Daniel Buysse

University of Pittsburgh | Pitt · Department of Psychiatry

Study objectives: To examine the feasibility, acceptability, and impact of a Sleep Promotion Program (SPP). Methods: This pilot trial randomized adolescents (13-15y) with insufficient sleep duration and irregular sleep timing to SPP-continuation (n=24; SPP in month 1, continuation treatment in month 2) or monitoring-SPP (n=20; monitoring in mont...

The current exploratory pilot study examined whether social rhythm regularity, as measured by a social rhythm metric, was associated with: (1) the regularity of circadian rhythms and/or sleep regularity metrics; and (2) sleep quality, affective function and alcohol use. Late adolescents (18–22 years old) who drink alcohol ( n = 36; 61.1% female, M...

Objectives: Study objectives were to: 1) iteratively adapt the Transdiagnostic Sleep and Circadian Intervention (TranS-C) for patients in cardiac rehabilitation (CR; Phase 1) and 2) conduct a preliminary single group pre-post intervention test to a) evaluate procedural feasibility and intervention acceptability and b) to explore preliminary pre-po...

Background Digital health interventions show potential to increase caregivers’ access to psychosocial care; however, it is unclear to what extent existing interventions may need to be tailored to meet caregivers’ unique needs. Purpose This study aimed to determine whether—and if so, how—an efficacious Internet-delivered insomnia program should be...

Background Delivering insomnia treatment by the Internet holds promise for increasing care access to family caregivers, but their ability to adhere to and benefit from such fully-automated programs has not been rigorously tested. Purpose This fully-powered, single-group trial tested whether characteristics of the caregiving context influence high-...

Study Objectives This single-arm, mixed-methods, pilot study examined the feasibility and preliminary efficacy of an adapted version of the transdiagnostic intervention for sleep and circadian dysfunction (TranS-C) on multidimensional sleep health (MDSH) in a sample of adults with excess weight and suboptimal sleep health. Methods Participants rec...

Study Objectives Harmonizing and aggregating data across studies enable pooled analyses that support external validation and enhance replicability and generalizability. However, the multidimensional nature of sleep poses challenges for data harmonization and aggregation. Here we describe and implement our process for harmonizing self-reported sleep...

Intravenous alpha-2-adrenergic receptor agonists reduce energy expenditure and lower the temperature when shivering begins in humans, allowing a decrease in core body temperature. Because there are few data about similar effects from oral drugs, we tested whether single oral doses of the sedative dexmedetomidine (1 µg/kg sublingual or 4 µg/kg swall...

Introduction We investigated the association between circadian rest/activity rhythms (RARs) and daytime insomnia symptoms among older adults with insomnia. We hypothesized that: 1) RARs differ between older adults with insomnia and healthy sleepers; and 2) among older adults with insomnia, RARs are associated with daytime insomnia symptoms. Method...

Introduction Adolescent sleep is compressed by early school start times and often competes with school, extracurricular, and social demands. Insufficient and mistimed weeknight sleep contributes to large shifts in weekend-weekday sleep-wake schedules, which may lead to adverse physical and mental health outcomes. The Sleep Promotion Program (SPP) i...

Introduction Alcohol use disorder (AUD) is characterized by sleep disturbances, but differentiating the effects of acute alcohol exposure, withdrawal, and chronic consumption remains an unsolved problem. This study takes a unique approach to examine proximate alcohol consumption effects on sleep electroencephalography (EEG) in young adults who enga...

Introduction Short sleep increases Alzheimer’s disease (AD) risk, and sleep facilitates clearance of AD-related metabolites. Blood-based AD biomarkers (e.g., beta amyloid [Aβ] 42/40 ratio, phosphorylated tau181 [p-Tau181], neurofilament light chain [NfL], glial fibrillary acidic protein [GFAP]) are validated and increasingly used clinically. Howeve...

Introduction Insomnia is associated with an increased risk for cardiovascular disease. Yoga may have the potential to improve both sleep and cardiovascular health. However, there is limited evidence of how vinyasa yoga (VY), a form of yoga that links breath with movement and exhibits a greater energy expenditure than most other styles, impacts slee...

Introduction Depression is a leading cause of disability in older adults, yet it remains underdiagnosed and undertreated. Establishing common multivariable sleep health profiles may eventually help to identify at-risk older adults and match them with appropriate treatments. However, profiles identified across cohorts often differ because of inconsi...

Introduction Circadian rest/activity rhythms (RARs) are associated with cognitive function among older adults. Reports of poor cognitive function are common among individuals with insomnia. We examined the association of circadian RARs with performance in multiple cognitive domains among older adults with insomnia. Methods Older adults with insomn...

Introduction Adolescents with later circadian timing evidence an increased risk for depression. Depressed individuals report higher negative affect (NA), especially in the morning, which may reflect altered circadian timing in NA. Untangling the circadian influences on mood is challenging due to inconsistent operationalizations of circadian timing....

Introduction Although individual sleep characteristics relate to mental and physical health among older adults, such sleep characteristics do not exist in isolation. Multidimensional sleep measures may better capture the comprehensive impact of sleep on health. However, few studies have examined multidimensional sleep health in relation to mental a...

Introduction Developmental shifts towards later sleep/circadian timing during adolescence are often at odds with early school start times, resulting in circadian misalignment and sleep restriction, as well as stark differences between sleep timing/duration on school nights versus weekends. While the sleep aspects of this mismatch have been well-cha...

Introduction The construct of multidimensional sleep health is increasingly used to examine the impact of sleep on health. However, psychometric validation of self-report sleep health measures is limited. We developed the Ru-SATED 4.0 Multidimensional Sleep Health Scale to evaluate 6 sleep health dimensions (Regularity, Satisfaction, Alertness, Tim...

Introduction Sleep health is defined as a multidimensional pattern of sleep and wakefulness that is adapted to individual, societal, and environmental demands, and that fosters mental and physical well-being. Prior research demonstrates that social determinants, operating at the household, interpersonal, and community levels, associate with individ...

Introduction Objective sleep patterns can be measured unobtrusively using instrumented “smart” bed systems, which offer an innovative method to record and evaluate behavioral sleep patterns in people’s own homes and over time. However, little is known about behavioral sleep patterns and their relationships with self-reported multidimensional sleep...

Objective Stability in the timing of key daily routine behaviors such as working/doing housework, sleeping, eating, and engaging in social interactions (i.e., behavioral–social rhythms) contributes to health. This study examined whether behavioral–social rhythms were associated with CVD risk factors in retired night shift workers and retired day wo...

Poor sleep health, a composite measure of key sleep characteristics, may relate to increased depressive symptoms among individuals treated for obstructive sleep apnea. The current investigation examined the association between sleep health and depressive symptomatology. In a pilot sample of 13 symptomatic OSA military Veterans with adequate CPAP ad...

Specific sleep characteristics have been associated with cognitive decline, Alzheimer’s disease, and related dementias; however, studies examining the association between multidimensional sleep (a more comprehensive integration of sleep parameters) and cognitive decline are lacking. Among 2,811 older men without dementia, those with none, 1-2, and...

BACKGROUND Vinyasa yoga (VY), a form of yoga that links breath with movement and has higher energy expenditure perhaps than most other types of yoga, has been sparsely studied for its effects on sleep among adults with insomnia. It remains unknown whether and how an acute bout of VY performed in the evening impacts sleep and autonomic function. The...

Introduction Identifying intervention methods that target sleep characteristics involved in memory processing is a priority for the field of cognitive aging. Older adults with greater sleep efficiency and non-rapid eye movement slow-wave activity (SWA) (0.5–4 Hz electroencephalographic activity) tend to exhibit better memory and cognitive abilities...

Objective: Digital health interventions show potential to increase caregivers’ access to psychosocial care; however, it is unclear to what extent existing interventions may need to be tailored to meet caregivers’ unique needs. This study aimed to determine whether – and if so, how – an efficacious Internet-delivered insomnia program should be modif...

Study objectives Healthy sleep is important for adolescent neurodevelopment, and relationships between brain structure and sleep can vary in strength over this maturational window. Although cortical gyrification is increasingly considered a useful index for understanding cognitive and emotional outcomes in adolescence, and sleep is also a strong pr...

Objectives The aims were to explore multidimensional sleep health and the different dimensions of sleep health in the adult Norwegian population in relation to sex, age, education, circadian preference, and chronic insomnia. Methods A representative sample of 1028 Norwegians, aged 18 + years completed a cross-sectional web-based survey. Sleep heal...

Healthy sleep is essential for physical and mental health, and social wellbeing; however, across the globe, and particularly in developing countries, national public health agendas rarely consider sleep health. Sleep should be promoted as an essential pillar of health, equivalent to nutrition and physical activity. To improve sleep health across th...

To the Editor: In their Letter to the Editor, Kawada [1] expressed interest in our recent paper comparing neurocognitive function between retired night shift workers and retired day workers [2]. The Letter raised important points regarding the role of night shift work in the development of cognitive impairment and dementia. We appreciate the opport...

Repetitive thinking about negative emotions or events is strongly associated with worse mental health, whereas repetitive positive thought is generally believed to be beneficial. This observation is at odds with the idea that all forms of repetitive thinking share underlying neural mechanisms. To resolve this apparent discrepancy, the present study...

Study objectives Healthy sleep is important for adolescent neurodevelopment, and relationships between brain structure and sleep can vary in strength over this maturational window. Although cortical gyrification is increasingly considered a useful index for understanding cognitive and emotional outcomes in adolescence, and sleep is also a strong pr...

Background: Although poor sleep health is associated with weight gain and obesity in the non-pregnant population, research on the impact of sleep health on weight change among pregnant people using a multidimensional sleep health framework is needed. Objectives: This secondary data analysis of the Nulliparous Pregnancy Outcome Study: Monitoring...

Background Train-the-trainer (TTT) is a promising method for implementing evidence-based psychological treatments (EBPTs) in community mental health centers (CMHCs). In TTT, expert trainers train locally embedded individuals (i.e., Generation 1 providers) to deliver an EBPT, who then train others (i.e., Generation 2 providers). The present study wi...

Study objectives: To present development considerations for online sleep diary systems that result in robust, interpretable, and reliable data; furthermore, to describe data management procedures to address common data entry errors that occur despite those considerations. Methods: The online sleep diary capture component of the Sleep Healthy Usi...

Shift workers experience poor sleep and dysregulated cardiac autonomic function during sleep. However, it is unknown if this dysregulation persists into retirement, potentially accelerating the age-associated risk for adverse cardiovascular outcomes. Using sleep deprivation as a physiological challenge to cardiovascular autonomic function, we compa...

Background Machine learning tools such as random forests provide important opportunities for modeling large, complex modern data generated in medicine. Unfortunately, when it comes to understanding why machine learning models are predictive, applied research continues to rely on ‘out of bag’ (OOB) variable importance metrics (VIMPs) that are known...

Introduction Cognitive complaints are common among older adults with insomnia. However, previous research is inconsistent regarding the association between insomnia and objective cognitive function. The purpose of this study was to compare subjective and objective cognitive function between older adults with insomnia and healthy sleepers. We hypoth...

Introduction Night shift work is associated with compromised cognitive function, and with chronic exposure, may place shift workers at elevated risk for dementia. Given that former night shift workers experienced prior long-term sleep and circadian rhythm disruption, their sleep in retirement—after returning to a daytime schedule—may be particularl...

Introduction Behavioral therapy has proved effective for insomnia in older adults. However, its efficacy has not been examined among those with nocturia (awakening to urinate) which is the most common cause of insomnia in this age group. Thus we assessed the impact of behavioral sleep treatment on sleep in older adults with nocturia. Methods Fifty...

Introduction Disrupted sleep and circadian rhythms, such as those occurring during night shift work, are established cardiovascular disease (CVD) risk factors like hypertension, obesity, and insulin resistance. However, we do not know whether the effects of shift work on CVD risk factors persist into retirement. Conversely, regularity in behavioral...

Introduction Adolescence is a critical developmental period for mental health, with the incidence of depression increasing significantly during this period. Both short sleep duration and insomnia are common and associated with depression risk. Longitudinal studies examining the relationship between sleep and depression in adolescents are scarce; th...

Introduction Nocturia (waking from sleep to urinate) is the most common cause of sleep interruption among older adults and nocturnal polyuria (NP; increased sleep time urine production) is its most common cause. Conversely, poor sleep with repeated awakenings contributes to both nocturia and NP. However, whether a behavioral intervention to reduce...

Background Train-the-trainer (TTT) is a promising method for implementing evidence-based psychological treatments (EBPTs) in community mental health centers (CMHCs). In TTT, expert trainers train locally embedded individuals (i.e., Generation 1 providers) to deliver an EBPT, who then train others (i.e., Generation 2 providers). The present study wi...

Background In pregnancy, epidemiological data have consistently shown strong associations between sleep quality and duration and maternal glycemia. However, other sleep disturbances such as difficulty falling asleep and staying asleep are common in pregnancy. They may contribute to impaired maternal glycemia through sympathetic nervous system activ...

Study Objectives Shift work is associated with compromised cognitive function, and with chronic exposure, may place shift workers at elevated risk for dementia. However, evidence of cognitive impairment among former night shift workers is mixed, possibly due to inconsistencies regarding retirement status, work history classification, and cognitive...

Later circadian timing during adolescence is linked to worse sleep, more severe depression and greater alcohol involvement, perhaps due to circadian misalignment imposed by early school schedules. School schedules shifted later during the COVID-19 pandemic, ostensibly reducing circadian misalignment and potentially mitigating problems with depressi...

Night shift work is associated with poor cardiometabolic outcomes, even post-retirement. However, the characteristics of cardiometabolic function in retired night shift workers (RNSW) compared to retired day workers (RDW) are not well-understood. Rigorous characterization of cardiometabolic dysfunction in RNSW and RDW will inform targeted risk stra...

Background Serious mental illness (SMI) can have devastating consequences. Unfortunately, many patients with SMI do not receive evidence-based psychological treatment (EBPTs) in routine practice settings. One barrier is poor “fit” between EBPTs and contexts in which they are implemented. The present study will evaluate implementation and effectiven...

Background. Machine learning tools such as random forests provide important opportunities for modeling large, complex modern data generated in medicine. Unfortunately, when it comes to understanding why machine learning models are predictive, applied research continues to rely on “out of bag” (OOB) variable importance metrics (VIMPs) that are known...

Background: Poor sleep health is associated with weight gain and obesity outside of pregnancy. Still, there is little research regarding the impact of sleep health on weight among pregnant populations, particularly using a multidimensional sleep-health framework. This study examined associations between mid-pregnancy sleep health indicators, multid...

Introduction: Consistent evidence suggests that poor sleep may impede weight loss efforts; however, the impact of poor sleep on lifestyle modification during attempted weight loss is unclear. Purpose: To examine the relationship between sleep health and measures of lifestyle modification in a sample of adults who participated in a 12-month behavior...

Introduction: Suboptimal sleep health is highly prevalent and multiple dimensions of poor sleep have been identified as obesity predictors. Prior sleep interventions have not demonstrated a convincing effect on reducing obesity but this may be due to focusing on a single sleep dimension. The Transdiagnostic Intervention for Sleep and Circadian Dysf...

Burnout is frequent among healthcare workers, and sleep problems are suspected risk factors. The sleep health framework provides a new approach to the promotion of sleep as a health benefit. The aim of this study was to assess good sleep health in a large sample of healthcare workers and to investigate its relationship with the absence of burnout a...

Background: Although poor sleep health is associated with weight gain and obesity in the non-pregnant population, research on the impact of sleep health on weight change among pregnant people using a multidimensional sleep-health framework is needed. This study examined associations among mid-pregnancy sleep health indicators, multidimensional slee...

Study objectives: Several studies have shown that patients with short sleep duration show a poor response to cognitive behavioral therapy for insomnia (CBT-I) but such studies have not included patients with comorbid conditions. The current study was conducted to determine whether pre-treatment sleep duration moderates the response of patients wit...

Objectives: To employ smart phone/ecological momentary assessment (EMA) methods to evaluate the impact of insomnia on daytime symptoms among older adults. Design: Prospective cohort study SETTING: Academic medical center PARTICIPANTS: Twenty-nine older adults with insomnia (M age = 67.5 ± 6.6 years, 69% women) and 34 healthy sleepers (M age = 70...

There are strong arguments for standardizing therapies for mental health difficulties in young people and for the development of digital therapies. At the same time, the importance of personalized treatments is also increasingly apparent. In this editorial, we discuss challenges and the continued need to find the sweet spot between standardization...

Background: Over 50% of pregnant people report poor sleep quality and insomnia, with approximately 25% reporting short sleep (less than 7 hours per night). Short sleep duration is associated with impaired glucose functioning, insulin resistance, and type 2 diabetes. Although short sleep is associated with elevated blood glucose in patients with GD...

Background Despite the high prevalence of depression and disruption to 24-h sleep-wake routines following the death of a spouse in late-life, no bereavement interventions have been developed to re-entrain a regular sleep-wake routine among older widow(er)s. We describe the rationale and methodology of the NIH-funded WELL Study (Widowed Elders' Life...

Objective Black individuals and those experiencing socioeconomic disadvantage are at increased risk for sleep problems and obesity. This study adds to the limited extant literature examining longitudinal associations between objectively measured sleep and changes in body mass index (BMI) in Black Americans. Design We focused on individuals with at...

Study objectives: Using the Ru-SATED sleep health framework, we examined the association between multidimensional sleep health and headache burden in a cohort of 98 adults with episodic migraine. Methods: Participants wore wrist actigraphs and completed twice-daily electronic diaries regarding sleep, headaches, and other health habits for six we...

Background Effective and equitable strategies to prevent youth suicidal thoughts and behaviors (STB) are an urgent public health priority. Adolescent sleep disturbances are robustly linked to STB but are rarely addressed in preventive interventions or among Black and/or Hispanic/Latinx youth for whom STB risk is increasing disproportionately. This...

Purpose: We examined whether interindividual differences in naturalistic sleep patterns correlate with any deviations from typical brain aging. Methods: Our sample consisted of 251 participants without current psychiatric diagnoses (9-25 years; mean [standard deviation] = 17.4 ± 4.52 yr; 58% female) drawn from the Neuroimaging and Pediatric Slee...

Dear Editor, Type 1 diabetes (T1D) is a form of organ failure impacting pancreatic insulin production. Without insulin, blood glucose levels become perilously high and can damage multiple organs. Exogenous insulin is lifesaving, but levels need to be constantly tweaked, and misjudgment can cause hypoglycemia, which can constitute a medical emergenc...

Obstructive sleep apnea (OSA) severely impacts sleep and has long-term health consequences. Treating sleep apnea with continuous positive airway pressure (CPAP) not only relieves obstructed breathing, but also improves sleep. CPAP improves sleep by reducing apnea-induced awakenings. CPAP may also improve sleep by enhancing features of sleep archite...

Study Objectives Using a large, nationally representative database, we aimed to estimate prevalence and trends of insomnia among pregnant women over a 12-year period. Additionally, we aimed to examine the interplay among insomnia, maternal comorbidities, and severe maternal morbidity (SMM). Methods We conducted a serial cross-sectional analysis of...

Study Objectives We examined whether homeostatic sleep drive and circadian rhythmicity differ in older adults with insomnia (OAI) compared to older good sleepers (GS) Methods OAI (n=37) and GS (n=30) participated in a 60-hour in-lab study with sleep deprivation and constant routine paradigms. Homeostatic sleep drive was assessed by examining the e...

Objective Excessive gestational weight gain (eGWG) is associated with adverse long-term maternal outcomes. Most lifestyle interventions that incorporate physical activity have been ineffective at reducing eGWG. The purpose of this study was to determine if sleep modified the relationships between physical activity change from the 2nd to 3rd trimest...

Restorative sleep is a commonly used term but a poorly defined construct. Few studies have assessed restorative sleep in nationally representative samples. We convened a panel of 7 expert physicians and researchers to evaluate and enhance available measures of restorative sleep. We then developed the revised Restorative Sleep Questionnaire (REST-Q)...

Objective Evidence regarding which activity patterns relate to depression symptoms can guide the development of approaches to prevent major depression and related consequences. While prior studies have linked activity pattern disruption and depression symptoms, little is known regarding these relationships in people who were previously exposed to t...

Objective: Behavioral risk factors for dementia tend to co-occur and inter-relate, especially poor diet, physical inactivity, sleep disturbances, and depression. Having multiple of these modifiable behavioral risk factors (MBRFs) may predict a particularly shortened cognitive healthspan, and therefore, may signal high-risk status/high intervention...