Gender and cognitive-emotional factors as predictors of pre-sleep arousal and trait hyperarousal in insomnia

J Psychosom Res. 2013 Apr;74(4):283-9. doi: 10.1016/j.jpsychores.2013.01.014. Epub 2013 Mar 7.

Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusion: These findings have clinical implications, suggesting that men and women may require different cognitive targets when addressing pre-sleep arousal.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Arousal / physiology*
  • Attitude
  • Cognition / physiology*
  • Emotions / physiology*
  • Female
  • Humans
  • Internal-External Control
  • Male
  • Middle Aged
  • Sex Factors
  • Sleep / physiology*
  • Sleep Initiation and Maintenance Disorders / physiopathology
  • Sleep Initiation and Maintenance Disorders / psychology*
  • Surveys and Questionnaires