Cognitive restructuring and imagery modification in insomnia disorder: a feasibility study

Abstract

Insomnia is defined by the DSM-5 (American Psychiatric Association, 2013, p. 362) as a "predominant complaint of dissatisfaction with sleep quantity or quality", especially difficulty initiating or maintaining sleep or earlymorning awakening; insomnia is widespread (prevalence of 5.7% in the German population; Schlack, Hapke, Maske, Busch, & Cohrs, 2013) and tends to persist for years (Morin et al., 2009). This disorder has serious effects on patient's lives; for instance, insomnia is predictive of subsequent depression (Baglioni et al., 2011) and is associated with suicide risk independent of depression (Drapeau & Nadorff, 2017; Etindele Sosso, 2017). Cognitive behavioural therapy is the method of choice for treating patients with chronic insomnia (American

The Roles of Intrusive Visual Imagery and Verbal Thoughts in Pre-Sleep Arousal of Patients with Insomnia Disorder: A Path Model

“…shows that insomnia complaints in many patients are due to intrusive thoughts and images (Harvey, 2000;Nelson & Harvey, 2002, 2003a, 2003b, and 2) that modification of these unwanted thoughts and images via cognitive therapy can alleviate insomnia severity (Harvey & Payne, 2002;Molen et al, 2013;Schmid & Steil, 2019;Sheikh, 1976;Woolfolk & McNulty, 1983). Moreover, a great deal of research yielded that insomnia patients had higher pre-sleep cognitive and somatic arousal scores than normal sleepers, and higher pre-sleep arousal was associated with longer sleep-onset latency, decreased total sleep time, more frequent middle of night and early morning awakenings, lower sleep quality, greater daytime impairment, and higher insomnia severity (Broman & Hetta, 1994;Jansson-Fröjmark & Norell-Clarke, 2012;Marques et al, 2015;Nicassio et al, 1985;Palagini et al, 2016Palagini et al, , 2017Puzino et al, 2019;Ruivo Marques et al, 2018;Yeh et al, 2015).…”