title: The exploratory power of sleep effort, dysfunctional beliefs and arousal for insomnia severity and polysomnography-determined sleep.
abstract: 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.
authors.affiliation: Department of Clinical Psychology and Psychophysiology/Sleep Medicine, Center for Mental Disorders, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Hertenstein
authors.affiliation: Department of Clinical Psychology and Psychophysiology/Sleep Medicine, Center for Mental Disorders, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Nissen
authors.affiliation: Department of Clinical Psychology and Psychophysiology/Sleep Medicine, Center for Mental Disorders, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Dieter
authors.initials: D
authors.lastname: Riemann
authors.affiliation: Department of Clinical Psychology and Psychophysiology/Sleep Medicine, Center for Mental Disorders, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Feige
authors.affiliation: Department of Clinical Psychology and Psychophysiology/Sleep Medicine, Center for Mental Disorders, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Chiara
authors.initials: C
authors.lastname: Baglioni
authors.affiliation: Department of Clinical Psychology and Psychophysiology/Sleep Medicine, Center for Mental Disorders, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Kai
authors.initials: K
authors.lastname: Spiegelhalder
mesh_terms: D000328:Adult; D001143:Arousal; D001290:Attitude; D016022:Case-Control Studies; D003863:Depression; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D017286:Polysomnography; D012044:Regression Analysis; D012890:Sleep; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology*; D013997:Time Factors
keywords: dysfunctional beliefs about sleep; hyperarousal; insomnia; polysomnography; sleep effort