Browsing by Subject "Insomnia"

Now showing 1 - 6 of 6
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    Content analysis of insomnia questionnaires: a step to better evaluate the complex and multifaceted construct of insomnia disorder
    (Oxford University Press, 2023-12) Coelho, Julien; Sánchez Ortuño, María Montserrat; Martin, Vicent P.; Gauld, Christophe; Richaud, Alexandre; Lopez, Régis; Pelou, Marie; Abi Saab, Poeiti; Philip, Pierre; Geoffroy, Pierre Alexis; Palagini, Laura; Micoulaud Franchi, Jean Arthur; Enfermería
    Insomnia disorder is a mental disorder that includes various types of symptoms (e.g., insomnia initiating, worries, mood disturbances) and impairments (e.g., distress related to sleep alterations). Self-report questionnaires are the most common method for assessing insomnia but no systematic quantified analysis of their content and overlap has been carried out. We used content analysis and a visualization method to better identify the different types of clinical manifestations that are investigated by nine commonly used insomnia questionnaires for adults and the Jaccard index to quantify the degree to which they overlap. Content analysis found and visualized 16 different clinical manifestations classified into five dimensions (“Insomnia symptoms”, “Insomnia-related symptoms”, “Daytime symptoms”, “Insomnia-related impairments”, “Sleep behaviors”). The average Jaccard Index was 0.409 (moderate overlap in content). There is a lack of distinction between symptoms and impairments, and the assessment of sleep duration and hyperarousal symptoms remains overlooked. This preliminary analysis makes it possible to visualize the content of each of the nine questionnaires and to select the most appropriate questionnaire based on the issue to be addressed. Suggestions are made regarding the development of future questionnaires to better distinguish symptoms and impairments, and the different phenotypes of insomnia disorder.
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    Determinants of dropout from a virtual agent–based app for insomnia management in a self-selected sample of users with insomnia symptoms: longitudinal study
    (JMIR Publications, 2023) Sánchez Ortuño, María Montserrat; Pecune, Florian; Coelho, Julien; Micoulaud Franchi, Jean Arthur; Salles, Nathalie; Auriacombe, Marc; Serre, Fuschia; Levavasseur, Yannick; De Sevin, Etienne; Sagaspe, Patricia; Philip, Pierre; Enfermería
    Background: Fully automated digital interventions delivered via smartphone apps have proven efficacious for a wide variety of mental health outcomes. An important aspect is that they are accessible at a low cost, thereby increasing their potential public impact and reducing disparities. However, a major challenge to their successful implementation is the phenomenon of users dropping out early. Objective: The purpose of this study was to pinpoint the factors influencing early dropout in a sample of self-selected users of a virtual agent (VA)–based behavioral intervention for managing insomnia, named KANOPEE, which is freely available in France. Methods: From January 2021 to December 2022, of the 9657 individuals, aged 18 years or older, who downloaded and completed the KANOPEE screening interview and had either subclinical or clinical insomnia symptoms, 4295 (44.5%) dropped out (ie, did not return to the app to continue filling in subsequent assessments). The primary outcome was a binary variable: having dropped out after completing the screening assessment (early dropout) or having completed all the treatment phases (n=551). Multivariable logistic regression analysis was used to identify predictors of dropout among a set of sociodemographic, clinical, and sleep diary variables, and users’ perceptions of the treatment program, collected during the screening interview. Results: The users’ mean age was 47.95 (SD 15.21) years. Of those who dropped out early and those who completed the treatment, 65.1% (3153/4846) were women and 34.9% (1693/4846) were men. Younger age (adjusted odds ratio [AOR] 0.98, 95% CI 0.97‐0.99), lower education level (compared to middle school; high school: AOR 0.56, 95% CI 0.35‐0.90; bachelor’s degree: AOR 0.35, 95% CI 0.23‐0.52; master’s degree or higher: AOR 0.35, 95% CI 0.22‐0.55), poorer nocturnal sleep (sleep efficiency: AOR 0.64, 95% CI 0.42‐0.96; number of nocturnal awakenings: AOR 1.13, 95% CI 1.04‐1.23), and more severe depression symptoms (AOR 1.12, 95% CI 1.04‐1.21) were significant predictors of dropping out. When measures of perceptions of the app were included in the model, perceived benevolence and credibility of the VA decreased the odds of dropout (AOR 0.91, 95% CI 0.85‐0.97). Conclusions: As in traditional face-to-face cognitive behavioral therapy for insomnia, the presence of significant depression symptoms plays an important role in treatment dropout. This variable represents an important target to address to increase early engagement with fully automated insomnia management programs. Furthermore, our results support the contention that a VA can provide relevant user stimulation that will eventually pay out in terms of user engagement.
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    Enfermería y Tratamiento no Farmacológico para el Manejo del Insomnio
    (Murcia: Servicio de Publicaciones de la Universidad de Murcia, 2019) Baides Noriega, Raquel; Noriega Camporro, Sara; Inclán Rodríguez, Alicia María
    Introducción: El insomnio es definido como la incapacidad para iniciar y/o mantener el sueño. Es el trastorno del sueño más frecuente y puede producir consecuencias para la salud en todas las dimensiones. Las medidas no farmacológicas han mostrado mejor efecto a largo plazo para el manejo del insomnio, por lo que el uso de fármacos debe restringirse como segunda línea de tratamiento. Metodología: Con objeto de conocer procedimientos no farmacológicos para el manejo del insomnio desde Enfermería de Atención Primaria, se realizó una revisión bibliográfica a través de fuentes primarias y secundarias. Resultados: Como primera línea de tratamiento destacan las terapias conductuales y cognitivo-conductuales asociadas a la educación para la salud y medidas de higiene de sueño. Según algunos estudios, nueve consultas de 30 minutos, con intervenciones no farmacológicas, reducirían el insomnio crónico con efectividad del 70 al 80%. Además existen terapias alternativas que asociadas como terapias complementarias pueden ayudar al manejo del insomnio con nivel de evidencia suficiente. Conclusiones: Las medidas no farmacológicas deben utilizarse como primera línea de tratamiento. Sin embargo, en nuestro país, apenas se prescriben y existe un alto consumo de fármacos destinados a solucionar este problema, con las consiguientes consecuencias para la salud que producen. Para poder abordar la situación se considera fundamental una mejora de los recursos humanos profesionales y formación al respecto.
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    From improved sleep regularity to reduced sleep complaints and mental health conditions: a population-based interventional study using a smartphone-based virtual agent
    (Oxford University Press, 2023-09) Coelho, Julien; Pecune, Florian; Levavasseur, Yannick; Sevin, Etienne de; D'incau, Emmanuel; Patricia Sagaspe, Patricia; Sánchez Ortuño, María Montserrat; Micoulaud Franchi, Jean Arthur; Philip, Pierre; Enfermería
    Study Objectives To explore the effect of sleep regularity on sleep complaints and mental health conditions (i.e. insomnia, fatigue, anxiety, and depressive symptoms) in a population-based interventional study using a smartphone-based virtual agent. Methods A populational cohort based on the Kanopée application, which provided interactions with a virtual companion to collect data on sleep and make personalized recommendations to improve sleep over 17 days. A pre-intervention sleep diary and interview were used for cross-sectional analysis (n = 2142), and a post-intervention sleep diary and interview were used for longitudinal analysis (n = 732). The intra-individual mean (IIM) and standard deviation (ISD) of total sleep time (TST) were calculated to measure sleep quantity and sleep regularity. Results The mean age at baseline was 49 years, 65% were female, 72% reported insomnia, 58% fatigue, 36% anxiety, and 17% depressive symptoms. Before the intervention, irregular and short sleep was associated with a higher likelihood of insomnia (Relative risk [RR] = 1.26 [1.21–1.30] for irregular TST and RR = 1.19 [1.15–1.23] for short TST), fatigue, anxiety, and depressive symptoms. After the intervention, the IIM of the TST increased while the ISD of the TST and sleep complaints and mental health conditions decreased. More regular TST was associated with reduced insomnia and depressive symptoms (RR = 1.33 [1.10–1.52] and RR = 1.55 [1.13–1.98], respectively). Conclusions Our results reveal a longitudinal association between sleep regularity and sleep complaints and mental health conditions. Policymakers, health professionals, and the general population should be aware that, beyond its positive effect on sleep health, regular sleep could promote mental health.
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    Predictors of users’ adherence to a fully automated digital intervention to manage insomnia complaints
    (Oxford University Press, 2023-12) Sánchez Ortuño, María Montserrat; Pecune, Florian; Coelho, Julien; Micoulaud Franchi, Jean Arthur; Salles, Nathalie; Auriacombe; Serre, Fuschia; Levavasseur, Yannick; Sevin, Etienne de; Sagaspe, Patricia; Philip, Pierre; Enfermería
    Objective Fully automated digital interventions show promise for disseminating evidence-based strategies to manage insomnia complaints. However, an important concept often overlooked concerns the extent to which users adopt the recommendations provided in these programs into their daily lives. Our objectives were evaluating users’ adherence to the behavioral recommendations provided by an app, and exploring whether users’ perceptions of the app had an impact on their adherence behavior. Material and methods Case series study of individuals completing a fully automated insomnia management program, conducted by a virtual agent, during December 2020 to September 2022. Primary outcome was self-reported adherence to the behavioral recommendations provided. Perceptions of the app and of the virtual agent were measured with the Acceptability E-Scale and ECA-Trust Questionnaire. Insomnia was evaluated with the Insomnia Severity Index at baseline (phase 1), after 7 days of sleep monitoring (phase 2) and post-intervention (phase 3). Results A total of 824 users were included, 62.7% female, mean age 51.85 (±12.55) years. Of them, 32.7% reported having followed at least one recommendation. Users’ trust in the virtual agent and acceptance of the app were related to a pre-intervention effect in insomnia severity (phase 2). In turn, larger pre-intervention improvements predicted better adherence. Mediational analyses showed that higher levels of trust in the virtual agent and better acceptance of the app exerted statistically significant positive effects on adherence (β = 0.007, 95% CI, 0.001-0.017 and β = 0.003, 95% CI 0.0004-0.008, respectively). Discussion Users’ adherence is motivated by positive perceptions of the app’s features and pre-intervention improvements. Conclusions Determinants of adherence should be assessed, and targeted, to increase the impact of fully automated digital interventions.
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    Psychometric Properties of the Irrational Beliefs Scale for Insomnia (IBSI) in Turkish Emerging Adults
    (Universidad de Murcia. Servicio de Publicaciones, 2025) Kabadayı, Fedai; Kılıç, Sabire; Yazıcı-Kabadayı, Sema
    The present study aimed to assess the psychometric properties of the Irrational Beliefs Scale for Insomnia (IBSI) in Turkish emerging adults. The measurement instrument aims to assess irrational beliefs by measuring four core irrational beliefs (demandingness, awfulizing, frustration intolerance, and global evolution of worth). A total of 762 emerging adults (556 female, 206 male) between the ages of 19 and 28 were included in all stages of the study. The results indicated that the IBSI, consisting of 4 dimensions and 24 items, is valid and reliable according to the results of EFA, CFA, and network analysis. The calculated Cronbach's α and McDonald's ω showed that the instrument was satisfactory. The results provide strong evidence that the IBSI is a valid and reliable instrument for Turkish emerging adults