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Pre-sleep arousal and fear of sleep in trauma-related sleep disturbances: A cluster-analytic approach
Werner, Gabriela G.
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Danböck, Sarah K.
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Metodiev, Stanislav
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Kunze, Anna E.
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DOI:
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https://doi.org/10.32872/cpe.v2i2.2699
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URL:
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https://cpe.psychopen.eu/index.php/cpe/article/vie...
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Additional URL:
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https://pubmed.ncbi.nlm.nih.gov/36397829/
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URN:
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urn:nbn:de:bsz:180-madoc-652895
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Document Type:
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Article
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Year of publication:
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2020
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The title of a journal, publication series:
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Clinical Psychology in Europe
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Volume:
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2
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Issue number:
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2
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Page range:
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1-20
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Place of publication:
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Trier
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Publishing house:
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PsychOpen
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ISSN:
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2625-3410
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Publication language:
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English
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Institution:
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School of Social Sciences > Klinische u. Biologische Psychologie u. Psychotherapie (Alpers 2010-)
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Pre-existing license:
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 Creative Commons Attribution 4.0 International (CC BY 4.0)
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Subject:
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150 Psychology
610 Medicine and health
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Keywords (English):
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trauma-related sleep disturbances , pre-sleep arousal , insomnia , nightmares , fear of sleep , posttraumatic stress disorder , cluster analysis
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Abstract:
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Background: Trauma-related sleep disturbances constitute critical symptoms of posttraumatic stress disorder (PTSD), but sleep symptoms often reside even after successful trauma-focused psychotherapy. Therefore, currently unattended factors – like fear of sleep (FoS) – might play a crucial role in the development and maintenance of residual sleep disturbances. However, it is unclear whether trauma-exposed individuals exhibit different symptomatic profiles of sleep disturbances that could inform individualized therapeutic approaches and eventually enhance treatment efficacy.
Method: In a large online study, a two-step cluster analysis and a hierarchical cluster analysis using Ward’s method were performed to explore subgroups among trauma-exposed individuals (N = 471) in terms of FoS, different aspects of trauma-related sleep disturbances (e.g., insomnia symptoms, nightmares, arousal), and PTSD symptoms. These variables were compared between resulting clusters using ANOVAs and Scheffé’s post-hoc tests.
Results: The hierarchical cluster analysis supported 3- and 4-cluster solutions. The 3-cluster solution consisted of one “healthy” (n = 199), one “subclinical” (n = 223), and one “clinical” (n = 49) cluster, with overall low, medium, and high symptomatology on all used variables. In the 4-cluster solution, the clinical cluster was further divided into two subgroups (n = 38, n = 11), where one cluster was specifically characterized by elevated somatic pre-sleep arousal and high levels of FoS.
Conclusions: A subgroup of trauma-exposed individuals with PTSD and sleep disturbances suffers from increased pre-sleep arousal and FoS, which has been suggested as one possible explanation for residual sleep disturbances. In these patients, FoS might be a relevant treatment target.
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 | Das Dokument wird vom Publikationsserver der Universitätsbibliothek Mannheim bereitgestellt. |
 | Dieser Datensatz wurde nicht während einer Tätigkeit an der Universität Mannheim veröffentlicht, dies ist eine Externe Publikation. |
 Search Authors in
BASE:
Werner, Gabriela G.
;
Danböck, Sarah K.
;
Metodiev, Stanislav
;
Kunze, Anna E.
Google Scholar:
Werner, Gabriela G.
;
Danböck, Sarah K.
;
Metodiev, Stanislav
;
Kunze, Anna E.
ORCID:
Werner, Gabriela G., Danböck, Sarah K.  ORCID: https://orcid.org/0000-0001-9989-1146, Metodiev, Stanislav and Kunze, Anna E.
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