Journal of Sleep Disorders & Therapy
Open Access
ISSN: 2167-0277
+44 1478 350008
ISSN: 2167-0277
+44 1478 350008
Agneta Markstrom1, Katarina Danielsson1, Jan-Erik Broman1 and Markus Jansson-Frojmark2,3
1Uppsala University, Sweden 2Stockholm University, Sweden 3Ã?Â?rebro University, Sweden
Scientific Tracks Abstracts: J Sleep Disord Ther
Delayed sleep phase disorder (DSPD) is common among young people and is characterized by a mismatch between the desired timing of sleep and the ability to fall asleep and remain asleep. The underlying cause of this could be related to biological or behavioral reasons. Individuals with DSPS have problems in falling asleep and consequently struggle with waking up in the morning. Sleep difficulties, excessive sleepiness leads to poor performance and they acquire difficulty with school and employment. This may result in adverse medical, psychological and social consequences. Light is the most effective environmental cue for circadian entrainment and light therapy (LT) has been shown effective for treatment of DSPS. Unfortunately, compliance is a concern and also the high amount of relapse. Cognitive behavioural therapy (CBT) might contribute as an adjunct therapy in DSPS. A randomized controlled short and long term trial with DSPS individuals aged 16 to 26 years was performed. Subjects received LT for 2 weeks and thereafter one group received CBT for 4 weeks while the other group received no further treatment at all. LT advanced sleep onset 1 hour 50 min and sleep offset 2 hour 20 min during the second week of LT for all participants and this was maintained at a 6 months follow-up. Insomnia sleepiness score (ISI) was the primary outcome measure for sleep difficulties and there was a significant decrease in ISI over time. Anxiety and depression scores decreased significantly more in the group that has received CBT and subjects in this group were able to retain the effect of LT better compared to the group that only received LT. It was concluded that CBT given after LT can maintain the effect of LT better and can decrease sleep difficulties beyond those improvements observed with light therapy alone.
Agneta Markstrom is since 2009 working as an Associate Professor and Senior Consultant at the Centre of Sleep and Breathing at Uppsala University Hospital, Sweden. She works full time taking care of diagnostics in persons with insomnia, parasomnia, circadian rhythm disorders, hypersomnia, narcolepsy and people with sleep breathing disorders. She works as a Consultant at the Department of Women’s and Children’s Health at Karolinska Institutet in Stockholm, Sweden and is a national expert in initiating CPAP and home mechanical ventilation in children. Her research interests lay in the fields of sleep particularly in the treatment of insomnia, circadian rhythm disorders, concrete delayed sleep phase disorder and sleep breathing disorder.