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1.
Behav Res Ther ; 145: 103943, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34411948

RESUMO

BACKGROUND: Insomnia identity, the conviction that one has insomnia, occurs independently of sleep quality or quantity, and is associated with numerous negative health outcomes. Little is known about factors influencing insomnia identity. This study planned to evaluate insomnia identity, perceived sleep experience, and sleep parameters. METHOD: Individuals seeking treatment for an insomnia complaint reported demographics, insomnia identity ratings, and daily sleep diaries. Insomnia complaint and insomnia identity were independently crossed with sleep diary data yielding: complaining good (n = 10) and poor sleepers (n = 51), and good (n = 7) and poor sleepers (n = 40) with insomnia identity. Participants were additionally classified as with (n = 50) and without (n = 14) insomnia identity. Group differences and predictors of insomnia identity were assessed. RESULTS: Complaining poor sleepers and poor sleepers with insomnia identity reported significantly poorer sleep ratings compared to their counterparts. Insomnia identity severity was predicted by worse sleep quality comparisons and increased helplessness. Analyses revealed poorer sleep parameters among those with an insomnia identity versus without. DISCUSSION: Group differences may reflect variation in perceived sleep assessment and insomnia identity rating. Results further indicated that not all who complain of insomnia (and seek treatment) endorse insomnia identity. Implications of results and future study directions on insomnia identity are discussed.


Assuntos
Distúrbios do Início e da Manutenção do Sono , Humanos , Sono
2.
Prev Sci ; 22(8): 1173-1184, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-33974226

RESUMO

Machine learning creates new opportunities to design digital health interventions for youth at risk for acquiring HIV (YARH), capitalizing on YARH's health information seeking on the internet. To date, researchers have focused on descriptive analyses that associate individual factors with health-seeking behaviors, without estimating of the strength of these predictive models. We developed predictive models by applying machine learning methods (i.e., elastic net and lasso regression models) to YARH's self-reports of internet use. The YARH were aged 14-24 years old (N = 1287) from Los Angeles and New Orleans. Models were fit to three binary indicators of YARH's lifetime internet searches for general health, sexual and reproductive health (SRH), and social service information. YARH responses regarding internet health information seeking were fed into machine learning models with potential predictor variables based on findings from previous research, including sociodemographic characteristics, sexual and gender minority identity, healthcare access and engagement, sexual behavior, substance use, and mental health. About half of the YARH reported seeking general health and SRH information and 26% sought social service information. Areas under the ROC curve (≥ .75) indicated strong predictive models and results were consistent with the existing literature. For example, higher education and sexual minority identification was associated with seeking general health, SRH, and social service information. New findings also emerged. Cisgender identity versus transgender and non-binary identities was associated with lower odds of general health, SRH, and social service information seeking. Experiencing intimate partner violence was associated with higher odds of seeking general health, SRH, and social service information. Findings demonstrate the ability to develop predictive models to inform targeted health information dissemination strategies but underscore the need to better understand health disparities that can be operationalized as predictors in machine learning algorithms.


Assuntos
Comportamento de Busca de Informação , Minorias Sexuais e de Gênero , Adolescente , Adulto , Humanos , Internet , Aprendizado de Máquina , Serviço Social , Adulto Jovem
3.
Sleep Health ; 7(2): 266-272, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33446469

RESUMO

OBJECTIVE: We and others have found that couples' sleep is a shared and dyadic process. Couples' sleep-wake concordance (whether couples are awake or asleep at the same time) is associated with couples' relationship factors; however, we know little of the temporal associations between concordance and daily relationship characteristics. The purpose of this study was to examine daily positive and negative interpersonal interactions to determine how they predict, and are predicted by, nightly sleep-wake concordance. METHOD: Participants were 48 heterosexual couples between 18 and 45 years of age who shared a bed with their spouse. Couples completed questionnaires and daily assessments of positive and negative interactions. Each member of the dyad wore wrist actigraphs for 10 days. Sleep-wake concordance was calculated as the percentage of time couples were awake or asleep throughout the night at one-minute intervals. Multilevel modeling with lagged effects determined bidirectional and lagged associations between concordance and couples' daily interactions. RESULTS: Couples had more negative interactions than their usual following nights with higher concordance than their usual (but not vice versa) and this was more pronounced for well-adjusted couples. In contrast, across all couples, more positive interactions and perceived warmth and support from partners were associated with higher concordance. CONCLUSIONS: Our findings demonstrate that the valence of sleep-wake concordance depends on relationship quality characteristics (eg, marital adjustment). Future research on relationships, sleep, and health should consider couples' shared sleep behaviors as one mechanism by which relationships are associated with long-term health outcomes.

4.
J Behav Med ; 44(4): 507-518, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33083923

RESUMO

Using a social-ecological framework, we identify social determinants that interact to influence sleep health, identify gaps in the literature, and make recommendations for targeting sleep health in rural mothers. Rural mothers experience unique challenges and protective factors in maintaining adequate sleep health during the postpartum and early maternal years. Geographic isolation, barriers to comprehensive behavioral medicine services, and intra-rural ethno-racial disparities are discussed at the societal (e.g., public policy), social (e.g., community) and individual levels (e.g., stress) of the social-ecological model. Research on sleep health would benefit from attention to methodological considerations of factors affecting rural mothers such as including parity in population-level analyses or applying community-based participatory research principles. Future sleep health programs would benefit from using existing social support networks to disseminate sleep health information, integrating behavioral health services into clinical care frameworks, and tailoring culturally-appropriate Telehealth/mHealth programs to enhance the sleep health of rural mothers.


Assuntos
Mães , População Rural , Feminino , Humanos , Gravidez , Sono , Meio Social , Apoio Social
5.
Behav Sleep Med ; 19(2): 192-207, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32036690

RESUMO

Objective: To assess whether worry and rumination differ in predicting nighttime sleep disturbance versus daytime sleep-related impairment, as assessed using short forms from the Patient Reported Outcomes Measurement Information System (PROMIS). Participants: Adults recruited from the United States population (N = 459) via an online crowdsourcing service. Methods: Factor analysis explored whether items comprising validated measures of worry and rumination loaded onto separate factors. Hierarchical multiple regression models entered worry and rumination in a stepwise fashion to assess their relative strength in predicting PROMIS sleep disturbance and sleep-related impairment, after controlling for 17 covariates. All analyses were run twice using sleep-specific and general measures of worry and rumination. Results: Worry and rumination items loaded onto separate factors. In the regression analysis of sleep-specific cognition, only worry entered the model predicting sleep disturbance, whereas rumination entered after worry in the model predicting sleep-related impairment. In the analysis of general cognition, both cognitive process variables significantly predicted the PROMIS outcomes. Worry was the stronger predictor of sleep disturbance, whereas rumination was the stronger predictor of sleep-related impairment. Conclusions: Worry and rumination were observed to be distinct constructs that separately contributed to predicting daytime sleep-related impairment. Future studies should more closely examine how cognitive processes relate to insomnia symptomology during the day.


Assuntos
Ansiedade/psicologia , Comportamento Obsessivo/psicologia , Personalidade , Distúrbios do Início e da Manutenção do Sono/psicologia , Adulto , Análise Fatorial , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Análise de Regressão , Autorrelato , Transtornos do Sono-Vigília/psicologia , Adulto Jovem
7.
Prev Sci ; 21(4): 487-497, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31927654

RESUMO

There is a need to optimize the fit between psychosocial interventions with known efficacy and the demands of real-word service delivery settings. However, adaptation of evidence-based interventions (EBI) raises questions about whether effectiveness can be retained. This randomized controlled trial (RCT) evaluated a streamlined package of cognitive, behavior, and social skills training strategies known to prevent and reduce anxiety symptom and disorder escalation in youth. A total of 109 youth (Mage = 9.72; 68% girls; 54% Latinx) at risk based on high anxiety were randomized to the streamlined prevention and early intervention (SPEI) (n = 59) or control (n = 50) and were assessed at pretest, posttest, and 12-month follow-up. A main objective was to determine whether our redesign could be delivered by community providers, with acceptable levels of fidelity, quality, and impact. In terms of process evaluation results, there was high protocol fidelity, excellent clinical process skills, few protocol adaptations, and high satisfaction with the SPEI. In terms of outcomes, there were no significant main or moderated effects of the SPEI at the immediate posttest. However, at the follow-up, youth in the SPEI reported greater self-efficacy for managing anxiety-provoking situations, greater social skills, and fewer negative cognitive errors relative to controls. Collectively, findings suggest that the redesigned SPEI might be an attractive and efficient solution for service delivery settings.


Assuntos
Transtornos de Ansiedade/prevenção & controle , Transtornos de Ansiedade/terapia , Terapia Cognitivo-Comportamental/métodos , Transtornos de Ansiedade/etnologia , Arizona , Criança , Feminino , Humanos , Masculino , Avaliação de Resultados em Cuidados de Saúde , Serviços Preventivos de Saúde , Fatores de Tempo
8.
J Clin Child Adolesc Psychol ; 49(1): 60-78, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30644774

RESUMO

This study presents findings from a randomized effectiveness trial of the New Beginnings Program (NBP), which has demonstrated efficacy in 2 prior randomized efficacy trials. Family courts in 4 counties facilitated recruitment of divorcing and separating parents, and providers in community agencies delivered the program. Participants were 830 parents of children ages 3-18 who were randomized to receive either the 10-session NBP or an active 2-session comparison condition in which parents learned about the same parenting skills but did not complete home practice of these skills. Parents were ethnically diverse (59.4% non-Hispanic White, 31.4% Hispanic, 9.2% other race or ethnicity). Multiple rater assessments of parenting, interparental conflict, and child mental health problems were conducted at pretest, posttest, and 10-month follow-up. The results indicated positive moderated effects of the NBP as compared with the active control condition to strengthen parenting at posttest and to reduce child mental health problems at posttest and 10 months. Many of these moderated effects showed positive benefits for non-Hispanic White families but not for Hispanic families. The findings indicate support for the effectiveness of the NBP when delivered by community-based agencies but also indicate the need for further adaptations to make the program effective for Hispanic parents.


Assuntos
Divórcio/psicologia , Adolescente , Criança , Feminino , Humanos , Masculino
9.
Sleep Med Clin ; 14(2): 235-243, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31029189

RESUMO

Cognitive behavioral treatment for insomnia (CBTI) is an effective treatment of insomnia; however, there are insufficient CBTI providers for the 10% to 25% of the population who have insomnia. Brief behavioral treatment for insomnia (BBTI) is a 4-session manualized treatment paradigm administrable in medical settings by nonpsychologist health professionals. BBTI is effective in reducing symptoms of insomnia, such as sleep onset latency, wake after sleep onset, and sleep efficiency. In some cases, BBTI resulted in full remission from insomnia. Ongoing clinical trials are further testing the efficacy of BBTI using alternative treatment deliveries and in primary medical care settings.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Psicoterapia Breve/métodos , Distúrbios do Início e da Manutenção do Sono/terapia , Humanos
10.
Curr Hypertens Rep ; 21(5): 39, 2019 04 13.
Artigo em Inglês | MEDLINE | ID: mdl-30982174

RESUMO

PURPOSE OF REVIEW: Present a conceptual model and review the recent literature on family dynamics, sleep, and hypertension. RECENT FINDINGS: Family dynamics predict hypertension and hypertension risk, in part, due to shared health behaviors. Sleep health behaviors (sleep duration, quality, and efficiency) predict hypertension risk in children and youth and are emerging as a family-level health behavior. Importantly, both family dynamics and sleep are modifiable. Family members influence one another's sleep through their physical presence and through psychological and emotional mechanisms. Family members' sleep patterns may also be coregulated. Negative family dynamics are associated with poor sleep health and predict greater cardiovascular risk. Sleep health behaviors in the family context may also interact with family dynamics to dampen or exacerbate hypertension risk factors in children and youth. This review proposes that promoting sleep health in a family context could be one way to reduce long-term hypertension risk.


Assuntos
Relações Familiares , Comportamentos Relacionados com a Saúde , Hipertensão/epidemiologia , Sono , Humanos , Fatores de Risco
11.
Sleep Health ; 5(1): 58-63, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30670167

RESUMO

OBJECTIVES: Insufficient sleep can increase risk for adverse psychological and physical outcomes. Parental monitoring of daily activities is associated with youth health behaviors. We examined parental monitoring of waking and bedtime behaviors and sleep in a community sample of high-risk youth. METHODS: One-hundred sixty-five 10- to 14-year-olds from low-socioeconomic status families participated (11.8 years ±1.16, 52% female; 78% Black/African American). Parents and youth evaluated parental monitoring of waking activities. Parent expectations about bedtime and parent knowledge about adolescent's bedtime and sleep routine were independently rated. Youth sleep was assessed via parent report and actigraphy over 7 days. RESULTS: More parental knowledge about bedtime was associated with longer parent-reported sleep duration (ß = .18, P < .05). Parental monitoring of waking activities (youth reported) was associated with more actigraph-assessed sleep over 7 days (B = 2.73, SE = .91), weekdays (B = 2.44, SE = .01), and weekends (B = 3.88, SE = .1.41, all Ps < .05), whereas parent reported monitoring was associated with more sleep on weekdays only (B = 2.10, SE = .87, P < .05). Parental knowledge and expectations about bedtime behaviors were not associated with actigraph-assessed sleep (P values > .05). Parental monitoring of waking and bedtime behaviors was not associated with sleep duration variability (P values > .05). CONCLUSIONS: Parental monitoring of waking activities may indirectly influence adolescent sleep via increased structure and felt security in the parent-adolescent relationship. Youth perception of monitoring may be particularly relevant for youth sleep duration.


Assuntos
Relações Pais-Filho , Poder Familiar/psicologia , Sono , Actigrafia , Adolescente , Criança , Feminino , Humanos , Masculino , Autorrelato , Fatores de Tempo
13.
Dev Psychopathol ; 30(5): 1611-1627, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30451140

RESUMO

Growth mixture modeling with a sample of 749 Mexican heritage families identified parallel trajectories of adolescents' and their mothers' heritage cultural values and parallel trajectories of adolescents' and their fathers' heritage cultural values from Grades 5 to 10. Parallel trajectory profiles were then used to test cultural gap-distress theory that predicts increased parent-adolescent conflict and adolescent psychopathology over time when adolescents become less aligned with Mexican heritage values compared to their parents. Six similar parallel profiles were identified for the mother-youth and father-youth dyads, but only one of the six was consistent with the hypothesized problem gap pattern in which adolescents' values were declining over time to become more discrepant from their parents. When compared to families in the other trajectory groups as a whole, mothers in the mother-adolescent problem gap trajectory group reported higher levels of mother-adolescent conflict in the 10th grade that accounted for subsequent increases in internalizing and externalizing symptoms assessed in 12th grade. Although the findings provided some support for cultural gap-distress predictions, they were not replicated with adolescent report of conflict nor with the father-adolescent trajectory group analyses. Exploratory pairwise comparisons between all six mother-adolescent trajectory groups revealed additional differences that qualified and extended these findings.


Assuntos
Conflito Familiar/psicologia , Relação entre Gerações/etnologia , Transtornos Mentais/psicologia , Americanos Mexicanos/psicologia , Relações Pais-Filho/etnologia , Valores Sociais/etnologia , Adolescente , Comportamento do Adolescente , Adulto , Criança , Conflito Familiar/etnologia , Pai , Feminino , Humanos , Masculino , Transtornos Mentais/etnologia , Mães , Pais , Teoria Psicológica , Estresse Psicológico/etnologia , Estresse Psicológico/psicologia
14.
J Consult Clin Psychol ; 86(10): 845-855, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30265043

RESUMO

OBJECTIVE: Effects are reported of the Family Bereavement Program (FBP) on the mental health of bereaved youth and their surviving parent 15 years following the program. METHOD: On-hundred and 56 families (244 children ages 8-16; 54% male; 67% Non-Hispanic White) were randomly assigned to receive either the FBP (N = 90) or a literature control condition (N = 66). At the 15-year follow-up 80% of the youth and 76% of the bereaved parents were reinterviewed. Mental health problems and service use were self-reported by young adults and their parents. Key informants reported on mental health problems of young adults. RESULTS: Young adults in the FBP reported significantly less use of mental health services and of psychiatric medication than controls. Key informants reported significantly lower mental health problems for young adults who were in FBP as compared with controls and for those who were younger lower internalizing and externalizing problems for those in the FBP as compared with controls. Bereaved parents reported a significantly lower rate of alcoholism and less use of support groups than controls. CONCLUSIONS: The results provided evidence that FBP led to lower mental health problems and less service use by bereaved young adults and their parents as compared with controls. (PsycINFO Database Record (c) 2018 APA, all rights reserved).


Assuntos
Luto , Transtornos Mentais/psicologia , Serviços de Saúde Mental/estatística & dados numéricos , Morte Parental/psicologia , Pais/psicologia , Avaliação de Programas e Projetos de Saúde , Psicoterapia/métodos , Adolescente , Adulto , Criança , Feminino , Seguimentos , Humanos , Masculino , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Adulto Jovem
15.
Eval Health Prof ; 41(2): 290-320, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29635949

RESUMO

We used a multigroup propensity score approach to evaluate a randomized effectiveness trial of the New Beginnings Program (NBP), an intervention targeting divorced or separated families. Two features of effectiveness trials, high nonattendance rates and inclusion of an active control, make program effects harder to detect. To estimate program effects based on actual intervention participation, we created a synthetic inactive control comprised of nonattenders and assessed the impact of attending the NBP or active control relative to no intervention (inactive control). We estimated propensity scores using generalized boosted models and applied inverse probability of treatment weighting for the comparisons. Relative to the inactive control, NBP strengthened parenting quality as well as reduced child exposure to interparental conflict, parent psychological distress, and child internalizing problems. Some effects were moderated by parent gender, parent ethnicity, or child age. On the other hand, the effects of active versus inactive control were minimal for parenting and in the unexpected direction for child internalizing problems. Findings from the propensity score approach complement and enhance the interpretation of findings from the intention-to-treat approach.


Assuntos
Divórcio , Poder Familiar , Pais/educação , Adolescente , Fatores Etários , Criança , Pré-Escolar , Grupos Étnicos , Humanos , Relações Pais-Filho , Pontuação de Propensão , Fatores Sexuais , Fatores Socioeconômicos , Estresse Psicológico/prevenção & controle
16.
Prev Sci ; 19(4): 538-548, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-28913663

RESUMO

This paper reports on the effects on parenting and on children's mental health problems and competencies from a randomized trial of a parenting program for divorced and separated fathers. The program, New Beginnings Program-Dads (NBP-Dads), includes ten group sessions (plus two phone sessions) which promote parenting skills to increase positive interactions with children, improve father-child communication, use of effective discipline strategies, and skills to protect children from exposure to interparental conflict. The program was adapted from the New Beginnings Program, which has been tested in two randomized trials with divorced mothers and shown to strengthen mothers' parenting and improve long-term outcomes for children (Wolchik et al. 2007). Fathers were randomly assigned to receive either NBP-Dads or a 2-session active comparison program. The sample consisted of 384 fathers (201 NBP-Dads, 183 comparisons) and their children. Assessments using father, youth, and teacher reports were conducted at pretest, posttest, and 10-month follow-up. Results indicated positive effects of NBP-Dads to strengthen parenting as reported by fathers and youth at posttest and 10-month follow-up. Program effects to reduce child internalizing problems and increase social competence were found at 10 months. Many of the program effects were moderated by baseline level of the variable, child age, gender, and father ethnicity. This is the first randomized trial to find significant effects to strengthen father parenting following divorce. In view of recent changes in family courts to allot fathers increasing amounts of parenting time following divorce, the results have significant implications for improving outcomes for children from divorced families.


Assuntos
Relações Pai-Filho , Poder Familiar , Pais/educação , Adolescente , Adulto , Arizona , Criança , Saúde da Criança , Pré-Escolar , Comunicação , Divórcio , Análise Fatorial , Conflito Familiar , Humanos , Entrevistas como Assunto , Masculino , Saúde Mental , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde/métodos , Pesquisa Qualitativa
17.
Sleep ; 40(1)2017 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-28364457

RESUMO

Aim: To determine whether interdependence in couples' sleep (sleep-wake concordance i.e., whether couples are awake or asleep at the same time throughout the night) is associated with two markers of cardiovascular disease (CVD) risk, ambulatory blood pressure (BP) and systemic inflammation. Methods: This community-based study is a cross-sectional analysis of 46 adult couples, aged 18-45 years, without known sleep disorders. Percent sleep-wake concordance, the independent variable, was calculated for each individual using actigraphy. Ambulatory BP monitors measured BP across 48 h. Dependent variables included mean sleep systolic BP (SBP) and diastolic BP (DBP), mean wake SBP and DBP, sleep-wake SBP and DBP ratios, and C-reactive protein (CRP). Mixed models were used and were adjusted for age, sex, education, race, and body mass index. Results: Higher sleep-wake concordance was associated with lower sleep SBP (b = -.35, SE = .01) and DBP (b = -.22, SE = .10) and lower wake SBP (b = -.26, SE = .12; all p values < .05). Results were moderated by sex; for women, high concordance was associated with lower BP. Men and women with higher sleep-wake concordance also had lower CRP values (b = -.15, SE = .03, p < .05). Sleep-wake concordance was not associated with wake DBP or sleep/wake BP ratios. Significant findings remained after controlling for individual sleep quality, duration, and wake after sleep onset. Conclusions: Sleep-wake concordance was associated with sleep BP, and this association was stronger for women. Higher sleep-wake concordance was associated with lower systemic inflammation for men and women. Sleep-wake concordance may be a novel mechanism by which marital relationships are associated with long-term CVD outcomes.


Assuntos
Pressão Sanguínea/fisiologia , Doenças Cardiovasculares/etiologia , Inflamação/etiologia , Sono/fisiologia , Cônjuges , Actigrafia , Adolescente , Adulto , Biomarcadores/sangue , Monitorização Ambulatorial da Pressão Arterial , Proteína C-Reativa/metabolismo , Estudos Transversais , Feminino , Humanos , Inflamação/sangue , Inflamação/diagnóstico , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Cônjuges/psicologia , Adulto Jovem
18.
Sleep Health ; 3(2): 98-101, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28346164

RESUMO

OBJECTIVES: This study examined the association between stress-related interpersonal behaviors, presleep arousal (PSA), and sleep quality. METHODS: Sixty-four participants (53% female) described a recent stressful interpersonal event that was coded for overall degree of affiliation (warmth vs hostility) and autonomy (independence vs interdependence). Cognitive and somatic PSA and sleep quality were examined using regression with affiliation and autonomy scores as predictors. Specific interpersonal behaviors that comprise overall affiliation were also examined. RESULTS: More affiliation (warmth) was associated with lower cognitive PSA (ß=-.32) and better sleep quality (ß=-.28). Autonomy was not associated with sleep quality or PSA. The specific behavior trust in others was associated with better sleep quality (rs=-.25). CONCLUSIONS: Behaviors during stress reflect underlying dimensions of interpersonal security. Findings underscore importance of interpersonal frameworks for understanding associations between stress and sleep, and provide support for the anthropological theory that interpersonal security is necessary for healthy sleep.


Assuntos
Nível de Alerta/fisiologia , Relações Interpessoais , Sono/fisiologia , Estresse Psicológico/psicologia , Emoções , Feminino , Humanos , Masculino , Distúrbios do Início e da Manutenção do Sono/psicologia , Comportamento Social , Inquéritos e Questionários , Adulto Jovem
19.
Sleep ; 38(6): 933-9, 2015 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-25581920

RESUMO

STUDY OBJECTIVES: Coregulation of biological systems is a defining feature of normative attachment in close adult relationships. Sleep is a shared, intimate biological process between couples; however, sleep is usually examined at the individual level. We examined minute-by-minute concordance in couples' actigraphy-defined sleep-wake patterns, and how attachment style and marital satisfaction relate to concordance. DESIGN: Couples completed measures of avoidant and anxious attachment styles and relationship functioning and wore wrist actigraphs for 10 days. Minute-by-minute concordance of sleep and wake (i.e., the percentage of epochs in which both partners were asleep, or both were awake) was calculated for each sleep period. Mixed modeling was used to account for measurement occasions across time. RESULTS: Percent concordance ranged from 53-88% and was not associated with couples' sleep quality or circadian preference. For wives, neither anxious nor avoidant attachment was associated with sleep-wake concordance. For husbands, anxious attachment style was associated with higher concordance, but was moderated by wives' marital satisfaction. High marital satisfaction in wives was associated with higher concordance, regardless of husbands' attachment style. In couples in which wives reported low satisfaction, concordance was higher when husbands had an anxious attachment style. Avoidant attachment style in husbands was not related to concordance. CONCLUSIONS: Sleep concordance provides a unique measure of couples' cosleep and varies depending on attachment style and relationship satisfaction.


Assuntos
Características da Família , Casamento/psicologia , Satisfação Pessoal , Sono/fisiologia , Cônjuges/psicologia , Actigrafia , Adulto , Ansiedade/psicologia , Ritmo Circadiano , Feminino , Humanos , Masculino , Fatores de Tempo , Vigília/fisiologia
20.
Sleep Med Rev ; 22: 23-36, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25454674

RESUMO

The ineffectiveness of sleep hygiene as a treatment in clinical sleep medicine has raised some interesting questions. If it is known that, individually, each specific component of sleep hygiene is related to sleep, why wouldn't addressing multiple individual components (i.e., sleep hygiene education) improve sleep? Is there still a use for sleep hygiene? Global public health concern over sleep has increased demand for sleep promotion strategies accessible to the population. However, the extent to which sleep hygiene strategies apply outside clinical settings is not well known. The present review sought to evaluate the empirical evidence for sleep hygiene recommendations regarding exercise, stress management, noise, sleep timing, and avoidance of caffeine, nicotine, alcohol, and daytime napping, with a particular emphasis on their public health utility. Thus, our review is not intended to be exhaustive regarding the clinical application of these techniques, but rather to focus on broader applications. Overall, though epidemiologic and experimental research generally supported an association between individual sleep hygiene recommendations and nocturnal sleep, the direct effects of individual recommendations on sleep remains largely untested in the general population. Suggestions for clarification of sleep hygiene recommendations and considerations for the use of sleep hygiene in nonclinical populations are discussed.


Assuntos
Promoção da Saúde/métodos , Sono , Dissonias/complicações , Dissonias/prevenção & controle , Humanos , Saúde Pública , Medicina do Sono/métodos
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