Maladaptive Sleep Hygiene Practices in Good Sleepers and Patients with Insomnia

Yang, Chien‐Ming; Lin, Shih Chun; Hsu, Shih Chieh; Chêng, Chu-yüan

doi:10.1177/1359105309346342

Cited by 104 publications

(98 citation statements)

References 22 publications

(25 reference statements)

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“…23,48 However, other studies have failed to observe differences in sleep hygiene behaviors between those with and without insomnia. [49][50][51] Interestingly, our data are consistent with the findings of Cheek and colleagues, 24 who found that midlife women with insomnia consumed less caffeine and were more likely to abstain from alcohol compared with women without insomnia. It is possible that midlife women suffering from insomnia are more mindful of the detrimental effects of poor sleep hygiene and, as a result, are more likely to follow positive sleep hygiene behaviors and avoid negative sleep hygiene behaviors.…”

Section: Discussionsupporting

confidence: 89%

Sleep Hygiene Behaviors Among Midlife Women with Insomnia or Sleep-Disordered Breathing: The SWAN Sleep Study

Kline

Irish

Buysse

et al. 2014

Journal of Women's Health

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Background: Insomnia and sleep-disordered breathing (SDB) are the most common sleep disorders among midlife women. Although promoting sleep hygiene behaviors may be a useful behavioral approach for the management of insomnia or SDB, the frequency with which women engage in these behaviors is unclear. Methods: Participants were from the Study of Women's Health Across the Nation (SWAN) Sleep Study (N = 321; age range = 48-58 years). Out of the full sample, 10.3% (n = 33) met Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition diagnostic criteria for insomnia, 15.3% (n = 49) had clinically significant SDB (apnea-hypopnea index ‡ 15), and 4.7% (n = 15) met criteria for both insomnia and SDB, resulting in an overall prevalence of 15.0% (n = 48) for insomnia and 19.9% (n = 64) for SDB. Participants provided diary-based assessments of sleep hygiene behaviors for 14-35 days. Two positive behaviors (sufficient exercise, regular morning out-of-bed time) and four negative behaviors (taking long daytime naps, caffeine consumption near bedtime, alcohol consumption near bedtime, smoking) were examined. These behaviors were compared between women with and without insomnia or SDB following adjustment for sociodemographic factors and mental and physical health indices. Results: Women with insomnia engaged in significantly fewer negative sleep hygiene behaviors than women without insomnia (1.61 -0.15 vs. 2.09 -0.09 behaviors; p < 0.01); specifically, women with insomnia were less likely to take long naps (odds ratio [OR] = 0.30, 95% confidence interval [CI]: 0.12-0.74) or consume caffeine near bedtime (OR = 0.44,. In contrast, women with SDB were less likely to be physically active than women without SDB (OR = 0.52, 95% CI: 0.27-0.98), but no other differences in sleep hygiene behaviors were observed. Conclusions: These data suggest that insomnia in midlife women is not associated with poor sleep hygiene. Increasing physical activity may be a valuable recommendation for midlife women with SDB.

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Section: Discussionsupporting

confidence: 89%

Sleep Hygiene Behaviors Among Midlife Women with Insomnia or Sleep-Disordered Breathing: The SWAN Sleep Study

Kline

Irish

Buysse

et al. 2014

Journal of Women's Health

View full text Add to dashboard Cite

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“…When considered in light of clinically significant insomnia prevalence as high as 50% among veterans, 5 and prior research suggesting that only half of patients with probable insomnia discuss their insomnia complaint with their PCP, 18,19 it appears from our findings that veterans report insomnia to their VA PCPs at rates similar to the general population (20% to 39%). In prior research, those discussing their insomnia complaint with their providers had more comorbid conditions and poorer self-ratings of overall health.…”

Section: Discussionmentioning

confidence: 58%

“…In prior research, sleep hygiene was strongly associated with sleep quality among normal sleepers but not in those with insomnia. 18 Findings for PCP documentation of insomnia in the medical record were noteworthy as well. In prior research, Hermes and colleagues 32 suggested that, more often than not, insomnia is not documented in the medical record by VA health care providers.…”

mentioning

confidence: 99%

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Veterans Affairs Primary Care Provider Perceptions of Insomnia Treatment

Ulmer

Bosworth

Beckham

et al. 2017

Journal of Clinical Sleep Medicine

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Study Objectives: Insomnia is a widespread issue among United States adults and rates of insomnia among veterans are even higher than the general population. Prior research examining primary care provider (PCP) perspectives on insomnia treatment found that: sleep hygiene and pharmacotherapy are the primary treatments offered; PCPs tend to focus on perceived causes of insomnia rather than the insomnia itself; and neither patients nor providers are satisfied with insomnia treatment options. Although insomnia complaints are typically first reported to primary care providers, little research has focused on perspectives regarding insomnia treatment among PCPs working in the largest integrated health care system in the United States-the Veterans Affairs (VA) health care system. This study was conducted to examine VA PCP perceptions of the availability of insomnia treatments, identify specific strategies offered by PCPs, and examine perceptions regarding the importance of treating insomnia and the role of comorbid conditions. Methods: A survey was conducted within the VA health care system. Primary care providers completed surveys electronically. Results: A high percentage of veterans (modal response = 20% to 39%) seen in VA primary care settings report an insomnia complaint to their provider. Almost half of respondents do not consistently document insomnia in the medical record (46% endorsed "sometimes," "rarely," or "never"). PCPs routinely advise sleep hygiene recommendations for insomnia (ie, avoid stimulants before bedtime [84.3%], and keep the bedroom environment quiet and dark and comfortable [68.6%]) and many are uncertain if cognitive behavioral therapy for insomnia is available at their facility (43.1%). Conclusions: Findings point to the need for systems-level changes within health care systems, including the adoption of evidence-based clinical practice standards for insomnia and PCP education about the processes that maintain insomnia. Commentary: A commentary on this article appears in this issue on page 937.

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“…The SHPS is a 30-item self-rating scale. Respondents rate how frequently they engage in behavioral practices on a 6-point Likert scale, ranging from 1 (never) to 6 (always) (Yang, Lin, Hsu, & Cheng, 2010). Higher scores indicate a higher frequency of inappropriate sleep hygiene behavior (Lin, Yang, Hsu, & Cheng, 2009).…”

Section: Sleep Hygiene Practice Scalementioning

confidence: 99%