The relation between repetitive thinking, daily sleepiness and insomnia

Rezultati brojnih epidemioloških studija ukazuju kako čak trećina odrasle populacije navodi da ima neke od simptoma nesanice, što nesanicu čini jednim od najčešćih zdravstvenih poteškoća. Utvrđena je povezanost nesanice sa sniženom kvalitetom života, problemima u dnevnom funkcioniranju, povećanom razdražljivosti, lošom koncentracijom, te problemima na poslu. Uz to, nesanica je rizični faktor za razvoj nekih fizičkih i psihopatoloških poremećaja, naročito depresije i anksioznosti. Pretpostavlja se da je u podlozi razvoja nesanice više različitih uzroka s bihevioralnim, fiziološkim i kognitivnim elementima. Kognitivni modeli nesanice naglašavaju važnost repetitivnih procesa mišljenja, naročito brige, a u novije vrijeme i ruminacije. Međutim, malo je istraživanja koja su istodobno uključila oba procesa mišljenja u proučavanju odnosa s nesanicom. Stoga je cilj ovoga rada bio istražiti odnos brige i ruminacije s nesanicom, te utvrditi postoji li razlika u subjektivnoj procjeni dnevne pospanosti između osoba koje imaju i onih koje nemaju nesanicu. U istraživanju su sudjelovale 562 osobe, ali su analize provedene na uzorku od 451 osobe u rasponu od 18 do 61 godine, koje su navele da ne boluju od kroničnih tjelesnih i/ili psihičkih bolesti. Primijenjen je upitnik sociodemografskih podataka, Atenska skala nesanice (Athens Insomnia Scale – AIS; Soldatos, Dikeos i Paparrigopoulos, 2000), Upitnik za procjenu briga (Penn State Worry Questionnaire – PSWQ; Meyer, Miller, Metzger i Borkovec, 1990), Upitnik anksioznosti i zaokupljenosti spavanjem (The Anxiety and Preoccupation about Sleep Questionnaire – APQ; Harvey i Tang, 2013), Skala ruminativnog stila mišljenja (Ruminative Thought Style Questionnaire – RTS; Brinker i Dozois, 2009), Skala odgovora na simptome nesanice tijekom dana (Daytime Insomnia Symptom Response Scale – DISRS; Carney, Harris, Falco i Edinger, 2013), te Epworthova skala pospanosti (Epworth Sleepiness Scale – ESS; Johns, 1991). Rezultati su pokazali da postoji umjerena pozitivna povezanost opće brige i ruminacije s nesanicom, kao i umjerena pozitivna povezanost brige i ruminacije povezanih sa spavanjem i nesanice. Dalje, nije utvrđena razlika u subjektivnoj procjeni dnevne pospanosti između sudionika koji imaju i onih koji nemaju nesanicu. Konačno, rezultati hijerarhijske regresijske analize pokazuju da su dob, briga i ruminacija povezane sa spavanjem, te sklonost ka brizi značajni prediktori nesanice. Odnosno, stariji pojedinci, osobe koje brinu i ruminiraju o spavanju, te osobe koje su sklone brizi, imaju više poteškoća sa spavanjem. Dobiveni rezultati su u skladu s očekivanjima, te imaju praktične implikacije za tretman nesanice.Epidemiological studies indicate that almost one third of the adult population report having some of the symptoms of insomnia, making insomnia one of the most common health issues. It has been associated with reduced quality of life, impairment in daily functioning, increased irritability, poor concentration and problems at work. In addition, insomnia is a risk factor for developing physical and psychopathological disorders, especially depression and anxiety. It is assumed that there are various different causes of insomnia with behavioral, physiological, and cognitive elements. Cognitive models of insomnia emphasize the importance of repetitive thought processes, especially worry, and more recently rumination. However, there are few studies that have simultaneously explored both thought processes in the context of insomnia. Therefore, the aim of this paper was to investigate the relationship of worry and rumination with insomnia, and to determine whether there is a difference in the subjective daytime sleepiness between subjects with and without insomnia. The study involved 562 people, but statistical analyses were performed on a sample of 451 people ranging in age from 18 to 61, who did not have chronic physical and/or psychiatric disorder. The respondents were given sociodemographic questionnaire, Athens Insomnia Scale (AIS; Soldatos, Dikeos and Paparrigopoulos, 2000), Penn State Worry Questionnaire (PSWQ; Meyer, Miller, Metzger and Borkovec, 1990), The Anxiety and Preoccupation about Sleep Questionnaire (APQ; Harvey and Tang, 2013), Ruminative Thought Style Questionnaire (RTS; Brinker and Dozois, 2009), Daytime Insomnia Symptoms Response Scale (DISRS; Carney, Harris, Falco and Edinger, 2013), and the Epworth Sleepiness Scale (ESS; Johns, 1991). The results indicate that there is a moderate positive correlation of general worry and rumination with insomnia, as well as a moderate positive correlation of sleep-related worry and sleep-related rumination with insomnia. Furthermore, no significant difference was found for subjective daily sleepiness between participants who have and those who do not have insomnia. Finally, the results of the hierarchical regression analysis show that age, sleep-related worry, sleep-related rumination and tendency to worry are significant predictors of insomnia. That is, older individuals, people who worry and ruminate about sleep, and people who are prone to worry have more difficulty sleeping. The results obtained are in line with expectations and have practical implications for the treatment of insomnia