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Health, 2017, 9, 138-152
http://www.scirp.org/journal/health
ISSN Online: 1949-5005
ISSN Print: 1949-4998
DOI: 10.4236/health.2017.91010 January 22, 2017
Infatuation and Lovesickness on Sleep Quality
and Dreams in Adolescence
Angelika A. Schlarb*, Nathalie Brock, Fridtjof W. Nussbeck, Merle Claßen
Faculty for Psychology and Sports Science, Bielefeld University, Bielefeld, Germany
Abstract
Background:
Infatuation and lovesickness are widespread and significant e
x-
periences in adolescence. Less is known about the connection between infat
u-
ation/lovesickness and sleep. The few studies, examining the link between i
n-
fatuation and sleep quality show inconsistent results. The link between lov
e-
sickness and sleep as well as the link
between infatuation/lovesickness and
dreams has not been investigated yet. The aim of this study was to examine
whether infatuation and lovesickness are linked to sleep quality and dr
eams in
adolescents.
Methods:
A self-assessment online questionnaire was con
structed
to assess adolescents’
infatuation, lovesickness, sleep quality and dreams. In
total, data of 630 adolescents and young adults
(150 males, 480 females; aged
16 - 21) were analyzed in this study.
Results:
Infatuation did not relate to
overall sleep quality and dreams. Sleep disturbances, as a component of ove
r-
all sleep quality, were more frequent in infatuated adolescents. Adolescents
currently suffering from lovesickness reported a significantly lower sleep qua
-
lity, more negative dreams and nightmares. Furthermore, nightmares infl
u-
enced them more strongly the next day.
Conclusions:
The associations b
e-
tween infatuation/lovesickness and sleep provide evidence for the far
reaching
effects of infatuation and lovesickness in adolescents’ lives. The fact that lov
e-
sickness leads to lower sleep quality and more negative dreams should be i
n-
tegrated in new approaches of insomnia treatment.
Keywords
Infatuation, Lovesickness, Sleep Quality, Dreams, Adolescence, Nightmares
1. Introduction
Infatuation is described as a strong and passionate feeling [1]. The state of infat-
uation is connected to changes on the domains: psychological, behavioral, and
How to cite this paper:
Schlarb, A.A.,
Brock, N
., Nussbeck, F.W. and Claßen, M.
(201
7) Infatuation and Lovesickness on
Sleep
Quality and Dreams in Adolescence
.
Health
,
9
, 138-152.
http://dx.doi.org/10.4236/health.2017.91010
Received:
October 26, 2016
Accepted:
January 19, 2017
Published:
January 22, 2017
Copyright © 201
7 by authors and
Scientific
Research Publishing Inc.
This work is licensed under the Creative
Commons Attribution International
License (CC BY
4.0).
http://creativecommons.org/licenses/by/4.0/
Open Access
Konstanzer Online-Publikations-System (KOPS)
URL: http://nbn-resolving.de/urn:nbn:de:bsz:352-2-1e69zqg4qwpig4
Erschienen in: Health ; 09 (2017), 01. - S. 138-152
https://dx.doi.org/10.4236/health.2017.91010
A. A. Schlarb et al.
139
physiological level. Psychological effects are among others focused attention on
the beloved, obsessive, intrusive, persistent thinking of him or her, and euphoria
[2]. On the behavioral level, infatuated individuals show more goal directed be-
havior as, for example, changing their habits to impress or remain in contact
with the beloved [3] [4]. Observable physiological effects are sweaty palms, a
pounding heart and increased energy. Additionally, the hormonal system changes:
cortisol levels increase in both sexes, testosterone levels decrease in men and in-
crease in women [5]. This supports the assumption that attachment and social
contacts are associated to a moderate level of stress in both humans and animals
[6] [7] [8] [9]. Moreover, reward and motivation systems in the human brain are
involved in infatuation [4]. Additionally, Fisher
et al
. supposed that infatuation
is not a specific emotion but mainly a motivation system which is connected to
various emotions [3]. Various research projects have shown that the stage of in-
fatuation is comparable to symptoms of the “bright” side of hypomania with in-
creased activity, enhanced mood and increased self-confidence [2] [10] [11].
The few investigations on the impact of infatuation on sleep patterns show
diverse outcomes. In one study, infatuated participants reported fewer hours of
sleep, increased subjective sleep quality, decreased daytime sleepiness, and in-
creased concentration during the day compared to the non-infatuated [2]. In
two other studies, no impact of infatuation on sleep quality could be detected
[10] [11]. Astonishingly and to the best of our knowledge, no studies investigat-
ing the connection between infatuation and dreams exist although the continuity
hypothesis of dreaming has long been established postulating that dreams reflect
on waking life experiences [12] [13] [14] and, hence, infatuation as a strong ex-
perience should influence dream contents.
Apart from infatuation, lovesickness is another widespread experience of ado-
lescents associated with romantic love. In a representative study, 33% - 53% of
adolescents reported problems with lovesickness within the last two years and
lovesickness was the most frequent problem of adolescents of all subcultures
[15]. Furthermore, in another study 82% of the adolescents reported to have al-
ready experienced lovesickness [16]. These findings lead to the assumption that
lovesickness is a similarly universal experience in adolescence just like infatua-
tion. However, scientific research concerning lovesickness is surprisingly rare
considering the possible fatal consequences of this mental state. Analyzing fare-
well letters and police reports, lovesickness was discovered as the most frequent
reason for adolescent suicide [17] [18]. Other findings show that romantic rela-
tionship breakup is a predictor for the first but not for recurrent episodes of a
major depressive disorder in adolescents [19]. An indication for a possible con-
nection between lovesickness and sleep has been found in the study of Senger,
who stated that 80% - 83% (female-male) of the interviewed lovesick individuals
suffered from sleep disturbances [20]. Furthermore, sleep disturbance has been
mentioned within a list of characteristics of lovesickness [21]. In addition to these
findings, lovesickness can be conceived of a social stressor and as such should
decrease the sleep quality [22]. Beyond that, Vandekerckhove
et al
. found that
A. A. Schlarb et al.
140
negative pre-sleep emotions lead to deteriorated sleep quality [23]. Hence, nega-
tive emotions occurring while suffering from lovesickness should also negatively
influence sleep quality. Yet, as all studies analyzed data from adult individuals it
remains an open question if their findings generalize to adolescents.
To the best of our knowledge, no study exists examining the link between
lovesickness and dream contents. In related fields, some studies show that affec-
tive disorders like depression lead to more negative dream contents [24] and,
additionally, lovesickness can lead to depressive feelings [19] [25], hence, we as-
sume that lovesickness leads to increased levels of negative dream contents.
In this study, we presume that the above mentioned findings generalize to
adolescents. Hence, we hypothesize infatuated adolescents report 1) a better
overall sleep quality, and 2) more positive dream contents. To the opposite we
hypothesize that lovesick adolescents’ report, 3) lower overall sleep quality, and
4) more negative dream contents and/or nightmares.
2. Procedure
In order to test these hypotheses, we recruited adolescents via internet strongly
relying on social networks (e.g., Facebook, university groups). Before providing
any information, adolescents were informed about the study content and that
their participation was strictly voluntary, that they could resign from participa-
tion at any time, and that anonymity was granted by the study protocol. After
agreeing to participate, adolescents filled in an online-survey assessing infatua-
tion, lovesickness as well as sleep and dream quality. Multiple compilation could
not be controlled in favor of anonymity, but no duplicates could be found based
on demographic statistics.
3. Methods
Participants
Initially, 755 individuals being 16 to 21 years old participated in this study. Par-
ticipants up to 21 were considered as adolescents according to German guide-
lines for children and adolescents psychotherapy. Due to the inclusion criteria
(passing relevant cut-off values for being infatuated or being lovesick, respec-
tively; not being infatuated and lovesick simultaneously) data from 630 adoles-
cents (150 male and 480 female participants) were considered for statistical
analyses. Overall, the average age was 20.07 (
SD
= 1.05) with female adolescents
being older (20.12;
SD
= 1.01) compared to their male counterparts (19.90;
SD
= 1.17;
t
(223.91) = 2.07;
p
= 0.04). 439 adolescents indicated to be infatuated
(89 males, 350 females) were assigned to the infatuation-group. 32 adolescents
(6 males, 26 females) reported to suffer from lovesickness. 152 (53 males, 99
females) were neither infatuated nor lovesick, and served as control group. For
analysis, data from 359 adolescents being in a romantic relationship (308 females,
51 males) as well as data from 271 singles (99 male, 172 females) were used. Mean
duration of romantic relationship was 22.41 months (SD = 17.84).
A. A. Schlarb et al.
141
4. Measurement Instruments
4.1. Demographics
Adolescents provided information about their age, gender, school or university
degree, relationship status, and relationship duration (if applicable).
4.2. Infatuation
Adolescents had to indicate if they are infatuated (single item) and had to fill in
three items of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS; [26]). The
following items, validated by Brand
et al
. [2], were used: “
How much time do
you think of the other person
?”, “
While thinking of the other person
,
do you feel
distracted
?”, “
How well can you resist the need to think of the other person
?”.
Items were coded on a five-point Likert scale (0 - 4) with a maximum at 12 and a
cut-off for being infatuated set at 6 points leading to the exclusion of 7 partici-
pants. Internal consistency (Cronbach’s alpha) of this scale was
α
= 0.89.
4.3. Lovesickness
The lovesickness questionnaire [25] assesses if participants currently feel love-
sick, if so, participants have to indicate for how long they have been lovesick and
why they feel lovesick. Moreover, participants have to answer a set of items as-
sessing feelings that may be associated to their lovesickness. If the participants
did not suffer from lovesickness at that time, they were requested to apply their
answers to a former lovesickness. In the current study, only the first item was
used to identify lovesick participants (“
Do you feel lovesick at the moment
?”).
4.4. Sleep Quality
The Pittsburgh Sleep Quality Index (PSQI; German version [27]) is a retrospective
self- and peer-rating questionnaire assessing the sleep quality and the sleeping be-
havior of the previous four weeks. It comprises 19 self-rating items and 5 peer-
report items to be answered by the partner or roommate assessing 7 components
of sleeping behavior/quality: subjective sleep quality, sleep latency, sleep duration,
sleep efficiency, sleep disturbances, use of sleep medication, and daytime dys-
function. The total score of the PSQI has an internal consistency of
α
= 0.85 [28].
4.5. Nightmares
The Nightmares Effects Questionnaire (NEQ, [29]) assesses the frequency of
nightmares and their consequences on waking life regarding the last three months.
For this study, the items “
How often have remembered dreams been positive
”,
“
During the past three months
,
how often did you have bad dreams without awa-
kening
” and
“
During the past three months
,
how often did you remember night-
mares
?”
serve to assess dream quality. Items were coded on a 7-point rating scale
(0 = not at all, 1 = less than 4 times/year, 2 = once in 2 months, 3 = once a month,
4 = 2 - 3 times/month, 5 once a week, 6 = 2 - 3 times/week, 7 = every morning).
Sum score ranges between 0 - 37 with higher scores indicating more nightmare
effects. Internal consistency (Cronbach’s alpha) of this scale was
α
= 0.76.
A. A. Schlarb et al.
142
5. Statistical Analysis
Based on their self-reports, adolescents were separated into three groups: 1) be-
ing infatuated, 2) being lovesick, and 3) being neither infatuated nor lovesick
(control group). All hypotheses refer to differences in central tendencies, hence,
either t-tests or Mann-Whitney U-tests (for comparisons including the love-
sickness group) have to be calculated. In order to test the formulated hypotheses
we adopt a Type-I error rate of 5% (one-sided).
6. Results
6.1. Descriptive Statistics
Table 1 provides the demographic descriptive statistics for the three groups (in-
fatuated, lovesick, and control group). For the infatuated adolescents, we found
differences with respect to age with female adolescents being roughly three
month older on average than male adolescents (t(437) = 2.05;
p
= 0.013). Neither
for the lovesick nor for the control group, we found a statistically significant dif-
ference for age (lovesick: t(5.88) = 0.68;
p
= 0.52; control: t(150) = −0.34;
p
=
0.74).
Out of the infatuated group, 344 adolescents (78.4%) reported to be in a ro-
mantic relationship. Mean duration of romantic relationship in months was
22.03 (
SD
= 17.72) (one year and 10 months). Relationship duration ranked
from less than a month to 100 months, (eight years and four months) (see Table
1). See Table 2 for further sociodemographic characteristics.
Four adolescents (12.5%) suffering from lovesickness reported to be in a ro-
mantic relationship. Mean duration of romantic relationship in these four ado-
lescents was 22.75 (
SD
= 18.71; 1 year and 10 month; range less than 1 month to
40 months). 18 (56.3%) adolescents reported a
romantic relationship breakup
as
being the reason for their current lovesickness, 8 (25%) participants named a
one-sided love without reply
of the beloved and 3 of them (9.4%) reported of a
sexual affair which did not end up into a romantic relationship
. The majority of
the control-group reported to be single (n = 146, 96%). Only six of them (3.9%)
were in a romantic relationship (mean duration = 32.83 month;
SD
= 18.74; 2
years and 8 month; range from less than a month to 48 months).
Table 1. Age, relationship duration.
Infatuation group
n = 439
Lovesickness group
n = 32
Control group
n = 152
Mean
SD
Mean
SD
Mean
SD
Age woman 20.16 1.01 20.12 0.96 19.96 1.03
Age men 19.85 1.17 19.67 1.58 20.02 1.15
Age sum 20.10 1.05 20.04 1.08 19.98 1.07
Relationship
duration 22.03 17.72 22.75 18.71 32.83 18.74
Notes: Due to exclusion of 7 participants being infatuated but scoring lower than 6 on the Y-BOCS sample
size reduced to 623.
A. A. Schlarb et al.
143
Table 2. Sociodemographic characteristics of the participants.
Infatuation group
n = 439
Lovesickness group
n = 32
Control group
n = 152
Women
Men
Women
Men
Women
Men
Secondary school
certificate
4
(1.1%)
3
(3.3%)
1
(3.8%)
0
(0%)
1
(1%)
1
(1.9%)
Advanced school-leaving
certificate
346
(98.9%)
86
(96.7%)
20
(96.2%)
6
(100%)
98
(99%)
52
(98.1%)
University
students
324
(92.5%)
76
(85.3%)
21
(80.7%)
6
(100%)
85
(85.9%)
45
(84.9%)
Notes: Due to exclusion of 7 participants being infatuated but scoring lower than 6 on the Y-BOCS sample
size reduced to 623.
6.2. Sleep and Sleep Disturbances
The mean PSQI sum score was 7.09 (
SD =
3.37), see also Table 3. Overall, 57%
of the participants scored than 5 higher on the PSQI. In detail, considering the
score of 5 on the PSQI as cut-off for poor sleep quality, the sample consists of
51.1% poor sleepers (>5 and <10) and 5.9% of chronic insomnia symptoms pa-
tients (higher than 10). Women (7.28 ± 3.44) reported significantly higher PSQI
sum scores than men (6.47 ± 3.05), (
t
(628) = 2.59;
p
= 0.010). Furthermore,
women scored significantly higher in various components as
subjective sleep
quality
(
t
(628) = 2.75;
p
= 0.006),
sleep disturbances
(
t
(628) = 4.15;
p
< 0.001),
use
of sleep medication
(
t
(479) = 4.10;
p
< 0.001) and
daytime dysfunction
(
t
(628) =
1.96;
p
= 0.050).
6.3. Nightmares
The mean score for NEQ sum score was 5.46 (
SD
= 5.47). The higher the sum
score of NEQ, the more did nightmares affect on the mental and health states of
adolescents the next day. Mean score and standard deviation of NEQ sum score
and all subscales are displayed in Table 4. Women (6.00 ± 5.78) reported of sig-
nificantly more nightmare effects than men (3.73 ± 4.93), (
t
(628) = 4.35;
p
<
0.001). They scored higher in the subscales
anxiety and depression
(
t
(310.15) =
6.20;
p
< 0.001),
problems of concentration and attention
(
t
(286.75) = 2.90;
p
=
0.004) and
aggression
(
t
(300.14) = 3.36;
p
= 0.001). The mean score for the item,
“
How often have remembered dreams been positive
” was 5.05 (
SD
= 1.84), mean
score for
“
During the past three months
,
how often did you have bad dreams
without awakening
?” was 3.57 (
SD =
2.01), and for “
During the past three
months
,
how often did you remember nightmares
”, it was 3.90 (
SD
= 2.07).
6.4. Infatuation and Sleep Quality
For overall sleep quality (PSQI total score), we did not find a statistically signifi-
cant difference between the infatuated and control group (
t
(589) = 0.18;
p =
0.87). However, concerning sleep disturbances according to the PSQI, the infa-
A. A. Schlarb et al.
144
Table 3. Mean score and standard deviation of PSQI sum score and separated subscales.
M
SD
PSQI sum score 7.09 3.37
Subjective sleep quality 1.04 0.64
Sleep latency 1.98 1.57
Sleep duration 0.23 0.55
Sleep efficiency 0.52 0.77
Sleep disturbances 1.07 0.38
Use of sleep medication 0.05 0.32
Daytime dysfunction 2.19 1.32
Notes: M = Mean Score; SD = Standard Deviation; PSQI = Pittsburgh Sleep Quality Index.
Table 4. Mean score and standard deviation of NEQ sum score and separated subscales.
M
SD
NEQ sum score 5.46 5.67
Anxiety/depression 2.59 2.06
Problems of concentration and attention 1.33 1.72
Aggression 1.08 1.60
Antisocial behavior 0.25 0.63
Physical symptoms 0.22 0.56
Notes: M = Mean Score; SD = Standard Deviation; NEQ: Nightmares Effects Questionnaire.
tuated group reported to have more sleep disturbances (
t
(266.64) = 2.84;
p
=
0.005;
α
(Bonferroni) = 0.05/7 = 0.007 for the multiple comparisons of the PSQI com-
ponents). For all other components of the PSQI, we did not find any statistically
significant difference (Table 5).
6.5. Infatuation and Dreams
No difference was found between the infatuated and control group regarding the
frequency of positive dreams (Mann-Whitney: z = −0.58,
p
= 0.56).
6.6. Lovesickness and Sleep Quality
The t-test revealed that lovesick adolescents scored significantly higher (worse)
in the PSQI sum score than adolescents of the control group (
t
(128) = 3.06;
p
<
0.01). Analyzing the separated components of the PSQI, we found that the love-
sickness-group reported more sleep disturbances (
t
(37.25) = 3.29;
p
= 0.002) and
more daytime dysfunction (
t
(182) = 3.30;
p
= 0.001) than the control-group.
However, no significant differences have been found in the other components.
The results of the group comparison concerning the PSQI are presented in Ta-
ble 6.
6.7. Lovesickness and Dreams
With respect to the total score of the NEQ, adolescents of the lovesick group
A. A. Schlarb et al.
145
Table 5. Results of the T-test comparing PSQI scores of the infatuation-group and the
control-group.
Mean (
SD
)
T
df
p
Infatuation
(n = 439)
Control
(n = 152)
PSQI sum score 7.02 (3.42) 6.96 (3.23) 0.18 589 0.856
Subjective sleep quality 1.04 (0.66) 1.01 (0.65) 0.52 589 0.603
Sleep latency 1.93 (1.52) 2.02 (1.68) −0.54 589 0.590
Sleep duration 0.22 (0.56) 0.26 (0.54) −0.75 587 0.452
Sleep efficiency 0.52 (0.76) 0.55 (0.77) −0.45 586 0.655
Sleep disturbances 1.08 (0.37) 0.99 (0.36) 2.85 266.64 0.005*
Use of sleep medication 0.07 (0.37) 0.03 (0.20) 1.67 487.77 0.095
Daytime dysfunction 2.16 (1.32) 2.13 (1.24) 0.26 589 0.793
Notes: *p ≤ 0.05; Mean = Mean score; SD = Standard deviation; T = T-test value; df = Degrees of free-
dom; p = Two-tailed significance. Type-I error rate for all comparisons was set to 0.05/7 = 0.007. (Bonfer-
roni corrected multiple comparisons of components of the PSQI; the test of the PSQI sum score is not cor-
rected). Abbreviations: PSQI = Pittsburgh Sleep Quality Index; Infatuation = Infatuation-group; Control =
Control-group; n = Number.
Table 6. Results of the T-test comparing PSQI scores of the lovesickness-group and the
control-group.
Mean (
SD
)
Lovesickness
(n = 32)
Control
(n = 152)
T
df
p
PSQI sum score 8.88 (3.18) 6.96 (3.23) 3.06 182 0.003*
Subjective sleep quality 1.21 (0.55) 1.01 (0.65) 1.73 182 0.086
Sleep latency 2.53 (1.68) 2.01 (1.68) 1.59 182 0.115
Sleep duration 0.31 (0.59) 0.26 (0.53) 0.51 181 0.610
Sleep efficiency 0.56 (0.76) 0.55 (0.77) 0.06 180 0.951
Sleep disturbances 1.31 (0.54) 0.99 (0.36) 3.29 37.25 0.002*
Use of sleep medication 0.00 (0.00) 0.03 (0.20) −0.75 182 0.453
Daytime dysfunction 2.94 (1.41) 2.13 (1.24) 3.30 182 0.001***
Notes: *p ≤ 0.05; ***p ≤ 0.001; Mean = Mean score; SD = Standard deviation; T = the T-test statistic; df =
Degrees of freedom; p = two-tailed significance. Type-I error rate for all comparisons was set to 0.05/7 =
0.007. (Bonferroni corrected multiple comparisons of components of the PSQI; the test of the PSQI sum
score is not corrected). Abbreviations: PSQI = Pittsburgh Sleep Quality Index; Lovesickness = Lovesick-
ness-group; Control = Control-group; n = Number.
showed more (negative) effects than the control group (
t
(182) = 4.07;
p
< 0.001).
Especially the negative repercussions
anxiety/depression
(
t
(182) = 4.23;
p
< 0.001),
concentration and attention problems
(
t
(182) = 2.66;
p
= 0.009),
aggression
(
t
(182) = 3.17;
p
= 0.002) and
physical symptoms
(
t
(33.60) = 2.15;
p
= 0.039)
occur more frequently in the lovesickness-group (see Table 7).
Additionally, lovesick adolescents reported of significantly more negative
dreams without awakening (
U
(32,152) = 1457;
p
< 0.001)/(
z
= −3.62;
p
< 0.001)
and nightmares (
U
(32,152) = 1579;
p
= 0.002)/(
z
= −3.15;
p
= 0.002).
A. A. Schlarb et al.
146
Table 7. Results of the T-test comparing NEQ scores of the lovesickness-group and the
control-group.
Mean (
SD
)
Lovesickness
(n = 32)
Control
(n = 152)
T
df
p
NEQ sum score 9.12 (5.11) 4.72 (5.65) 4.07 182 <0.001***
Anxiety/depression 4.09 (2.96) 2.06 (2.36) 4.23 182 <0.001***
Concentration and attention
problems
2.09 (1.55) 1.20 (1.75) 2.66 182 0.009*
Aggression 2.03 (1.69) 1.01 (1.64) 3.17 182 0.002*
Antisocial behavior 0.41 (0.71) 0.30 (0.70) 0.76 180 0.449
Physical symptoms 0.50 (0.92) 0.14 (0.41) 2.15 33.60 0.039*
U
Z
P
Negative dreams
without awaking 4.63 (1.88) 3.20 (1.99) 1457.00 −3.62 <0.001***
Nightmares 4.78 (2.04) 3.45 (2.11) 1579.00 −3.15 0.002
Notes: *p ≤ 0.05; ***p ≤ 0.001; Mean = Mean score; SD = Standard deviation; T = the T-test statistic; df =
Degrees of freedom; U = the Mann-Whitney U test statistic; Z = the Mann-Whitney U test Z-score; p =
two-tailed significance. Type-I error rate for all comparisons was set to 0.05/7 = 0.007. (Bonferroni cor-
rected multiple comparisons of components of the PSQI; the test of the PSQI sum score is not corrected).
7. Discussion
The purpose of this study was to investigate if infatuation and lovesickness are
related to sleep quality and dreams in adolescents. The transitions on physiolog-
ical, psychological and behavioral levels [2] [3] [4] [17] [18] [19] [25] caused by
infatuation and lovesickness suggest that there might also be influences on sleep
quality and dreams. Previous research suggested impaired sleep quality due to
circadian changes in adolescence also found in this sample [30].
Infatuated adolescents did not report a higher sleep quality and more positive
dreams than adolescents in the control group. On the contrary, infatuated ado-
lescents showed significantly more sleep disturbances like problems to fall asleep,
nightly or early morning awakening, and breathing difficulties. However, we
found that adolescents who suffer from lovesickness had a lower sleep quality
than adolescents in the control group. Especially the PSQI-components “
sleep
disturbances
” and “
daytime dysfunction
” were affected. Additionally, lovesick-
ness was related to more negative dreams without awakening, a higher frequency
of nightmares, and more daytime effects of nightmares. The findings of this
study do not replicate the results of Brand and colleagues [2]. Brand and col-
leagues reported that infatuated adolescents report a higher subjective sleep qua-
lity, decreased daytime sleepiness, and increased concentration during the day.
Yet, in their study, Brand and colleagues [2] included adolescents being in a
much earlier stage of a romantic relationship (mean duration of romantic rela-
tionship = 5.3 months;
SD
= 6.78) compared to the sample in this study. How-
ever, in a follow-up analysis, we compared infatuated adolescents being in a rela-
tively short relationship (no longer than 8 months) to those being in a longer re-
A. A. Schlarb et al.
147
lationship and did not find any differences on our study variables. An additional
alternative explanation could be that although infatuated adolescents scored rel-
atively high in the Y-BOCS, it is conceivable that numerous adolescents of the
infatuation group already passed the early and intense stage of infatuation and
its (physiological) effects. Marazziti & Canale found that hormonal changes in
infatuated individuals reverse after a few months [5]. Hormonal changes in in-
fatuated adults being in early phases of their romantic relationship (no more
than six months) have been found to level off 12 - 18 months later. With respect
to the components of the PSQI, infatuated adolescents report more sleep distur-
bances. These findings could be attributed to the fact that infatuation is related
to hormonal changes like increased cortisol levels [5] and that attachment and
social contacts are supported by a moderate level of stress [6] [7] [8] [9] [31]. On
the other hand, it is conceivable, that the beginning of a romantic relationship
lead to cognitive arousal, brooding and focusing on the relationship, which
causes stress [3] [4] [5]. Infatuation, although known as a positive life event [10],
might be on the other hand a stressful experience which causes sleep distur-
bances. Coming back to our results concerning the relation of infatuation and
overall sleep quality, our findings fit rather to the results of Bajoghli
et al
. [10]
[11] who have shown that infatuation is not related to a higher sleep quality in
Iranian adolescents. Unfortunately, the authors do not report about a restriction
of relationship duration in their infatuation group. This supports the assumption
that the connection between infatuation and sleep could be moderated by rela-
tionship duration. However, in a second follow-up analysis, we did not find a
relation between sleep quality and infatuation moderated by relationship length.
Bajoghli
et al
. explained their non-significant findings by taking into considera-
tion cultural rules which possibly lead Iranian parents to supervise their child-
ren’s behavior more thoroughly, especially regarding to sleep patterns [10]. To
clarify, whether infatuation affects sleep pattern differently across cultures, fur-
ther cross-cultural research is needed.
The connection between infatuation and dreams in adolescents has not been
investigated before. Based up on the continuity-hypothesis [12] [13] [14], pre-
suming that dreams reflect on waking life experiences, we hypothesized that the
positive life event of being infatuated [10] should influence adolescents’ dreams.
Yet, our findings do not support this hypothesis. Again, due to the unrestricted
relationship duration participants may have passed the intensive stage of infatu-
ation [5] and, hence, the effects of infatuation leveled off.
The association between lovesickness and sleep quality is mainly unexplored.
The outcomes of this study correspond to the statement of Senger [20], indicat-
ing that 83% of the male and 80% of the female interviewed participants suffered
from sleep disturbances. Besides, sleep disturbances were mentioned as a typical
characteristic of lovesickness by Maurer & Bred [21]. However, both articles did
not focus on adolescents. Especially Maurer & Bred concentrated on lovesick-
ness of married couples or within relationships lasting for years. In a broader
sense, our findings also fit to previous studies where social stress [22] and nega-
A. A. Schlarb et al.
148
tive pre-sleep emotions [23] have been identified as predictors for lower sleep
quality. Including the reported reasons for lovesickness in our sample (
i.e
., se-
paration of the partner or a one-sided love without reply), it is obvious that love-
sickness is a kind of social stress because it generates in interactions with a be-
loved person. In addition, the finding that there are negative effects of lovesick-
ness on sleep quality in adolescents, is in line with previous studies focusing on
the consequences of lovesickness and romantic relationship breakups on depres-
sive feelings [19] [32] [33]. Furthermore, sleep is known to be affected by de-
pressive disorders [34]. Therefore, the derivation of our presumption that love-
sickness influences dreams just as depressive disorders is supported by our find-
ings. All in all, the comparison of our outcomes with these few previous exami-
nations underline that more research is needed to clarify how lovesickness is re-
lated to sleep patterns, particularly in adolescence.
Our findings concerning lovesickness and negative dreams can be explained
by the continuity hypothesis [12] [13] [14]. The painful waking life experience of
suffering from lovesickness might be reflected in adolescent’s dreams and there-
fore lovesickness leads to more negative dreams and nightmares. However, the
comparison of our results and the findings of these investigations should be
drawn carefully as the mentioned previous investigations [24] [35] focused on
adult patients, not on adolescent ones. Interpreting the finding that adolescents
who suffer from lovesickness report more nightmare effects, it has to be consi-
dered that the nightmare effects might just display the consequences of suffering
from lovesickness. Further longitudinal research has to clarify, how lovesickness
predicts dreams and nightmares in adolescents. In addition, it has to be ex-
amined whether these effects are moderated by depressive symptoms.
Some limitations have to be taken in consideration. First of all, the sample is
unbalanced for gender and therefore generalizability is limited. Furthermore,
some participants reported to be infatuated and lovesick at the same time and
the size of all groups was unbalanced. Multiple compilation and faked data en-
tries could not be ruled out completely even though no duplicates were found.
The measurement of sleep quality has only been a subjective self-report. Objec-
tive sleep related measurements like actigraphy could be reasonable [36]. In ad-
dition, it has to be mentioned that the NEQ was primarily drawn up to measure
the effects of nightmares. For further research, it could be appropriate to use a
daily dream diary to have more detailed information about different types of
dreams (e.g., positive dreams related or unrelated to the beloved person, night-
mares). In addition, the NEQ measures the effects of nightmares on daily mental
and physiological states. It is doubtful whether these states can be seen as con-
sequences of nightmares or just as a consequence of lovesickness itself. Finally,
the different questionnaires refer to different periods of time: the PSQI refers
back to the last four weeks, the NEQ refers to the last three months and the
items of the Y-BOCS and lovesickness-questionnaire refer to the current state.
Therefore, it is possible that assessing states before getting infatuated or lovesick
adulterate the results, particularly in the examination of sleep quality.
A. A. Schlarb et al.
149
8. Conclusion
To sum up, this study supports the assumption that lovesickness is related to
lower sleep quality and more negative dreams. The postulated association be-
tween infatuation and higher sleep quality and between infatuation and positive
dreams could not be found. To the contrary, infatuation seems to be related to
sleep disturbances and low daytime functioning. Future studies, using improved
measurement instruments and a balanced sample are needed to expand findings
in this interesting field of research. Infatuation and lovesickness are known as
widespread experiences in adolescents of all cultures. Especially, if the possible
consequences with clinical relevance are taken into consideration, there remains
no doubt that research in this field is not sufficient yet. The results hint to the
notion that lovesickness should be integrated and dealt with in new approaches
of insomnia treatment.
Acknowledgements
We acknowledge support for the Article Processing Charge by the Deutsche
Forschungsgemeinschaft and the Open Access Publication Fund of Bielefeld
University.
Declaration
Ethics approval and consent to participate. The study was approved by the Eth-
ics Committee of Bielefeld University (Number: EUB-2015-045). Participants
gave their informed consent and were informed that participation was voluntary.
The study follows the latest version of the Declaration of Helsinki.
Availability of Data and Materials
The datasets during and/or analyzed during the current study available from the
corresponding author on reasonable request.
Competing Interests
The authors declare that they have no competing interests.
Authors’ Contributions
AS made substantial contributions to conception and design, interpretation of
data and has been involved in drafting the manuscript and revising it critically.
NB made substantial contributions to acquisition and analysis of data and has
been involved in drafting the manuscript. FN made substantial contributions to
analysis and interpretation of data. MC made substantial contributions to analy-
sis and interpretation of data. All authors read and approved the final manu-
script.
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List of Abbreviations
Y-BOCS, Yale-Brown Obsessive Compulsive Scale;
NEQ, Nightmare Effect Questionnaire;
PSQI, Pittsburgh Sleep Quality Index.
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