The natural history of insomnia: Does sleep extension differentiate between those that do and do not develop chronic insomnia?
acute insomnia
ageing
insomnia
natural history
sleep extension
Journal
Journal of sleep research
ISSN: 1365-2869
Titre abrégé: J Sleep Res
Pays: England
ID NLM: 9214441
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
revised:
04
03
2021
received:
06
11
2020
accepted:
05
03
2021
pubmed:
15
4
2021
medline:
4
10
2022
entrez:
14
4
2021
Statut:
ppublish
Résumé
According to the "3P model" of insomnia, the variable that mediates the transition from acute insomnia (AI) to chronic insomnia is "sleep extension" (the behavioural tendency to expand sleep opportunity to compensate for sleep loss). In the present analysis, we sought to evaluate how time in bed (TIB) varies relative to the new onset of AI and chronic insomnia. A total of 1,248 subjects were recruited as good sleepers (GS). Subjects were monitored over 1 year with sleep diaries. State transitions were defined, a priori, for AI, recovered from AI (AI-REC), and for chronic insomnia (AI-CI). Two additional groupings were added based on profiles that were unanticipated: subjects that exhibited persistent poor sleep following AI (AI-PPS [those that neither recovered or developed chronic insomnia]) and subjects that recovered from chronic insomnia (CI-REC). All the groups (GS, AI-REC, AI-CI, AI-PPS and CI-REC) were evaluated for TIB differences with longitudinal mixed effects models. Post hoc analyses for the percentage of the groups that were typed as TIB "restrictors, maintainers, and expanders" were conducted using longitudinal mixed effects models and contingency analyses. Significant differences for pre-post AI TIB were not detected for the insomnia groups. Trends were apparent for the AI-CI group, which suggested that minor increases in TIB occurred weeks before the declared onset of AI. Additionally, it was found that a significantly larger percentage of AI-CI subjects engaged in sleep extension (as compared to GS). The present data suggest that transition from AI to chronic insomnia does not appear to be initiated by sleep extension and the transition may occur before the elapse of 3 months of ≥3 nights of sleep continuity disturbance. Given these findings, it may be that the mismatch between sleep ability and sleep opportunity is perpetuated over time given the failure to "naturally" engage in sleep restriction (as opposed to sleep extension).
Identifiants
pubmed: 33853197
doi: 10.1111/jsr.13342
pmc: PMC8446292
mid: NIHMS1694562
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13342Subventions
Organisme : NIA NIH HHS
ID : R56 AG050620
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG041783
Pays : United States
Organisme : NIA NIH HHS
ID : K24 AG055602
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG054521
Pays : United States
Organisme : NHLBI NIH HHS
ID : K23 HL141581
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021 European Sleep Research Society.
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