Vicious Cycles of Sleeplessness, Sleep Phobia, and Sleep-Incompatible Behaviours in Patients with Persistent Insomnia

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Abstract
In order to study the possible role of vicious cycles of sleeplessness, sleep-incompatible behaviours, and sleep phobia in patients with persistent insomnia, 70 insomniacs were compared with 70 controls on a Sleep Behaviour Questionnaire. Although the insomniacs reported much shorter sleep time than the controls, they did not differ on the amount of time spent in bed. They reported more thinking about problems and planning in bed, but did not report more overt sleep-incompatible behaviours than the controls. The notion of sleep phobia was weakly supported, but the results clearly supported the notion of vicious cycles of sleeplessness (worries, frustration, and negative expectations about sleeplessness). In a second study, SBQ items were factor analyzed, and correlations between SBQ items and personality variables, depression, and stress measures were studied. The item that correlated most strongly with degree of reported sleeping problems referred to negative expectations about sleeplessness. Factor analysis identified four factors: negative expectations, worrying, frustration over sleeplessness, and sleep phobia, with negative expectations accounting for most of the variance.

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