjects instructed to simulate inter-identity amnesia, a guessor group that had no knowledge of the stimulus material and a normal control group. A multiple-choice recognition test was included. The rate of incorrect answers was determined. Moreover, the specific simulation strategy used was examined by providing subjects with a range of choices that varied in extent of disagreement with the correct answer and determining whether plausible or implausible answer alternatives were selected. RESULTS: On the recognition test DID patients selected incorrect answers above chance like simulators. Patients thus seem to use their knowledge of the correct answer in determining their given answer. They were not characterized by a well-thought-out simulating behaviour style, as indicated by the differences in selection of specific answer alternatives found between patients and simulators. CONCLUSIONS: DID patients were found not to be characterized by an actual memory retrieval inability, in contrast to their subjective reports. Instead, it is suggested that DID may more accurately be considered a disorder characterized by meta-memory problems, holding incorrect beliefs about their own memory functioning.     

慢性失眠症患者的应对方式和睡眠行为特征对照研究

目的 :调查慢性失眠症患者的睡眠行为特征、应对方式和心理控制源 ,以及三者之间的关系。方法 :62名慢性失眠症男女患者和配对睡眠正常者完成睡眠行为特征量表 (包括有无对睡眠的不合理信念、非功能性睡眠行为和夜间情绪焦虑三个分量表 )、应对方式和I—E心理控制源量表评估。结果 :慢性失眠症组与睡眠正常组比较有更多的对睡眠的不合理信念、非功能性睡眠行为 (t =8 96,P <0 0 1)和夜间情绪焦虑 (t =3 7 61,P <0 0 1) ,应对方式在解决问题因子分 (t =6 3 6,P <0 0 1)和自责因子分 (t =4 17,P <0 0 5 )分别低于和高于睡眠正常组 ,I—E心理控制源量表分高于睡眠正常组 (t =4 5 ,P <0 0 5 )。逐步多元回归分析显示失眠患者的不合理信念和非功能性睡眠行为与解决问题、心理控制源有相关性 (P均 <0 0 1)。结论 :慢性失眠症患者存在对睡眠的不合理信念、非功能性睡眠行为和夜间情绪焦虑。应对方式和心理控制源与睡眠正常者比较主要表现在解决问题能力低 ,心理控制源外控。解决问题方式和心理控制源外控可能对患者的不合理信念和非功能性睡眠行为的形成构成影响。     

A primary care "friendly" cognitive behavioral insomnia therapy

OBJECTIVES: This study was conducted to test the effectiveness of an abbreviated cognitive-behavioral insomnia therapy (ACBT) with primary DESIGN: A single-blind, randomized group design was used in which study patients were randomized to either a brief, 2-session ACBT or a similarly brief intervention (SHC) that included only generic sleep hygiene recommendations. SETTING: A university-affiliated Department of Veterans Affairs medical center. PARTICIPANTS: Twenty (2 women) veteran patients (M(age) = 51.0 yrs., SD = 13.7 years) who met criteria for chronic primary insomnia. MEASUREMENTS AND RESULTS: Participants completed sleep logs for 2 weeks and questionnaires to measures insomnia symptoms, sleep-related self-efficacy, and dysfunctional beliefs about sleep before treatment, during a 2-week posttreatment assessment, and again at a 3-month posttreatment follow-up. Statistical analyses showed that ACBT produced significantly larger improvements across a majority of outcome measures than did SHC. Case-by-case analyses showed that only the ACBT produced consistent positive effects across study patients, and a sizeable proportion of these patients receiving this treatment achieved clinically significant improvements by their study endpoints. Approximately 52% of those receiving the ACBT reported at least a 50% reduction in their wake time after sleep onset, and 55.6% of ACBT-treated patients who entered the study with pathologic scores on an Insomnia Symptom Questionnaire (ISQ), achieved normal ISQ scores by their final outcome assessment. CONCLUSIONS: ACBT is effective for reducing subjective sleep disturbance and insomnia symptoms in primary care patients.     

Comparison of sleep condition and sleep-related psychological activity after cognitive-behavior and pharmacological therapy for chronic insomnia

BACKGROUND: Previous studies of insomnia focused mainly on the improvement of sleep condition and ignored the effects of sleep-related psychological activity and daytime function after pharmacological and behavioral treatments. We compared the clinical effects of both therapies on sleep condition, sleep-related psychological activity and daytime function in chronic insomnia. METHODS: Seventy-one patients with chronic insomnia were randomly divided into 4 groups and either received cognitive-behavior therapy (CBT, n = 19), pharmacological therapy (PCT, n = 17), CBT plus medication (Combined, n = 18) or placebo (n = 17). The treatments lasted for 8 weeks with follow-ups conducted at 3 and 8 months. On the day after treatment ended, all patients were assessed using a polysomnogram (PSG), a sleep diary and a psychological assessment. RESULTS: The three active treatments were more effective than placebo at the time the treatments were completed. Subjective sleep-onset latency, sleep efficacy and total sleep time were better in the PCT group than in the CBT group. At the 3-month follow-up, subjective and objective sleep-onset latency, sleep efficacy and total sleep time were better in the CBT group than in both the PCT and the Combined group. At the 8-month follow-up, the CBT group showed a steady comfortable sleep state, while the PCT and Combined groups were gradually returning to the pre-treatment condition. The Combined group showed a variable long-term effect. On the other hand, pre-sleep arousal at nighttime, dysfunctional beliefs about sleep as well as daytime functioning in the CBT group not only improved, but was better than in the other active treatment groups. CONCLUSION: Medication and Combined therapy produced a short-term effect on chronic insomnia while CBT had a long-term effect of improved sleep-related psychological activity and daytime functioning.     

Sleep education for paradoxical insomnia

This case study series investigated a new treatment for paradoxical insomnia patients as there is no standard treatment for this patient group at this time. Four paradoxical insomnia patients had a polysomnography (PSG) sleep study, an unsuccessful brief course of behavioral treatment for insomnia, and then a novel sleep education treatment comprising review of their PSG with video and exploration of the discrepancy between their reported and observed sleep experience. Two patients responded well to sleep education, mainly with improved self-reported sleep onset latency, total sleep time, and Insomnia Severity Index scores; and the other two, who exhibited sleep architecture anomalies, were unresponsive. These findings suggest that sleep education holds promise for some paradoxical insomnia patients. Suggestions for future studies are given.     

Instrumental conditioning of human sensorimotor rhythm (12-15 Hz) and its impact on sleep as well as declarative learning

STUDY OBJECTIVES: To test whether instrumental conditioning of sensorimotor rhythm (SMR; 12-15 Hz) has an impact on sleep parameters as well as declarative memory performance in humans. DESIGN: Randomized, parallel group design SETTING: 10 instrumental conditioning sessions, pre- and posttreatment investigation including sleep evaluations PARTICIPANTS: 27 healthy subjects (13 male) Interventions: SMR-conditioning (experimental group) or randomized-frequency conditioning (control group); declarative memory task before and after a 90-min nap MEASUREMENT AND RESULTS: The experimental group was trained to enhance the amplitude of their SMR-frequency range, whereas the control group participated in a randomized-frequency conditioning program (i.e., every session a different 3-Hz frequency bin between 7 and 20 Hz). During pre- and posttreatment the subjects had to attend the sleep laboratory to take a 90-min nap (2:00-3:30 pm) and to perform a declarative memory task before and after sleep. The experimental design was successful in conditioning an increase in relative 12-15 Hz amplitude within 10 sessions (d = 0.7). Increased SMR activity was also expressed during subsequent sleep by eliciting positive changes in different sleep parameters (sleep spindle number [d = 0.6], sleep onset latency [d = 0.7]); additionally, this increased 12-15 Hz amplitude was associated with enhancement in retrieval score computed at immediate cued recall (d = 0.9). CONCLUSION: Relative SMR amplitude increased over 10 instrumental conditioning sessions (in the experimental group only) and this "shaping of one's own brain activity" improved subsequent declarative learning and facilitated the expression of 12-15 Hz spindle oscillations during sleep. Most interestingly, these electrophysiological changes were accompanied by a shortened sleep onset latency.     

Interrelationship between cortisol levels in plasma and the circadian rhythm of temperature, pulse and blood pressure in depressed patients with good and disturbed sleep

Cortisol levels in plasma were measured in 122 depressed patients at 8:00 a.m. and 11:00 p.m. on the first day and at 8:00 a.m., 4:00 p.m. and 11:00 p.m. on the second day after oral administration of dexamethasone. Some of the patients were studied before and after medication so the total number of plasma cortisol level examinations came to 173. All patients had to describe the state of their sleep with the help of a questionnaire. The temperature and pulse of 92 patients were taken hourly from 7:00 a.m. to 11:11 p.m. for two consecutive days where the total measurements came to 34. 27 patients out of these had their blood pressure taken. A control group of 65 healthy persons without somatic and psychic disorders was tested at the same time. We found out that plasma cortisol levels in patients with disturbed sleep were higher compared to the group with good sleep. It was also noticed that younger patients and males had higher plasma cortisol level. Patients with disturbed sleep had higher Mesors (midline-estimating statistic of rhythm, ‘Mesor’) of temperature, pulse and systolic blood pressure. Healthy persons had significantly lower pulse Mesors compared to patients with good and disturbed sleep. The percentage distribution of suppressors and nonsuppressors showed no differences by sex, age and sleep disturbances.     

How is persistent insomnia maintained? A prospective study on 50–60 years old adults in the general population

Objectives. The purpose of this study was to examine whether arousal, distress and sleep‐related beliefs are related to the maintenance of insomnia in old adults. Design. From a randomly selected sample from the general population (N = 3,600; 50–60 years old), 2,239 participants filled out a baseline and 1‐year follow‐up survey. Methods. Logistic regressions were used to investigate whether psychological mechanisms were related to sleep status (insomnia: N = 230; poor sleep: N = 210; normal sleep: N = 658; good sleep: N = 253) over one year. Cluster analysis was employed to assess whether it was possible to classify the participants based on their profiles of psychological functioning. Results. The results showed that arousal, sleep‐related beliefs about future consequences and anxiety were significantly related to the maintenance of insomnia (14–66% of the variance). Out of the individuals with persistent insomnia, 67% belonged to a cluster characterized by high scores on arousal, sleep‐related beliefs and anxiety, 24% to a cluster defined by medium scores on the three mechanisms and 9% to a cluster characterized by low scores on the three mechanisms. Conclusions. This investigation shows not only that arousal, sleep‐related beliefs and anxiety are associated with the maintenance of persistent insomnia, but also that these mechanisms often co‐occur in individuals with persistent insomnia.     

Beliefs about sleep and perceived sleep quality are associated with quality of life among perimenopausal women

Sleep disturbance is a common complaint among perimenopausal women and is hypothesized to contribute to compromises in their quality of life (QoL). We investigated the degree to which sleep disturbance and QoL were related and whether dysfunctional beliefs and attitudes about sleep were significantly associated with QoL ratings among a community sample of 168 perimenopausal women (88% return rate). Questionnaires included measures of subjective sleep quality, beliefs and attitudes about sleep, and QoL. Subjective sleep quality accounted for a significant amount of variance in both the physical and mental health aspects of QoL. Dysfunctional beliefs and attitudes about sleep significantly accounted for the physical components of QoL but not mental components. The interplay among sleep quality, dysfunctional beliefs and attitudes about sleep, and QoL is discussed, as well as potential clinical implications and ideas for future investigations specific to perimenopausal women.