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A comparison of sleep restriction and sleep compression on objective measures of sleep: A sub-sample from a large randomised controlled trial
Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.ORCID iD: 0000-0003-3480-9476
Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology. Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0001-8049-8504
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Number of Authors: 52023 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 32, no 4, article id e13826Article in journal (Refereed) Published
Abstract [en]

Sleep restriction therapy is a central component of cognitive behavioural therapy for insomnia, but can lead to excessive sleepiness, which may impede treatment adherence. Sleep compression therapy has been suggested as a possibly gentler alternative. The aim of this study was to compare the effects of sleep restriction therapy and sleep compression therapy on objective measures of sleep, with a focus on magnitude and timing of effects. From a larger study of participants with insomnia, a sub-sample of 36 underwent polysomnographic recordings, before being randomised to either sleep restriction (n = 19) or sleep compression (n = 17) and receiving online treatment for 10 weeks. Assessments with polysomnography were also carried out after 2, 5, and 10 weeks of treatment. Data were analysed with multilevel linear mixed effect modelling. As per treatment instructions, participants in sleep restriction initially spent shorter time in bed compared with sleep compression. Participants in sleep restriction also showed an initial decrease of total sleep time, which was not seen in the sleep compression group. Both treatments led to improvements in sleep continuity variables, with a tendency for the improvements to come earlier during treatment in sleep restriction. No substantial differences were found between the two treatments 10 weeks after the treatment start. The results indicate that homeostatic sleep pressure may not be as important as a mechanism in sleep compression therapy as in sleep restriction therapy, and an investigation of other mechanisms is needed. In conclusion, the treatments led to similar changes in objective sleep at a somewhat different pace, and possibly through different mechanisms. 

Place, publisher, year, edition, pages
John Wiley & Sons, 2023. Vol. 32, no 4, article id e13826
Keywords [en]
CBT-I, digital treatment, internet therapy, mechanisms, SRT, time in bed regularisation
National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:su:diva-215184DOI: 10.1111/jsr.13826ISI: 000921347700001PubMedID: 36709965Scopus ID: 2-s2.0-85147308137OAI: oai:DiVA.org:su-215184DiVA, id: diva2:1740607
Note

This research was supported by grants from the L. J. Boëthius foundation.

Available from: 2023-03-01 Created: 2023-03-01 Last updated: 2024-01-14Bibliographically approved

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D'Onofrio, PaoloÅkerstedt, Torbjörn

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