The exploratory power of sleep effort, dysfunctional beliefs and arousal for insomnia severity and polysomnography‐determined sleep

Abstract

Summary Differences between subjective sleep perception and sleep determined by polysomnography (PSG) are prevalent, particularly in patients with primary insomnia, indicating that the two measures are partially independent. To identify individualized treatment strategies, it is important to understand the potentially different mechanisms influencing subjective and PSG‐determined sleep. The aim of this study was to investigate to what extent three major components of insomnia models, i.e. sleep effort, dysfunctional beliefs and attitudes about sleep, and presleep arousal, are associated with subjective insomnia severity and PSG‐ determined sleep. A sample of 47 patients with primary insomnia according to DSM‐IV criteria and 52 good sleeper controls underwent 2 nights of PSG and completed the Glasgow Sleep Effort Scale, the Dysfunctional Beliefs and Attitudes about Sleep Scale, the Pre‐Sleep Arousal Scale and the Insomnia Severity Index. Regression analyses were conducted to investigate the impact of the three predictors on subjective insomnia severity and PSG‐ determined total sleep time. All analyses were adjusted for age, gender, depressive symptoms and group status. The results showed that subjective insomnia severity was associated positively with sleep effort. PSG‐determined total sleep time was associated negatively with somatic presleep arousal and dysfunctional beliefs and attitudes about sleep. This pattern of results provides testable hypotheses for prospective studies on the impact of distinct cognitive and somatic variables on subjective insomnia severity and PSG‐determined total sleep time.

Predictors of Nightly Subjective-Objective Sleep Discrepancy in Poor Sleepers over a Seven-Day Period

“…We included a measure of self-reported physiological arousal because an experimental study has shown that increases in physiological arousal lead to increases in TST and SOL discrepancy [41]. The inclusion of a measure of sleep effort was based on research demonstrating that sleep effort is strongly associated with subjective reports of sleep disturbance but not objective sleep parameters (PSG) [55]. Mood upon awakening was assessed due to evidence that low mood and general feeling state, at the time of reporting of subjective sleep, may mediate underestimations of objective sleep parameters [35,56].…”

A phenomenological inquiry into the experience of sleep: Perspectives of US military veterans with insomnia and serious mental illness

“…Participants endorsed many of the same sleep-related ideas as nonveterans and people without SMI (Harvey, 2002), including that they (Carney, Edinger, Meyer, Lindman, & Istre, 2006;Hertenstein et al, 2015) and underscores the value of cognitive treatment to address unhelpful insomnia-related cognitions (Harvey, 2002).…”

“…'s recent () qualitative report on how insomnia is experienced by people with psychosis. Such preoccupation and efforts are also common within the general population with insomnia (Carney, Edinger, Meyer, Lindman, & Istre, ; Hertenstein et al., ) and underscores the value of cognitive treatment to address unhelpful insomnia‐related cognitions (Harvey, ).…”

Glasgow Sleep Effort Scale: Translation and Psychometric properties of the Persian Version

“…In addition, sleep effort is one of the basic mechanisms that explain differences in subjective and objective insomnia. For example, there are studies show that sleep effort is the predictor of severity of subjective insomnia, while dysfunctional beliefs about insomnia is predictor of objective insomnia (24). The available treatments to reduce sleep effort in patients with insomnia show that patients who received paradoxical intention therapy (e.g., deliberate practice of remaining awake) had lower sleep effort and performance anxiety in comparison with control group (25).…”