The Relationship between Emotion Regulation, Dysfunctional Beliefs about Sleep and Sleep Quality - an Exploratory Study

IntroductionInsomnia is the most common sleep disturbance and one of the most common sleep health complaints. Several models have been proposed in order to better understand this condition. While prior models underline the importance of behavioural factors such as classic conditioning (Ribordy & Denney, 1977) or unhealthy sleep-related behaviours (Spielman, Caruso & Glovinsky, 1987), the latter focus on physiological (Riemann et al., 2010) and psychological factors (Espie, Broomfield, MacMahon, Macphee & Taylor, 2006) or a combination of them (Morin, Rodrigue & Ivers, 2003). Cognitive processes have been documented that they play a significant role in insomnia and dysfunctional beliefs about sleep are one of the most researched cognitive phenomena (Harvey, 2005). Intrusive thoughts, excessive and uncontrollable worry, unrealistic sleep expectations, misconceptions about the cause of sleeplessness, misattributions or amplifications of its consequences and faulty beliefs about sleep practices are the most important types of beliefs that interfere with sleep (Harvey, 2005; Morin, 1993). Dysfunctional beliefs about sleep are essential in maintaining insomnia (Carney & Edinger, 2006) as they promote worry about sleep and unhealthy sleep-related behaviours (Harvey, 2005; Sanchez-Ortuno & Edinger, 2010).Another major question regarding insomnia is what premorbid psychological factors play key roles in its aetiology. Personality traits such as neuroticism, internalization, anxious concerns and traits associated with perfectionism have been proposed (van de Laar, Verbeek, Pevernagie, Aldenkamp & Overeem 2010). Emotions such as shame, guilt or regret were positively associated with self-reported insomnia symptoms (Schmidt & Van der Linden, 2009). The coping style, as an emotion regulation strategy, was investigated in relation with sleep quality. Problem-focused coping, emotion-focused coping or disengagement seem to moderate the relationship between stress and sleep (Sadeh, Keinan & Daon, 2004), while avoidant coping style was found to be related with symptoms of insomnia, as well as impaired daily functioning (Hoyt, Thomas, Epstein, & Dirksen, 2009) and to predict worse sleep in cancer patients (Thomas, Bower, Hoyt & Sepah, 2010). Vandekerckhove et al. (2012) induced two different coping styles, i.e. experiential coping, which involves understanding and expressing the emotional experience about a situation, and cognitive analytical coping, which means analysing the causes, meaning and implication of the situation for the self, and studied their relationship with sleep. They found that participants who applied experiential coping strategies had a longer total sleep time and higher sleep efficiency than participants who used the analytical approach.Our study aims to explore whether difficulties in emotion regulation, i.e. a complex concept that includes awareness, understanding, and acceptance of emotions, the ability to act in desired ways when distress, as well as the modulation of emotional arousal (Gratz & Roemer, 2004) play a role in insomnia. First, we determined whether poor sleepers report more difficulties in emotion regulation compared to good sleepers. Second, we measured the relationship between emotion regulation difficulties, on one side, and dysfunctional beliefs about sleep and sleep quality, on the other. Third, we tested whether the above mentioned psychological characteristics predicted poor sleep.MethodParticipantsWe recruited 133 adults, aged between 19 and 63 (M= 26.14, SD= 7.61) from the general community. Most of them were women (N= 109, 81.95%). All the subjects had graduated from high school and most of them had higher education, with 60% reported having a bachelor's degree and 17% post graduate degree. Our sample was represented mostly by students (48%) and working people (43%), with a lower percentage of retired and unemployed people (9%). …