What's new in sleep research?
In this Research Roundup, we explore new studies on sleep disorders, with a special focus on treatment outcomes, the impact of cannabis on sleep, and sleep disturbances in children.
CBT-I, Exercise, and Pharmacotherapy for Insomnia
Researchers analyzed 13 randomized controlled studies (N=1350 participants) of patients aged 8 years or older with chronic insomnia via 18 pairwise comparisons of the use of cognitive behavioral therapy for insomnia, exercise interventions (ie, tai chi and aerobic and muscle-strengthening exercise), and the pharmacotherapeutic agent temazepam. The Athens insomnia scale, insomnia severity index, insomnia symptom questionnaire, Pittsburgh sleep quality index, and sleep diaries were used as to assess outcomes.
In comparison with controls, exercise and CBT-I were found effective in the long-term (approximately 10 months) analysis, but temazepam failed to produce sustained benefits. However, all interventions showed sleep improvement around the 8.5 weeks point.
“Our results demonstrated that both exercise and CBT-I showed superior long-term effectiveness on improving sleep compared to the control, while pharmacotherapy (temazepam) showed excellent treatment effectiveness,” the authors concluded. “More importantly, using a network meta-analytical approach, this is the first study demonstrated that exercise had comparable treatment effectiveness to that of CBT-I (SMD, 0.16; 95% CI, −0.07 to 0.40). Our findings support current physical activity guidelines recommending regular exercise in adults to improve sleep.”
Yu DJ, Recchia F, Bernal JDK, et al. Effectiveness of Exercise, Cognitive Behavioral Therapy, and Pharmacotherapy on Improving Sleep in Adults with Chronic Insomnia: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. Healthcare (Basel). 2023;11(15):2207.
Exploring Cannabis Use Impact on Sleep Across Race and Ethnicity
Leveraging data from the National Comorbidity Survey-Replication, researchers looked at the impact of cannabis use on sleep disturbances among English-speaking US residents aged 18 years or older (N=3929). They examined rates of cannabis use and sleep disturbances among minoritized racial and ethnic groups.
The researchers “found that cannabis use was associated with ‘multiple sleep disturbances and daytime sleepiness’ after adjustment for sociodemographic characteristics and health behaviors (but not after adjustment for clinical characteristics), overall and did not vary by race and ethnicity or sex/gender.” They added, “Associations between cannabis use and sleep may vary by age.”
Gaston SA, Alhasan DM, Jones RD Jr, et al. Cannabis use and sleep disturbances among White, Black, and Latino adults in the United States: A cross-sectional study of National Comorbidity Survey-Replication (2001-2003) data [published online ahead of print, 2023 Aug 11]. Sleep Health. 2023;S2352-7218(23)00125-0.
Parent-Reported Childhood Sleep Disturbances and Risk of Future Psychiatric Illness
To investigate the link between sleep disturbances and increased risk of future psychiatric illness, researchers conducted a retrospective study of children (N=348) aged 5 years 11 months and younger. The researchers looked at polysomnogram results as well as caregiver reported sleep disturbances to ascertain links with future risk as well as evaluation agreement.
The data indicated that caregiver and clinician findings based on polysomnogram had slight to fair agreement on sleep disturbances.
“Parental reports of subjective sleep concerns are indicative of different sleep pathologies compared to sleep pathologies detected on PSG,” they concluded. “The addition of PSG to caregiver reported data appears to have limited clinical utility in understanding sleep concerns associated with the risk of subsequent psychiatric illness in young children.”
Pease E, Shekunov J, Savitz ST, et al. Association between early childhood sleep difficulties and subsequent psychiatric illness [published online ahead of print, 2023 Aug 4]. J Clin Sleep Med. 2023;10.5664/jcsm.10756.
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