Evidence map›Paper›PMID 33853197›Full record

ArticleJournal of sleep research2021

The natural history of insomnia: Does sleep extension differentiate between those that do and do not develop chronic insomnia?

Michael L Perlis, Knashawn H Morales, Ivan Vargas, Donn A Posner, Michael A Grandner, Alexandria L Muench, Mark W Seewald, Nalaka S Gooneratne, Jacqueline D Kloss, Amy M Gencarelli and 3 more

Abstract read
In one paragraph

Article in Journal of sleep research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Trial
  2. Article
  3. Insomnia disorder.Nature reviews. Disease primers · 2026
    Review
  4. Article
  5. Article
  6. The characteristics and related factors of insomnia among postoperative patients with gastric cancer: a cross-sectional survey.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

Michael L PerlisDepartment of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
Knashawn H MoralesDepartment of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, USA.
Ivan VargasDepartment of Psychological Sciences, University of Arkansas, Fayetteville, AR, USA.ORCID 0000-0002-0787-5630
Donn A PosnerDepartment of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA.
Michael A GrandnerDepartment of Psychiatry, University of Arizona, Tucson, AZ, USA.
Alexandria L MuenchDepartment of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.ORCID 0000-0003-4826-8498
Mark W SeewaldDepartment of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
Nalaka S GooneratneDepartment of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Jacqueline D KlossDepartment of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
Amy M GencarelliDepartment of Psychology, East Carolina University, Greenville, NC, USA.
Waliuddin S KhaderDepartment of Psychology, University of Arizona, Tucson, AZ, USA.
Michael E ThaseDepartment of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
Jason G EllisNorthumbria Center for Sleep Research, Northumbria University, Newcastle, UK.ORCID 0000-0002-8496-520X

Funding

Three Approaches to Maintenance Therapy for Chronic Insomnia in Older AdultsR01AG054521 · NIA · UNIVERSITY OF PENNSYLVANIA · PI PERLIS, MICHAEL LLOYD · 2018 to 2021
$2.5M
Prospective Assessment of The Etiology of Insomnia in Middle Aged & Elder AdultsR01AG041783 · NIA · UNIVERSITY OF PENNSYLVANIA · PI PERLIS, MICHAEL LLOYD · 2013 to 2016
$2.4M
Behavioral Sleep Medicine: Training in Sleep and AgingK24AG055602 · NIA · UNIVERSITY OF PENNSYLVANIA · PI Michael Lloyd Perlis · 2017 to 2026
$1.6M
Three Approaches to Maintenance Therapy for Chronic Insomnia in Older AdultsR56AG050620 · NIA · UNIVERSITY OF PENNSYLVANIA · PI PERLIS, MICHAEL LLOYD · 2016 to 2016
$805k
Circadian and Ultradian Cortisol Rhythms in Chronic Sleep Continuity DisturbanceK23HL141581 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI VARGAS, IVAN · 2019 to 2023
$677k
NHLBI NIH HHS K23 HL141581NIA NIH HHS K24 AG055602NIA NIH HHS R01 AG041783NIA NIH HHS R01 AG054521NIA NIH HHS R56 AG050620
6 · The paper itself

Abstract

According to the "3P model" of insomnia, the variable that mediates the transition from acute insomnia (AI) to chronic insomnia is "sleep extension" (the behavioural tendency to expand sleep opportunity to compensate for sleep loss). In the present analysis, we sought to evaluate how time in bed (TIB) varies relative to the new onset of AI and chronic insomnia. A total of 1,248 subjects were recruited as good sleepers (GS). Subjects were monitored over 1 year with sleep diaries. State transitions were defined, a priori, for AI, recovered from AI (AI-REC), and for chronic insomnia (AI-CI). Two additional groupings were added based on profiles that were unanticipated: subjects that exhibited persistent poor sleep following AI (AI-PPS [those that neither recovered or developed chronic insomnia]) and subjects that recovered from chronic insomnia (CI-REC). All the groups (GS, AI-REC, AI-CI, AI-PPS and CI-REC) were evaluated for TIB differences with longitudinal mixed effects models. Post hoc analyses for the percentage of the groups that were typed as TIB "restrictors, maintainers, and expanders" were conducted using longitudinal mixed effects models and contingency analyses. Significant differences for pre-post AI TIB were not detected for the insomnia groups. Trends were apparent for the AI-CI group, which suggested that minor increases in TIB occurred weeks before the declared onset of AI. Additionally, it was found that a significantly larger percentage of AI-CI subjects engaged in sleep extension (as compared to GS). The present data suggest that transition from AI to chronic insomnia does not appear to be initiated by sleep extension and the transition may occur before the elapse of 3 months of ≥3 nights of sleep continuity disturbance. Given these findings, it may be that the mismatch between sleep ability and sleep opportunity is perpetuated over time given the failure to "naturally" engage in sleep restriction (as opposed to sleep extension).

Indexed as

Sleep Initiation and Maintenance DisordersHumansSleepacute insomniaageinginsomnianatural historysleep extension

Identifiers

PMID33853197
PMCPMC8446292

What OpenQuestion holds

Textmetadata
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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.