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Störe, Siri JakobssonORCID iD iconorcid.org/0000-0001-5749-0774
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Publications (10 of 13) Show all publications
Støre, S. J. (2024). Lean, mean sleep machine?: Effects and experiences of a sleep robot intervention for adults with insomnia. (Doctoral dissertation). Karlstad: Karlstads universitet
Open this publication in new window or tab >>Lean, mean sleep machine?: Effects and experiences of a sleep robot intervention for adults with insomnia
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Many adults suffer from insomnia disorder, struggling to fall asleep, stay asleep, or with early morning awakenings. Hyperarousal is an important predisposing, precipitating and perpetuating factor to insomnia. Anxiety, depression and ADHD are common comorbid disorders, with shared cognitive, behavioral, genetic, and neurological features. Cognitive Behavioral Therapy for insomnia (CBT-I) is the gold-standard treatment, more effective and economical than pharmacological treatments, though not suitable or available for everyone. Unfortunately, sleeping pills are still more common than CBT-I, despite known risks. One potential treatment avenue is consumer sleep technology, including interventional sleep robots. 

This thesis aimed to assess the safety, acceptability, effects, and experiences of a commercial sleep robot for insomnia in adults. Overall, the thesis does not strongly support the sleep robot as an effective insomnia treatment. The intervention might not have addressed important precipitating factors of the participants’ insomnia, and the robot’s impact on stress reactivity and other potentially important factors remain uncertain. Until more robust research studies are conducted, the current sleep robot intervention should not be considered an evidence-based treatment for adults with insomnia.

Abstract [en]

Many adults suffer from insomnia disorder, which entails a difficulty initiating sleep and maintaining sleep, or undesired early morning awakenings coupled with trouble going back to sleep. Hyperarousal is an important causal and maintaining factor in insomnia. Furthermore, comorbid conditions such as anxiety, depression, and ADHD are common. The first line treatment of insomnia is Cognitive Behavioral Therapy, which has been found to be more effective and economical than pharmaceuticals, albeit not suitable or available for all. Sleeping pills are still the most common treatments of insomnia, which is unfortunate due to established risks. Thus, research on credible treatment options is warranted. One potential type of treatment is consumer sleep technology. The current thesis aimed to assess the safety, acceptability, effects, and experiences of the Somnox sleep robot in adults with insomnia.

Overall, the findings from the studies included in the thesis were not strongly in support of the Somnox sleep robot effectively alleviating symptoms of insomnia in adults. To further improve the understanding of the efficiency of technological devices in reducing arousal, future studies could investigate their impact on stress reactivity levels in participants (as opposed to a generalized hyperarousal), with or without prior stress inducement. There is a lack of empirical evidence on whether relaxation techniques actually improve participants’ sleep. It is also possible that the robot could improve sleep through means other than reducing arousal (e.g., stimulus control). Additionally, without measuring participants’ breathing, it is unclear if potentially reduced arousal is due to more adaptive breathing. Nonetheless, it is important to assess first whether the intervention has any effects at all. Until there is substantial evidence from more studies that demonstrate its efficacy, the Somnox sleep robot should not be considered an evidence-based treatment of insomnia.

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2024. p. 85
Series
Karlstad University Studies, ISSN 1403-8099 ; 2023:29
Keywords
ADHD, anxiety, depression, hyperarousal, insomnia, robot, sleep
National Category
Applied Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-96957 (URN)978-91-7867-406-0 (ISBN)978-91-7867-407-7 (ISBN)
Public defence
2023-01-12, 1B309 Sjöströmsalen, Universitetsgatan 2, Karlstad, 09:15 (English)
Opponent
Supervisors
Available from: 2023-12-01 Created: 2023-10-11 Last updated: 2023-12-01Bibliographically approved
Störe, S. J., Van Zalk, N., Schwartz, W. G., Nilsson, V. & Tillfors, M. (2024). The Relationship Between Social Anxiety Disorder and ADHD in Adolescents and Adults: A Systematic Review. Journal of Attention Disorders, 28(9), 1299-1319
Open this publication in new window or tab >>The Relationship Between Social Anxiety Disorder and ADHD in Adolescents and Adults: A Systematic Review
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2024 (English)In: Journal of Attention Disorders, ISSN 1087-0547, E-ISSN 1557-1246, Vol. 28, no 9, p. 1299-1319Article in journal (Refereed) Published
Abstract [en]

Objective: This review aimed to systematically gather empirical data on the link between social anxiety disorder and ADHD in both clinical and non-clinical populations among adolescents and adults.Method: Literature searches were conducted in PsycInfo, PubMed, Scopus, and Web of Science, resulting in 1,739 articles. After screening, 41 articles were included. Results were summarized using a narrative approach.Results: The prevalence of ADHD in adolescents and adults with SAD ranged from 1.1% to 72.3%, while the prevalence of SAD in those with ADHD ranged from 0.04% to 49.5%. Studies indicate that individuals with both SAD and ADHD exhibit greater impairments. All studies were judged to be of weak quality, except for two studies which were rated moderate quality.Discussion: Individuals with SAD should be screened for ADHD and vice versa, to identify this common comorbidity earlier. Further research is needed to better understand the prevalence of comorbid ADHD and SAD in adolescents.

Place, publisher, year, edition, pages
Sage Publications, 2024
Keywords
ADHD, comorbidity, SAD, subgroup, systematic review
National Category
Psychiatry
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-99587 (URN)10.1177/10870547241247448 (DOI)001207416400001 ()38651640 (PubMedID)2-s2.0-85191328309 (Scopus ID)
Note

Downloads before file update (240709): 91

Available from: 2024-05-10 Created: 2024-05-10 Last updated: 2024-07-09Bibliographically approved
Störe, S. J., Tillfors, M., Angelhoff, C. & Norell-Clarke, A. (2023). A robot intervention for adults with ADHD and insomnia-A mixed-method proof-of-concept study. PLOS ONE, 18(9), 1-20, Article ID e0290984.
Open this publication in new window or tab >>A robot intervention for adults with ADHD and insomnia-A mixed-method proof-of-concept study
2023 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 9, p. 1-20, article id e0290984Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To investigate individual effects of a three-week sleep robot intervention in adults with ADHD and insomnia, and to explore participants’ experiences with the intervention. METHODS: A proof-of-concept study with a mixed-methods design (n = 6, female = 4) where a repeated ABA single-case study was combined with interviews. Data were collected with the Consensus Sleep Diary, wrist actigraphy, questionnaires on symptoms of insomnia, arousal, emotional distress, and ADHD, and through individual interviews. RESULTS: Visual analysis of the sleep diary and actigraphy variables did not support any effects from the robot intervention. Half of participants reported clinically relevant reductions on the Insomnia Severity Index from pre- to post-intervention. No changes regarding ADHD or arousal. Thematic analysis of the interviews resulted in three themes: (1) A pleasant companion, (2) Too much/not enough, and (3) A new routine. CONCLUSION: Adjustments of the intervention ought to be made to match the needs of patients with both ADHD and insomnia before the next trial is conducted.

Place, publisher, year, edition, pages
Public Library of Science (PLoS), 2023
Keywords
Actigraphy, Adult, Attention Deficit Disorder with Hyperactivity, Female, Humans, Robotics, Sleep, Sleep Initiation and Maintenance Disorders, actimetry
National Category
Psychiatry Applied Psychology Occupational Health and Environmental Health
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-96756 (URN)10.1371/journal.pone.0290984 (DOI)37656707 (PubMedID)2-s2.0-85169846833 (Scopus ID)
Available from: 2023-09-19 Created: 2023-09-19 Last updated: 2023-10-12Bibliographically approved
Störe, S. J., Tillfors, M., Wästlund, E., Angelhoff, C., Andersson, G. & Norell-Clarke, A. (2023). Mind, Body and Machine: Preliminary Study to Explore Predictors of Treatment Response After a Sleep Robot Intervention for Adults with Insomnia. Nature and Science of Sleep, 15, 567-577
Open this publication in new window or tab >>Mind, Body and Machine: Preliminary Study to Explore Predictors of Treatment Response After a Sleep Robot Intervention for Adults with Insomnia
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2023 (English)In: Nature and Science of Sleep, ISSN 1179-1608, Vol. 15, p. 567-577Article in journal (Refereed) Published
Abstract [en]

Introduction: The study aimed to explore characteristics of responders to a sleep robot intervention for adults with insomnia, and the likelihood that participants responded to the intervention. Methods: Data from the intervention and the control group in a randomized waitlist-controlled trial (n = 44) were pooled together after both had undergone the intervention. A repeated measures ANOVA and Friedman tests were used to explore changes over time. Differences in baseline characteristics between responders (n = 13), defined as a reduction of -5 on the Insomnia Severity Index from pre- to post-intervention, and non-responders (n = 31) were analyzed with t-tests and chi-square tests. Finally, logistic regression models were estimated.Results: Baseline anxiety was the only statistically significant difference between responders and non-responders (p = 0.03). A logistic regression model with anxiety and sleep quality as predictors was statistically significant, correctly classifying 83.3% of cases. Discussion: The results imply that people with lower anxiety and higher sleep quality at baseline are more likely to report clinically significant improvements in insomnia from the sleep robot intervention.

Place, publisher, year, edition, pages
Dove Medical Press, 2023
Keywords
anxiety, depression, insomnia, sleep, sleep diary, sleep robot, treatment response
National Category
Public Health, Global Health, Social Medicine and Epidemiology Nursing
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-96322 (URN)10.2147/NSS.S408714 (DOI)001031039800001 ()37465662 (PubMedID)2-s2.0-85170092331 (Scopus ID)
Available from: 2023-08-10 Created: 2023-08-10 Last updated: 2023-10-12Bibliographically approved
Störe, S. J., Norell-Clarke, A. & Jakobsson, N. (2023). Sleep researchers' rankings of sleep journals. Journal of Sleep Research, 32(3), Article ID e13756.
Open this publication in new window or tab >>Sleep researchers' rankings of sleep journals
2023 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 32, no 3, article id e13756Article in journal (Refereed) Published
Abstract [en]

The impact factor is used to rank the quality of scientific journals but has been criticised for a number of reasons. The aim of the study was to investigate sleep researchers' perceptions of sleep journals to determine whether subjective rankings of journals were in line with the journals' impact factors. Clarivate's Journal Citation Reports website was used to identify journals containing the words 'sleep' or 'dream' in the titles with an impact factor since 2018, resulting in 12 journals. A survey including questions about how the respondent would rank these journals (e.g., three most prestigious journals) was developed. A total of 122 sleep researchers completed the survey. Sleep, Sleep Medicine Reviews and Journal of Sleep Research were ranked as the three most prestigious sleep journals, in line with the impact factors of the journals. For the rest of the journals, the subjective rankings and impact factors did not correspond as much.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
impact factor, sleep journal, survey
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-92562 (URN)10.1111/jsr.13756 (DOI)000877873900001 ()36316796 (PubMedID)2-s2.0-85141431569 (Scopus ID)
Available from: 2022-11-29 Created: 2022-11-29 Last updated: 2023-06-12Bibliographically approved
Störe, S. J. (2022). Swedish Internet forum users’ views and experiences of melatonin treatments for troubled sleep. Sleep Health, 8(2), 225-229
Open this publication in new window or tab >>Swedish Internet forum users’ views and experiences of melatonin treatments for troubled sleep
2022 (English)In: Sleep Health, ISSN 2352-7218, E-ISSN 2352-7226, Vol. 8, no 2, p. 225-229Article in journal (Refereed) Published
Abstract [en]

Objective: To investigate Internet forum users’ views and experiences of melatonin treatments for troubled sleep. Design: A thematic analysis of online disclosures about melatonin treatments was conducted. Setting: The largest Swedish Internet forum (Flashback.org). Key search terms were melatonin and circadin/cirkadin. Results: The search generated 2669 posts from 857 unique profiles in 174 different threads, posted between September 2004 and January 2021. The thematic analysis resulted in 4 themes: (1) being one's own pharmacist, (2) wanted and unwanted effects, (3) history of unmet needs, and (4) national guidelines and clinical practice in Sweden. Conclusions: The current study suggests that experiences with melatonin treatments are diverse, and the views on exogenous melatonin polarized, albeit with a general consensus on the importance of individual factors when it comes to administration and efficacy. The study also suggests that there is an extensive off-label use of melatonin (eg, younger patients and longer treatment periods than indicated). More studies on melatonin treatments are warranted to bridge the gap between scientific knowledge and clinical practice.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Circadian rhythm, Circadin, Internet forum, Melatonin, Sleep, Thematic analysis
National Category
Applied Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-89477 (URN)10.1016/j.sleh.2021.12.005 (DOI)000795455500016 ()2-s2.0-85124534429 (Scopus ID)
Available from: 2022-04-12 Created: 2022-04-12 Last updated: 2022-06-02Bibliographically approved
Störe, S. J., Tillfors, M., Wästlund, E., Angelhoff, C. & Norell-Clarke, A. (2022). Technically sleeping?: A clinical single-case study of a commercial sleep robot. Frontiers in Psychology, 13, Article ID 919023.
Open this publication in new window or tab >>Technically sleeping?: A clinical single-case study of a commercial sleep robot
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2022 (English)In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 13, article id 919023Article in journal (Refereed) Published
Abstract [en]

The Somnox sleep robot is promoted as sleep enhancing. The currentstudy investigated individual effects, the acceptability and the safety of, andexperiences with, a 3-week intervention in adults with insomnia. A repeatedABA single-case design (n = 4) was used to evaluate the effects of the sleeprobot compared with baseline, as measured with a sleep diary and actigraphy.Pre-, post-, and 1-month follow-up assessments were conducted, measuringsymptoms of insomnia, level of somatic arousal, and symptoms of depressionand anxiety. Questions about adherence were included in the sleep diary.Individual interviews were conducted post intervention to explore theparticipants’ experiences with the sleep robot. The sleep diary and actigraphydata showed marginal differences, and if something, often a slight deteriorationin the intervention phase. Three participants reported improvements regardingtheir sleep in the interviews compared with baseline, which mirrored theresults on the questionnaires (insomnia and arousal) for two of the participants.The same three participants adhered to the intervention. Stable or improvedself-assessed symptoms of depression and anxiety, and information fromthe individual interviews, suggest that the intervention is safe for adults withinsomnia. The results regarding the effects of the sleep robot were mixed, andought to be scrutinized in larger studies before confident recommendationscan be made. However, the study supports the acceptability and safety of theintervention in adults with insomnia.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2022
Keywords
arousal, hyperarousal, insomnia, sleep, wake after sleep onset
National Category
Applied Psychology Nursing
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-93045 (URN)10.3389/fpsyg.2022.919023 (DOI)000905639700001 ()2-s2.0-85145507084 (Scopus ID)
Available from: 2023-01-23 Created: 2023-01-23 Last updated: 2023-10-12Bibliographically approved
Störe, S. J. & Jakobsson, N. (2022). The Effect of Mandala Coloring on State Anxiety: A Systematic Review and Meta-Analysis. Art Therapy, 39(4), 173-181
Open this publication in new window or tab >>The Effect of Mandala Coloring on State Anxiety: A Systematic Review and Meta-Analysis
2022 (English)In: Art Therapy, ISSN 0742-1656, E-ISSN 2159-9394, Vol. 39, no 4, p. 173-181Article in journal (Refereed) Published
Abstract [en]

This meta-analysis assessed the effectiveness of mandala coloring, compared with free drawing on state anxiety in adults. A systematic search for studies yielded eight studies, which constituted a total of 578 participants, with 289 in the mandala coloring group and 289 in the free drawing group. The results indicated that coloring mandala designs was not found to reduce state anxiety significantly more than free drawing. Larger effect sizes were found in the studies with lower precision, indicating some evidence of bias toward finding an effect. The findings suggest that mandala coloring and free drawing are equally effective coloring techniques to achieve anxiety reduction. More high-quality studies are warranted before any recommendations can be made with confidence.

Place, publisher, year, edition, pages
Taylor & Francis, 2022
Keywords
anxiety, mandalas, coloring, art, meta-review
National Category
Psychiatry Applied Psychology
Research subject
Psychology; Economics
Identifiers
urn:nbn:se:kau:diva-88333 (URN)10.1080/07421656.2021.2003144 (DOI)000738536000001 ()2-s2.0-85122267470 (Scopus ID)
Available from: 2022-04-07 Created: 2022-04-07 Last updated: 2023-02-02Bibliographically approved
Störe, S. J., Beckman, L. & Jakobsson, N. (2022). The effect of robot interventions on sleep in adults: a systematic review and network meta-analysis. Journal of Clinical Sleep Medicine (JCSM), 18(7), 1877-1884
Open this publication in new window or tab >>The effect of robot interventions on sleep in adults: a systematic review and network meta-analysis
2022 (English)In: Journal of Clinical Sleep Medicine (JCSM), ISSN 1550-9389, E-ISSN 1550-9397, Vol. 18, no 7, p. 1877-1884Article, review/survey (Refereed) Published
Abstract [en]

Study Objectives: Robotic pets or companion robots have demonstrated positive effects on several emotional and physiological factors in humans. Robots could constitute a complementary or alternative method to treat sleep problems, but individual studies on robots' effectiveness regarding sleep show mixed results. The aim of the current study was to compare the effects of robots, plush toys, and treatment as usual on sleep in adults. Methods: The current study is a systematic review and frequentist network meta-analysis of all randomized and cluster randomized controlled trials comparing the effects of robots, plush toys, and treatment as usual on total sleep time in adults. Results: Four studies were included in the analysis. Three studies were considered to have a high risk of bias, whereas one was rated with some concerns. The studies comprised 381 participants. These participants were older adults, with or without dementia, living in nursing homes. The total sleep time was the only common sleep measure included in all 4 studies. The network meta-analysis showed no statistically significant differences between the 3 experimental groups. Conclusions: The robot interventions were not found to have positive effects on total sleep time in older adults compared with plush toys or treatment as usual. Future studies should use robots especially made to target sleep, include a thorough screening of the participants, and exclude people with adequate sleep, select appropriate sleep measures, and report the results appropriately for future meta-analyses.

Place, publisher, year, edition, pages
American Academy of Sleep Medicine, 2022
Keywords
companion robot, network meta-analysis, plush toy, randomized controlled trial, robot, service robot, robotic pets, sleep, social robot, systematic review
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-91530 (URN)10.5664/jcsm.10022 (DOI)000823115600019 ()35404223 (PubMedID)2-s2.0-85133215210 (Scopus ID)
Available from: 2022-08-19 Created: 2022-08-19 Last updated: 2023-10-12Bibliographically approved
Störe, S. J., Tillfors, M., Wästlund, E., Angelhoff, C., Andersson, G. & Norell-Clarke, A. (2022). The effects of a sleep robot intervention on sleep, depression and anxiety in adults with insomnia: A randomized waitlist-controlled trial. Journal of Sleep Research, 32(3), Article ID 13758.
Open this publication in new window or tab >>The effects of a sleep robot intervention on sleep, depression and anxiety in adults with insomnia: A randomized waitlist-controlled trial
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2022 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 32, no 3, article id 13758Article in journal (Refereed) Published
Abstract [en]

The study objective was to assess if a 3-week intervention with the Somnox sleep robot had effects on symptoms of insomnia, somatic arousal, and/or concurrent symptoms of depression and anxiety in adults with insomnia, compared with a waitlist-control group. The participants (n = 44) were randomized to a 3-week intervention with the sleep robot (n = 22), or to a waitlist-control group (n = 22). The primary outcome measure was the Insomnia Severity Index administered at baseline, mid-intervention, post-intervention and at 1-month follow-up. Secondary outcome measures were the Pre-Sleep Arousal Scale, and the Hospital Anxiety and Depression Scale. Additionally, sleep-onset latency, wake time after sleep onset, total sleep time and sleep efficiency were measured the week prior to and the last week of the intervention, both subjectively with the Consensus Sleep Diary and objectively with wrist actigraphy. Mixed-effects models were used to analyse data. The effect of the sleep robot on the participants' insomnia severity was not statistically significant. The differences between the intervention group and the control group on the measures of arousal, anxiety and depression were also not statistically significant, and neither were the sleep diary and actigraphy variables. In conclusion, a 3-week intervention with daily at-home use of the robot was not found to be an effective method to relieve the symptom burden in adults with insomnia.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
Keywords
arousal, hyperarousal, robot, sleep
National Category
Psychiatry
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-92400 (URN)10.1111/jsr.13758 (DOI)000871837800001 ()36285420 (PubMedID)2-s2.0-85140398595 (Scopus ID)
Funder
Region Värmland, HNT 2017/279
Available from: 2022-11-04 Created: 2022-11-04 Last updated: 2023-06-08Bibliographically approved
Organisations
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ORCID iD: ORCID iD iconorcid.org/0000-0001-5749-0774

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