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Ziel des Vorhabens war es, ein internetgestütztes Programm zu entwickeln, das zur Prävention von Schlafstörungen eingesetzt werden kann und verhaltensorientierte Bausteine zum besseren Umgang mit Schlafproblemen enthält. Neben einem Selbsttest zur ersten Einschätzung von Schlafstörungen, einem Schlaftagebuch zur Kontrolle der Schlafeffizienz, setzt das Programm wesentlich auf eine individualisierte Onlineberatung, die Hilfe und Unterstützung bei der Verbesserung der Schlafeffizienz leisten und zur Verminderung der Symptome des SWD beitragen kann. Die geplanten Projektziele im Sinne der Verbesserung von Schlafstörungen und Müdigkeit durch Onlineschlaf-beratung wurden bei der Stichprobe, die das Beratungsprogramm vollständig durchlaufen haben, erreicht.
Chronic tinnitus causes a decrease in well-being and can negatively affect sleep quality. It has further been indicated that there are clinically relevant gender differences, which may also have an impact on sleep quality. By conducting a retrospective and explorative data analysis for differences in patients with tinnitus and patients diagnosed with tinnitus and insomnia, hypothesized differences were explored in the summed test scores and on item-level of the validated psychometric instruments. A cross-sectional study was conducted collecting data from a sample of tinnitus patients (n = 76). Insomnia was diagnosed in 49 patients. Gender differences were found on aggregated test scores of the MADRS and BDI with men scoring higher than women, indicating higher depressive symptoms in men. Women stated to suffer more from headaches (p < 0.003), neck pain (p < 0.006) and nervousness as well as restlessness (p < 0.02). Women also reported an increase in tinnitus loudness in response to stress compared to men (p < 0.03). Male individuals with tinnitus and insomnia have higher depression scores and more clinically relevant depressive symptoms than women, who suffer more from psychosomatic symptoms. The results indicate a need for a targeted therapy of depressive symptoms in male patients and targeted treatment of psychosomatic symptoms, stress-related worsening of insomnia and tinnitus in women.
Sleep Disorders in Cancer
(2021)
Sleep disorders, especially insomnia, are very common in different kinds of cancers, but their prevalence and incidence are not well-known. Disturbed sleep in cancer is caused by different reasons and usually appears as a comorbid disorder to different somatic and psychiatric diagnoses, psychological disturbances and treatment methods. There can be many different predictors for sleep disturbances in these vulnerable groups, such as pre-existing sleep disorders, caused by the mental status in cancer or as side effect of the cancer treatment. Methods: A systematic literature review of 8073 studies was conducted on the topic of sleep and sleep disorders in cancer patients. The articles were identified though PubMed, PsycInfo and Web of Knowledge, and a total number of 89 publications were qualified for analysis. Results: The identified eighty-nine studies were analyzed on the topic of sleep and sleep disorders in cancer, twenty-six studies on sleep and fatigue in cancer and sixty-one studies on the topic of sleep disorders in cancer. The prevalence of sleep disturbences and/or sleep disorders in cancer was up to 95%. Discussion: Sleep disturbances and sleep disorders (such as insomnia, OSAS, narcolepsy and RLS; REM-SBD) in cancer patients can be associated with different conditions. Side effects of cancer treatment and cancer-related psychological dysfunctions can be instigated by sleep disturbances and sleep disorders in these patients, especially insomnia and OSAS are common. An evidence-based treatment is necessary for concomitant mental and/or physical states.
Shift work is associated with an increased risk of sleep disorders, yet tailored prevention and treatment programs remain rare and understudied. Cognitive behavioral therapy for insomnia is the first-line treatment for insomnia in the general population. We thus developed an anonymous online counselling service based on cognitive behavioral principles, adapted it to shift workers’ needs, and evaluated it in a sample of German shift workers from various industries. This prospective, randomized, controlled superiority trial compares two parallel groups: an intervention group that received four personalized counselling messages and completed four weekly sleep diaries, and a waiting-list control-group that completed sleep diaries only during the four-week waiting period. In the Intention to Treat sample (n = 66), significant improvements were observed in both groups for the primary outcome, sleep efficiency, and for the secondary outcomes, symptoms of insomnia and depression. Daytime sleepiness did not improve in either group. However, improvements were not significantly greater in the treatment than in the control group. We can thus not demonstrate superiority of the counselling intervention over the control condition, where repeated sleep diary completion and study participation may themselves have had therapeutic effects. Limitations regarding time frame and sample size, as well as implications for research and practice are discussed.
Trial registration:
The study was registered with the German Clinical Trials Register DRKS under the trial ID DRKS00017777 ( https://drks.de/search/en/trial/DRKS00017777
). Date of registration: 14.01.2020. This study was registered during the early stages of data collection. Of the 27 participants in the final sample, the first four had initiated data collection at the date of registration. No complete data sets were available at that time.
Der Begriff „Coronasomnia“ beschreibt populärwissenschaftlich Schlafstörungen, die im Zusammenhang mit der COVID-19-Pandemie in Erscheinung treten. Diese können auch im Anschluss der Pandemie einen Teil der Bevölkerung betreffen. Erste wissenschaftliche Hinweise deuten darauf hin, dass durch die Pandemie entstandene Insomniebeschwerden sich nach dem Ende der Pandemie chronifizieren und somit die schlafmedizinische Gemeinschaft weiterhin beschäftigen werden.
AbstractBackgroundMany shift workers suffer from sleep issues, which negatively affect quality of life and performance. Scientifically evaluated, structured programs for prevention and treatment are scarce. We developed an anonymous online cognitive behavioral therapy for insomnia (CBT-I) program. After successful completion of a feasibility study, we now start this prospective, randomized, controlled superiority trial to compare outcomes of two parallel groups, namely an intervention group and a waiting-list control-group. Additionally, we will compare these outcomes to those of a face-to-face CBT-I outpatient sample.MethodsCollaborating companies will offer our anonymous online intervention to their shift-working employees. Company physicians and counseling services will screen those interested for inclusion and exclusion criteria. Participants will receive access to our online service, where they will complete psychometric assessment and receive random assignment to either the intervention group or the waiting-list control group. Participants and providers will be aware of the group assignment. We aim to allocate at leastN= 60 participants to the trial. The intervention consists of psychoeducation, sleep restriction, stimulus control, relaxation techniques, and individual feedback delivered via four e-mail contacts. During the intervention, as well as during the waiting period, participants will fill out weekly sleep diaries. Immediately after completion of the program, the post-intervention assessment takes place. Participants in the control group will be able to participate in the program after all study assessments. To recruit an additional sample, collaborating outpatient sleep clinics will provide six sessions of standard face-to-face CBT-I to an ad hoc sample of shift working patients. We expect both the online and the face-to-face CBT-I interventions to have beneficial effects compared to the control group on the following primary outcomes: self-reported symptoms of depression and insomnia, sleep quality, and daytime sleepiness.ConclusionsThe online intervention allows shift workers to follow a CBT-I program independently of their working schedule and location. Forthcoming results might contribute to further improvement of prevention and therapy of sleep issues in shift workers.Trial registrationGerman Clinical Trials Register DRKSDRKS00017777. Registered on 14 January 2020—retrospectively registered.
Sleep quality and duration as well as activity-rest-cycles at individual level are crucial for maintaining physical and mental health. Although several methods do exist to monitor these parameters, optimal approaches are still under consideration and technological development. Wrist actigraphy is a non-invasive electro-physical method validated in the field of chronobiology to record movements and to allow for monitoring human activity-rest-cycles. Based on the continuous recording of motor activity and light exposure, actigraphy provides valuable information about the quality and quantity of the sleep–wake rhythm and about the amount of motor activity at day and night that is highly relevant for predicting a potential disease and its targeted prevention as well as personalisation of medical services provided to individuals in suboptimal health conditions and patients. Being generally used in the field of sleep medicine, actigraphy demonstrates a great potential to be successfully implemented in primary, secondary and tertiary care, psychiatry, oncology, and intensive care, military and sports medicines as well as epidemiological monitoring of behavioural habits as well as well-being medical support, amongst others.
