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Browsing by Author "Bush, Andrew J."

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    Hopelessness Mediates the Relation between Insomnia and Suicidal Ideation
    (American Academy of Sleep Medicine, 2014) Woosley, Julie A.; Lichstein, Kenneth L.; Taylor, Daniel J.; Riedel, Brant W.; Bush, Andrew J.; University of Alabama Tuscaloosa; University of North Texas Denton; University of Memphis; University of Tennessee Health Science Center
    Introduction: A growing body of literature indicates that insomnia is related to suicidality. However, the mechanism through which insomnia correlates with suicide risk is unclear. The goal of the present research was to determine whether hopelessness, a robust predictor of suicidality, mediates the relation between insomnia and suicidal ideation (SI). Methods: The present study used archival data from community-dwelling adults. Participants (n = 766) completed a Health Survey, two weeks of daily sleep diaries, and five measures of daytime functioning, including the Beck Depression Inventory (BDI). BDI item 2 was used to assess hopelessness, and BDI item 9 was used to assess SI. Criteria from the DSM-5 as well as quantitative criteria were used to identify participants with insomnia (n = 135). Results: The analyses revealed that hopelessness is a significant mediator of the relation between insomnia and SI. After adding depression as an additional mediator, hopelessness remained a significant predictor of SI. Conclusion: The present research suggests the need for clinicians to routinely screen clients who have insomnia for hopelessness and SI, and to treat hopelessness when it is present. Further research should address the limitations in this sample and should also consider other potential mediators of the insomnia-SI link.
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    Psychological treatment of hypnotic-dependent insomnia in a primarily older adult sample
    (Pergamon, 2013) Lichstein, Kenneth L.; Nau, Sidney D.; Wilson, Nancy M.; Aguillard, R. Neal; Lester, Kristin W.; Bush, Andrew J.; McCrae, Christina S.; University of Alabama Tuscaloosa; University of Memphis; University of Tennessee Knoxville; University of Florida
    Objective: This study tested cognitive behavior therapy (CBT) in hypnotic-dependent, late middle-age and older adults with insomnia. Method: Seventy volunteers age 50 and older were randomized to CBT plus drug withdrawal, placebo biofeedback (PL) plus drug withdrawal, or drug withdrawal (MED) only. The CBT and PL groups received eight, 45 min weekly treatment sessions. The drug withdrawal protocol comprised slow tapering monitored with about six biweekly, 30 min sessions. Assessment including polysomnography (PSG), sleep diaries, hypnotic consumption, daytime functioning questionnaires, and drug screens collected at baseline, posttreatment, and 1-year follow-up. Results: Only the CBT group showed significant sleep diary improvement, sleep onset latency significantly decreased at posttreatment. For all sleep diary measures for all groups, including MED, sleep trended to improvement from baseline to follow-up. Most PSG sleep variables did not significantly change. There were no significant between group differences in medication reduction. Compared to baseline, the three groups decreased hypnotic use at posttreatment, down 84%, and follow-up, down 66%. There was no evidence of withdrawal side-effects. Daytime functioning, including anxiety and depression, improved by posttreatment. Rigorous methodological features, including documentation of strong treatment implementation and the presence of a credible placebo, elevated the confidence due these findings. Conclusions: Gradual drug withdrawal was associated with substantial hypnotic reduction at posttreatment and follow-up, and withdrawal side-effects were absent. When supplemented with CBT, participants accrued incremental self-reported, but not PSG, sleep benefits. (C) 2013 Elsevier Ltd. All rights reserved.
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    Psychological treatment of insomnia in hypnotic-dependant older adults
    (Elsevier, 2008-01) Soeffing, James P.; Lichstein, Kenneth L.; Nau, Sidney D.; McCrae, Christina S.; Wilson, Nancy M.; Aguillard, R. Neal; Lester, Kristin W.; Bush, Andrew J.; University of Alabama Tuscaloosa; State University System of Florida; University of Florida; University of Memphis; University of Tennessee System; University of Tennessee Health Science Center
    Background: The existing literature does not address the question of whether cognitive-behavioral therapy would have an impact on insomnia in older adults who are chronic users of sleep medication and have current insomnia, but are also stable in their quantity of medication usage during treatment. The present report seeks to answer this question. Methods: Hypnotic-dependant older adults, who were stable in their amount of medication usage and still met the criteria for chronic insomnia put forth by American Academy of Sleep Medicine, were treated using a cognitive-behavioral intervention for insomnia. The three-component treatment included relaxation training, stimulus control, and sleep hygiene instructions. Participants were randomly assigned to either the active treatment group or a comparably credible placebo control group, and were instructed not to alter their pattern of hypnotic consumption during treatment. Results: The active treatment group had significantly better self-report measures of sleep at post-treatment. Statistically significant improvement was paralleled by clinically meaningful improvement for key sleep variables. As planned, there was no significant change in sleep medication usage from pre- to post-treatment. Conclusions: The findings support the use of cognitive-behavioral therapy for insomnia in hypnotic-dependant older adults. (c) 2007 Elsevier B.V. All rights reserved.
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    Variability in Self-Reported Normal Sleep Across the Adult Age Span
    (Oxford University Press, 2014-05) Dillon, Haley R.; Lichstein, Kenneth L.; Dautovich, Natalie D.; Taylor, Daniel J.; Riedel, Brant W.; Bush, Andrew J.; University of Alabama Tuscaloosa; University of North Texas System; University of North Texas Denton; University of Tennessee System; University of Tennessee Health Science Center
    Objectives. Illustrate the importance of examining within- and between-person differences in sleep across the adult age span. Method. Two weeks of sleep diary data were analyzed for 592 normal sleepers ranging in age from 20 to 96 years. Variability in total sleep time (TST), number of nighttime awakenings (NWAK), sleep-onset latency (SOL), and wake-time after sleep onset (WASO) were examined overall and by age, sex, and race utilizing multilevel models and multiple regression. Results. Night-to-night differences in sleep within the same individual generally exceeded differences between individuals for TST, SOL, and WASO. The amount of intraindividual variability in TST and NWAK decreased with older age. Further, the degree of reduction in variability in TST associated with age depended on sex and race, with young black females showing the greatest variability. In general, females tended to have more intraindividual variability in SOL and NWAK than males, while race differences were complicated by high variability between blacks. Discussion. To truly assess and understand individual differences in the sleep of older adults, future research needs to take into account night-to-night variability (including what makes sleep vary from one night to the next), in addition to average sleep.
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    Vitamins and sleep: An exploratory study
    (Elsevier, 2007-12) Lichstein, Kenneth L.; Payne, Kristen L.; Soeffing, James P.; Durrence, H. Heith; Taylor, Daniel J.; Riedel, Brant W.; Bush, Andrew J.; University of Alabama Tuscaloosa
    Study objective: We analyzed archival data from an epidemiology study to test the association between vitamin use and sleep. Design: Random digit dialing was used to recruit 772 people ranging in age from 20 to 98 for a study of people's sleep experience. These individuals completed a set of questionnaires about their sleep, health, and daytime functioning. Five hundred and nineteen of these participants had available vitamin use data. Setting: Home. Participants: Five hundred and nineteen people participated. Recruitment applied minimal screening criteria and no attempt was made to favor people with or without sleep disturbance. Interventions: This survey included no intervention. Participants completed 2 weeks of sleep diaries and a set of questionnaires. Of particular salience to the present study, participants reported their vitamin use in listing all medications and nutritional supplements being used currently. Measurements and results: For those individuals taking a multivitamin or multiple single vitamins, sleep diaries revealed poorer sleep compared to non-vitamin users in the number and duration of awakenings during the night. After controlling for age, ethnicity, and sex the difference in number of awakenings was still marginally significant. The rate of insomnia, conservatively defined, and consumption of sleep medication were also marginally significantly higher among individuals taking multi-/multiple vitamins compared to those not taking vitamins. Conclusions: Disturbed sleep maintenance was associated with multi-/multiple vitamin use. Five equally plausible explanations were advanced to explain this association including vitamins cause poor sleep, poor sleepers seek vitamins, and unidentified factors promote both poor sleep and vitamin use. These data are considered preliminary. Methodological characteristics of future studies were described that hold the promise of more clearly illuminating the association between vitamins and sleep. (c) 2007 Elsevier B.V. All rights reserved.