Scholars@Duke
Melanie K. Leggett

Melanie K. Leggett

Associate Professor in Psychiatry and Behavioral Sciences
Psychiatry & Behavioral Sciences, Behavioral Medicine & Neurosciences
melanie.leggett@duke.edu
N/A, Durham, NC 27705
N/A, Durham, NC 27705

Selected Publications

Does physiological hyperarousal enhance error rates among insomnia sufferers?

Journal Article Sleep · August 1, 2013 OBJECTIVE: To examine the association between physiological hyperarousal and response accuracy on reaction time tasks among individuals with insomnia. DESIGN AND SETTING: This study was conducted at affiliated Veterans Administration (VA) and academic medi ... Full text Link to item Cite

Sensitivity and specificity of polysomnographic criteria for defining insomnia.

Journal Article J Clin Sleep Med · May 15, 2013 STUDY OBJECTIVES: In recent years, polysomnography-based eligibility criteria have been increasingly used to identify candidates for insomnia research, and this has been particularly true of studies evaluating pharmacologic therapy for primary insomnia. Ho ... Full text Link to item Cite

Testing the reliability and validity of DSM-IV-TR and ICSD-2 insomnia diagnoses. Results of a multitrait-multimethod analysis.

Journal Article Arch Gen Psychiatry · October 2011 CONTEXT: Distinctive diagnostic classification schemes for insomnia diagnoses are available, but the optimal insomnia nosology has yet to be determined. OBJECTIVES: To test the reliability and validity of insomnia diagnoses listed in the American Psychiatr ... Full text Link to item Cite

Nightmare reduction in a Vietnam veteran using imagery rehearsal therapy.

Journal Article J Clin Sleep Med · October 15, 2010 Following exposure to traumatic events, approximately 19% of combat veterans develop posttraumatic stress disorder. One of the main symptoms of this mental illness is reexperiencing the trauma, which is commonly expressed in the form of chronic trauma-rela ... Link to item Cite

Nonpharmacological Treatments

Journal Article · April 30, 2010 Full text Cite

Home is where sleep is: an ecological approach to test the validity of actigraphy for the assessment of insomnia.

Journal Article J Clin Sleep Med · February 15, 2010 STUDY OBJECTIVES: This study tested the ecological validity of actigraphy (ACT) for estimating objective sleep parameters in participants' homes. We also examined how well ACT and polysomnography (PSG) measures discriminated (1) individuals with and withou ... Link to item Cite

Ethnic differences in continuous positive airway pressure (CPAP) adherence in veterans with and without psychiatric disorders.

Journal Article Behav Sleep Med · 2010 Continuous positive airway pressure (CPAP) is a safe, effective treatment for sleep apnea, yet adherence is notoriously problematic. Vulnerable populations that may be at increased risk of sleep apnea include African Americans (AAs) and individuals with ps ... Full text Link to item Cite

Cognitive behavioral therapy for patients with primary insomnia or insomnia associated predominantly with mixed psychiatric disorders: a randomized clinical trial.

Journal Article Sleep · April 2009 OBJECTIVE: This study was conducted to evaluate the efficacy of cognitive behavioral therapy (CBT) against a sleep hygiene education control therapy in patients with primary or comorbid insomnia. DESIGN AND SETTING: Randomized, parallel-group, clinical tri ... Full text Link to item Cite

Nonpharmacologic treatment of insomnia.

Journal Article Curr Treat Options Neurol · September 2008 Insomnia is a widespread and debilitating disorder. Regardless of the initial cause, it may assume a chronic course perpetuated by psychological and behavioral factors. Although sedative-hypnotic medications are the most common treatment for insomnia, they ... Full text Link to item Cite

Psychomotor performance deficits and their relation to prior nights' sleep among individuals with primary insomnia.

Journal Article Sleep · May 2008 OBJECTIVE: To examine psychomotor (reaction time) performance deficits and their relation to subjective and objective sleep measures among individuals with primary insomnia (PI). DESIGN AND SETTING: This study was conducted at affiliated VA and academic me ... Full text Link to item Cite

Objective evidence of sleep disturbance in women with posttraumatic stress disorder.

Journal Article J Trauma Stress · December 2007 Although sleep disturbance is considered a hallmark of posttraumatic stress disorder (PTSD), objective evidence for sleep disturbance in patients with PTSD has been equivocal. The goal of the current investigation was to objectively examine sleep disturban ... Full text Link to item Cite

Sleep Disturbance in Fibromyalgia

Journal Article Sleep Medicine Clinics · March 1, 2007 Fibromyalgia (FM), characterized by diffuse myalgia, multiple topographically specific tender points, chronic fatigue, psychosocial distress, and disturbed, unrefreshing sleep, is a significant health problem. Clinical survey studies suggest that the major ... Full text Cite

Graded exposure therapy for addressing claustrophobic reactions to continuous positive airway pressure: a case series report.

Journal Article Behav Sleep Med · 2007 Continuous positive airway pressure (CPAP) is a safe, effective treatment for obstructive sleep apnea, and yet many patients develop claustrophobic reactions to the CPAP nasal mask and cannot tolerate this treatment. We examined the efficacy of a graded in ... Full text Link to item Cite

Defining insomnia: quantitative criteria for insomnia severity and frequency.

Journal Article Sleep · April 2006 STUDY OBJECTIVE: Recent efforts have been made to develop quantitative frequency, duration, and severity criteria for insomnia. The current study was conducted to test a range of frequency and severity criteria sets for discriminating primary insomnia suff ... Full text Link to item Cite

Sleep disturbances in aging

Journal Article Advances in Cell Aging and Gerontology · December 1, 2005 The prevalence of insomnia, SDB, circadian rhythm disorders, and sleep-related movement disorders increases substantially in late-life. In addition, normal age-related changes in sleep architecture create a fragmented and light sleep pattern that sets the ... Full text Cite

Nonpharmacologic Therapy of Insomnia

Journal Article · November 4, 2005 Full text Cite

Cognitive-behavioral therapy for primary insomnia.

Journal Article Clin Psychol Rev · July 2005 Primary insomnia (PI) is a prevalent form of sleep difficulty that impairs diurnal functioning, reduces quality of life and enhances health care utilization/costs for millions worldwide. Whereas the underlying pathophysiology of PI remains poorly understoo ... Full text Link to item Cite

CPAP compliance in sleep apnea patients with and without laboratory CPAP titration.

Journal Article Sleep Breath · March 2004 Advances in auto-adjusting positive airway pressure technology for obstructive sleep apnea now permit this treatment to be initiated outside of the sleep laboratory environment, bypassing the need for laboratory-based titration studies. Thus far, little re ... Full text Link to item Cite

A pilot study of inexpensive sleep-assessment devices.

Journal Article Behav Sleep Med · 2004 Polysomnography (PSG), the gold standard sleep-assessment methodology, is impractical for many applications. Although alternative assessment methodologies are available, it is not clear which most correlates with PSG measures. This study compared sleep log ... Full text Link to item Cite

Accuracy of sleep perceptions among insomnia sufferers and normal sleepers.

Journal Article Sleep Med · July 2003 OBJECTIVE: To examine the distribution, consistency, and correlates of sleep time perceptions in primary insomnia sufferers and normal sleepers across settings (laboratory and home). METHODS: Fifty-two middle-aged and older insomnia sufferers and 49 matche ... Full text Link to item Cite

Changes in depressive symptoms after continuous positive airway pressure treatment for obstructive sleep apnea.

Journal Article Sleep Breath · March 2003 It is generally believed that obstructive sleep apnea (OSA) causes depression in some patients, yet it is unknown whether this depression is an actual clinical phenomenon or purely a result of overlapping somatic/physical symptoms shared by both disorders. ... Full text Link to item Cite

Behavioral treatment of insomnia.

Journal Article Expert Rev Neurother · January 2002 Insomnia is a prevalent and potentially serious condition that compromises the functioning, health status and quality of lives of millions of individuals worldwide. Chronic insomnia is often perpetuated by psychological and behavioral factors, such as dysf ... Full text Link to item Cite

Relaxation therapy for insomnia: nighttime and day time effects.

Journal Article Behav Res Ther · July 2000 We compared day time functioning in college students with and without insomnia and explored changes in day time functioning after progressive relaxation (PR) treatment for insomnia. Students with insomnia (SWI; n = 57) were compared to a control group of s ... Full text Link to item Cite

Relaxation to assist sleep medication withdrawal.

Journal Article Behav Modif · July 1999 This study explores the usefulness of relaxation and gradual medication withdrawal in weaning insomniacs from sleep (hypnotic) medication. We recruited 40 volunteers from the community who had insomnia, half of whom were chronic users of hypnotics while th ... Full text Link to item Cite

A comparison of the efficacy of stimulus control for medicated and nonmedicated insomniacs.

Journal Article Behav Modif · January 1998 A sample of 21 medicated and 20 nonmedicated insomniacs participated in a sleep medication withdrawal program that provided education about sleep medication and a gradual medication withdrawal schedule. Ten medicated participants received stimulus control ... Full text Link to item Cite

Fatigue and sleep disorders.

Journal Article Behav Res Ther · August 1997 Fatigue has often been confused with sleepiness and has received little study as an independent symptom of sleep disturbance. To investigate if fatigue is a common and severe symptom in sleep disordered individuals, the Fatigue Severity Scale (FSS) was adm ... Full text Link to item Cite

Acute deprivation of the terminal four hours of sleep does not increase delta (0-3-Hz) electroencephalograms: a replication.

Journal Article Sleep · August 1991 This experiment evaluated further our previous finding that substitution of waking for the terminal 3-4 hr of sleep produces little or no increase in either visually scored or computer measures of delta sleep. Eleven young adults (mean age 24.5 yr) were st ... Full text Link to item Cite