Scribd
Upload
53 views2 pages

Insomnia: More Questions Need Answers: Editorial

The editorial summarizes several studies on insomnia published in the Journal of Sleep Research. It discusses studies that investigated the link between impulsivity and dysfunctional thought control strategies related to insomnia severity. Another study found that the severity of insomnia symptoms in individuals varies night to night, with most instances of better sleep following 1-3 nights of poor sleep. Additional studies examined questionnaires used to assess insomnia, gender differences in insomnia symptoms, and the prevalence of insomnia in populations with intellectual disabilities or among patients in general practice. The editorial concludes that while much is known about insomnia, further research is still needed to better understand the disorder and develop effective assessment and treatment approaches.

Uploaded by

muhamed.f
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
53 views2 pages

Insomnia: More Questions Need Answers: Editorial

The editorial summarizes several studies on insomnia published in the Journal of Sleep Research. It discusses studies that investigated the link between impulsivity and dysfunctional thought control strategies related to insomnia severity. Another study found that the severity of insomnia symptoms in individuals varies night to night, with most instances of better sleep following 1-3 nights of poor sleep. Additional studies examined questionnaires used to assess insomnia, gender differences in insomnia symptoms, and the prevalence of insomnia in populations with intellectual disabilities or among patients in general practice. The editorial concludes that while much is known about insomnia, further research is still needed to better understand the disorder and develop effective assessment and treatment approaches.

Uploaded by

muhamed.f
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 2

Editorial

J. Sleep Res. (2010) 19, 12


doi: 10.1111/j.1365-2869.2010.00836.x

Insomnia: more questions need answers


What is our insomnia but the mad obstinacy of our mind in
manufacturing thoughts and trains of reasoning, syllogisms
and denitions of its own, refusing to abdicate in favor of that
divine stupidity of closed eyes, or wise folly of dreams? The
man who cannot sleep refuses more or less consciously to
entrust himself to the ow of things (Yourcenar, 1954).
Marguerite Yourcenars poetic description of insomnia in
Memoirs of Hadrian (Yourcenar, 1954) could be an excellent
introduction to Schmidt et al.s (2010) paper Linking impulsivity to dysfunction thought control and insomnia: a structural
equation model in this issue of Journal of Sleep Research, or
even to the entire issue, which includes seven papers on
insomnia and disrupted sleep. Schmidt et al. investigated how
strategies of thought control at bedtime are associated with
insomnia. Investigating 391 students who completed questionnaires on impulsivity, use of thought-control strategies at
bedtime and on the severity of insomnia, they reported that
specic personality traits may incline individuals with dysfunctional thought-control strategies to unwanted mental activity at
night. Using structural equation-modelling analyses, they
reported that two facets of impulsivity, urgency and lack of
perseverance, were associated with more frequent use of
aggressive suppression and worry at bedtime, and that this
association was related to the severity of insomnia. Although
the correlational nature of the study does not allow conclusions
about causality and as much as impulsivity may aect sleep, the
reverse is also possible by which insomnia may aect impulsivity; these results add more insight to the phenomenon by which
the mad obstinacy of our mind in manufacturing thoughts at
bedtime competes with sleep. Harrow and Espie (2010),
however, reported that increased cognitive arousal at bedtime
does not alter time perception in insomniacs. Thus, time
estimation, at bedtime and during the day, of 26 participants
meeting the criteria of primary insomnia was similar to that of
26 good sleepers, despite evidence supporting increased cognitive arousal at bedtime in insomnia. A dierent question that is
rarely considered in the insomnia literature was addressed in a
pilot study by Perlis et al. (2010), who investigated the temporal
patterning of the night-to-night variability in the severity of
insomnia. They reported that the severity of insomnia in 10
participants with untreated primary insomnia varies in such a
manner that insomniacs experienced good sleep during 2955%
of the nights, and that nearly 90% of the instances of better than
average sleep tend to occur following 13 nights of poor sleep.
If replicated in a larger study, these ndings may have important
clinical implications.
Notwithstanding, in two of the above studies, participants
were recruited from student populations using a variety of selfadministered questionnaires to assess insomnia. Insomniarelated questionnaires are the subject of two papers in this issue

 2010 European Sleep Research Society

(Ellis et al., 2010; Yen et al., 2010). The eight-item Athens


Insomnia Scale (AIS-8) was developed to assess the severity of
insomnia in adults based on the International Classication of
Diseases version 10 diagnostic criteria. Yen et al.s (2010)
study examined the factor structure of the AIS-8 in adolescents.
Analysing data obtained from 8319 adolescents, they found
that insomnia is a prevalent problem among the adolescent
population and that the AIS-8 is composed of two factors:
insomnia symptoms and subjective sleep and daytime distress.
Interestingly, they found gender dierences only in insomnia
symptoms, whereas the severity of depression was associated
with both factors. Ellis et al. (2010) raised a word of caution
about the manner in which questionnaires are used in studies
involving insomniacs. Investigating 118 psychology students,
they demonstrated that, in poor sleepers, presentation of the
Dysfunctional Beliefs and Attitudes about Sleep Scale and the
Insomnia Severity Index before the presentation of the Insomnia
Ambiguity Task inuenced the results signicantly by increasing
the number of insomnia congruent responses, in comparison
with the reverse order of presentations. Investigators should be
mindful of these ndings when designing questionnaire-based
studies to investigate insomnia, as the order in which questionnaires are presented may confound the results.
The present issue also includes two epidemiological studies.
Boyle et al. (2010) reported one of the few population-based
studies that examined the prevalence of insomnia in adults
with intellectual disabilities. They reported that the 4-week
period prevalence of insomnia in 1032 adults with intellectual
disabilities was 9.2%. Mental ill-health, use of psychotropic
medications and problem behaviours were associated closely
with insomnia. The second paper describes the experience of
general practitioners with the assessment and treatment of
insomnia based on a national survey of general practitioners in
Norway (Silvertsen et al., 2010). The authors report that the
prevalence of insomnia among patients in general practice was
11.2%, almost two-thirds of which were believed to be caused
by a medical condition. Disappointingly, general practitioners
rarely referred patients to polysomnographic recordings and
only 8% relied on sleep diaries or questionnaires for the
assessment of insomnia. Most general practitioners relied on
anamnestic information (91%) and blood tests (40%).
Although the collection of papers in the present issue conrms
what has been known for many years, that insomnia is a prevalent
sleep disorder aecting people of dierent ages, their results also
show that there are still many questions about insomnia that need
answers before eective assessment procedures and treatment
interventions can be implemented successfully.
Peretz Lavie
Editor in Chief

Editorial

REFERENCES
Boyle, A., Melville, C. A., Morrison, J. et al. A cohort study of the
prevalence of sleep problems in adults with intellectual disabilities.
J. Sleep Res., 2010, 19: 4253.
Ellis, J., Gardani, M. and Hogh, H. Priming aects poor sleepers but not
normal sleepers on an Insomnia Ambiguity Task. J. Sleep Res., 2010,
19: 2730.
Harrow, L. and Espie, C. Applying the quarter-hour rule: can people
with insomnia accurately estimate 15-min periods during sleep-onset
phase? J. Sleep Res., 2010, 19: 1926.
Perlis, M. L., Swinkels, C. M., Gehrman, P. R., Pigeon, W. R.,
Matteson-Rusby, S. E. and Jungquist, C. R. The incidence and
temporal patterning of insomnia: a pilot study. J Sleep Res., 2010,
19: 3135.

Schmidt, R. E., Gay, P., Ghisletta, P. and Van der Linden, M. Linking
impulsivity to dysfunctional thought control and insomnia: a
structural equation model. J. Sleep Res., 2010, 19: 311.
Silvertsen, B., Nordhus, I. H., Bjorvatn, B. and Pallesen, S. Sleep
problems in general practice: a national survey of assessment and
treatment routines of general practitioners in Norway. J. Sleep Res.,
2010, 19: 3641.
Yen, C.-F., King, B. H. and Chang, Y.-P. Factor structure of the
Athens Insomnia Scale and its associations with demographic
characteristics and depression in adolescents. J. Sleep Res., 2010, 19:
1218.
Yourcenar, M. The Memoirs of Hadrian. Trans. Grace Frick. Farrar,
New York, 1954.

 2010 European Sleep Research Society, J. Sleep Res., 19, 12

You might also like