Examining maladaptive beliefs about sleep across insomnia patient groups.
OBJECTIVE
Unhelpful beliefs about sleep have been linked to insomnia, and increasing one's cognitive flexibility about sleep has been linked to posttreatment sleep improvement. This study evaluated whether levels of such beliefs differ across insomnia groups and whether there are particular beliefs that differ for specific insomnia subtypes.


METHODS
Participants (N=1384) were people with insomnia and good sleepers ranging from 18 to 89 years old (mean=42.6; S.D.=19.4). Data from previous studies at five insomnia clinical sites were pooled to examine responses on the Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS) across differing insomnia groups.


RESULTS
Group analyses revealed that those from community-based insomnia clinics and those who are hypnotic-dependent generally had the highest levels of unhelpful sleep-related beliefs. With the exception of beliefs about sleep needs (wherein only community sleep clinic patients had high scores relative to good sleepers), all insomnia groups had higher scores on the 16-item DBAS (DBAS-16) than good sleepers. A validity analysis suggested that a DBAS-16 index score of >3.8 represented the level of unhelpful beliefs associated with clinically significant insomnia, although a slightly lower cutoff may be useful for identifying an unhelpful degree of sleep-related beliefs in highly screened primary-insomnia-only and medical patient groups.


CONCLUSIONS
This study offers descriptive data for the use of DBAS-16 across insomnia subgroups, which will help the user understand what degree of maladaptive sleep beliefs is most strongly associated with clinically significant levels of insomnia. Results also may have implications for cognitive targeting during treatment for particular insomnia groups.
Carney
Colleen E
CE
Sleep and Depression Laboratory, Departmentof Psychology, Ryerson University, 350 Victoria Street, Toronto, Ontario, Canada. ccarney@psych.ryerson.ca
Edinger
Jack D
JD
Morin
Charles M
CM
Manber
Rachel
R
Rybarczyk
Bruce
B
Stepanski
Edward J
EJ
Wright
Helen
H
Lack
Leon
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D019540:Area Under Curve; D001294:Attitude to Health; D003469:Culture; D005260:Female; D006266:Health Education; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D012890:Sleep; D007319:Sleep Initiation and Maintenance Disorders / Q000523:psychology*; D011795:Surveys and Questionnaires