Subjective beliefs about reasons of sleep disturbances in patients with insomnia, parasomnias and sleep apnea...

Relevance. In psychosomatics, subjective attributions of the causes of the disease are considered as one of the components of illness representation. In somnology, the disfunctional beliefs about illness reasons are considered as a factor in insomnia perpetuation. Study of the characteristics of subjective perceptions of sleep disorders reasons in good sleepers versus sleep disorders, as well as their relationship to well-being, can help to clarify theoretical knowledge about the functions of reasons’ representations in various illnesses.

Objective. The aim was to compare the subjective reasons of sleep disorders in good sleepers, insomnia, parasomnias and sleep apnea, as well as to reveal the relationship between beliefs about the reasons of sleep disorders and anxiety and depression.

Methods. The clinical group consisted of 77 patients with sleep apnea syndrome, 18 patients with parasomnias, 105 patients with chronic insomnia who filled the Checklists of Sleep Quality, Subjective Reasons of Sleep Disorders, Screening for Sleep Apnea, Epworth Sleepiness Scale, Hospital Anxiety and Depression Scale. In 46 patients with apnea, 15 patients with parasomnias and 93 patients with insomnia, polysomnography was performed over one night. The control group included 102 people, 67 of them with periodic sleep complaints, and 33 without sleep complaints who filled Checklists of Sleep Quality, Subjective Reasons of Sleep Disorders.

Results. Good sleepers are characterized by a wide range of sleep problems’ attributions. In case of complaints for some sleep problems, the focus on emotional causes was enhanced while in case of chronic disorders, the number of reasons was narrowed to those specific for that sleep disorder. In both apnea and insomnia, subjective belief that sleep is disturbed by unpleasant sensations in the arms and legs was especially stressful for participants and was associated with depression and marginally associated with anxiety. Attribution of sleep disorders to life events was associated with a higher level of anxiety, especially in insomnia.

Conclusions. The data supports the hypothesis that some subjective reasons of sleep disorders are associated with psychological distress, regardless of the subjective and objective quality of sleep.

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