Parasomnias are unwanted events during sleep. These refer to sleep terrors, sleepwalking, sleep eating, nightmares, and movement during REM sleep. There are few systematic behavioral treatments for these problems and individuals with them often receive little education about self-management. This research examines and evaluates the effectiveness of a 4 week online course providing education and guidance about managing parasomnias. The primary outcomes are improvement in parasomnia frequency and distress. The secondary outcomes are improvements in work and social adjustment, mood, anxiety, stress level, fatigue, sleepiness, insomnia, and cognitive interference.
Parasomnia disorders are prevalent and impactful conditions, however, there are challenges with disseminating evidence-based interventions for these problems. The rationale for this project is to deliver an online evidence-based course for parasomnias to adults with these disorders to provide education and help for these conditions. The objectives are to determine whether participation in the course reduces the frequency and severity of parasomnias, as evaluated using a sleep diary. Study hypotheses are as follows: a) those receiving the course compared to sleep hygiene education will have a reduction in frequency and severity of parasomnias; b) those receiving the online course compared to sleep hygiene education will have a reduction in sleepiness, fatigue, insomnia, perceived cognitive interference, depression, anxiety, stress, and work and social life interference. This is a single-blind, randomized controlled trial with two conditions (online course, sleep hygiene education). Participants will be 20 adult outpatients referred to the Behavioral Sleep Medicine Clinic at the Health Sciences Center for treatment of a parasomnia. Participants will be recruited off the waiting list of an outpatient Behavioral Sleep Medicine Clinic. A research coordinator will screen eligible participants over the telephone and obtain informed consent. Following this, participants will be given a study ID# and link to a pre-treatment survey. Once survey materials have been submitted, participants will be randomized to the online course or to weekly sleep hygiene newsletter, through an automated randomization service. Both groups will monitor their sleep throughout the study using a sleep diary (daily), and complete several questionnaires (weekly). The online course will consist of 4 weekly virtual logins and review of material. The control group will consist of receipt of weekly sleep hygiene tips communicated through a newsletter. At the end of 4 weeks, and at a 2 month follow-up, the surveys will be re-administered.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
20
Week 1: education about types of parasomnias and their causes Week 2: safety planning, relaxation training and imagery rehearsal therapy Week 3: Lucid dreaming, imagery rehearsal therapy, scheduled awakenings Week 4: cognitive therapy, review
Week 1: safety planning Week 2: caffeine, cannabis, alcohol, nicotine Week 3: exercising, napping, eating before bed Week 4: noise, light, temperature
Psychealth Center, University of Manitoba
Winnipeg, Manitoba, Canada
RECRUITINGself-reported parasomnia severity
sleep diary recorded parasomnia severity rating (from 0 to 3, with 3 being most severe)
Time frame: baseline, week 4, week 6
self-reported parasomnia frequency
frequency of parasomnia events per week (0 to 100)
Time frame: baseline, week 4, week 6
Secondary measures
general fatigue (Multi-Dimensional Fatigue Inventory, General Fatigue subscale); scores range from 4 (low fatigue) to 20 (high fatigue)
Time frame: baseline, week 4, week 6
Sleepiness
Epworth Sleepiness Scale; scores range from 0 (low sleepiness) to 24 (high sleepiness)
Time frame: baseline, week 4, week 6
Insomnia Severity
Insomnia Severity Index; scores range from 0 (absent) to 21 (high)
Time frame: baseline, week 4, week 6
NREM parasomnia symptoms
Paris Arousal Disorders Severity Scale; scores range from 0 (absent or low severity) to 50 (high severity)
Time frame: baseline, week 4, week 6
REM parasomnia symptoms
REM Sleep Behavior Questionnaire; scores range from 0 (absent or few symptoms) to 13 (more symptoms)
Time frame: baseline, week 4, week 6
nightmare frequency and severity
Nightmare Experience Scale; scores range from 0 (absent or less frequent/severe nightmares) to 16 (more frequent/severe nightmares)
Time frame: baseline, week 4, week 6
Daytime consequences of parasomnias
Parasomnia Effects Scale; scores range from 0 (less or no consequences) to 120 (more consequences)
Time frame: baseline, week 4, week 6
Work and Social Interference
Work and Social Adjustment Scale; scores range from 0 (no interference) to 40 (significant interference)
Time frame: baseline, week 4, week 6
Perceived Cognition
PROMIS-Applied Cognition Scale; scores range from 4 (low or no problems with cognition) to 20 (significant problems with cognition)
Time frame: baseline, week 4, week 6
Mental Health Symptoms
Depression, Anxiety, and Stress Scale; depression subscale ranges from 0 (low) to 21 (high); anxiety subscale ranges from 0 (low) to 21 (high), stress subscale ranges from 0 (low) to 21 (high)
Time frame: baseline, week 4, week 6
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