Examination of Sleep Health dimensions and their associations with perceived stress and health in a UK sample

Background: Sleep health is a relatively new multidimensional concept, however there is no consensus on its underlying dimensions. A previous study examined potential indicators of sleep health using an aggregated sleep health measure. However, the psychometric properties of which are yet to be determined. . The primary aim of the current study was to assess the factor structure, reliability and validity of this measure A secondary aim was to explore the relationships between sleep health and perceived stress, in addition to physical and mental health Methods: A cross-sectional online survey was conducted with 257 adults from the UK aged 18-65 years (78.4% female, mean age=29.39 [SD=11.37]). Participants completed 13 Sleep health items, the Pittsburgh Sleep Quality Inventory, Insomnia Severity Scale, Epworth Sleepiness Scale, Perceived Stress Scale and SF-12 Health Survey. Results: The measure exhibited good internal consistency (α=.785) and construct validity as determined by associations with existing sleep measures. Principle components analysis was conducted and four factors emerged; sleep quality (α=.818), sleep adaptability (α=.917), sleep wellness (α=.621) and daytime functioning (α=.582). Adaptability (β=-241) was strongest predictor of perceived stress, and daytime functioning was strongest predictor of physical (β =.322) and mental health (β =.312). Conclusions: Sleep health is a multidimensional construct comprising four distinct but related dimensions. The importance of sleep health in terms of lower perceived stress and better mental and physical health is highlighted

Anxiety mediates the relationship between perfectionism and insomnia symptoms: A longitudinal study

Objectives Individuals with insomnia often report aspects of perfectionism and symptoms of anxiety and depression. Investigation of these factors together has been limited. As such, the aim of the present study was to examine the extent to which the association between perfectionism and insomnia symptoms was mediated by anxiety and depression, concurrently and longitudinally. Methods Seventy-six members from the general-population participated at baseline. Data from 57 participants were subsequently analysed at twelve-month follow-up. Insomnia symptoms were assessed using The Insomnia Severity Index (ISI). Perfectionism was assessed using two Multidimensional Perfectionism Scales (F-MPS; HF-MPS). Symptoms of anxiety and depression were assessed using The Hospital Anxiety and Depression Scale (HADS). Correlational analysis examined longitudinal associations between perfectionism and insomnia symptoms. Hierarchical regression analysis examined whether significant associations remained after controlling for anxiety and depression. Results Baseline insomnia symptoms were associated with future doubts about action. Further, this relationship was mediated by preceding symptoms of anxiety and concurrent symptoms of insomnia. Similarly, baseline insomnia symptoms were also associated with future parental criticism. However this relationship was partially mediated by preceding symptoms of anxiety, and was not mediated by concurrent insomnia symptoms. Conclusions Symptoms of insomnia appear to be related to an increase in negative perfectionistic thinking in the form of doubts about action and parental criticism, however these relationships appear to be mediated by symptoms of anxiety. Therefore, treatments for insomnia should address anxiety symptoms with the prospect of preventing the accentuation of aspects of perfectionism due to poor sleep

Anxiety mediates the relationship between multidimensional perfectionism and insomnia disorder

Individuals with insomnia often report aspects of perfectionism alongside symptoms of anxiety and depression. However, there has been limited examination of these factors together. The current study investigated whether individuals with insomnia report increased perfectionism compared to normal-sleepers. Further, the mediating role of anxiety and depression was examined. Participants were 39 individuals with DSM-5 defined Insomnia Disorder, and 39 normal-sleepers, who completed two measures of multidimensional perfectionism and the Hospital Anxiety and Depression Scale. Results demonstrated that, compared to normal-sleepers, individuals with insomnia display increased perfectionistic traits of: concern over mistakes, doubts about action, and parental criticism. In addition, these differences were partiality mediated by symptoms of anxiety, but not depression. Our findings highlight the significance of treating symptoms of anxiety with the prospect of alleviating negative thoughts concerning one's mistakes, doubts about action, and perception of parental criticism, which may contribute to insomnia

Exploration of potential objective and subjective daily indicators of sleep health in normal sleepers

Purpose: While the concept of "sleep health" has only recently been defined, how it relates to both subjective and objective sleep parameters is yet to be determined. The current study aimed to identify potential indicators of poorer sleep health, from subjective and objective daily sleep characteristics, in normal sleepers. Participants and methods: Eighty-three individuals aged 18-65 years with no history of sleep disorders, chronic physical or psychiatric illnesses, or substance misuse were recruited from the North of England. Secondary analysis of a series of standardized studies, which included psychometrics, actigraphy, and an in-lab polysomnography (PSG) component, was undertaken. Questions from several psychometric sleep scales were combined to create an aggregate measure of sleep health status. Subjective sleep continuity was assessed by 2-week sleep diary. Objective measures comprised two continuous weeks of actigraphy and two nights of in-lab PSG. Results: Significant negative correlations were evident between sleep health scores and both diary-derived subjective sleep latency (SL; diary) and actigraphy-derived SL (actigraphy). This was reflected by independent samples t-test between high and low sleep health groups. No relationships between sleep health and PSG parameters were observed. Regression analyses indicated sleep latencies from both the sleep diary and actigraphy as significant predictors, explaining 28.2% of the variance in sleep health. Conclusion: Perceived increases in SL appear to be a primary indicator of declining sleep health in normal sleepers. The majority of objective sleep parameters, including gross PSG sleep parameters, appear not to be sensitive to sleep health status in normal sleepers. Future research is needed to understand the physical and psychological correlates of sleep health in larger samples

Exploratory Study On The Role Of Emotion Regulation In Perceived Valence, Humour, And Beneficial Use Of Depressive Internet Memes In Depression.

This study examined whether individuals experiencing significant depressive symptoms would differ from non-depressed controls in their interpretation of internet memes related to depression, whilst incorporating the mediating role of emotion regulation difficulty. Forty-three individuals presenting clinically significant depressive symptoms (indicating ≥15 on the PHQ-9) and 56 non-depressed controls (indicating ≤4) rated the emotional valance, humour, relatability, shareability, and mood improving potential of 32 depressive and control (depicting general neutral or positive social commentaries) internet memes. Measures of depression and emotion dysregulation were also completed. The perception of humour, relatability, shareability and mood improving potential of depressive, but not control, memes were all greater amongst individuals with symptoms of depression relative to controls. However, these differences were mediated by deficits in the ability to deploy adaptive emotion regulation strategies. Despite their negative orientation, internet memes related to depression may be beneficial for individuals experiencing consistent symptoms. Specifically, by potentially facilitating: a humorous take on a negative experience and situation; the perception of peer-support through affiliation with others experiencing similar symptoms; and adaptive emotion regulation strategies amongst those with deficits in the ability to deploy such strategies

Pharmacovigilance in hospice/palliative care: net effect of haloperidol for nausea or vomiting

Background: Haloperidol is widely prescribed as an antiemetic in patients receiving palliative care, but there is limited evidence to support and refine its use. Objective: To explore the immediate and short-term net clinical effects of haloperidol when treating nausea and/or vomiting in palliative care patients. Design: A prospective, multicenter, consecutive case series. Setting/Subjects: Twenty-two sites, five countries: consultative, ambulatory, and inpatient services. Measurements: When haloperidol was started in routine care as an antiemetic, data were collected at three time points: baseline; 48 hours (benefits); day seven (harms). Clinical effects were assessed using the National Cancer Institute's Common Terminology Criteria for Adverse Events (NCI CTCAE). Results: Data were collected (May 2014–March 2016) from 150 patients: 61% male; 86% with cancer; mean age 72 (standard deviation 11) years and median Australian-modified Karnofsky Performance Scale 50 (range 10–90). At baseline, nausea was moderate (88; 62%) or severe (11; 8%); 145 patients reported vomiting, with a baseline NCI CTCAE vomiting score of 1.0. The median (range) dose of haloperidol was 1.5 mg/24 hours (0.5–5 mg/24 hours) given orally or parenterally. Five patients (3%) died before further data collection. At 48 hours, 114 patients (79%) had complete resolution of their nausea and vomiting, with greater benefit seen in the resolution of nausea than vomiting. At day seven, 37 (26%) patients had a total of 62 mild/moderate harms including constipation 25 (40%); dry mouth 13 (21%); and somnolence 12 (19%). Conclusions: Haloperidol as an antiemetic provided rapid net clinical benefit with low-grade, short-term harms

Eye tracking and attentional bias for depressive internet memes in depression

Previous research highlights the potential benefits of engaging with depressive internet memes for those experiencing symptoms of depression. This study aimed to determine whether: compared to non-depressed controls, individuals experiencing depressive symptoms were quicker to orient and maintain overall attention for internet memes depicting depressive content relative to neutral memes. N = 21 individuals were grouped based on the severity of reported depression symptoms using the PhQ-9. Specifically, a score of:  ≤ 4 denoted the control group; and  ≥ 15 the depressive symptoms group. Participants viewed a series of meme pairs depicting depressive and neutral memes for periods of 4000 ms. Data for the first fixation onset and duration, total fixation count and total fixation and gaze duration of eye-movements were recorded. A significant group x meme-type interaction indicated that participants with depressive symptoms displayed significantly more fixations on depressive rather than neutral memes. These outcomes provide suggestive evidence for the notion that depressive symptoms are associated with an attentional bias towards socio-emotionally salient stimuli