Clinical significance of night-to-night sleep variability in insomnia

Sooyeon Suh, Sara Nowakowski, Rebecca A. Bernert, Jason C. Ong, Allison T. Siebern, Claire L. Dowdle, Rachel Manber

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Objectives: To evaluate the clinical relevance of night-to-night variability of sleep schedules and insomnia symptoms. Methods: The sample consisted of 455 patients (193 men, mean age = 48) seeking treatment for insomnia in a sleep medicine clinic. All participants received group cognitive behavioral therapy for insomnia (CBTI). Variability in sleep parameters was assessed using sleep diary data. Two composite scores were computed, a behavioral schedule composite score (BCS) and insomnia symptom composite score (ICS). The Insomnia Severity Index, the Beck Depression Inventory, and the Morningness-Eveningness Composite Scale were administered at baseline and post-treatment. Results: Results revealed that greater BCS scores were significantly associated with younger age, eveningness chronotype, and greater depression severity (p<0.001). Both depression severity and eveningness chronotype independently predicted variability in sleep schedules (p<0.001). Finally, CBTI resulted in reduced sleep variability for all sleep diary variables except bedtime. Post-treatment symptom reductions in depression severity were greater among those with high versus low baseline BCS scores (p<0.001). Conclusions: Results suggest that variability in sleep schedules predict reduction in insomnia and depressive severity following group CBTI. Schedule variability may be particularly important to assess and address among patients with high depression symptoms and those with the evening chronotype.

Original languageEnglish (US)
Pages (from-to)469-475
Number of pages7
JournalSleep Medicine
Volume13
Issue number5
DOIs
StatePublished - May 2012
Externally publishedYes

Fingerprint

Sleep Initiation and Maintenance Disorders
Sleep
Appointments and Schedules
Depression
Cognitive Therapy
Therapeutics
Medicine
Equipment and Supplies

Keywords

  • CBTI
  • Chronotype
  • Circadian rhythm
  • Depression
  • Insomnia
  • Sleep variability

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Suh, S., Nowakowski, S., Bernert, R. A., Ong, J. C., Siebern, A. T., Dowdle, C. L., & Manber, R. (2012). Clinical significance of night-to-night sleep variability in insomnia. Sleep Medicine, 13(5), 469-475. https://doi.org/10.1016/j.sleep.2011.10.034

Clinical significance of night-to-night sleep variability in insomnia. / Suh, Sooyeon; Nowakowski, Sara; Bernert, Rebecca A.; Ong, Jason C.; Siebern, Allison T.; Dowdle, Claire L.; Manber, Rachel.

In: Sleep Medicine, Vol. 13, No. 5, 05.2012, p. 469-475.

Research output: Contribution to journalArticle

Suh, S, Nowakowski, S, Bernert, RA, Ong, JC, Siebern, AT, Dowdle, CL & Manber, R 2012, 'Clinical significance of night-to-night sleep variability in insomnia', Sleep Medicine, vol. 13, no. 5, pp. 469-475. https://doi.org/10.1016/j.sleep.2011.10.034
Suh S, Nowakowski S, Bernert RA, Ong JC, Siebern AT, Dowdle CL et al. Clinical significance of night-to-night sleep variability in insomnia. Sleep Medicine. 2012 May;13(5):469-475. https://doi.org/10.1016/j.sleep.2011.10.034
Suh, Sooyeon ; Nowakowski, Sara ; Bernert, Rebecca A. ; Ong, Jason C. ; Siebern, Allison T. ; Dowdle, Claire L. ; Manber, Rachel. / Clinical significance of night-to-night sleep variability in insomnia. In: Sleep Medicine. 2012 ; Vol. 13, No. 5. pp. 469-475.
@article{59b750dc77eb4ac5b20938507050dab8,
title = "Clinical significance of night-to-night sleep variability in insomnia",
abstract = "Objectives: To evaluate the clinical relevance of night-to-night variability of sleep schedules and insomnia symptoms. Methods: The sample consisted of 455 patients (193 men, mean age = 48) seeking treatment for insomnia in a sleep medicine clinic. All participants received group cognitive behavioral therapy for insomnia (CBTI). Variability in sleep parameters was assessed using sleep diary data. Two composite scores were computed, a behavioral schedule composite score (BCS) and insomnia symptom composite score (ICS). The Insomnia Severity Index, the Beck Depression Inventory, and the Morningness-Eveningness Composite Scale were administered at baseline and post-treatment. Results: Results revealed that greater BCS scores were significantly associated with younger age, eveningness chronotype, and greater depression severity (p<0.001). Both depression severity and eveningness chronotype independently predicted variability in sleep schedules (p<0.001). Finally, CBTI resulted in reduced sleep variability for all sleep diary variables except bedtime. Post-treatment symptom reductions in depression severity were greater among those with high versus low baseline BCS scores (p<0.001). Conclusions: Results suggest that variability in sleep schedules predict reduction in insomnia and depressive severity following group CBTI. Schedule variability may be particularly important to assess and address among patients with high depression symptoms and those with the evening chronotype.",
keywords = "CBTI, Chronotype, Circadian rhythm, Depression, Insomnia, Sleep variability",
author = "Sooyeon Suh and Sara Nowakowski and Bernert, {Rebecca A.} and Ong, {Jason C.} and Siebern, {Allison T.} and Dowdle, {Claire L.} and Rachel Manber",
year = "2012",
month = "5",
doi = "10.1016/j.sleep.2011.10.034",
language = "English (US)",
volume = "13",
pages = "469--475",
journal = "Sleep Medicine",
issn = "1389-9457",
publisher = "Elsevier",
number = "5",

}

TY - JOUR

T1 - Clinical significance of night-to-night sleep variability in insomnia

AU - Suh, Sooyeon

AU - Nowakowski, Sara

AU - Bernert, Rebecca A.

AU - Ong, Jason C.

AU - Siebern, Allison T.

AU - Dowdle, Claire L.

AU - Manber, Rachel

PY - 2012/5

Y1 - 2012/5

N2 - Objectives: To evaluate the clinical relevance of night-to-night variability of sleep schedules and insomnia symptoms. Methods: The sample consisted of 455 patients (193 men, mean age = 48) seeking treatment for insomnia in a sleep medicine clinic. All participants received group cognitive behavioral therapy for insomnia (CBTI). Variability in sleep parameters was assessed using sleep diary data. Two composite scores were computed, a behavioral schedule composite score (BCS) and insomnia symptom composite score (ICS). The Insomnia Severity Index, the Beck Depression Inventory, and the Morningness-Eveningness Composite Scale were administered at baseline and post-treatment. Results: Results revealed that greater BCS scores were significantly associated with younger age, eveningness chronotype, and greater depression severity (p<0.001). Both depression severity and eveningness chronotype independently predicted variability in sleep schedules (p<0.001). Finally, CBTI resulted in reduced sleep variability for all sleep diary variables except bedtime. Post-treatment symptom reductions in depression severity were greater among those with high versus low baseline BCS scores (p<0.001). Conclusions: Results suggest that variability in sleep schedules predict reduction in insomnia and depressive severity following group CBTI. Schedule variability may be particularly important to assess and address among patients with high depression symptoms and those with the evening chronotype.

AB - Objectives: To evaluate the clinical relevance of night-to-night variability of sleep schedules and insomnia symptoms. Methods: The sample consisted of 455 patients (193 men, mean age = 48) seeking treatment for insomnia in a sleep medicine clinic. All participants received group cognitive behavioral therapy for insomnia (CBTI). Variability in sleep parameters was assessed using sleep diary data. Two composite scores were computed, a behavioral schedule composite score (BCS) and insomnia symptom composite score (ICS). The Insomnia Severity Index, the Beck Depression Inventory, and the Morningness-Eveningness Composite Scale were administered at baseline and post-treatment. Results: Results revealed that greater BCS scores were significantly associated with younger age, eveningness chronotype, and greater depression severity (p<0.001). Both depression severity and eveningness chronotype independently predicted variability in sleep schedules (p<0.001). Finally, CBTI resulted in reduced sleep variability for all sleep diary variables except bedtime. Post-treatment symptom reductions in depression severity were greater among those with high versus low baseline BCS scores (p<0.001). Conclusions: Results suggest that variability in sleep schedules predict reduction in insomnia and depressive severity following group CBTI. Schedule variability may be particularly important to assess and address among patients with high depression symptoms and those with the evening chronotype.

KW - CBTI

KW - Chronotype

KW - Circadian rhythm

KW - Depression

KW - Insomnia

KW - Sleep variability

UR - http://www.scopus.com/inward/record.url?scp=84859500231&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84859500231&partnerID=8YFLogxK

U2 - 10.1016/j.sleep.2011.10.034

DO - 10.1016/j.sleep.2011.10.034

M3 - Article

C2 - 22357064

AN - SCOPUS:84859500231

VL - 13

SP - 469

EP - 475

JO - Sleep Medicine

JF - Sleep Medicine

SN - 1389-9457

IS - 5

ER -