How Your Mind Affects Sleep Even with Insomnia from Anxiety, Depression
We already knowthathow we think and behave toward sleepaffects how well we actually sleep. However, although a number of studies have linked primary insomnia with dysfunctional sleep thoughts and poorsleep hygiene,only a limited number have explored the association of such thoughts and behaviors with comorbid insomnia.
Perhaps that's because we're too quick to simply blame our insomnia on the other conditions we're living with.
Do our beliefs and behaviors toward sleep influence our sleep quality regardless of whether we are living with primary insomnia or comorbid insomnia? And if so, how can these be overcome?
A Japanese studypublished in theSleep and Biological Rhythmsin 2013 set out to answer these questions.
What is primary insomnia?
First, some definitions. Primary insomnia is thought to arise primarily from factors such as negative and incorrect thoughts toward sleep and physiological factors such as hyperarousal.
To be diagnosed with primary insomnia, an individual needs to be experiencing insomnia symptoms that are not attributable to a mental, medical, or environmental cause.
What is comorbid insomnia?
Comorbid insomnia is far more common than primary insomnia, accounting for nearly85 to 90 percent of insomnia cases.
Also known as secondary insomnia, comorbid insomnia is a symptom or result of another condition, such as:
Medical disorders
Psychiatric disorders
Neurological disorders
Sleep disorders such assleep apneaand restless legs syndrome
Some medications, such as those prescribed for depression and hypertension, can also lead to insomnia.
As many as67 to 84 percent of those living with depression also suffer with sleep disturbance, andtwo out of threeindividuals with generalized anxiety disorder report at least one type of sleep disorder.
The study
Researchers in theSleep and Biological Rhythms研究招募了292名参与者平均ge of 42, and of those:
97 were good sleepers
73 were living with primary insomnia
17 were living with insomnia and anxiety
39 were living with insomnia and depression
66 were living with insomnia and both anxiety and depression
All insomnia groups reported living with the sleep disorder for over six years, and there was no significant difference when it came to insomnia severity between the insomnia groups.
All participants completed the following subjective rating scales:
Dysfunctional beliefs and attitudes about sleep
Sleep hygiene practice scale
Insomnia severity index
Beck anxiety inventory
Beck depression inventory
The results
The study found that those in the insomnia with depression and insomnia with both anxiety and depression groups had significantly higher Beck depression inventory scores compared to those with primary insomnia or insomnia with anxiety.
Similarly, those with insomnia with anxiety and those with insomnia and both anxiety and depression had significantly higher Beck anxiety inventory scores compared to those with primary insomnia or insomnia with depression.
Most importantly, those with insomnia comorbid with anxiety or depression had similar scores on the dysfunctional beliefs and attitudes about sleep scale, when compared to those with primary insomnia. These scores were significantly higher than the scores of good sleepers (lower scores indicate the fewest dysfunctional beliefs and attitudes).
This suggests that bothprimary and comorbid depression, anxiety, and insomnia are influenced by our thoughts, beliefs, and attitudes toward sleep.
Those with insomnia and both anxiety and depression scored significantly higher on some subscales of the dysfunctional beliefs and attitudes about sleep scale compared to those with primary insomnia.
According to researchers, this suggests thatthose suffering from comorbid insomnia may have even more severe dysfunctional sleep beliefs than those suffering from primary insomnia alone.
Conclusion
This study found that those with comorbid insomnia may have similarnegative thoughts, attitudes, and beliefs about sleep as those with primary insomnia.
It also revealed that those with comorbid insomnia had similar (or worse) sleep hygiene scores compared to those with primary insomnia.
Researchers note that although those suffering from comorbid insomnia may have been more likely to report negative sleep beliefs due to the negative thinking that is associated with depression and anxiety, this alone can't explain the big difference in scores extracted from the dysfunctional beliefs and attitudes about sleep scale, according to study authors.
本研究表明,重要的是做ctors to pay more attention to the effect of negative and dysfunctional thoughts and behaviors toward sleep in those suffering from comorbid insomnia.
When it comes to treating the negative and incorrect thoughts that harm sleep, cognitive behavioral therapy for insomnia has been found to be particularly effective at improving sleepand improving mood symptoms, too.
