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Annie Vallières

Other affiliations: Southern General Hospital
Bio: Annie Vallières is an academic researcher from Laval University. The author has contributed to research in topics: Insomnia & Sleep diary. The author has an hindex of 19, co-authored 42 publications receiving 6370 citations. Previous affiliations of Annie Vallières include Southern General Hospital.

Papers
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Journal ArticleDOI
TL;DR: The clinical validation of the Insomnia Severity Index (ISI) indicates that the ISI is a reliable and valid instrument to quantify perceived insomnia severity and is likely to be a clinically useful tool as a screening device or as an outcome measure in insomnia treatment research.

5,143 citations

Journal ArticleDOI
20 May 2009-JAMA
TL;DR: In patients with persistent insomnia, the addition of medication to CBT produced added benefits during acute therapy, but long-term outcome was optimized when medication is discontinued during maintenance CBT.
Abstract: Context Cognitive behavioral therapy (CBT) and hypnotic medications are efficacious for short-term treatment of insomnia, but few patients achieve complete remission with any single treatment. It is unclear whether combined or maintenance therapies would enhance outcome. Objectives To evaluate the added value of medication over CBT alone for acute treatment of insomnia and the effects of maintenance therapies on long-term outcome. Design, Setting, and Patients Prospective, randomized controlled trial involving 2-stage therapy for 160 adults with persistent insomnia treated at a university hospital sleep center in Canada between January 2002 and April 2005. Interventions Participants received CBT alone or CBT plus 10 mg/d (taken at bedtime) of zolpidem for an initial 6-week therapy, followed by extended 6-month therapy. Patients initially treated with CBT attended monthly maintenance CBT for 6 months or received no additional treatment and those initially treated with combined therapy (CBT plus 10 mg/d of zolpidem) continued with CBT plus intermittent use of zolpidem or CBT only. Main Outcome Measures Sleep onset latency, time awake after sleep onset, total sleep time, and sleep efficiency derived from daily diaries (primary outcomes); treatment response and remission rates derived from the Insomnia Severity Index (secondary outcomes). Results Cognitive behavioral therapy used singly or in combination with zolpidem produced significant improvements in sleep latency, time awake after sleep onset, and sleep efficiency during initial therapy (all P Conclusion In patients with persistent insomnia, the addition of medication to CBT produced added benefits during acute therapy, but long-term outcome was optimized when medication is discontinued during maintenance CBT. Trial Registration clinicaltrials.gov Identifier: NCT00042146

627 citations

Journal ArticleDOI
01 Nov 2007-Sleep
TL;DR: This abbreviated version of the Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS-16), a 16-item self-report measure designed to evaluate a subset of sleep related cognitions, should prove a useful instrument to evaluate the role ofSleep related beliefs and attitudes in insomnia and to monitor change on this cognitive variable as a potential moderator of treatment outcome.
Abstract: Study Objective: Sleep related cognitions (e.g., faulty beliefs and appraisals, unrealistic expectations, perceptual and attention bias) play an important role in perpetuating insomnia. This paper presents new psychometric data on an abbreviated version of the Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS-16), a 16-item self-report measure designed to evaluate a subset of those sleep related cognitions.

587 citations

Journal ArticleDOI
TL;DR: A structured, time-limited intervention is effective in assisting chronic users of benzodiazepine medication to discontinue or reduce their use of medication, and sleep improvements became more noticeable over this period.
Abstract: OBJECTIVE: 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. METHOD: 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. RESULTS: 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...

276 citations

Journal ArticleDOI
TL;DR: The most common precipitating factors of insomnia were related to family, health, and work-school events, and sixty-five percent of precipitating events had a negative valence.
Abstract: Insomnia is a prevalent health complaint whose onset is precipitated by a variety of factors. There is an important need to identify and describe these factors to improve our understanding of risk factors and the natural history of insomnia. This article is aimed at identifying and describing the types of precipitating factors related to the onset of insomnia. A total of 345 patients evaluated for insomnia at a sleep-disorders clinic completed a sleep survey and underwent a semistructured clinical interview. As part of the evaluation, the specific precipitating events related to the onset of insomnia were identified. Subsequently, these factors were categorized (work-school, family, physical or psychological health, or indeterminate), and their affective valence (negative, positive, or indeterminate) was coded. The most common precipitating factors of insomnia were related to family, health, and work-school events. Sixty-five percent of precipitating events had a negative valence. These events differed wi...

191 citations


Cited by
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Journal ArticleDOI
TL;DR: The 16 meta-analyses reviewed support the efficacy of CBT for many disorders and are consistent with other review methodologies that also provide support for the efficacy CBT.

2,856 citations

Journal ArticleDOI
01 May 2011-Sleep
TL;DR: Findings provide further evidence that the Insomnia Severity Index is a reliable and valid instrument to detect cases of insomnia in the population and is sensitive to treatment response in clinical patients.
Abstract: Background Although insomnia is a prevalent complaint with significant morbidity, it often remains unrecognized and untreated. Brief and valid instruments are needed both for screening and outcome assessment. This study examined psychometric indices of the Insomnia Severity Index (ISI) to detect cases of insomnia in a population-based sample and to evaluate treatment response in a clinical sample. Methods Participants were 959 individuals selected from the community for an epidemiological study of insomnia (Community sample) and 183 individuals evaluated for insomnia treatment and 62 controls without insomnia (Clinical sample). They completed the ISI and several measures of sleep quality, fatigue, psychological symptoms, and quality of life; those in the Clinical sample also completed sleep diaries, polysomnography, and interviews to validate their insomnia/good sleep status and assess treatment response. In addition to standard psychometric indices of reliability and validity, item response theory analyses were computed to examine ISI item response patterns. Receiver operating curves were used to derive optimal cutoff scores for case identification and to quantify the minimally important changes in relation to global improvement ratings obtained by an independent assessor. Results ISI internal consistency was excellent for both samples (Cronbach α of 0.90 and 0.91). Item response analyses revealed adequate discriminatory capacity for 5 of the 7 items. Convergent validity was supported by significant correlations between total ISI score and measures of fatigue, quality of life, anxiety, and depression. A cutoff score of 10 was optimal (86.1% sensitivity and 87.7% specificity) for detecting insomnia cases in the community sample. In the clinical sample, a change score of -8.4 points (95% CI: -7.1, -9.4) was associated with moderate improvement as rated by an independent assessor after treatment. Conclusion These findings provide further evidence that the ISI is a reliable and valid instrument to detect cases of insomnia in the population and is sensitive to treatment response in clinical patients.

2,651 citations

Journal ArticleDOI
TL;DR: This clinical guideline is to provide clinicians with a practical framework for the assessment and disease management of chronic adult insomnia, using existing evidence-based insomnia practice parameters where available, and consensus-based recommendations to bridge areas where such parameters do not exist.
Abstract: Insomnia is the most prevalent sleep disorder in the general population, and is commonly encountered in medical practices. Insomnia is defined as the subjective perception of difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity for sleep, and that results in some form of daytime impairment.1 Insomnia may present with a variety of specific complaints and etiologies, making the evaluation and management of chronic insomnia demanding on a clinician's time. The purpose of this clinical guideline is to provide clinicians with a practical framework for the assessment and disease management of chronic adult insomnia, using existing evidence-based insomnia practice parameters where available, and consensus-based recommendations to bridge areas where such parameters do not exist. Unless otherwise stated, "insomnia" refers to chronic insomnia, which is present for at least a month, as opposed to acute or transient insomnia, which may last days to weeks.

1,441 citations

Journal ArticleDOI
TL;DR: It is suggested that self-oriented perfectionistic strivings are positive, if perfectionists are not overly concerned about mistakes and negative evaluations by others.
Abstract: Almost 30 years ago, Hamachek (1978) suggested that 2 forms of perfectionism be distinguished, a positive form labeled "normal perfectionism" and a negative form labeled "neurotic perfectionism." Focusing on the positive, we present an overview of the different empirical conceptions of the 2 forms of perfectionism and a common framework for the 2 basic approaches: the dimensional approach differentiating 2 dimensions of perfectionism (perfectionistic strivings and perfectionistic concerns) and the group-based approach differentiating 2 groups of perfectionists (healthy perfectionists and unhealthy perfectionists). Moreover, we review the evidence demonstrating that (a) perfectionistic strivings are associated with positive characteristics and (b) healthy perfectionists show higher levels of positive characteristics compared to unhealthy perfectionists and nonperfectionists. Although questions on core facets, positive effects, and developmental antecedents of positive forms of perfectionism remain, our findings suggest that self-oriented perfectionistic strivings are positive, if perfectionists are not overly concerned about mistakes and negative evaluations by others.

1,284 citations