Altering misperception of sleep in insomnia: Behavioral experiment versus verbal feedback

Department of Psychology, University of California, Berkeley, Berkeley, California, United States
Journal of Consulting and Clinical Psychology (Impact Factor: 4.85). 09/2006; 74(4):767-76. DOI: 10.1037/0022-006X.74.4.767
Source: PubMed


Forty-eight individuals with insomnia were asked to wear an actigraph and keep a sleep diary for 2 nights. On the following day, half were shown the discrepancy between the data recorded on the actigraph and their sleep diary via a behavioral experiment, whereas the other half were told of the discrepancy verbally. Participants were then asked to monitor their sleep for 2 further nights to index the effect of these interventions. Although both reduced sleep misperception, the behavioral experiment (effect size: 0.79 to 1.25) led to greater reduction in self-reported sleep impairment, insomnia symptoms, and sleep-related anxiety and distress compared with verbal feedback (effect size: -0.06 to 0.31). Further, the patients regarded the behavioral experiment as a more beneficial and acceptable intervention strategy than verbal feedback.

Download full-text


Available from: Nicole K Y Tang
  • Source
    • "Bipolar patients may be prone to misperceive sleep for wakefulness [3,32]. There will also be a focus on challenging and correcting sleep state misperception using cognitive and behavioral techniques [33]. Circadian rhythm is likely to be disturbed in the included patients, so there will be particular emphasis on stabilization of the circadian rhythm. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Patients with bipolar disorder experience sleep disturbance, even in euthymic phases. Changes in sleep pattern are frequent signs of a new episode of (hypo)mania or depression. Cognitive behavioral therapy for insomnia (CBT-I) is an effective treatment for primary insomnia, but there are no published results on the effects of CBT-I in patients with bipolar disorder. In this randomized controlled trial, we wish to compare CBT-I and treatment as usual with treatment as usual alone to determine its effect in improving quality of sleep, stabilizing minor mood variations and preventing new mood episodes in euthymic patients with bipolar disorder and comorbid insomnia. Patients with euthymic bipolar I or II disorder and insomnia, as verified by the Structured Clinical Interview for DSM Disorders (SCID-1) assessment, will be included. The patients enter a three-week run-in phase in which they complete a sleep diary and a mood diary, are monitored for seven consecutive days with an actigraph and on two of these nights with polysomnography in addition before randomization to an eight-week treatment trial. Treatment as usual consists of pharmacological and supportive psychosocial treatment. In this trial, CBT-I will consist of sleep restriction, psychoeducation about sleep, stabilization of the circadian rhythm, and challenging and correcting sleep state misperception, in three to eight sessions. This trial could document a new treatment for insomnia in bipolar disorder with possible effects on sleep and on stability of mood. In addition, more precise information can be obtained about the character of sleep disturbance in bipolar disorder.Trial registration: NCT01704352.
    Full-text · Article · Jan 2014 · Trials
  • Source
    • "For some individuals, certain medical or psychiatric treatment may be undertaken to improve sleep, and a home monitor may provide an adjunctive outcome measure in parallel with subjective response. There is even data to suggest that simply providing feedback to individuals with sleep problems, through objective sleep measurements, can improve subjective sleep complaints [36]. Finally, from a research and progress standpoint, having the capacity to add objective sleep measurements holds promise for improving the ability to phenotype sleep disorders such as insomnia that currently have purely subjective criteria. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Improving our understanding of sleep physiology and pathophysiology is an important goal for both medical and general wellness reasons. Although the gold standard for assessing sleep remains the laboratory polysomnogram, there is an increasing interest in portable monitoring devices that provide the opportunity for assessing sleep in real-world environments such as the home. Portable devices allow repeated measurements, evaluation of temporal patterns, and self-experimentation. We review recent developments in devices designed to monitor sleep-wake activity, as well as monitors designed for other purposes that could in principle be applied in the field of sleep (such as cardiac or respiratory sensing). As the body of supporting validation data grows, these devices hold promise for a variety of health and wellness goals. From a clinical and research standpoint, the capacity to obtain longitudinal sleep-wake data may improve disease phenotyping, individualized treatment decisions, and individualized health optimization. From a wellness standpoint, commercially available devices may allow individuals to track their own sleep with the goal of finding patterns and correlations with modifiable behaviors such as exercise, diet, and sleep aids.
    Preview · Article · Oct 2012
  • Source
    • "Two early studies found no difference in the efficacy of interventions that correspond to TRs and BEs (Jarrett & Nelson, 1987; O'Donohue & Szymanski, 1993). In contrast, more recent studies have suggested an advantage of BEs over TRs (Bennett-Levy, 2003; Tang & Harvey, 2006). There are a number of possible reasons for these inconsistent findings. "
    [Show abstract] [Hide abstract]
    ABSTRACT: While the efficacy and effectiveness of CBT protocols are well established, much less is known about the comparative contribution of the various techniques within CBT. The present study examined the relative efficacy, in comparison to a control condition, of two central techniques in CBT: thought records (TRs) and behavioral experiments (BEs). A mixed within and between participants design was used to compare the efficacy of a single session TR and a single session BE intervention with a control intervention, in a non-clinical sample. Ninety one participants were randomly allocated to one of the three conditions. The overall pattern of results suggests that both TR and BE had a beneficial therapeutic impact in comparison to the control condition on beliefs, anxiety, behavior and a standardized measure of symptoms. There was evidence of a small advantage of the BE over the TR intervention in that the target belief changed earlier and change generalized to beliefs about others as well as the self. The findings confirm the utility of both TR and BE interventions and point to BEs as more useful in effecting belief change in that the change in the BE condition occurred sooner and generalized further.
    Full-text · Article · Jul 2011 · Journal of Behavior Therapy and Experimental Psychiatry
Show more