Introceptive perception and sleep quality in chronic insomniaстатьяТезисы
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Дата последнего поиска статьи во внешних источниках: 4 мая 2020 г.
Аннотация:Introduction: Disturbances of introceptive perception and sensation-related cognitive processes (e.g., catastrophization about symptoms) were initially suggested as possible mechanisms of hypochondria and somatoform disorders (Nakao, Barsky, 2007, Rief et al., 1998 etc.). In functional illnesses poor differentiation of sensations (e.g., alexithymia, Taylor et al., 1997) could manifest in either too few or too many bodily sensations comparing to healthy controls as well as in misclassification of sensations as important, dangerous or caused by their illness (Tkhostov, 2002). Although insomnia was shown to be related to alexithymia (Lundh, Broman, 2006, Engin et al., 2010) and is comorbid to a wide range of mental disorders (Riemann, 2007), less is known about relationship between introceptive perception in insomnia and sleep and whether this relationship is explained by cognitive factors of insomnia (Perlis et al., 2011).
The aim was to reveal the relationship of bodily sensations and symptoms with beliefs about sleep, thoughts before sleep and sleep quality in patients with chronic insomnia.
Methods: 82 patients with primary chronic insomnia (25 males, 16-65 years old) and 105 good sleepers (32 males, 16-60 years old) classified descriptors for bodily sensations from checklist as familiar for them, frequent, related to their sleep, important, dangerous and painful (Classification of descriptors of introceptive sensations, Tkhostov, Elshansky, 2003). Then they filled Bodily Perception Scale (Tkhostov, 2002), Glasgow Content of Thoughts Inventory (Harvey, Espie, 2004), Dysfunctional Beliefs about Sleep Scale and Insomnia Severity Index (Morin, 1993). The sleep of 62 patients was recorded using polysomnography. Subsample didn’t differ from initial sample by age and gender.
Results: Comparing to good sleepers, patients scores on the Bodily Perception Scale had bimodal distribution reflecting either too few or too many somatic complaints (p<.01). Comparing to controls, patients also classified either much more or just a few of their bodily sensations as dangerous and painful (p<.05). In clinical sample the number of reported somatic complaints (r=.54, p<.01) as well as the proportion of familiar and proportion of related to sleep sensations (r=.34, p<.05 and r=.57, p<.01, respectively) correlated to subjective insomnia severity. The number of somatic symptoms were marginally related to longer stage 1 and shorter delta-sleep (r=.22 and r=-.22, p<.10) while tendency to report either too few or too many symptoms was associated to shorter REM (r=-.30, p<.05). The number of somatic symptoms (but neither their bimodal pattern nor classification of sensations) was associated to dysfunctional beliefs about sleep and thoughts before sleep (r=.30-.49, p<.01).
Conclusions: While the bimodal pattern of somatic complaints in insomnia was typical for functional illnesses, only exaggerated level of sensations and their subjective referral to sleep were associated with poorer sleep in patients. Unlike the exaggerated level of sensations, their referral to sleep was unrelated to dysfunctional beliefs and thoughts before sleep.
Acknowledgement. Research is supported by the Russian Foundation for Basic Research, project No. 17-06-00363.