Insomniacs’ perceptions of cognitive versus somatic determinants of sleep disturbance
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A study in Pennsylvania reported two main phenotypes of insomnia patients: with or without objectively short TST.
“A study carried out by a group of researchers in Pennsylvania reported two main phenotypes of insomnia patients: with or without objectively short TST. ( 47 )”
From Physical exercise as a therapeutic approach for adults with insomnia: Systematic review and meta-analysis (2022) · cites this paper as [47]
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Harvey, A. G. (2002) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(01)00061-4 · Cited by 1,790 · see citing works
Role of Stress, Arousal, and Coping Skills in Primary Insomnia
Morin, C. M., Rodrigue, S., & Ivers, H. (2003) · Psychosomatic Medicine · doi:10.1097/01.psy.0000030391.09558.a3 · Cited by 739 · see citing works
The phenomenology of the pre-sleep state: the development of the pre-sleep arousal scale
Nicassio, P. M., Mendlowitz, D. R., Fussell, J. J., & Petras, L. (1985) · Behaviour Research and Therapy · doi:10.1016/0005-7967(85)90004-x · Cited by 704 · see citing works
Psychosocial stress and impaired sleep
Åkerstedt, T. (2006) · Scandinavian Journal of Work, Environment & Health · doi:10.5271/sjweh.1054 · Cited by 585 · see citing works
“Worry and arousal are antithetical to optimal sleep (142), cortical arousal is the primary feature of insomnia (143), and most insomniacs attribute their problems to cognitive arousal (144).”
BackgroundBeta EEG activity and insomnia
Perlis, M. L., Merica, H., Smith, M. T., & Giles, D. E. (2001) · Sleep Medicine Reviews · doi:10.1053/smrv.2001.0151 · Cited by 345 · see citing works
Stress and Sleep Reactivity: A Prospective Investigation of the Stress-Diathesis Model of Insomnia
Drake, C. L., Pillai, V., & Roth, T. G. (2014) · SLEEP · doi:10.5665/sleep.3916 · Cited by 347 · see citing works
Rumination—relationship with negative mood and sleep quality
Thomsen, D. K., Yung Mehlsen, M., Christensen, S., & Zachariae, R. (2003) · Personality and Individual Differences · doi:10.1016/s0191-8869(02)00120-4 · Cited by 326 · see citing works
Alfano, C., Zakem, A. H., Costa, N. M., Taylor, L., & Weems, C. (2008) · Depression and Anxiety · doi:10.1002/da.20443 · Cited by 343 · see citing works
“Adult insomniacs are much more likely to attribute their sleep problems to cognitive rather than somatic factors([25]) and, similar to individuals with internalizing disorders, experience more negative thoughts at bedtime as compared to good sleepers([26]).”
BackgroundInsomnia causes, consequences, and therapeutics: An overview
Drake, C. L., Roehrs, T., & Roth, T. G. (2003) · Depression and Anxiety · doi:10.1002/da.10151 · Cited by 307 · see citing works
“Chronic insomnia patients also tend to attribute their insomnia to cognitive arousal rather than somatic factors [Lichstein and Rosenthal, 1980].”
BackgroundSleep quality and presleep arousal in chronic pain
Smith, M. T., Perlis, M. L., Smith, M. S., Giles, D. E., & Carmody, T. P. (2000) · Journal of Behavioral Medicine · doi:10.1023/a:1005444719169 · Cited by 302 · see citing works
Wicklow, A. A., & Espie, C. A. (2000) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(99)00136-9 · Cited by 282 · see citing works
“…with sleep disruption, and `having an overactive mind' has been the attribution of poor sleep rated most highly, both by insomniacs and non-insomniacs (Broman and Hetta, 1994; Espie, Brooks & Lindsay, 1989; Evans, 1977; Lichstein & Rosenthal, 1980; Nicassio, Mendlowitz, Fussel & Petras, 1985).”
BackgroundInsomnia as an interaction between sleep-interfering and sleep-interpreting processes
Lundh, L.-G., & Broman, J.-E. (2000) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(00)00150-1 · Cited by 263 · see citing works
Cognitive approaches to insomnia
Harvey, A. G., Tang, N. K. Y., & Browning, L. (2005) · Clinical Psychology Review · doi:10.1016/j.cpr.2005.04.005 · Cited by 254 · see citing works
Espie, C. A., Inglis, S. J., Harvey, L., & Tessier, S. (2000) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(99)00090-2 · Cited by 241 · see citing works
Cognitive-Emotional Hyperarousal as a Premorbid Characteristic of Individuals Vulnerable to Insomnia
Fernández-Mendoza, J., Vela-Bueno, A., Vgontzas, A. N., Ramos-Platón, M. J., Olavarrieta-Bernardino, S., Bixler, E. O., & De la Cruz-Troca, J. J. (2010) · Psychosomatic Medicine · doi:10.1097/psy.0b013e3181d75319 · Cited by 234 · see citing works
“Several studies have suggested that chronic insomniacs are more cognitively arousable, suffer from more sleep-retarding intrusive thoughts, ruminate more (2,6,7), and present higher levels of presleep cognitive and somatic arousal (13,39,51,52).”
BackgroundDistinguishing rumination from worry in clinical insomnia
Carney, C. E., Harris, A. L., Moss, T. G., & Edinger, J. D. (2010) · Behaviour Research and Therapy · doi:10.1016/j.brat.2010.03.004 · Cited by 215 · see citing works
Rumination predicts longer sleep onset latency after an acute psychosocial stressor
Zoccola, P. M., Dickerson, S. S., & Lam, S. (2009) · Psychosomatic Medicine · doi:10.1097/psy.0b013e3181ae58e8 · Cited by 209 · see citing works
“Participants indicated how much they thought about specific positive and negative items using a 5-point scale ranging from never (0) to very often (4).”
BackgroundHarvey, A. G., & Payne, S. (2002) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(01)00012-2 · Cited by 199 · see citing works
“Keywords: Insomnia; Treatment; Cognition; Imagery; Mental control Most people with insomnia complain of being unable to fall asleep because they cannot switch off their “racing” mind (Espie, Brooks, & Lindsay, 1989; Geer & Katkin, 1966; Harvey, 2000; Lichstein & Rosenthal, 1980).”
BackgroundEmerging research on the treatment and etiology of secondary or comorbid insomnia
Stepanski, E. J., & Rybarczyk, B. (2006) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2005.08.002 · Cited by 181 · see citing works
Pre-Sleep Arousal and Sleep Problems of Anxiety-Disordered Youth
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“A heightened state of physiological (somatic) arousal also has been found to contribute to problems initiating and/or maintaining sleep [21], however pre-sleep cognition is commonly cited as the most significant factor in persistent sleep disturbance [22,23].”
BackgroundHall, M. H., Thayer, J. F., Germain, A., Moul, D. E., Vasko, R., Puhl, M. D., Miewald, J. M., & Buysse, D. J. (2007) · Behavioral Sleep Medicine · doi:10.1080/15402000701263221 · Cited by 151 · see citing works
“…suggested that personality was an important predictor of the stress-sleep relationship (e.g., McGrath & Cohen, 1980); patients with insomnia have been characterized as neurotic, anxious worriers (Harvey & Greenall, 2003; Kales, Caldwell, Preston, Healey, & Kales, 1976; Lichstein & Rosenthal, 1980).”
BackgroundAn evaluation of tailored psychological treatment of insomnia
Espie, C. A., Brooks, D. N., & Lindsay, W. R. (1989) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/0005-7916(89)90047-5 · Cited by 147 · see citing works
Etiology and Pathophysiology of Insomnia
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“Sleep researchers have noted since the 1980s that unwanted, repetitive thought in the pre-sleep period is a reliable precipitant of sleep disturbance [34].”
BackgroundCatastrophic worry in primary insomnia
Harvey, A. G., & Greenall, E. (2003) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/s0005-7916(03)00003-x · Cited by 138 · see citing works
The influence of pre-sleep cognitive arousal on sleep onset processes
Wuyts, J., Valck, E. D., Vandekerckhove, M. M. P., Pattyn, N., Bulckaert, A., Berckmans, D., Haex, B., Verbraecken, J. A., & Cluydts, R. (2011) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2011.09.016 · Cited by 133 · see citing works
“Although insomnia patients tend to blame their sleep problems more on intrusive cognitivearousing thoughts than on physical arousal (Lichstein and Rosenthal, 1980), the disturbing role of changes in processes controlled by the autonomous nervous system – such as heart rate (Hall et al., 2004) and…”
BackgroundCoren, S. (1988) · Behaviour Research and Therapy · doi:10.1016/0005-7967(88)90076-9 · Cited by 127 · see citing works
Understanding insomnia through cognitive modelling
Espie, C. A. (2007) · Sleep Medicine · doi:10.1016/s1389-9457(08)70002-9 · Cited by 113 · see citing works
“[6,10,11] Such cognitive activity can include uncontrollable worry, intrusive thoughts and an overly active or ‘racing’ mind.”
BackgroundInsomnia and Sleep-Related Breathing Disorders
Wickwire, E. M., & Collop, N. A. (2010) · CHEST Journal · doi:10.1378/chest.09-1485 · Cited by 108 · see citing works
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“On the basis of findings concerning the role of general presleep cognitive worry and rumination in sleep disturbance [6,7,11,12,30,33,39,40,70], as well as the findings of Smith et al.”
ResultBehavioral assessment and treatment of insomnia: A review with an emphasis on clinical application
Lichstein, K. L., & Riedel, B. W. (1994) · Behavior Therapy · doi:10.1016/s0005-7894(05)80203-5 · Cited by 103 · see citing works
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“33 Emotional arousal might also contribute to sleep problems in an indirect way, as presleep cognitions may make individual feels anxious, remorseful, or dysphoric, producing an emotional arousal that interferes with sleep.”
BackgroundDrummond, S. P. A., Smith, M. T., Orff, H. J., Chengazi, V., & Perlis, M. L. (2004) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2003.10.005 · Cited by 92 · see citing works
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“A ‘racing mind’ while lying in bed is as a key symptom of insomnia (e.g., Espie, 1991; Harvey, 2000; Lichstein & Rosenthal, 1980) and hence difficulty with thought control has been implicated M.J. Ree et al. / Behaviour Research and Therapy 43 (2005) 985–998986”
BackgroundMARCHETTI, L. M., Biello, S. M., Broomfield, N. M., Macmahon, K., & Espie, C. A. (2006) · Journal of Sleep Research · doi:10.1111/j.1365-2869.2006.00510.x · Cited by 90 · see citing works
“Indeed, having an overactive mind has been the attribution of poor sleep rated most highly, both by insomniacs and non-insomniacs (Bootzin et al., 1991; Espie and Tweedie, 1991; Lichstein and Rosenthal, 1980; Nicassio et al., 1985).”
BackgroundRichdale, A. L., Baker, E., Short, M., & Gradisar, M. (2014) · Sleep Medicine · doi:10.1016/j.sleep.2014.05.005 · Cited by 87 · see citing works
“In line with previous research [8,35], our adolescents were more likely to experience cognitive arousal associated with sleep rather than somatic arousal.”
ResultPresleep cognitions and attributions in sleep-onset insomnia
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“People with insomnia are 10 times more likely to cite cognitive arousal as central to their sleep disturbance compared to somatic arousal (Lichstein & Rosenthal, 1980).”
BackgroundEmotion regulation as a moderator between anxiety symptoms and insomnia symptom severity.
Kirwan, M., Pickett, S. M., & Jarrett, N. L. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.04.028 · Cited by 69 · see citing works
“…individuals with insomnia were up to ten times more likely to report that their insomnia was due to cognitive arousal, rather than somatic arousal (Lichstein and Rosenthal, 1980), and furthermore, those with insomnia ruminate more about their sleeplessness when trying to fall asleep (Fichten et…”
BackgroundPresleep Cognitive Hyperarousal and Affect as Factors in Objective and Subjective Insomnia
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Cognitive and Affective Control in Insomnia
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“1 Department of Psychology, Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland 2 Department of Psychology, Cognitive Psychopathology and Neuropsychology Unit, University of Geneva, Geneva, Switzerland 3 Department of Psychology, University of California Berkeley,…”
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“Furthermore, data from thought sampling (e.g. Broman and Hetta, 1994; Lichstein and Rosenthal, 1980; Nicassio et al., 1985; Wicklow and Espie, 2000) and experimental cognitive manipulation studies (Ansfield et al., 1996; Gross and Borkovec, 1982; Hall et al., 1996), indicate that PI is associated…”
BackgroundPre-sleep cognitive intrusions and treatment of onset-insomnia
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Psychometric properties of the Pre-Sleep Arousal Scale in a large community sample
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“From a psychological viewpoint, cognitive arousal has been shown to be associated with sleep difficulties and particularly “having an overactive mind” [13–15].”
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“…their pre-sleep thoughts as intrusive, uncontrollable and negative (Harvey, 2000; Kuisk, Bertelson, & Walsh, 1989), and attribute sleeping difficulties to intrusions (Broman & Hetta, 1994; Espie, Brooks, & Lindsay, 1989; Lichstein & Rosenthal, 1980; Nicassio, Mendlowitz, Fussell, & Petras, 1985).”
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“32,35,36 Median sleep perception in the NC group was 91.4%, higher than patients with insomnia, but not statistically different from the OSA group.”
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“Received 8 July 2012 Received in revised form 25 December 2012 Accepted 10 January 2013”
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Self-citationPredictors of sleep quality in medical students during COVID-19 confinement
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“Lichstein & Rosenthal, 1980; Morin, Culbert, & Schwartz, 1994), our findings on the somatic and cognitive subscales of the Presleep Arousal Scale suggest that the cognitive aspects of state anxiety are more closely related to troubled sleep than are the somatic aspects.”
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“Indeed, nocturnal cognitive arousal is welldocumented in insomnia [11, 26, 29, 32, 50, 51].”
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“…of biological measurements (Riemann et al., 2010), people with insomnia have been more likely to perceive nighttime cognitive arousal as opposed to somatic activity to be the determining factor for their sleep problems (Espie, Brooks, & Lindsay, 1989; Harvey, 2000; Lichstein & Rosenthal, 1980).”
BackgroundThe differential functions of imagery and verbal thought in insomnia.
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“Cognitive arousal has been shown to be more important than physiological arousal in disrupting sleep (Lichstein and Rosenthal, 1980).”
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Cognitive-behavioural Analysis and 1 reatment ot Insomnia
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“2022;20:1-13 A study carried out by a group of researchers in Pennsylvania reported two main phenotypes of insomnia patients: with or without objectively short TST.(47) Given the different insomnia phenotypes, apparent discrepancies between subjective and objective improvements might be expected in insomnia patients w…”
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“In a sample of 296 patients with insomnia, cognitive arousal was 10 times more likely than somatic arousal to be cited as the main determinant of the sleeping disturbance ( Lichstein & Rosenthal, 1980 ).”
BackgroundCognitive anxiety in insomnia: An analogue test
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Self-citationCognitive-Behavioral Therapy for Insomnia
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Gieselmann, A., de Jong-Meyer, R., & Pietrowsky, R. (2012) · Zeitschrift für Klinische Psychologie und Psychotherapie · doi:10.1026/1616-3443/a000134 · Cited by 28 · see citing works
Neurobiologic Mechanisms in Chronic Insomnia
Perlis, M. L., Gehrman, P. R., Pigeon, W. R., Findley, J., & Drummond, S. P. A. (2009) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2009.07.002 · Cited by 29 · see citing works
Pre-sleep imagery under the microscope: a comparison of patients with insomnia and good sleepers
Nelson, J. M., & Harvey, A. G. (2003) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(02)00010-4 · Cited by 27 · see citing works
Guo, Y., Zou, G., Shao, Y., Chen, J., Li, Y., Liu, J., Yao, P., Zhou, S., Xu, J., Hu, S., et al. (2022) · SLEEP · doi:10.1093/sleep/zsac290 · Cited by 24 · see citing works
Nighttime Thought Control Strategies and Insomnia Severity
Gellis, L. A., & Park, A. (2012) · Cognitive Therapy and Research · doi:10.1007/s10608-012-9479-y · Cited by 24 · see citing works
“…were 10 times more likely to attribute their sleep problems to cognitive arousal (heightened thought reactivity such as worry or rumination) as opposed to somatic arousal (heightened physiologic or physical reactivity such as increased heart rate or muscle tension; Lichstein and Rosenthal 1980).”
BackgroundAn experimental investigation of daytime monitoring for sleep-related threat in primary insomnia
Semler, C. N., & Harvey, A. G. (2006) · Cognition & Emotion · doi:10.1080/02699930600639462 · Cited by 25 · see citing works
“…1993; Perlis, Giles, Mendelson, Bootzin, & Wyatt, 1997) and the empirical evidence for the importance of cognitive processes is accruing (e.g., Espie, Brooks, & Lindsay, 1989; Hall, Buysse, Reynolds, Kupfer, & Baum, 1994; Harvey, 2005; Harvey, Tang, & Browning, 2005; Lichstein & Rosenthal, 1980).”
Lichstein, K. L., & Fischer, S. M. (1985) · Springer eBooks · doi:10.1007/978-1-4613-2427-0_12 · Cited by 24 · see citing works
Self-citationInsomnia: psychological and neurobiological aspects and non-pharmacological treatments
Molen, Y. F., de Carvalho, L. B. C., do Prado, L. B. F., & do Prado, G. F. (2014) · Arquivos de Neuro-Psiquiatria · doi:10.1590/0004-282x20130184 · Cited by 23 · see citing works
Arbeitsstress, sozialer Stress und Schlafqualität:
Schulz, P., Hellhammer, J., & Schlotz, W. (2003) · Zeitschrift für Gesundheitspsychologie · doi:10.1026//0943-8149.11.1.1 · Cited by 23 · see citing works
Cognitive processes in comorbid poor sleep and chronic pain
Byers, H. D., Lichstein, K. L., & Thorn, B. E. (2015) · Journal of Behavioral Medicine · doi:10.1007/s10865-015-9687-5 · Cited by 21 · see citing works
Self-citationSelf-reported Sleep Quality and Cognitive Style in Older Adults
Willis, T. A., Yearall, S. M., & Gregory, A. M. (2009) · Cognitive Therapy and Research · doi:10.1007/s10608-009-9270-x · Cited by 21 · see citing works
“intrusive thoughts, racing mind) showing a particularly robust relationship ( Lichstein and Rosenthal 1980; Nicassio et al. 1985).”
InfluentialValidation of a French version of the thought control questionnaire-insomnia revised (TCQI-R)
Schmidt, R. E., Gay, P., & der Linden, M. V. (2007) · European Review of Applied Psychology · doi:10.1016/j.erap.2007.08.002 · Cited by 21 · see citing works
“Insomniacs typically complain of a “racing mind” when trying to get to sleep (e.g., Harvey, 2001), and they attribute their sleep disturbances to cognitive arousal up to 10 times more often than they do to somatic arousal (e.g., Espie et al., 1989; Harvey, 2000; Lichstein and Rosenthal, 1980).”
BackgroundVochem, J., Strobel, C., Maier, L., Spiegelhalder, K., Hertenstein, E., Riemann, D. W., & Feige, B. (2019) · Sleep Medicine · doi:10.1016/j.sleep.2019.01.022 · Cited by 20 · see citing works
- Authors
- Lichstein, K. L., & Rosenthal, T. L.
- Affiliations
- University of Memphis (US)
- Venue
- Journal of Abnormal Psychology
- Published
- 1980
- Volume
- 89
- Issue
- 1
- Pages
- 105-107
- ISSN
- 0021-843X (ISSN-L)
- 1939-1846
- OpenAlex
- W2037727848
- Cited by
- 239
- References
- 0
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 6 · 2023: 8 · 2022: 8 · 2021: 12 · 2020: 5 · 2019: 9 · 2018: 8 · 2017: 9 · 2016: 5 · 2015: 9 · 2014: 9 · 2013: 6 · 2012: 12
- FWCI
- 4.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Abnormal Psychology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- insomnia, sleep disorders, cognitive factors, patient perspectives
- MeSH terms
- Adult, Arousal, Cognition, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Psychophysiologic Disorders
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