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Cognitions and Insomnia Subgroups

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Abstract

This study explored cognitive predictors of multiple symptoms of insomnia (difficulty with sleep initiation, maintenance, and early morning awakenings) among a sample of individuals seeking cognitive-behavior therapy for insomnia. Participants consisted of 146 clinical patients with insomnia of which 67 (45.89%) were classified as Single Symptoms subgroup and 79 (54.11%) as Combined subgroup. A receiver operating curve (ROC) analysis was conducted to identify predictors of Combined versus Single Symptom subgroups. The set of predictor variables included demographics, sleep-related cognitions, circadian preferences, depression symptoms, and self-report sleep parameters with insomnia subgroups (Combined versus Single Symptom only) as the dependent variable. The ROC analysis identified two significant predictors: Self Efficacy Scale (SES) <23 and a 3-item subscale of the Glasgow Content of Thoughts Inventory (GCTI) assessing “thoughts about the environment” with scores ≥5. Post-hoc comparisons revealed that individuals with combined symptoms who had SES score <23 had significantly longer sleep onset latency (SOL) and more number of nights with SOL >30 min, poorer sleep quality, higher insomnia severity, less morningness tendency, higher depression symptom severity, and more anxiety about anxiety and about sleep compared to individuals with SES score ≥23. These findings indicate that low self-efficacy and increased thoughts about the environment are associated with having multiple symptoms of insomnia. Further research should examine the specific role of self-efficacy and thought content in the etiology of individuals who suffer from multiple symptoms of insomnia.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, 94305, USA

    Sooyeon Suh, Dana Steidtmann, Sara Nowakowski, Allison Siebern & Rachel Manber

  2. Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, 60612, USA

    Jason C. Ong

  3. Palo Alto University-Stanford Psy.D Consortium, Palo Alto, CA, 94304, USA

    Claire Dowdle & Erika Willett

  4. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 450 Broadway Street, M/C 5704, Redwood City, CA, 94063, USA

    Sooyeon Suh

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  1. Sooyeon Suh
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  2. Jason C. Ong
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  3. Dana Steidtmann
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  4. Sara Nowakowski
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  5. Claire Dowdle
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  6. Erika Willett
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  7. Allison Siebern
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  8. Rachel Manber
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Correspondence to Sooyeon Suh.

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Suh, S., Ong, J.C., Steidtmann, D. et al. Cognitions and Insomnia Subgroups. Cogn Ther Res 36, 120–128 (2012). https://doi.org/10.1007/s10608-011-9415-6

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  • DOI: https://doi.org/10.1007/s10608-011-9415-6

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