A Correlational Analysis of the Relationships among Intolerance of Uncertainty, Anxiety Sensitivity, Subjective Sleep Quality, and Insomnia Symptoms

Abstract

In this study, we used structural equation modeling to investigate the interplay among Intolerance of Uncertainty (IU), Anxiety Sensitivity (AS), and sleep problems. Three hundred undergraduate students completed the Intolerance of Uncertainty Scale, the Intolerance of Uncertainty Inventory, the Anxiety Sensitivity Index, the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Pittsburgh Sleep Quality Index and the Insomnia Severity Index. 68% and 40% of the students reported poor sleep quality or sub-threshold insomnia problems, respectively. Depression and anxiety levels were above the cut-off for about one-fourth of the participants. Structural equation modeling revealed that IU was strongly associated with AS, in turn influencing both insomnia severity and sleep quality via depression and anxiety. Significant indirect effects revealed that an anxious pathway was more strongly associated with insomnia severity, while a depression pathway was more relevant for worsening the quality of sleep. We discussed the results in the frameworks of cognitive models of insomnia. Viewing AS and IU as antecedents of sleep problems and assigning to AS a pivotal role, our study suggested indications for clinical interventions on a population at risk for sleep disorders.

Associations of Social Isolation with Anxiety and Depression During the Early COVID-19 Pandemic: A Survey of Older Adults in London, UK

“…Worry and ruminating thoughts provoke cognitive arousal and may disturb cortisol homeostasis, resulting in poorer sleep. Such associations have previously been reported under similar circumstances ( 41 ). Furthermore, there is existing evidence that loneliness and poor sleep have a bi-directional relationship ( 42 ).…”

Insomnia during the COVID-19 pandemic in a Greek population

“…Ruminating thoughts provoking cognitive arousal and unpleasant physical reactions also hinder sleep promotion. This is in line with previous findings (Lauriola et al, 2019) and may also explain the high AIS scores in those answering "I don't know" when asked if they, or someone else close to them, had contracted the virus, since this answer suggests uncertainty. In this study, COVID-19 worry was also associated with insomnia.…”

COVID-19 Uncertainty and Sleep: The Roles of Perceived Stress and Intolerance of Uncertainty during the Early Stage of the COVID-19 Outbreak

“…Sleep research has shown that stress uniquely predict poor sleep quality, while IU has been less studied with sleep problems [20]. Previous research has overlooked the role of cognitive dispositions that might exacerbate stress, thus contributing to the continuation of sleep problems [14]. Perceived uncertainty and IU might be such dispositions.…”

“…Intolerance of uncertainty (IU) relates to the cognitive unacceptability of uncertainty and represents a dispositional characteristic from those people who are more likely to " nd ambiguity stressful and upsetting, believe uncertainty is negative and should be avoided, and have di culty functioning in uncertain situations" [13,14]. Although uncertainty is pervasive and inherent in people's daily life, individuals who have high degree of perceived uncertainty or who are high in IU experience might signi cantly impair their daily functioning [15,16].…”

“…However, research on uncertainty in a lethal and urgent infectious disease outbreak and its side effect is limited among non-patients. The role of IU in sleep problems has not been studied extensively [14]. Unknown is how IU impacts the public in cognitively processing a COVID-19-related stressor, as well as how their sleeping behaviors are in uenced by such serious outbreak-related events.…”