2. Sleep and Mental Health Flashcards
What are 7 features of “bad” sleep?
- Duration
- Quality
- Continuity
- Initiation
- Daytime dysfunction
- Stages
- Other
Give four levels sleep can be measured at.
1. S____
2. B____
3. P____
4. G____
- Self-report
- Behavioural
- Physiological
- Genetic
What are four ways papers refer to bad sleep?
1. I____ sleep
2. Sleep d____
3. P____ sleep
4. Sleep d____
- Insufficient sleep
- Sleep deficiency
- Poor sleep
- Sleep disturbances
What is considered the gold standard for measuring sleep?
PSG.
Only measurement that can accurately characterise sleep stages
What are four downsides to PSG?
- Expensive, uncomfortable, un-naturalistic
- First night effect - sleep differently in new environment, so PSG studies often have an ‘adaptation night’
- Only know what’s happening at night - daytime factors and patterns also important
- Sleep staging requires analysis and interpretation - tricky and time-consuming
What is actigraphy?
Wrist-worn device
Captures continuous rest-activity profile around the 24h period
Sleep is inferred through absence of movement
What are four advantages of actigraphy?
- Inexpensive and more naturalistic
- Sample physical activity during wakefulness as well as sleep for longer durations (e.g. over few weeks)
- Gives data on regularity, timing and variability of sleep across days (weekdays vs weekends)
- Good accuracy for correctly identifying sleep when compared to PSG (90%)
What are three cons of actigraphy?
- Not very good at correctly identifying when someone is awake (~50%) of time
- misidentifies restful wake as sleep and overestimate sleep time
- means overestimates time bad sleepers sleep for, doesn’t pick up on waking up in night - Not accurate at identifying sleep stages
- Should be used in conjunction with sleep diary to be accurate
What 5 things do bedside sensors detect?
1. M____
2. R____
3. A____ l____
4. R____ t____
5. N____
- Movement
- Respiration
- Ambient lighting
- Room temp
- Noise
Who are bedside sensors better at measuring sleep for instead of watches?
People with mental health issues - don’t have to remember to put watch on, sleep is automatically measured without them having to do anything
Infrared video classifies body motion, automatically scoring sleep and wake rates as well as detecting what…?
Abnormal breathing
Special mattresses and sensor strips are placed under the mattress to detect what three things?
- Heart-rate
- Respiratory rate
- Body movements/position
The Multiple Sleep Latency Test (MSLT) is a measure of d____ s____ s____ typically used to diagnose n____
A measure of daytime sleepiness severity typically used to diagnose narcolepsy
The occurrence of more than one of what within 15 minutes of sleep onset in the MSLT is suggestive of narcolepsy?
Occurrence of REM sleep (sleep onset REM periods (SOREMs))
Sleep duration and prevalence of mental disorder follow what kind of relationship?
U-shaped relationship
What is chronic insomnia?
- Difficulty initiating, maintaining or re-initiating sleep
- 3 x week for at least 3 months
- Clinically significant daytime distress or impairment
What two approaches are common when measuring the comorbidity between psychiatric problems and insomnia?
- Rates of insomnia in different clinical populations
- Concurrent psychiatric diagnoses in populations with insomnia
What % of people with the following disorders have insomnia?
1. Depression
2. Anxiety disorders
3. Schizophrenia
- 60%
- 70%
- 44%
Insomniacs tend to underestimate and overestimate what?
Overestimate the amount of time it takes them to get to sleep
Underestimate the amount of time they’re asleep for
Sleep disturbances are associated with an increased prevalence of ________?
Mental health disorders
However this doesn’t tell us anything about causality
Geoffroy et al 2020 measured the amount of sleep ~36k US adults got and if they had experienced what 5 things in the last 12 months?
- Mood disorders
- Anxiety disorders
- Post-traumatic stress disorder
- Psychotic Disorder
- Suicide attempt
In Geoffroy et al 2020, what % of people who got an average of the following hours of sleep per night had a psychiatric condition?
1. <5 hours
2. 7 hours
3. 9+ hours
- 55%
- 27%
- 48%
What is a meta-analysis?
A method of combining and analysing data from many studies that address the same research question
Results of meta-analysis are often presented in what?
A forest plot
Shows results of the individual studies and they overall combined result
In forest plots, each study has an ____ size with ____ ____
Effect size
Confidence intervals
What is the line of no effect on forest plots?
placed at the point where the effect size equals no effect
What is meant by pooled results?
A summary of the effect across all the individual studies
What does the width of the diamond in pooled results indicate?
The confidence interval of that estimate
What did Baglioni et al 2016 look at?
A meta-analysis looking at sleep alterations as measured by PSG across a range of mental health disorders
What two groups did Baglioni et al 2016 compare PSG metrics between?
- Healthy Controls
- People in a mental health disorder episode at the time of PSG recordings
What were Baglioni et al 2016 three sleep metrics?
- Sleep continuity
- Sleep depth
- REM pressure
What were the findings of Baglioni et al 2016?
- Sleep continuity disturbances evidenced in all disorders, except for seasonal affective disorder, panic disorder and ADHD
- The result was marginally significant for eating disorder and Asperger syndrome, although this may be due to small number of studies available for these categories
What were the conclusions of Baglioni et al 2016?
Findings support the notion of transdiagnostic (i.e. across all disorders) disruptions of sleep continuity – except for ADHD
No single sleep variable alteration was specific for one single disorder BUT no two conditions had the same sleep profile
Constellations of sleep alterations may define distinct disorders better than alteration in one single variable
Sleep depth and REM sleep pressure disturbances were altered in a smaller number of disorders and occurred rarely in a single condition
Supports the idea that there are both disorder-specific and transdiagnostic alterations in sleep
Compare PSG and Actigraphy
PSG offers the advantage of accurate assessment of sleep stages, but is conducted in a sleep-clinic environment for a short time
Actigraphy allows objective assessments of sleep over longer periods in the home environment & gives data on patterns and levels of activity during the day
