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Rise and shine: A treatment experiment testing a morning routine to decrease subjective sleep inertia in insomnia and
Katherine A Kaplan1, David C Talavera2, Allison G Harvey3
1Department of Psychiatry, Stanford University School of Medicine, USA.
Behaviour Research and Therapy
|November 7, 2018
Summary
Adding a morning routine to Cognitive Behavioral Therapy for Insomnia (CBTI) significantly reduced sleep inertia symptoms in individuals with bipolar disorder. This intervention improved morning functioning and was well-received by participants.
Area of Science:
- Sleep Medicine
- Psychiatry
- Behavioral Science
Background:
- Sleep inertia, characterized by post-waking impairment, is prevalent in insomnia and can hinder treatment efficacy.
- Current Cognitive Behavioral Therapy for Insomnia (CBTI) protocols often lack specific strategies to manage sleep inertia.
- Comorbidity of insomnia with bipolar disorder presents unique challenges, potentially exacerbating sleep inertia.
Purpose of the Study:
- To evaluate the efficacy of the RISE-UP routine, a novel component addressing sleep inertia, integrated into CBTI for insomnia in bipolar disorder patients.
- To test the hypothesis that the RISE-UP routine increases morning physical activity and reduces sleep inertia duration and severity.
Main Methods:
- A randomized controlled trial comparing a modified CBTI with the RISE-UP routine against a psychoeducation (PE) control group.
- Sleep inertia and sleep patterns were assessed pre- and post-intervention using daily sleep diaries, actigraphy, and ecological momentary assessment (EMA).
- Participants (N=40) with insomnia comorbid with bipolar disorder were randomized to either CBTI-BP with RISE-UP or PE.
Main Results:
- The RISE-UP routine significantly reduced both the duration and severity of self-reported sleep inertia, confirmed by diary and EMA data.
- Objective increases in morning physical activity levels were verified through actigraphy in the RISE-UP group.
- The RISE-UP intervention was rated as acceptable and credible by participants, with high compliance observed.
Conclusions:
- Integrating behavioral modifications for morning sleep inertia, such as the RISE-UP routine, is a viable and effective addition to CBTI.
- This approach shows promise for improving morning functioning and treatment adherence in individuals with insomnia and comorbid bipolar disorder.
- Addressing sleep inertia directly can enhance the overall effectiveness of insomnia treatments.
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