Sleep quality and treatment of social anxiety disorder

Abstract

Background and Objectives: Poor sleep is prevalent among individuals with social anxiety disorder (SAD) and may affect treatment outcome. We examined whether: (1) individuals with SAD differed from healthy controls (HCs) in sleep quality, (2) baseline sleep quality moderated the effects of treatment (Cognitive-behavioral group therapy [CBGT] vs. mindfulness-based stress reduction [MBSR] vs. waitlist [WL]) on social anxiety, (3) sleep quality changed over treatment, and (4) changes in sleep quality predicted anxiety 12-months post-treatment. Design: Participants were 108 adults with SAD from a randomized controlled trial of CBGT vs. MBSR vs. WL and 38 HCs. Methods: SAD and sleep quality were assessed pre-treatment and post-treatment, and SAD was assessed again 12-months post-treatment. Results: Participants with SAD reported poorer sleep quality than HCs. The effect of treatment condition on post-treatment social anxiety did not differ as a function of baseline sleep quality. Sleep quality improved in MBSR, significantly more than WL, but not CBGT. Sleep quality change from pre-to post-treatment in CBGT or MBSR did not predict later social anxiety. Conclusions: MBSR, and not CBGT, improved sleep quality among participants. Other results were inconsistent with prior research; possible explanations, limitations, and implications for future research are discussed.

Anxiety Prevalence and its Associated Factors Among University Students In Malaysia: A National Cross-Sectional Study

“…Good sleeping quality is important to the students in the study process, as it is essential for their mental wellbeing and is interrelated with anxiety [40,41]. In this study, we found that the sleeping habit was significantly associated with anxiety.…”

Mindfulness-based therapy versus cognitive behavioral therapy for people with anxiety symptoms: a systematic review and meta-analysis of random controlled trials

“…The sample size of each study was between 26 and 148. The majority of participants were females (61.3% females in 90.9% of the included studies) (35)(36)(37)(38)(39)(40)(42)(43)(44)(45). Individuals with anxiety disorders (38)(39)(40)42,43,45) accounted for 48.7%, while people with anxiety symptoms were 51.3%.…”

“…The courses of intervention of the five studies (35,41-44) were 8 weeks, whereas for other studies (37,39), it was 10-18 weeks per arm. Only one of the studies included anxiety, depression, and sleep quality outcomes (35), seven studies reported both anxiety and depression outcome measures (37,38,40,(42)(43)(44), while two reported anxiety and sleep quality outcomes (41,45). One of the studies could only extract the anxiety outcome (39).…”

“…Six studies had an additional follow-up (35,36,(38)(39)(40)42), but only four sets of data could be extracted, and they ranged from 10 weeks to 6 months post-intervention (35,36,38,40). Of the nine studies that reported dropout rates, four (37,39,42,45) were below 20% (46), while five (35,36,38,40,44) were over 20%. 81.8% of the included studies (35)(36)(37)(38)(39)(40)(42)(43)(44) used intention-to-treat (ITT) for data analysis.…”

Sleep quality and outcome of exposure therapy in adults with social anxiety disorder

“…Similarly, another study found that individuals with co-occurring SAD and subjective sleep disturbances, compared to those without sleep disturbance, evidenced a more severe clinical presentation both at treatment onset and termination (Kushnir et al, 2014). Results from a recent study, however, found that baseline sleep quality did not moderate CBT treatment outcomes for SAD (Horenstein et al, 2019). Only one study to date has examined the withintreatment relation of sleep, in addition to baseline sleep, and exposure therapy.…”