SLEEPJ
May 8, 2026
Heba Afaneh, David Kalmbach, Philip Cheng et al.
Abstract Introduction Insomnia affects half of pregnant women and increases risk for depression. Identifying effective treatments for co-occurring insomnia and depression during pregnancy remains a critical priority. Cognitive-behavioral therapy for insomnia (CBTI) improves sleep quality but has limited impact on depression—an effect attributed to persistent cognitive arousal (worry and...
Sleep
May 1, 2026
Holland Doise, A. Gonzalez Quesada, Garrett Baber et al.
Abstract Introduction Nightmares are associated with more severe posttraumatic stress disorder (PTSD). The advent of large language models (LLM) offers unique advantages to efficiently code affective dream content over human methods, which can be resource intensive and prone to error. This study tested whether dream affect (DA), measured via self-report, human-rated narrative coding, and LLM...
Sleep advances : a journal of the Sleep Research Society
2026
David A Kalmbach, Anthony N Reffi, Philip Cheng et al.
Insomnia is common in pregnancy and is associated with maladaptive sleep behaviors and poor emotion regulation. Cognitive-behavioral therapy for insomnia (CBTI) and Perinatal Understanding of Mindful Awareness for Sleep (PUMAS) are effective interventions for alleviating prenatal insomnia. However, clinical benefits outside the primary target of sleep remain unclear. This randomized controlled...
European Journal of Psychotraumatology
October 8, 2024
Anthony N Reffi, Philip Cheng, David A Kalmbach et al.
ABSTRACT Background: Research suggests trauma-related nightmares (TRNs) during the acute aftermath of trauma may contribute to posttraumatic stress disorder (PTSD). However, it is unknown who is most vulnerable to TRNs, which is critical to identify at-risk patients toward whom early nightmare-focused treatments can be targeted to prevent PTSD. Objective: We tested trauma type (interpersonal...
Journal of Sleep Research
February 1, 2024
David A Kalmbach, Anthony N Reffi, Jason C Ong et al.
9 citations
Treating insomnia during pregnancy improves sleep and depressed mood. However, given well-established links between poor sleep and a broad spectrum of adverse maternal outcomes, the benefits of insomnia care may reach beyond sleep and depression. The present study evaluated the preliminary efficacy of 'Perinatal Understanding of Mindful Awareness for Sleep' (PUMAS)-a mindfulness sleep programme...
Sleep Medicine
August 1, 2023
David A Kalmbach, Philip Cheng, Anthony N Reffi et al.
15 citations
Cognitive-behavioral therapy is effective for prenatal insomnia, but unresolved cognitive arousal limits patient outcomes. Therapies aimed at reducing cognitive arousal may benefit pregnant women with insomnia. This proof-of-concept trial evaluated Perinatal Understanding of Mindful Awareness for Sleep (PUMAS, which combines mindfulness with behavioral sleep strategies) on insomnia, depression,...
Sleep advances : a journal of the Sleep Research Society
2023
David A Kalmbach, Philip Cheng, Anthony N Reffi et al.
16 citations
Combining mindfulness with behavioral sleep strategies has been found to alleviate symptoms of insomnia and depression during pregnancy, but mechanisms for this treatment approach remain unclear. The present study examined nocturnal cognitive arousal and sleep effort as potential treatment mechanisms for alleviating insomnia and depression via a mindfulness sleep program for pregnant women....