Papers by Annie Vallières
International Journal of Dream Research, Oct 1, 2019
The administration of treatments for nightmares, and more broadly, clinical work with patients re... more The administration of treatments for nightmares, and more broadly, clinical work with patients reporting dysphoric dreams as a concomitant psychological difficulty, could be improved based on a better understanding of the experience of nightmare sufferers. The objective of this study was to explore the perceptions of nightmare sufferers regarding the functions, causes, and consequences of their nightmares, as well as their strategies for coping with nightmares. Twenty university students with frequent nightmares took part in an individual semi-structured interview constructed by the research team. The interviews were recorded and transcribed verbatim. Verbatim were analysed using a content analysis method. Four major findings emerge from this study. Firstly, the main perceived causes of nightmares, including one's occupational and social life, support the hypothesis that dreams reflect waking concerns. Secondly, nightmares tend to decrease sleep quality and to provoke sleep fragmentation, which may be aggravated by sleep avoidance and voluntary awakening from lucid nightmares. In turn, the fatigue that results from a disturbed sleep can negatively affect concentration, daily functioning and mood. Thirdly, nightmares can impact emotions upon awakening and during the day, directly and indirectly, through various mechanisms. Fourthly, nightmares are frequently perceived as a source of personal insight: half of the participants believe that their dreams can reveal information about themselves, searching for the meaning of nightmares is one of the most common coping strategies, and many participants experienced a reflection or realization following a nightmare. A model is proposed to integrate the findings and explain how the nightmare problem might perpetuate itself.
Sleep Health, Jun 1, 2020
OBJECTIVE Shift Work Disorder (SWD) is explained mainly by a misalignment between the sleep sched... more OBJECTIVE Shift Work Disorder (SWD) is explained mainly by a misalignment between the sleep schedule and the circadian rhythm. However, the possible role of cognitive variables in maintaining SWD remains unknown. Therefore, the objective of this study is to evaluate whether cognitive variables known to maintain insomnia in day workers might also be involved in perpetuating SWD. DESIGN Cross-sectional. SETTING Sleep laboratory. PARTICIPANTS Twenty-five shift workers diagnosed with SWD (84% females; mean age = 35.9) and 22 shift workers who are good sleepers (91% females; mean age = 34.1). MEASUREMENTS The participants completed a sleep diary for two weeks, answered questionnaires, and underwent the Harvey's semistructured interview and the catastrophizing procedure. Data from the catastrophizing procedure underwent a content analysis. RESULTS Compared with good sleepers, shift workers with SWD reported experiencing more thoughts that keep them awake, more presleep cognitive arousal, more dysfunctional beliefs related to worries and helplessness, and more selective attention toward worries and noises. However, the two groups did not differ on the tendency to catastrophize about difficulties falling asleep. Furthermore, 12 catastrophizing themes were identified in the entire sample, the most frequently endorsed being "sleepiness and energy" and "performance at work." CONCLUSIONS The results suggest that cognitive variables may play a role in maintaining SWD. Finally, worries that interfere with sleep in shift workers are related to their work context.
Sleep, Oct 1, 2003
The present study explores the clinical utility and sensitivity of actigraphy as an outcome measu... more The present study explores the clinical utility and sensitivity of actigraphy as an outcome measure in the treatment of chronic insomnia. Design: Following a screening-adaptation night, polysomnography, actigraphy, and sleep-diary data were collected in the sleep laboratory for 2 baseline nights and 2 posttreatment nights. Setting: A university-affiliated sleep disorders center. Participants: Seventeen participants with chronic primary insomnia. Mean age was 41.6 years. Interventions: Participants took part in a treatment protocol investigating different sequential treatments for insomnia (these results are reported elsewhere). Measurements and Results: Compared to polysomnography, both actigraphy and sleep-diary instruments underestimated total sleep time and sleep efficiency and overestimated total wake time. Also, actigraphy underestimated sleep-onset latency while the sleep diary overestimated it as compared to polysomnography. Actigraphy data were more accurate than sleep-diary data when compared to polysomnography. Finally, actigraphy was sensitive in detecting the effects of treatment on several sleep parameters. Conclusions: These results suggest that actigraphy is a useful device for measuring treatment response and that it should be used as a complement to sleep-diary evaluation.
Behavior Therapy, 1996
... Hallucinatory-delusional verbalizations: Modification in a chronic schizophrenic by self-cont... more ... Hallucinatory-delusional verbalizations: Modification in a chronic schizophrenic by self-control and cognitive restructuring. Be-havior Modification, 6, 421-435. ... Assessment of delusional beliefs during the modification of delusional verbalizations. ...
Behaviour Research and Therapy, Dec 1, 2005
This study explores the efficacy of sequential treatments involving medication and cognitive beha... more This study explores the efficacy of sequential treatments involving medication and cognitive behavioral treatment (CBT) for primary insomnia. Seventeen participants took part in a multiple baseline design and were assigned to: (a) medication for 5 weeks, followed by combined medication plus CBT for 5 weeks; (b) combined treatment for 5 weeks, followed by CBT alone; or (c) CBT alone. Each treatment sequence produced significant sleep improvements, but at different points in time. For the first sequence, most of the sleep improvement was obtained after the introduction of CBT, while for the other sequence and CBT alone, improvement appeared during the first weeks. These results suggest that sleep improvement seems affected by the way treatments are combined. Also, a sequence beginning with a combined treatment followed by CBT alone seems to produce the best outcome. Additional research should be conducted with larger samples to determine the most effective sequence.
Sleep Medicine, Jul 1, 2001
Background: Insomnia is a prevalent health complaint that is often dif®cult to evaluate reliably.... more Background: Insomnia is a prevalent health complaint that is often dif®cult to evaluate reliably. There is an important need for brief and valid assessment tools to assist practitioners in the clinical evaluation of insomnia complaints. Objective: This paper reports on the clinical validation of the Insomnia Severity Index (ISI) as a brief screening measure of insomnia and as an outcome measure in treatment research. The psychometric properties (internal consistency, concurrent validity, factor structure) of the ISI were evaluated in two samples of insomnia patients. Methods: The ®rst study examined the internal consistency and concurrent validity of the ISI in 145 patients evaluated for insomnia at a sleep disorders clinic. Data from the ISI were compared to those of a sleep diary measure. In the second study, the concurrent validity of the ISI was evaluated in a sample of 78 older patients who participated in a randomized-controlled trial of behavioral and pharmacological therapies for insomnia. Change scores on the ISI over time were compared with those obtained from sleep diaries and polysomnography. Comparisons were also made between ISI scores obtained from patients, signi®cant others, and clinicians. Results: The results of Study 1 showed that the ISI has adequate internal consistency and is a reliable self-report measure to evaluate perceived sleep dif®culties. The results from Study 2 also indicated that the ISI is a valid and sensitive measure to detect changes in perceived sleep dif®culties with treatment. In addition, there is a close convergence between scores obtained from the ISI patient's version and those from the clinician's and signi®cant other's versions. Conclusions: The present ®ndings indicate that the ISI is a reliable and valid instrument to quantify perceived insomnia severity. The ISI is likely to be a clinically useful tool as a screening device or as an outcome measure in insomnia treatment research.
Sleep Health, Oct 1, 2022
Sleep Medicine, Dec 1, 2014
Shift work disorder involves insomnia and/or excessive sleepiness associated with the work schedu... more Shift work disorder involves insomnia and/or excessive sleepiness associated with the work schedule. The present study examined the impact of insomnia on the perceived physical and psychological health of adults working on night and rotating shift schedules compared to day workers. A total of 418 adults (51% women, mean age 41.4 years), including 51 night workers, 158 rotating shift workers, and 209 day workers were selected from an epidemiological study. An algorithm was used to classify each participant of the two groups (working night or rotating shifts) according to the presence or absence of insomnia symptoms. Each of these individuals was paired with a day worker according to gender, age, and income. Participants completed several questionnaires measuring sleep, health, and psychological variables. Night and rotating shift workers with insomnia presented a sleep profile similar to that of day workers with insomnia. Sleep time was more strongly related to insomnia than to shift work per se. Participants with insomnia in the three groups complained of anxiety, depression, and fatigue, and reported consuming equal amounts of sleep-aid medication. Insomnia also contributed to chronic pain and otorhinolaryngology problems, especially among rotating shift workers. Work productivity and absenteeism were more strongly related to insomnia. The present study highlights insomnia as an important component of the sleep difficulties experienced by shift workers. Insomnia may exacerbate certain physical and mental health problems of shift workers, and impair their quality of life.
American Journal of Psychiatry, Feb 1, 2004
This study evaluated the effectiveness of a supervised benzodiazepine taper, singly and combined ... more This study evaluated the effectiveness of a supervised benzodiazepine taper, singly and combined with cognitive behavior therapy, for benzodiazepine discontinuation in older adults with chronic insomnia. Seventy-six older adult outpatients (38 women, 38 men; mean age of 62.5 years) with chronic insomnia and prolonged use (mean duration of 19.3 years) of benzodiazepine medication for sleep were randomly assigned for a 10-week intervention consisting of a supervised benzodiazepine withdrawal program (N=25), cognitive behavior therapy for insomnia (N=24), or supervised withdrawal plus cognitive behavior therapy (N=27). Follow-up assessments were conducted at 3 and 12 months. The main outcome measures were benzodiazepine use, sleep parameters, and anxiety and depressive symptoms. All three interventions produced significant reductions in both the quantity (90% reduction) and frequency (80% reduction) of benzodiazepine use, and 63% of the patients were drug-free within an average of 7 weeks. More patients who received medication taper plus cognitive behavior therapy (85%) were benzodiazepine-free after the initial intervention, compared to those who received medication taper alone (48%) and cognitive behavior therapy alone (54%). The patients in the two groups that received cognitive behavior therapy perceived greater subjective sleep improvements than those who received medication taper alone. Polysomnographic data showed an increase in the amount of time spent in stages 3 and 4 sleep and REM sleep and a decrease in total sleep time across all three conditions from baseline to posttreatment. Initial benzodiazepine reductions were well maintained up to the 12-month follow-up, and sleep improvements became more noticeable over this period. No significant withdrawal symptoms or adverse events were associated with benzodiazepine tapering. A structured, time-limited intervention is effective in assisting chronic users of benzodiazepine medication to discontinue or reduce their use of medication. The addition of cognitive behavior therapy alleviates insomnia, but sleep improvements may become noticeable only after several months of benzodiazepine abstinence.
Presses de l'Université Laval eBooks, Aug 17, 2021
Sleep, Apr 1, 2020
The aim of this study was to assess parent perceptions of sleep problems in young children and pa... more The aim of this study was to assess parent perceptions of sleep problems in young children and parent-identified areas of change in a global sample. Methods: Caregivers (95.6% mothers) of 1555 infants/toddlers (birth-37 mos; M=12.2 mos; 49.5% male) completed an online survey, representing Indonesia (n=187), Japan (n=718), New Zealand (n=231), Singapore (n=199), and Thailand (n=221). The survey included an abbreviated version of the Brief Infant Sleep Questionnaire, and a list of potential sleep-related areas of change. Results: 36.9% reported a perceived sleep-problem, whereas 92.9% indicated an area of desired change related to their child's sleep. In terms of areas of change, 82.5% endorsed bedtime/how child falls asleep, 70.0% nighttime sleep, and 57.8% related to the morning. As expected, 99.7% of parents who endorsed a problem indicated a desired change compared to 88.9% who did not perceive a problem, p < .001. Those who noted a problem were more likely to endorse a change at bedtime (92.5%) and during the night (90.1%), compared to the morning (68.8%). There were country-based differences, with caregivers in New Zealand (47.0%) and Singapore (44.2%) more likely to report a child sleep problem compared to Thailand (35.3%), Japan (34.1%) and Indonesia (29.4%), p < .001. No differences were noted in parent-report of desired change across Japan, New Zealand, Singapore, and Thailand (94-96%) but were significantly higher than Indonesia (83.4%). Conclusion: Although one-third of parents of young children in a global sample indicate a perceived sleep problem, almost all parents wish to change something about their child's sleep, primarily relate to bedtime and during the night. Sleep education and assessment delivered by health care providers should focus not only on what families consider to be "problematic," but also what families would like to modify, or improve, about their child's sleep within a developmentally appropriate framework.
Sleep Medicine, Jul 1, 2019
Sleep Medicine, Sep 1, 2011
Introduction and Objectives: Vigilance and mood are known to be affected by sleep, with circadian... more Introduction and Objectives: Vigilance and mood are known to be affected by sleep, with circadian phase modulating performance and affective experience. These are also affected by sleep loss, with increased lability to emotional images. Time of testing could therefore affect emotion task performance. The perception of emotion from faces has special significance, as faces can be used to communicate information like threat and danger. Materials and Methods: In a first study, participants (n=55, mean age 25, 43 females) completed an emotion recognition task. Normal sleepers and poor sleepers were identified, and two time of day groups were created. In a follow-up study designed to control for time since awakening, good sleepers (n=36, mean age = 22, 25 females) were asked to categorize emotional faces and images as angry, fearful, happy or sad. Performance was assessed at 3, 6, 9, or 12 hours since waking, based on sleep diary responses. Results: Pilot data indicated a significant interaction of emotion, time of day and sleep group (P<0.05). Follow up tests showed normal sleepers were less sensitive to angry and fearful faces after 3pm (for both, P<0.05). Results from the current study indicate that participants tested at 12 hours are more sensitive towards happy facial expressions than those tested at 3 hours (P<0.05). Participants tested at 9 and 12 hours could also be more sensitive towards angry facial expressions than those tested at 6 hours (for both, P<0.1). Ongoing work aims to clarify these effects. Conclusion: These results indicate that time of day could affect sensitivity towards angry faces in particular, suggesting that sensitivity towards different emotions varies over the course of the day. This finding adds to the literature linking sleep and emotion, and learning how sleep and emotion perception are linked may help inform models of insomnia development. Acknowledgements: This research was supported by an ESRC studentship to L. Beattie, an EPS research bursary to M. Bindemann and N. Forsberg, and a Carnegie Trust vacation scholarship to M. Holm.
Sleep Medicine, Dec 1, 2013
Sleep Medicine, Mar 1, 2022
Positive airway pressure treatment (CPAP) is the gold standard for obstructive sleep apnea syndro... more Positive airway pressure treatment (CPAP) is the gold standard for obstructive sleep apnea syndrome (OSAS). CPAP is highly effective, but its issue lays in poor adherence rates mainly caused by its invasive nature and related stigma. In accordance with a biopsychosocial model of CPAP adherence, psychosocial interventions have been implemented to alleviate low rates of adherence with promising results. The increase in the number of psychosocial interventions has highlighted the need to systematically evaluate their effectiveness. This review aims to identify psychosocial interventions used to increase CPAP adherence, to compile available data on their effectiveness, and the reasons why they are effective. Moreover, the review evaluates the impact of the interventions on sleep quality. Experimental and quasi-experimental studies testing psychosocial interventions (excluding educational only interventions) that aimed to increase CPAP adherence in adults with obstructive sleep apnea vs. no intervention or control group were included. A literature search in PsycINFO, MEDLINE, COCHRANE, EMBASE, CINAHL, and Web of Science was performed for studies published in English and French between 1980 and January 2020. Risk of bias and methodological quality were assessed using the Joanna Briggs Institute Critical Appraisal Tools. Fourteen studies were included involving 1923 participants, six trials tested a motivational intervention, three trials tested a cognitive behavioral intervention and five others tested one of the following: relaxation, exposition therapy, phone coaching, audiotape or stage-matched intervention. Thirteen studies reported a positive effect of the intervention on CPAP adherence, while one reported no effect. Psychosocial interventions for CPAP adherence appear effective at increasing sleep quality, but more studies are needed to test this hypothesis. Reasons for the effectiveness of the interventions were pooled into five categories: time related, the intervention's adaptability, the patient's characteristics, the intervention's nature and characteristics and the intervention's specifics and target. The current review raises a significant gap between the biomedical and psychosocial domains. In fact, even in a psychosocial intervention study, the interpretation of the results revolves around biomedical models and very little consideration is given to biopsychosocial models. Our findings demonstrate the importance of examining the relationship between psychosocial variables and CPAP adherence to better tailor interventions to increase CPAP adherence.
Sleep Medicine, Dec 1, 2019
knowledge regarding the disease and benefits of treatment and prevention (Benjafield A et al., 20... more knowledge regarding the disease and benefits of treatment and prevention (Benjafield A et al., 2018). It is very well known that patients' knowledge and attitudes/beliefs regarding their illnesses influence their health variables including compliance to treatment (Golay A et al., 2006). But as per the researcher's knowledge very few or possibly no studies on assessment of knowledge and attitude/belief, among OSA patients have been done so far in India and worldwide, focusing on developing an informational booklet for the patients.
Sleep Medicine Clinics, Mar 1, 2021
In this systematic review we extracted information from 53 studies that have measured adherence t... more In this systematic review we extracted information from 53 studies that have measured adherence to Cognitive Behaviour Therapy for insomnia (CBT-I). There has been an increase in more complex and less biased methods for assessing adherence that move beyond simply asking the patient whether they have adhered to the intervention or not. This demonstrates the need for a consensus around how to measure adherence, if we want to derive at an estimate of "optimal adherence". Heterogeneity of studies, particularly in the way adherence is operationalised, prohibited conclusions about the relationship between adherence and outcome as well as predictors of adherence to be drawn. the "dose" of therapy is ill defined so optimal levels of adherence cannot be determined, and there are variations in the way that treatment is delivered (different combinations of components for example). Consequently, it is not clear which elements of the intervention are the mechanistic drivers of improvement, and which factors predict non-adherence. In a 2013 systematic review of adherence to CBT-I 8 identified considerable heterogeneity in the way adherence to CBT-I was operationalised and measured. The current literature review therefore aims to understand whether clinical trials involving CBT-I published since Matthews et al.'s review in 2013 have 1) measured adherence and whether this has been more homogeneous 2) reported any relationship between adherence and CBT-I outcomes 3) identified any consistent factors influencing adherence to CBT-I. Methods Searches: A systematic literature search was carried out with the assistance of a trained social sciences librarian. Searches were carried out in November 2019, in the databases PsychInfo, MEDLINE and Scopus. Pubmed was not used as a search engine, based on advice by the librarian, since it is similar to MEDLINE and might have generated a number of duplicates. In PsychInfo and Scopus, full texts were searched for combinations of: ("cognitive behavio* therap*" or "sleep restriction" or "sleep hygiene" or "stimulus control" or "sleep education" or relaxation or "cognitive therap*"), ("sleep disorder*" or insomnia), and (adherence or compliance or nonadherence or noncompliance or attrition). Searches were filtered to include only journal articles including human samples, written in English or German. The search in Medline database included the same search terms as keywords and relevant subject headings. Searches were limited to papers published from May 2012 onwards, as the most recent systematic review in this area 8 was conducted until this point. The search terms and criteria used in the Matthews et al.'s review were used for this review. References of papers were reviewed to determine any papers that were missed in the literature searches. Papers that were published since the end of our literature search were reviewed and included where appropriate. Inclusion/exclusion criteria Studies that met the following criteria were included within the review: a) peer-reviewed papers b) written in English or German c) measured adherence, meaning implementing behaviour change (not simply attrition or session attendance/engagement with the digital intervention) d) assessed a CBT-I intervention e) adult participants with insomnia (either characterised as sleep difficulties or measured via clinical assessment). The following exclusion criteria were used: a) paediatric or adolescent samples b) or having only measured participant attendance or attrition/engagement in the digital intervention and c) qualitative papers, editorials, single case studies and literature reviews.
... II apparaît judicieux, dans le but d'améliorer l'efficacité de la thérapie cognitiv... more ... II apparaît judicieux, dans le but d'améliorer l'efficacité de la thérapie cognitive-comportementale, de miew connaître ce qui influence et détermine le niveau ... La thérapie cognitivo-comportementale offerte pour le TPA est dune durée de 15 sessions hebdomadaires ...
Uploads
Papers by Annie Vallières