Insomnia or poor sleep is said to affect from 15-30% of the general population and predominantly midlife women, leading to substantial use and misuse of hypnotics. Inadequate sleep impairs daytime function, may be an early sign of some psychiatric disorders, and contributes to cardiovascular disease and premature mortality. Studies of the objective sleep patterns of insomniacs have shown that some people have definite sleep changes and others do not but assessment over short times and in an unnatural environment (the laboratory) may lead to false assumptions about the extent or type of insomnia exhibited. Excessive stress arousal and learned behaviors incompatible with good sleep are believed to be major contributing factors to insomnia. Preliminary studies have shown that insomniac women with and without objective sleep disturbances based on one night of assessment have higher psychological distress and evidence of somatic stress arousal than women who are good sleepers. Refined assessment of general stress arousal and stress reactivity to a challenge situation in relation to objective sleep patterns is proposed. Supportive results would guide therapeutic prescriptions and reveal assessment indicators based on stress responses.
The specific aims of this proposal are to: 1) validate insomnia subtypes with and without objective sleep disturbances by monitoring over longer times at home, 2) test for negative environmental conditioning as a contributing factor to insomnia, 3) compare insomnia subtypes on stress response indicators, 4) examine the relationships among stress response indicators, psychological distress, stress exposure, and coping strategies as contributing factors to insomnia with objective sleep disturbances, and 5) begin testing 2 therapies tailored for 2 of the subtypes of insomnia. The purposes of this study are to assess objective sleep patterns over 6 nights at home, determine the effect of removing women with insomnia to the laboratory for one night of sleep, and assess for general stress arousal and reaction to laboratory stress application as a basis of determining subtypes. A preliminary test of 2 therapies for insomnia, environmental conditioning and stress self-management, as applied to subtypes based on assessment will be done.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR001118-10
Application #
2256646
Study Section
Nursing Research Study Section (NURS)
Program Officer
Helmers, Karin F
Project Start
1984-06-01
Project End
1996-07-31
Budget Start
1995-03-01
Budget End
1996-07-31
Support Year
10
Fiscal Year
1995
Total Cost
Indirect Cost
Name
University of Washington
Department
Other Health Professions
Type
Schools of Nursing
DUNS #
135646524
City
Seattle
State
WA
Country
United States
Zip Code
98195
Landis, Carol A (2011) Sleep, pain, fibromyalgia, and chronic fatigue syndrome. Handb Clin Neurol 98:613-37
Landis, Carol A; Lentz, Martha J; Tsuji, Joyce et al. (2004) Pain, psychological variables, sleep quality, and natural killer cell activity in midlife women with and without fibromyalgia. Brain Behav Immun 18:304-13
Cheek, Rita E; Shaver, Joan L F; Lentz, Martha J (2004) Variations in sleep hygiene practices of women with and without insomnia. Res Nurs Health 27:225-36
Thomas, Karen A; Burr, Robert; Wang, Shu-Yuann et al. (2004) Axillary and thoracic skin temperatures poorly comparable to core body temperature circadian rhythm: results from 2 adult populations. Biol Res Nurs 5:187-94
Landis, Carol A; Lentz, Martha J; Rothermel, James et al. (2004) Decreased sleep spindles and spindle activity in midlife women with fibromyalgia and pain. Sleep 27:741-50
Cheek, Rita E; Shaver, Joan L; Lentz, Martha J (2004) Lifestyle practices and nocturnal sleep in midlife women with and without insomnia. Biol Res Nurs 6:46-58
Landis, Carol A (2002) Sleep and methods of assessment. Nurs Clin North Am 37:583-97
Landis, C A; Lentz, M J; Rothermel, J et al. (2001) Decreased nocturnal levels of prolactin and growth hormone in women with fibromyalgia. J Clin Endocrinol Metab 86:1672-8
Johnston, S K; Landis, C A; Lentz, M J et al. (2001) Self-reported nap behavior and polysomnography at home in midlife women with and without insomnia. Sleep 24:913-9
Lentz, M J; Landis, C A; Rothermel, J et al. (1999) Effects of selective slow wave sleep disruption on musculoskeletal pain and fatigue in middle aged women. J Rheumatol 26:1586-92

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