Psychophysiological reactivity to sleep-related emotional stimuli in primary insomnia.
ABSTRACT The present study examined psychophysiological reactivity to emotional stimuli related and non-related to sleep in people with primary insomnia (PPI) and in good sleepers (GS). Twenty-one PPI and 18 GS were presented with five blocks of neutral, negative, positive, sleep-related negative and sleep-related positive pictures. During the presentation of the pictures, facial electromyography (EMG) of the corrugator and the zygomatic muscles, heart rate (HR) and cardiac vagal tone (CVT) were recorded. Subjective ratings of the stimuli were also collected. We found that only PPI exhibited greater inhibition of the corrugator activity in response to sleep-related positive stimuli compared to the other blocks of stimuli. Furthermore, PPI rated the sleep-related negative stimuli as more unpleasant and arousing and showed higher CVT in response to all stimuli as compared to GS. Results were interpreted as indicating that PPI exhibit craving for sleep-related positive stimuli, and also hyper-arousability in response to sleep-related negative stimuli, as compared to GS. Our results suggest that psychological treatment of insomnia could benefit by the inclusion of strategies dealing with emotional processes linked with sleep processes.
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ABSTRACT: The purpose of this study was to examine whether individuals with primary insomnia (PI) have an attentional bias towards insomnia-specific stimuli, relative to normal sleepers (NS). Also, the aim was to determine if the attentional bias was characterized by vigilance or disengagement. A between-groups, matched design was employed. Forty-two individuals completed the study (PI = 21; NS = 21). Participants completed a dot-probe task with stimuli comprising insomnia-specific (fatigue/malaise) and neutral pictures. It was hypothesized that individuals with PI would show greater attentional bias to insomnia-specific stimuli compared with NS. An overall bias effect was noted. This effect was however not due to vigilance; taking into account the reaction times on neutral trials, the PI group and the NS group did not display significantly different results in reaction times to insomnia-specific pictures. On the contrary, the results suggest that the overall bias effect was due to disengagement; the PI group had significantly longer reaction times than the NS group when shifting away from the insomnia-specific pictures, relative to neutral–neutral picture presentations. The findings suggest that individuals with insomnia are not more vigilant than normal sleepers to insomnia-specific stimuli, but instead have greater difficulties in shifting away from such stimuli.Cognitive Therapy and Research 06/2013; 37(3). DOI:10.1007/s10608-012-9486-z · 1.70 Impact Factor
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ABSTRACT: Elevated pre-sleep arousal has been consistently associated with insomnia, yet the cognitive-emotional mechanisms involved in sleep-related arousal remain unclear. The purpose of this study was to identify predictors of pre-sleep arousal and trait hyperarousal from a set of variables that included self-reported affect, sleep-related cognitions, locus of control, and gender. Cross-sectional data were analyzed for 128 participants (89 females) who met criteria for psychophysiological insomnia and completed a set of questionnaires that included the Beliefs and Attitudes about Sleep (BAS), Positive and Negative Affect Schedule (Negative Subscale (nPANAS) and Positive Subscale (pPANAS)), Sleep Locus of Control (SLOC), Pre-Sleep Arousal Scale (PSAS), Hyperarousal Scale (HAS) and demographic information. Step-wise regression was conducted with a set of independent variables, with PSAS and HAS serving as separate dependent variables. Trait hyperarousal was associated with higher levels of both negative and positive emotionality, as well as negative beliefs about sleep, in both genders. Pre-sleep arousal was associated with greater negative emotionality and internal sleep locus of control, varying by gender. Among women, high pre-sleep arousal was associated with negative emotionality, while in men greater pre-sleep arousal was associated with an internal sleep locus of control. These findings have clinical implications, suggesting that men and women may require different cognitive targets when addressing pre-sleep arousal.Journal of psychosomatic research 04/2013; 74(4):283-9. DOI:10.1016/j.jpsychores.2013.01.014 · 2.84 Impact Factor
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ABSTRACT: While there is an accumulating evidence to suggest that therapies using mindfulness and acceptance-based approaches have benefits for improving the symptoms of insomnia, it is unclear how these treatments work. The goal of this paper is to present a conceptual framework for the cognitive mechanisms of insomnia based upon mindfulness and acceptance approaches. The existing cognitive and behavioral models of insomnia are first reviewed and a two-level model of cognitive (primary) and metacognitive (secondary) arousal is presented in the context of insomnia. We then focus on the role of metacognition in mindfulness and acceptance-based therapies, followed by a review of these therapies in the treatment of insomnia. A conceptual framework is presented detailing the mechanisms of metacognition in the context of insomnia treatments. This model proposes that increasing awareness of the mental and physical states that are present when experiencing insomnia symptoms and then learning how to shift mental processes can promote an adaptive stance to one's response to these symptoms. These metacognitive processes are characterized by balanced appraisals, cognitive flexibility, equanimity, and commitment to values and are posited to reduce sleep-related arousal, leading to remission from insomnia. We hope that this model will further the understanding and impact of mindfulness and acceptance-based approaches to insomnia.Behaviour Research and Therapy 08/2012; 50(11):651-60. DOI:10.1016/j.brat.2012.08.001 · 3.85 Impact Factor