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Sleep Initiation and Maintenance Disorders: HELP
Articles by Wilfred R. Pigeon
Based on 38 articles published since 2010
(Why 38 articles?)
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Between 2010 and 2020, Wilfred Pigeon wrote the following 38 articles about Sleep Initiation and Maintenance Disorders.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Editorial Is insomnia a breathing disorder? 2012

Pigeon, Wilfred R / Sateia, Michael J. · ·Sleep · Pubmed #23204600.

ABSTRACT: -- No abstract --

2 Editorial Insomnia and the risk for suicide: does sleep medicine have interventions that can make a difference? 2010

Pigeon, Wilfred R / Caine, Eric D. · ·Sleep Med · Pubmed #20817603.

ABSTRACT: -- No abstract --

3 Review Sleep problems and suicide risk in youth: A systematic review, developmental framework, and implications for hospital treatment. 2018

Kearns, Jaclyn C / Coppersmith, Daniel D L / Santee, Angela C / Insel, Catherine / Pigeon, Wilfred R / Glenn, Catherine R. ·Department of Psychology, University of Rochester, Rochester, NY, USA. · Department of Psychology, Harvard University, Cambridge, MA, USA. · Department of Psychology, Harvard University, Cambridge, MA, USA; Center for Brain Science, Harvard University, Cambridge, MA, USA. · VISN 2 Center for Excellence at Canandaigua VA Medical Center, Canandaigua, NY, USA; Sleep and Neurophysiology Research Lab, Department of Psychiatry, University of Rochester Medical Center Rochester, NY, USA; Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY, USA. · Department of Psychology, University of Rochester, Rochester, NY, USA. Electronic address: catherine.glenn@rochester.edu. ·Gen Hosp Psychiatry · Pubmed #30301558.

ABSTRACT: OBJECTIVE: Sleep problems are transdiagnostic symptoms that confer significant risk for suicidal thoughts and behaviors (STBs) in adults. However, less is known about the sleep-STB association in adolescence-a developmental period when rates of STBs increase drastically, and sleep problems may be particularly pernicious. This article provides a systematic review of research on the sleep-STB association in youth, an overview of changes in sleep regulation during adolescence that may make sleep problems particularly detrimental for youth, and a discussion of the clinical implications of the sleep-STB association for hospitalized youth. METHOD: The systematic review included all longitudinal studies in which sleep problems were examined as prospective predictors of STBs in adolescents (aged 10-24 years). The search was conducted on December 1, 2017 using PsychINFO, PubMed, and Web of Science databases. RESULTS: Ten studies qualified for inclusion in this review. Of these, seven studies found at least one type of sleep problem significantly predicted a STB outcome. CONCLUSIONS: Although findings are mixed, growing research suggests that sleep problems may be a unique risk factor for STBs in youth. Sleep problems may be particularly important intervention target because they are easily assessed across healthcare settings and are amenable to treatment.

4 Review Insomnia as a Precipitating Factor in New Onset Mental Illness: a Systematic Review of Recent Findings. 2017

Pigeon, Wilfred R / Bishop, Todd M / Krueger, Kelsey M. ·VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, 400 Fort Hill Avenue, Canandaigua, NY, 14244, USA. wilfred.pigeon2@va.gov. · Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA. wilfred.pigeon2@va.gov. · VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, 400 Fort Hill Avenue, Canandaigua, NY, 14244, USA. · Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA. ·Curr Psychiatry Rep · Pubmed #28616860.

ABSTRACT: PURPOSE: We aimed to systematically review recent publications (01/2014-03/2017) with longitudinal designs allowing for the assessment of the prospective risk of insomnia on new onset mental illness in key conditions: anxiety, depression, bipolar disorder, posttraumatic stress disorder, substance use disorders, and suicide. RECENT FINDINGS: A literature yielded 1859 unique articles meeting search criteria were identified; 16 articles met all selection criteria and reviewed with some studies reporting on more than one mental health outcome. Overall, the review supports the hypothesis that insomnia is a predictor of subsequent mental illness. The evidence is strongest for an insomnia-depression relationship. The new studies identified and reviewed add to a modest number of publications supporting a prospective role of insomnia in new onset mental illness in three areas: anxiety disorders, bipolar disorder, and suicide. The few selected new studies focused on SUD were mixed, and no studies focused on PTSD were identified that met the selection criteria. Treatment of insomnia may also be a preventive mental health strategy.

5 Review Posttraumatic Stress Disorder and Sleep. 2015

Pigeon, Wilfred R / Gallegos, Autumn M. ·Department of Veterans Affairs VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, 400 Fort Hill Road, Canandaigua, NY 14424, USA; Sleep and Neurophysiology Research Laboratory, Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Boulevard, Rochester, NY 14642, USA; Department of Veterans Affairs Center for Integrated Healthcare, Syracuse VA Medical Center, 800 Irving Avenue, Syracuse, NY 13210, USA. Electronic address: Wilfred_Pigeon@urmc.rochester.edu. · Department of Veterans Affairs VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, 400 Fort Hill Road, Canandaigua, NY 14424, USA; Sleep and Neurophysiology Research Laboratory, Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Boulevard, Rochester, NY 14642, USA. ·Sleep Med Clin · Pubmed #26055672.

ABSTRACT: The purpose of this article is to provide a brief overview of sleep in the context of posttraumatic stress disorder (PTSD) and focus on the treatment of the most common sleep disorders encountered by patients with PTSD: insomnia and nightmares. The effects of the standard treatments for PTSD are discussed along with a review of available treatments for insomnia and nightmares. Particular emphasis is placed on nonpharmacologic treatments for these sleep disorders and how they may be adapted for delivery to patients with PTSD.

6 Review The evidence base of sleep restriction therapy for treating insomnia disorder. 2014

Miller, Christopher B / Espie, Colin A / Epstein, Dana R / Friedman, Leah / Morin, Charles M / Pigeon, Wilfred R / Spielman, Arthur J / Kyle, Simon D. ·Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Sydney Medical School, University of Sydney, Australia; Institute of Neuroscience & Psychology, University of Glasgow, UK. Electronic address: chris.miller@sydney.edu.au. · Nuffield Department of Clinical Neurosciences and Sleep & Circadian Neuroscience Institute, University of Oxford, UK. · Phoenix Veterans Affairs Health Care System, USA; Arizona State University College of Nursing and Health Innovation, USA. · Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA. · Université Laval, Québec City, Québec, Canada. · Sleep & Neurophysiology Research Lab, University of Rochester Medical Center, USA; Center of Excellence for Suicide Prevention, U.S. Department of Veterans Affairs, USA. · Cognitive Neuroscience Doctoral Program, The City College of the City University of New York, USA; Weill Cornell Medical College, Center for Sleep Medicine, NY, USA. · School of Psychological Sciences, University of Manchester, UK. ·Sleep Med Rev · Pubmed #24629826.

ABSTRACT: Sleep restriction therapy is routinely used within cognitive behavioral therapy to treat chronic insomnia. However, the efficacy for sleep restriction therapy as a standalone intervention has yet to be comprehensively reviewed. This review evaluates the evidence for the use of sleep restriction therapy in the treatment of chronic insomnia. The literature was searched using web-based databases, finding 1344 studies. Twenty-one were accessed in full (1323 were deemed irrelevant to this review). Nine were considered relevant and evaluated in relation to study design using a standardized study checklist and levels of evidence. Four trials met adequate methodological strength to examine the efficacy of therapy for chronic insomnia. Weighted effect sizes for self-reported sleep diary measures of sleep onset latency, wake time after sleep onset, and sleep efficiency were moderate-to-large after therapy. Total sleep time indicated a small improvement. Standalone sleep restriction therapy is efficacious for the treatment of chronic insomnia for sleep diary continuity variables. Studies are insufficient to evaluate the full impact on objective sleep variables. Measures of daytime functioning in response to therapy are lacking. Variability in the sleep restriction therapy implementation methods precludes any strong conclusions regarding the true impact of therapy. A future research agenda is outlined.

7 Review Meta-analysis of sleep disturbance and suicidal thoughts and behaviors. 2012

Pigeon, Wilfred R / Pinquart, Martin / Conner, Kenneth. ·Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, 400 Fort Hill Ave, Canandaigua, NY 14424, USA. Wilfred.pigeon2@va.gov ·J Clin Psychiatry · Pubmed #23059158.

ABSTRACT: OBJECTIVE: The potential association of various sleep disturbances to suicidal thoughts and behaviors is the subject of several reviews. The current meta-analysis was conducted to estimate the size of the association generally as well as between more specific relationships. DATA SOURCES: Electronic databases for years 1966-2011 were searched to identify candidate studies using PubMed search terms suicide and sleep or sleep initiation/maintenance disorders or dreams or nightmares or sleep disorders/psychology or sleep disorders/epidemiology as well as Ovid search terms suicide and sleep or insomnia or nightmares. The search was supplemented by cross-referencing from identified articles and reviews. STUDY SELECTION: Original studies reporting both sleep disturbance and suicide outcomes were identified with 39 of 98 studies (40%) comprising 147,753 subjects selected for inclusion. DATA EXTRACTION: Data were extracted by multiple independent observers and verified by a study author. The meta-analysis was performed using random-effects models. The size of associations was calculated for all types of sleep disturbances and suicide outcomes combined and for more specific categories including nightmares, insomnia, and insomnia subtypes and suicidal ideation, suicide attempts, and suicide. Moderator effects were evaluated. RESULTS: Overall, sleep disturbance was significantly associated with an increased relative risk for suicidal ideation, suicide attempt, and suicide ranging from 1.95 (95% CI, 1.41-2.69) to a relative risk of 2.95 (95% CI, 2.48-3.50) in unadjusted studies. Associations were smaller, but remained highly significant among adjusted studies. Depression did not moderate the association between sleep and suicide variables. CONCLUSIONS: This meta-analysis supports an association between sleep disturbance and suicidal thoughts and behaviors. Sleep disturbances in general, as well as insomnia and nightmares individually, appear to represent a risk factor for suicidal thoughts and behavior. This proposition is further bolstered by the result that depression did not show risk moderation.

8 Review The pathophysiology of insomnia: from models to molecules (and back). 2012

Pigeon, Wilfred R / Cribbet, Matthew R. ·Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, New York, USA. Wilfred_Pigeon@URMC.Rochester.edu ·Curr Opin Pulm Med · Pubmed #22990658.

ABSTRACT: PURPOSE OF REVIEW: To provide an overview of foundational theories on the psychosocial and neurobiological mechanisms that underlie the pathophysiology of insomnia, a review of recent findings from across the spectrum of sleep sciences that are germane to conceptualizations of insomnia, and how such findings contribute to newer integrative models. RECENT FINDINGS: Recent findings come from a broad diversity of the sleep research spectrum including basic animal science, sleep neuroscience, especially sleep-wake regulation, psychoneuroimmunology, human genetics, epidemiology, psychology, and from the clinical research realm. SUMMARY: Our review focuses on the factors contributing to insomnia and to its maintenance over time as well as the theoretical models developed (and developing) to explain this pathophysiology. Early theoretical contributions have provided a backbone for insomnia research; the sleep sciences, in turn, have supported novel and increasingly complex theoretical models of insomnia. The overarching contention is that integrative models are needed that are fully comprehensive in scope.

9 Review Diagnosis, prevalence, pathways, consequences & treatment of insomnia. 2010

Pigeon, Wilfred R. ·Sleep & Neurophysiology Research Laboratory, Department of Psychiatry, University of Rochester Medical Center, New York, USA. Wilfred_Pigeon@URMC.rochester.edu ·Indian J Med Res · Pubmed #20308757.

ABSTRACT: Insomnia is a highly prevalent sleep disorder that frequently occurs in its acute form and occurs at a rate of approximately 10 per cent in its chronic form in many countries. There is a high prevalence of insomnia in a variety of medical and psychiatric conditions for which insomnia often serves as a risk factor. The aetiology and pathophysiology of insomnia is such that several factors may predispose individuals for or precipitate and/or perpetuate the condition. Both sedative-hypnotic and cognitivebehavioural interventions exist for insomnia and each type of intervention have substantial levels of empirical support for their efficacy.

10 Article Sleep, suicide behaviors, and the protective role of sleep medicine. 2019

Bishop, Todd M / Walsh, Patrick G / Ashrafioun, Lisham / Lavigne, Jill E / Pigeon, Wilfred R. ·Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua NY, USA; Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA. Electronic address: todd.bishop@va.gov. · Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua NY, USA; Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA. · Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua NY, USA; Wegmans School of Pharmacy, St. John Fisher College, Rochester, NY, USA. ·Sleep Med · Pubmed #31727433.

ABSTRACT: OBJECTIVE/BACKGROUND: Sleep disturbance is associated with suicidal thoughts and behaviors. The relationship of specific sleep disorders to suicide attempts is less well established. Whether treating sleep disorders reduces suicide attempts remains controversial. METHODS: Suicide attempts, treatment utilization, and psychiatric diagnoses were extracted from electronic medical records and a suicide attempt database from the U.S. Department of Veterans Affairs. The sample (N = 60,102) consisted of patients with any record of suicide attempt in FY13-14 and a 1:1 case-control of patients with no record of attempt, who were propensity score-matched based on age, gender, and prior year mental health treatment utilization. Associations among sleep disorders and suicide attempt were examined via logistic regression. Covariates included depression, anxiety, posttraumatic stress disorder (PTSD), bipolar, schizophrenia, substance use disorder (SUD), medical comorbidity, and obesity. RESULTS: Insomnia (OR = 5.62; 95% CI, 5.39-5.86), nightmares (odds ratio, OR = 2.49; 95% confidence interval, CI, 2.23-2.77), and sleep-related breathing disorders (OR = 1.37; 95% CI, 1.27-1.48) were positively associated with suicide attempt after accounting for age, gender, treatment utilization, and comorbid sleep disorders. Furthermore, when controlling for depression, anxiety, PTSD, bipolar, schizophrenia, substance use disorder (SUD), medical comorbidity, and obesity, insomnia (OR = 1.51, 95% CI, 1.43-1.59) remained positively associated with suicide attempt nightmares (OR = 0.96; 95% CI, 0.85-1.09) nor sleep-related breathing disorders (OR = 0.87, 95% CI = 0.79-0.94). Additionally, sleep medicine visits 180 days prior to index date were associated with decreased likelihood of suicide attempt for individuals with sleep disorders (OR = 0.86; 95% CI, 0.79-0.94). CONCLUSION: Insomnia is associated with suicide attempt among veterans. Sleep medicine visits were associated with a reduced risk of suicide attempt in sleep disordered patients. The assessment and treatment of sleep disorders should be considered in context of strategies to augment suicide prevention efforts.

11 Article Mobile App Use for Insomnia Self-Management: Pilot Findings on Sleep Outcomes in Veterans. 2019

Reilly, Erin D / Robinson, Stephanie A / Petrakis, Beth Ann / Kuhn, Eric / Pigeon, Wilfred R / Wiener, Renda Soylemez / McInnes, D Keith / Quigley, Karen S. ·Center for Social and Community Reintegration Research, Edith Nourse Rogers Memorial VA Hospital, Bedford, MA, United States. · Center for Healthcare Outcomes and Implementation Research, Edith Nourse Rogers Memorial VA Hospital, Bedford, MA, United States. · National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States. · Stanford University School of Medicine, Standford, CA, United States. · Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, NY, United States. · University of Rochester Medical Center, Rochester, NY, United States. · Boston University School of Medicine, Boston, MA, United States. · Boston University School of Public Health, Boston, MA, United States. · Northeastern University, Boston, MA, United States. ·Interact J Med Res · Pubmed #31342904.

ABSTRACT: BACKGROUND: Sleep disturbance is a major health concern among US veterans who have served since 2001 in a combat theater in Iraq or Afghanistan. We report subjective and objective sleep results from a pilot trial assessing self-management-guided use of a mobile app (CBT-i Coach, which is based on cognitive behavioral therapy for insomnia) as an intervention for insomnia in military veterans. OBJECTIVE: The primary aim of this study was to evaluate changes in subjective and objective sleep outcomes from pre to postintervention. METHODS: Subjective outcomes included the Insomnia Severity Index, the Pittsburgh Sleep Quality Inventory, and sleep-related functional status. A wearable sleep monitor (WatchPAT) measured objective sleep outcomes, including sleep efficiency, percent rapid eye movement (REM) during sleep, sleep time, and sleep apnea. A total of 38 participants were enrolled in the study, with 18 participants being withdrawn per the protocol because of moderate or severe sleep apnea and 9 others who dropped out or withdrew. Thus, 11 participants completed the full 6-week CBT-i Coach self-management intervention (ie, completers). RESULTS: Completer results indicated significant changes in subjective sleep measures, including reduced reports of insomnia (Z=-2.68, P=.007) from pre (mean 16.63, SD 5.55) to postintervention (mean 12.82, SD 3.74), improved sleep quality (Z=-2.37, P=.02) from pre (mean 12.82, SD 4.60) to postintervention (mean 10.73, SD 3.32), and sleep-related functioning (Z=2.675, P=.007) from pre (mean 13.86, SD 3.69) to postintervention (mean 15.379, SD 2.94). Among the objective measures, unexpectedly, objective sleep time significantly decreased from pre to postintervention (χ CONCLUSIONS: These findings suggest that the CBT-i Coach app can improve subjective sleep and that incorporating objective sleep measures into future, larger clinical trials or clinical practice may yield important information, particularly by detecting previously undetected sleep apnea. TRIAL REGISTRATION: ClinicalTrials.gov NCT02392000; http://clinicaltrials.gov/ct2/show/NCT02392000.

12 Article Brief CBT for insomnia delivered in primary care to patients endorsing suicidal ideation: a proof-of-concept randomized clinical trial. 2019

Pigeon, Wilfred R / Funderburk, Jennifer S / Cross, Wendi / Bishop, Todd M / Crean, Hugh F. ·VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, NY, USA. · Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA. · Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY, USA. · Department of Psychology, Syracuse University, Syracuse, NY, USA. ·Transl Behav Med · Pubmed #31271210.

ABSTRACT: Insomnia co-occurs frequently with major depressive disorder (MDD) and posttraumatic stress disorder (PTSD); all three conditions are prevalent among primary care patients and associated with suicidal ideation (SI). The purpose of the article was to test the effects of a brief cognitive behavioral therapy for insomnia (bCBTi) and the feasibility of delivering it to primary care patients with SI and insomnia in addition to either MDD and/or PTSD. Fifty-four patients were randomized to receive either bCBTi or treatment-as-usual for MDD and/or PTSD. The primary outcome was SI intensity as measured by the Columbia-Suicide Severity Rating Scale; secondary clinical outcomes were measured by the Insomnia Severity Index, Patient Health Questionnaire for depression, and PTSD Symptom Checklist. Effect sizes controlling for baseline values and sample size were calculated for each clinical outcome comparing pre-post differences between the two conditions with Hedge's g. The effect size of bCBTi on SI intensity was small (0.26). Effects were large on insomnia (1.91) and depression (1.16) with no effect for PTSD. There was a marginally significant (p = .069) effect of insomnia severity mediating the intervention's effect on SI. Findings from this proof-of-concept trial support the feasibility of delivering bCBTi in primary care and its capacity to improve mood and sleep in patients endorsing SI. The results do not support bCBTi as a stand-alone intervention to reduce SI, but this or other insomnia interventions may be considered as components of suicide prevention strategies.

13 Article Prescription Medications for the Treatment of Insomnia and Risk of Suicide Attempt: a Comparative Safety Study. 2019

Lavigne, Jill E / Hur, Kwan / Kane, Cathleen / Au, Anthony / Bishop, Todd M / Pigeon, Wilfred R. ·Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, NY, USA. jill.lavigne@va.gov. · St John Fisher College, Wegnens School of Pharmacy, Rochester, NY, USA. jill.lavigne@va.gov. · VA Center for Medication Safety, Hines, IL, USA. · Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, NY, USA. · Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA. ·J Gen Intern Med · Pubmed #31161572.

ABSTRACT: IMPORTANCE: Guidelines for the pharmacological treatment of chronic insomnia in adults recognize that trazodone and other off-label medications are commonly prescribed despite poor evidence. The Department of Veterans Health Affairs (VA) fills high volumes of inexpensive, over-the-counter sedating antihistamines and older antidepressants in addition to benzodiazepines and zolpidem. Yet little is known about the comparative safety of these agents with regard to suicidal behavior. OBJECTIVES: To assess the comparative effectiveness of the safety of medications routinely used to treat insomnia in VA. DESIGN: Comparative effectiveness using propensity score-matched samples. SETTING: VA. PARTICIPANTS: VA patients without any history of suicidal ideation or behavior 12 months prior to first exposure. EXPOSURES: VA formularies and data were used to identify prescriptions for insomnia. Agents accounting for at least 1% of total insomnia fill volume were < 200 mg trazodone, hydroxyzine, diphenhydramine, zolpidem, lorazepam, diazepam, and temazepam. Exposure was defined as an incident monotherapy exposure preceded by 12 months without any insomnia medications. Subjects with insomnia polypharmacy or cross-overs in the 12 months following first exposure were excluded. MAIN OUTCOMES AND MEASURES: Suicide attempts within 12 months of first exposure. RESULTS: Three hundred forty-eight thousand four hundred forty-nine subjects met criteria and three well-balanced cohorts by drug class matched to zolpidem were created. After adjusting for days' supply, mental health history, and pain and central nervous system medication history, hazard ratios (compared to zolpidem) were as follows: (< 200 mg) trazodone (HR = 1.61, 95% CI 1.07-2.43); sedating antihistamines (HR = 1.37, 95% CI 0.90-2.07); and benzodiazepines (HR = 1.31, 95% CI 0.85-2.08). CONCLUSIONS AND RELEVANCE: Compared to zolpidem, hazard of suicide attempt was 61% higher with trazodone (< 200 mg). No significant differences in suicide attempt risk were identified between benzodiazepines or sedating antihistamines and zolpidem, respectively. These findings provide the first comparative effectiveness evidence against the use of trazodone for insomnia.

14 Article Sleep and Interpersonal Violence: A Systematic Review. 2019

Gallegos, Autumn M / Trabold, Nicole / Cerulli, Catherine / Pigeon, Wilfred R. ·1 Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA. · 2 College of Health Science and Technology, Rochester Institute of Technology, Rochester, NY, USA. · 3 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, NY, USA. ·Trauma Violence Abuse · Pubmed #31131736.

ABSTRACT: Sleep disturbance is a significant public health issue that disproportionately affects survivors of interpersonal violence (IPV). This systematic review presents data on the relationship of IPV and sleep. Inclusion criteria for this review were studies that included subjects 18 years of age or older, used an IPV measure and sleep disturbance measure, and were published in a peer-reviewed journal in English. A total of 23 articles met full inclusion criteria and were included in the present review. Studies were largely cross sectional, were conducted in a wide range of clinical and nonclinical samples, and utilized a variety of measures to assess IPV (sexual violence, physical violence, or psychological aggression perpetrated by an intimate partner or sexual or physical violence by any perpetrator in childhood or adulthood) and sleep disturbances (both general sleep disturbance excluding specific sleep disorders and the two specific sleep disorders of insomnia and nightmares). The findings examined the prevalence and association of sleep disturbance in IPV samples from population and community studies, the prevalence and association of sleep disturbance in IPV studies, and the associations between post-traumatic stress disorder and sleep disturbance in IPV samples. All studies identified a relationship between IPV and sleep disturbance. The results of this review provide important information for clinicians, researchers, and policy makers on the prevalence of and relationship between IPV and sleep disturbance.

15 Article Suicidal ideation among recently returned veterans and its relationship to insomnia and depression. 2019

Bishop, Todd M / Crean, Hugh F / Hoff, Rani A / Pigeon, Wilfred R. ·VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, NY, United States; Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States. Electronic address: todd.bishop@va.gov. · VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, NY, United States; Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States. · Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; VISN 1 MIRECC, VA Connecticut Healthcare System, West Haven, CT, United States. ·Psychiatry Res · Pubmed #31125902.

ABSTRACT: Suicide is a significant public health problem associated with numerous health factors such as insomnia. Suicidal ideation is common among veterans, who often present with multiple comorbidities. The present study examined direct and indirect relationships among suicidal ideation, insomnia, depression, and alcohol use. U.S. veterans (n = 850) recently separated from military service completed phone-based interviews covering multiple domains. Tests of indirect effects and bias-corrected confidence intervals were used to conduct a cross-sectional analysis of baseline data from a larger parent study examining relationships among the latent variables of suicidal ideation, insomnia, alcohol use, and depression. In this analysis insomnia did not have direct associations with suicidal ideation (Β = 0.06, t = 0.29, p = .772) or alcohol use (Β = 0.07, t = 1.73, p = .084). Insomnia severity was, however, significantly and positively related to depression severity (Β = 0.58, t = 21.70, p < .001). Additionally, more severe depression was associated with greater intensity of suicidal ideation (Β = 0.59, t = 3.64, p < .001). Notably, insomnia's indirect effect on suicidal ideation was driven by depression. In this sample of returning veterans, insomnia appears to indirectly impact suicidal ideation through its relationship with depression. This finding suggests the potential utility of addressing insomnia as part of an overall approach to reducing depressive symptomatology and indirectly, suicidal ideation.

16 Article Cognitive Behavioral Therapy for Insomnia Reduces Depression in Cancer Survivors. 2019

Peoples, Anita R / Garland, Sheila N / Pigeon, Wilfred R / Perlis, Michael L / Wolf, Julie Rya / Heffner, Kathi L / Mustian, Karen M / Heckler, Charles E / Peppone, Luke J / Kamen, Charles S / Morrow, Gary R / Roscoe, Joseph A. ·Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, New York. · Departments of Psychology and Oncology, Memorial University, Newfoundland, Canada. · Departments of Psychiatry and Public Health Sciences, University of Rochester Medical Center, Rochester, New York. · Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania. · Departments of Dermatology and Radiation Oncology, University of Rochester Medical Center, Rochester, New York. · School of Nursing and Department of Psychiatry, University of Rochester Medical Center, Rochester, New York. · Department of Surgery, University of Rochester Medical Center, Rochester, New York. ·J Clin Sleep Med · Pubmed #30621831.

ABSTRACT: STUDY OBJECTIVES: The current archival analyses examine the direct and indirect effects of cognitive behavioral therapy for insomnia (CBT-I) on depression in cancer survivors. METHODS: We report on 67 cancer survivors from a 2 × 2 randomized controlled trial of CBT-I and armodafinil for insomnia, after collapsing across the noneffective study medication conditions (armodafinil/placebo) to create CBT-I (yes/no). Depression and insomnia were assessed before, during the 7-week CBT-I intervention, at postintervention, and 3 months later by the Patient Health Questionnaire and the Insomnia Severity Index, respectively. RESULTS: Mean depression at baseline for all participants was 6.44 (standard error = 0.41, range 0-15). Paired CONCLUSIONS: Our findings provide preliminary support that in cancer survivors, CBT-I reduces depression via improvement in insomnia. Further, this reduction in depression remained stable 3 months after completing CBT-I. This suggests that a CBT-I intervention has a meaningful effect on depression. CLINICAL TRIAL REGISTRATION: Registry: ClinicalTrials.gov; Title: Cognitive Behavioral Therapy +/- Armodafinil for Insomnia and Fatigue Following Chemotherapy; Identifier: NCT01091974; URL: https://clinicaltrials.gov/ct2/show/record/NCT01091974.

17 Article Insomnia and risk for suicidal behavior: A test of a mechanistic transdiagnostic model in veterans. 2019

Britton, Peter C / McKinney, Jessica M / Bishop, Todd M / Pigeon, Wilfred R / Hirsch, Jameson K. ·VISN 2 Center of Excellence for Suicide Prevention, Department of Veteran Affairs Medical Center, Canandaigua, NY, United States; Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States. Electronic address: peter.britton@va.gov. · East Tennessee State University, Johnson City, TN, United States. · VISN 2 Center of Excellence for Suicide Prevention, Department of Veteran Affairs Medical Center, Canandaigua, NY, United States; Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States. ·J Affect Disord · Pubmed #30423469.

ABSTRACT: BACKGROUND: Insomnia has been shown to have direct and indirect associations with suicidal ideation, attempts, and death in U.S. military and veteran populations. However, transdiagnostic models of insomnia and psychopathology have not been used to examine the contribution of psychopathology. METHOD: The present study is a secondary analysis examining the associations among insomnia symptoms, posttraumatic stress disorder (PTSD) and depressive symptoms, interpersonal theory of suicide variables, and risk for suicidal behavior in community veterans (n = 392). Serial mediation was used to test sequential associations, allowing for examination of direct and indirect associations. RESULTS: The model with insomnia, PTSD, and depressive symptoms, and thwarted belongingness, accounted for 29% of the variance in risk. Insomnia symptoms had an indirect association through PTSD and depressive symptoms, and thwarted belongingness. The model with insomnia, PTSD, and depressive symptoms, and perceived burdensomeness accounted for 35% of the variance in risk. Insomnia symptoms had an indirect association through PTSD and depressive symptoms, and perceived burdensomeness. LIMITATIONS: Data are cross-sectional, precluding the testing of causal associations. CONCLUSIONS: In veterans, insomnia symptoms may be associated with increased PTSD and depressive symptoms, which may be associated with increased risk for suicidal behavior directly and indirectly through relationship disruptions.

18 Article Clinical Pain-related Outcomes and Inflammatory Cytokine Response to Pain Following Insomnia Improvement in Adults With Knee Osteoarthritis. 2018

Heffner, Kathi L / France, Christopher R / Ashrafioun, Lisham / Quiñones, Maria / Walsh, Patrick / Maloney, Michael D / Giordano, Brian D / Pigeon, Wilfred R. ·University of Rochester Medical Center, Rochester. · Department of Psychology, Ohio University, Athens, OH. · Department of Veterans Affairs, VA Center of Excellence in Suicide Prevention, Canandaigua, NY. ·Clin J Pain · Pubmed #30134281.

ABSTRACT: OBJECTIVES: Clinical insomnia is known to affect pain, but mechanisms are unclear. Insomnia can dysregulate inflammatory pathway, and inflammation plays a mediating role in pain. It is unclear whether insomnia-related alterations in inflammation can be modified with insomnia improvement, and if such alterations parallel improvement in pain. The current study objective was to provide proof of concept for the role of insomnia in inflammation and pain by testing whether improving insomnia would reduce pain and related physical function, and, concurrently, modulate inflammatory responses. MATERIALS AND METHODS: Thirty adults with osteoarthritis knee pain and insomnia (Insomnia Severity Index >10) provided baseline measures of osteoarthritis and laboratory pain, and serial blood samples for inflammatory biomarkers, interleukin 6, and tumor necrosis factor α, before and after pain testing. To manipulate insomnia, participants were randomly assigned to a 6-week cognitive-behavioral therapy for insomnia (n=16); or wait-list control (n=14). At 8-weeks (time 2), all measures were repeated. To directly test insomnia improvement effects, participants were grouped by insomnia status at time 2 after confirming baseline equivalency on all outcomes. RESULTS: Compared with those maintaining insomnia at time 2 (Insomnia Severity Index ≥8; n=18), those whose insomnia improved at time 2 (n=12) had significantly improved physical functioning, decline in knee pain during transfer activities, and attenuated increase in interleukin 6 and less decrease in tumor necrosis factor α across the pain testing session. DISCUSSION: These findings suggest further exploration of inflammatory pathways linking clinical insomnia, and its improvement, to chronic pain.

19 Article The sleep and sex survey: Relationships between sexual function and sleep. 2018

Seehuus, Martin / Pigeon, Wilfred. ·Middlebury College, Department of Psychology, United States; University of Rochester Medical Center, Department of Psychiatry, United States; University of Vermont, Department of Psychology, United States. Electronic address: mseehuus@middlebury.edu. · University of Rochester Medical Center, Department of Psychiatry, United States; Veterans Administration, VISN 2 Center of Excellence for Suicide Prevention, United States. ·J Psychosom Res · Pubmed #30097137.

ABSTRACT: OBJECTIVE: Distress and dysfunction in sleep and sex are both very common, and have been found to be separately related to anxiety, depression, and stress. Even so, and despite evidence linking obstructive sleep apnea and erectile disfunction, the connections between sleep and sex are largely understudied. METHOD: A large (N = 703) survey of people in the United States between 18 and 65 years old was conducted using Mechanical Turk, an on-line crowd-sourcing platform. Approximately 30% of participants were Black, Hispanic, Asian, or Native American, 8% identified as lesbian, gay or bisexual, and the sampling structure ensured an even gender distribution in each of 5 age strata. The Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), International Index of Erectile Function (IIEF), and Female Sexual Function Index (FSFI) assessed sleep and sexual dysfunction; the Perceived Stress Scale (PSS), Patient Health Questionnaire (PHQ-9), and General Anxiety Disorder scale (GAD-7) measured stress, depression, and anxiety to measure variance. RESULTS: We found a significant connection between insomnia severity and sexual function. The relationship remained significant after accounting for the shared variability associated with depressive and anxious symptoms, and perceived stress. CONCLUSION: Given this relationship, clinicians observing dysfunction in one area should routinely assess for dysfunction in the other. Further research will be required to determine (a) if treatment of one has an effect on the other, and (b) if this connection is related to a common psychopathological factor and/or is a conditioned association related to the commonly shared context of bed.

20 Article Insomnia, Posttraumatic Stress Disorder Symptoms, and Danger: Their Impact on Victims' Return to Court for Orders of Protection. 2018

Mazzotta, Catherine M / Crean, Hugh F / Pigeon, Wilfred R / Cerulli, Catherine. ·1 State University of New York at Buffalo, USA. · 2 University of Rochester, NY, USA. ·J Interpers Violence · Pubmed #29589520.

ABSTRACT: The linkages between intimate partner violence (IPV), posttraumatic stress disorder (PTSD), and insomnia have been the subject of inquiry. This study is the first to explore the associations between clinical-level insomnia, PTSD symptoms, danger, and victim socio-demographics, and whether IPV victims pursue permanent orders of protection (OPs). Data for this secondary analysis were collected through surveys, interviews, and reviews of court records on 112 women who resided in upstate New York. Women initiated actions to obtain OPs from the Domestic Violence Intensive Intervention Court (DVIIC), from 2007 to 2008. The following factors were analyzed to determine their impact on whether a woman returned to court: (a) age, (b) race, (c) employment status, (d) perceived danger, (e) PTSD symptoms, and (f) clinical-level insomnia. This study finds that the following factors significantly relate to return to court: race, clinical-level insomnia and perceived danger, clinical-level insomnia and PTSD symptoms, and severe danger level. However, in the final multivariate logistic regression, only race emerged as a predictor of whether a woman returned to court. Specifically, women of color were a third less likely to return to court than White women. These results have significant implications for future research and clinical intervention.

21 Article A Secondary Analysis of Sleep Quality Changes in Older Adults From a Randomized Trial of an MBSR Program. 2018

Gallegos, Autumn M / Moynihan, Jan / Pigeon, Wilfred R. ·1 University of Rochester Medical Center, NY, USA. · 2 Canandaigua VA Medical Center, NY, USA. ·J Appl Gerontol · Pubmed #27511921.

ABSTRACT: This secondary analysis examined changes in sleep quality associated with participation in a Mindfulness-Based Stress Reduction (MBSR) program among healthy older adults. Data were collected at baseline, 8-weeks post-treatment, and a 6-month follow-up from adults aged ≥ 65 ( N = 200), randomly assigned to MBSR or a waitlist control. Group differences were examined using mixed analysis of covariance with repeated measures on the total Pittsburgh Sleep Quality Index (PSQI) score. A small-sized, significant effect was found on overall sleep among MBSR participants with baseline PSQI scores > 5, indicative of a sleep disturbance, F(2, 80) = 4.32, p = .02, η

22 Article The natural history of sleep disturbance among OEF/OIF veterans with TBI and PTSD and the role of proxy variables in its measurement. 2017

King, Paul R / Donnelly, Kerry T / Warner, Gary / Wade, Michael / Pigeon, Wilfred R. ·Center for Integrated Healthcare, VA Western New York Healthcare System, Buffalo, NY, United States; Department of Counseling, School, and Educational Psychology, University at Buffalo, State University of New York, Buffalo, NY, United States. Electronic address: Paul.King2@va.gov. · Department of Counseling, School, and Educational Psychology, University at Buffalo, State University of New York, Buffalo, NY, United States; Behavioral Health Careline, VA Western New York Healthcare System, Buffalo, NY, United States. Electronic address: Kerry.Donnelly@va.gov. · Behavioral Health Careline, Canandaigua VA Medical Center, Canandaigua, NY, United States. Electronic address: Gary.Warner@va.gov. · Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY, United States. Electronic address: Michael.Wade@va.gov. · VA Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, NY, United States; Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States. Electronic address: Wilfred.Pigeon2@va.gov. ·J Psychosom Res · Pubmed #28545794.

ABSTRACT: OBJECTIVE: Sleep disturbance crosscuts post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI). Though previous cross-sectional findings demonstrate a compounding effect of PTSD and TBI comorbidity, relatively little is known about the longitudinal trajectory of sleep-related complaints in veterans with TBI history and current PTSD symptoms. In this study, we explored patterns and predictors of sleep complaints in a sample of combat veterans with and without TBI and PTSD. METHODS: Secondary analysis of data gathered during a longitudinal study of U.S. veterans of Operations Enduring and Iraqi Freedom (OEF/OIF) with and without TBI. Data from a subsample of 291 participants with sleep self-report data were analyzed using multinomial logistic regression logit testing and linear mixed models. RESULTS: Over an 18-month period, we observed an average 23-28% reduction in sleep symptoms in our sample as measured by two proxy scales, with the bulk of change (12-14% overall reduction) detected at the first six-month follow-up assessment. TBI history emerged, overall, as the most prominent predictor of worse general sleep symptoms, though baseline PTSD and pain status also demonstrated an association with worse sleep symptoms. CONCLUSION: Whereas changes in PTSD symptoms over time were associated with worsening sleep symptoms, improvement in sleep reports was most consistently predicted by the passage of time. Our data also provide preliminary support for using three-to-four core items (i.e., trouble sleeping, changes in sleep, fatigue, and nightmares) to screen for sleep complaints in veterans with TBI and PTSD and/or track sleep-related outcomes.

23 Article Brief cognitive behavioral therapy for insomnia delivered to depressed veterans receiving primary care services: A pilot study. 2017

Pigeon, Wilfred R / Funderburk, Jennifer / Bishop, Todd M / Crean, Hugh F. ·Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, USA; Center for Integrated Healthcare, Syracuse VA Medical Center, USA; University of Rochester Medical Center, Department of Psychiatry, USA. Electronic address: Wilfred.Pigeon2@va.gov. · Center for Integrated Healthcare, Syracuse VA Medical Center, USA; University of Rochester Medical Center, Department of Psychiatry, USA; Syracuse University, USA. · Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, USA; Center for Integrated Healthcare, Syracuse VA Medical Center, USA; University of Rochester Medical Center, Department of Psychiatry, USA. · Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, USA; University of Rochester School of Nursing, USA. ·J Affect Disord · Pubmed #28395207.

ABSTRACT: BACKGROUND: Depression and insomnia are treatable, often co-occur and are common among primary care patients. Treatments designed for primary care must be brief, effective and ideally have the potential to address multiple symptoms. A brief form of cognitive behavioral therapy for insomnia (CBT-I) was piloted among depressed primary care patients with insomnia some of whom endorsed suicidal ideation. METHODS: Veterans Affairs primary care patients were randomized to either CBT-I or sleep hygiene. CBT-I consisted of two, 20-40min in-person sessions and two 15-20min telephone sessions; SH consisted of one in-person and one telephone session. Participants were assessed at baseline, post-treatment, and a 3 month follow-up. RESULTS: Compared to SH (n=14), brief CBT-I (n=13) had large effects on insomnia severity, sleep efficiency, number of awakenings, and time awake after sleep onset with between group effect sizes ranging from .75 to 1.09 at post-treatment and .66-.89 at follow-up, though significance was not maintained at follow-up. Although both groups experienced significant reductions in depression severity, statistically significant group by time interactions were not observed for depression. LIMITATIONS: Notable limitations include the small sample size, having excluded patients with the most severe suicide risk, and the absence of objective testing to detect presence of sleep disorders other than insomnia. CONCLUSIONS: The effects observed for insomnia outcomes, corroborate support for using CBT-I in depressed patients and extend this support to a brief from of CBT-I structured for delivery in primary care. Whether a brief form of CBT-I delivered to patients in primary care who endorse suicidal ideation would have a significant effect on depressive symptoms and/or suicidal ideation remains to be tested in a fully powered trial.

24 Article Insomnia and suicidal ideation and behaviors in former and current U.S. service members: Does depression mediate the relations? 2017

Allan, Nicholas P / Conner, Kenneth R / Pigeon, Wilfred R / Gros, Daniel F / Salami, Temilola K / Stecker, Tracy. ·Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA; Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA; Department of Psychology, Ohio University, Athens, OH, USA. Electronic address: allan@ohio.edu. · Departments of Emergency Medicine and Psychiatry, University of Rochester Medical Center, Rochester, NY, USA. · Center of Excellence for Suicide Prevention, Canandaigua Veterans Affairs Medical Center, Canandaigua, NY, USA; Departments of Emergency Psychiatry and Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA. · Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA; Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA. · Department of Psychology, University of Georgia, Athens, GA, USA. ·Psychiatry Res · Pubmed #28301827.

ABSTRACT: Insomnia is a risk factor for Suicidal Ideation (SI) and Behavior (SB), yet the nature of the relations is unclear, including the potential mediating role of cognitive and affective/somatic symptoms of depression. It was hypothesized that the impact of insomnia on SI would be mediated through depressive symptoms and that insomnia would directly impact SB. Current and former military service members (N =405; M age =31.6 years, SD =7.3; 90.4% male, 76.5% White) who endorsed recent suicidal ideation and/or a history of suicide attempt completed measures of insomnia, depression, SI, and SB at baseline and at month 12 follow-up. Mediation models were conducted using structural equation modeling. Significant mediation from insomnia to baseline SI and month 12 SI was found through cognitive/affective depression. Insomnia was directly related to SB occurring between baseline and month 12 follow-up. These findings suggest that cognitive/affective depression mediates the association with SI but not SB. Results build on research showing the importance of depressive symptoms in SI in particular. The direct and indirect pathways from insomnia to SI/SB suggest that clinicians should be aware of these relations when treating patients reporting insomnia.

25 Article Sleep and Suicide in Older Adults: An Opportunity for Intervention. 2016

Bishop, Todd M / Simons, Kelsey V / King, Deborah A / Pigeon, Wilfred R. ·VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, New York; Department of Psychiatry, University of Rochester Medical Center, Rochester, New York. ·Clin Ther · Pubmed #27751672.

ABSTRACT: Whether as a standalone disorder or as a symptom associated with existing pathology, the prevalence of sleep disturbance increases with age. Older adults also experience a myriad of risk factors for suicide, including depression, and have elevated rates of suicide. There is now significant evidence linking sleep disturbances to suicidal thoughts and behaviors. The use of pharmacologic means to treat insomnia (e.g., sedative hypnotics) is also commonplace among older cohorts and has been associated with suicide. Behavioral treatment of insomnia represents an efficacious alternative to pharmacotherapy among older adults, which while improving sleep, may concurrently reduce depressive symptomatology. Implications and clinical recommendations of the sleep-suicide relationship are discussed.

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