Conceptual Framework for Insomnia: A Cognitive Model in Practice

Abstract

Insomnia is a widespread neuropsychological sleep-related disorder known to result in various predicaments including cognitive impairments, emotional distress, negative thoughts, and perceived sleep insufficiency besides affecting the incidence and aggravation of other medical disorders. Despite the available insomnia-related theoretical cognitive models, clinical studies, and related guidelines, an evidence-based conceptual framework for a personalized approach to insomnia seems to be lacking. This study proposes a conceptual cognitive framework (CCF) providing insight into cognitive mechanisms involved in the predisposition, precipitation, and perpetuation of insomnia and consequent cognitive deficits. The current CCF for insomnia relies on evaluative conditional learning and appraisal which generates negative valence (emotional value) and arousal (cognitive value). Even with the limitations of this study, the suggested methodology is well-defined, reproducible, and accessible can help foster future high-quality clinical databases. During clinical insomnia but not the neutral one, negative mood (trait-anxiety) causes cognitive impairments only if mediating with a distorted perception of insomnia (Ind-1 = 0.161, 95% CI 0.040–0.311). Further real-life testing of the CCF is intended to formulate a meticulous, decision-supporting platform for clinical interventions. Furthermore, the suggested methodology is expected to offer a reliable platform for CCF-development in other cognitive impairments and support the causal clinical data models. It may also improve our knowledge of psychological disturbances and complex comorbidities to help design rehabilitation interventions and comprehensive frameworks in line with the “preventive medicine” policies.

Assessment of Insomnia and Associated Factors Among Patients Who Have Recovered from COVID-19 in Vietnam

“…Figure 1 shows the proportion of participants who had an insomnia disorder (ISI ≥ 8) and categorized the level of insomnia disorder, including the absence of insomnia (0-7), mild insomnia (8)(9)(10)(11)(12)(13)(14), moderate insomnia (15)(16)(17)(18)(19)(20)(21), and severe insomnia (22)(23)(24)(25)(26)(27)(28). There was approximately one-third of respondents who had insomnia symptoms (34.5%) categorized as mild, moderate or severe symptoms of insomnia, which were recorded as 18.2%, 12.6% and 3.7%, respectively.…”

“…The cut-off score for diagnosing insomnia disorder is ≥8 while the absence of insomnia scored in the range from 0 to 7. 26 The total score of insomnia disorder is categorized as follows; mild insomnia (8)(9)(10)(11)(12)(13)(14), moderate insomnia (15)(16)(17)(18)(19)(20)(21), and severe insomnia (22)(23)(24)(25)(26)(27)(28). 27…”

“…Insomnia is considered a widespread neuropsychological sleep-related disorder known to result in various issues including cognitive impairments, negative thoughts, emotional distress, and perceived sleep insufficiency, besides affecting the rate of other medical disorders. 10 Clinically, insomnia is considered one of the major psychiatric disorders in adolescents, including the main symptom being perceived sleep dissatisfaction, and difficulty in initiating or maintaining sleep. 11 , 12 Additionally, insomnia was commonly reported among various populations, not only in the acute phase of COVID-19 infection but also after recovery.…”

Characteristics of Sleep Disturbance in Patients with Long COVID: A Retrospective Observational Study in Japan

“…Another systematic review [6] that included information from 32 countries showed that there was an increase in the prevalence of mental health issues in the general population during the COVID-19 pandemic, with estimated global prevalence of depression, anxiety, and sleep problems of 27% to 28%, indicating that social and economic burdens during and after epidemics or pandemics have a great global impact. Among these frequent symptoms of long COVID, insomnia has recently been recognized as a neuropsychological disorder leading to various medical issues including cognitive impairments, emotional distress, negative thoughts, and further medical disorders [7]. In addition, sleep disturbance has been reported in various populations, not only in the acute phase of infection, but also in the chronic phase after recovery from acute symptoms [8].…”

Plataforma de computação neurocognitiva:protótipo na reabilitação do zumbido através da regulação da emoção concomitante com a estimulação transcraniana por corrente diret

“…The neurocognitive approach has opened new avenues for research and innovation in clinical practice. Clinical utilities were revealed in recent studies about neurocognitive evaluation in the differential diagnosis (HALE et al, 2011;WEISSMAN et al, 2012), the cognitive-behavioral efficacy (KUELZ et al, 2006;LEGERSTEE et al, 2010;MATHEWS et al, 1995;GORMAN, 2005;THASE, 2006), pharmacological (HALE; FIORELLO; BROWN, 2005;HALE et al, 2011), and neurocognitive rehabilitation (KERNS; ESO; THOM-SON, 1999;KOSTER;FOX;MACLEOD, 2009;VASSILOPOULOS;PRANTZA-LOU, 2009)in affective disorders and cognitive impairments GHODRATITOOSTANI et al, 2016a;TOOSTANI et al, 2017;VAZIRI et al, 2021). Another compelling reason for adopting a neurocognitive perspective is recognizing and measuring the severity of symptoms, syndromes, and disorders.…”