Prediction of insomnia severity based on cognitive, metacognitive, and emotional variables in college students

Abstract

Objective: Insomnia is the most common sleep disorder whose origin is attributed to various variables. The current study aims to predict the symptoms of insomnia by investigating some of its predictors.

Methods: Numerous variables such as depression and anxiety symptoms, worry, pre-sleep arousal (cognitive arousal and somatic arousal), dysfunctional cognitions, and metacognitive beliefs about sleep were assessed as insomnia predictors. A total of 400 students of Tehran University of Medical Sciences completed the Depression Anxiety Stress Scale (DASS), the Penn State Worry Questionnaire (PSWQ), the Pre-Sleep Arousal Scale (PSAS), the Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS-10), the Metacognitions Questionnaire-Insomnia (MCQ-I), and the Insomnia Severity Index (ISI).

Results: All variables were significantly correlated with insomnia symptoms (P < .001). Stepwise multiple regression analysis suggested a predictive model for insomnia including cognitive arousal, dysfunctional beliefs about sleep, metacognitive beliefs about sleep, and depressive symptoms.

Conclusions: The findings underline the significant role of cognitive and metacognitive variables for predicting insomnia symptoms. Moreover, the results suggest that metacognitive beliefs about sleep may need to be considered as a significant component in the context of insomnia.

Keywords: Insomnia; anxiety; arousal; cognition; depression; metacognition; worry.