Comparative investigation of the psychophysiologic and idiopathic insomnia disorder phenotypes: Psychologic characteristics, patients' perspectives, and implications for clinical management
Open accessAbstract
Study Objectives: Insomnia is a common disorder, yet its proposed behavioral phenotypes are seldom differentiated. Two consecutive studies were designed to investigate psychologic characteristics and treatment preferences of people with idiopathic insomnia (IdI) relative to psychophysiologic insomnia (PI). Design: Cross-sectional, two-group comparison studies. Setting: Specialized sleep research center. Participants: 40 participants (29 female, mean age 46 yr) participated in study 1. An additional cohort of 61 adults (48 female, mean age 37 yr) participated in study 2. In total, samples comprised 51 participants with PI and 50 with IdI. All participants met diagnostic criteria for their respective insomnia phenotype. Interventions: N/A Measurements and Results: Study 1 investigated sensitivity to arousal conditioning and sleep effort using self-report measures. Consistent with a model of conditioned arousal, participants with PI exhibited greater behavioral inhibition, i.e., sensitivity to threat and higher levels of sleep preoccupation. Study 2 investigated illness perceptions and cognitions and coping styles using self-report scales, and explored treatment acceptability based on the evaluation of 3 therapeutic scenarios. Results lend support to the hypothesis that IdI is considered somewhat more permanent than PI. Behavioral intervention was preferred to pharmacotherapy by both groups, and an acceptance treatment was considered more favorably by IdI study participants than by those with PI. Conclusions: Many similarities between IdI and PI were observed across psychologic measures, and both groups exhibited a preference for behavioral treatment. However, their distinctive characteristics appear to suggest that an acceptance-based therapy may also be appropriate for some people with IdI.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
2 of 14 cited sources checked · 0 supported · 0 flagged · accuracy not yet measured
- Background§ Submitted for publication May, 2011 Submitted in final revised form September, 2011 Accepted for publication September, 2011
The authors suggest that idiopathic insomnia may be partly defined by the absence of precipitating and maintaining factors and by only minor psychologic abnormalities.
“IdI is partly defined by the absence of precipitating and maintaining factors, and patients appear to exhibit only minor psychologic abnormalities.”
Quote in the paperNot yet classified1 of 2 sources checked- cites [12] Hauri, 1980, Childhood-onset insomnia, Sleep source
In Sleep Variables (page unavailable), most childhood-onset patients could not identify a stress at onset, and the authors report a trend toward less fluctuation with mood than in adult-onset patients. The Discussion (page unavailable) suggests a less psychological basis. But the paper studies childhood-onset insomnia, not idiopathic insomnia as a whole; it does not establish an absence of maintaining factors or that patients have only minor psychological abnormalities. (LLM, conf=0.84)
Experimental — accuracy not yet measured - cites [13] Hauri, 1983, A cluster analysis of insomnia, Sleep source
- Finding§ DISCUSSION
The authors conclude that cognitive behavioral therapy is a rational intervention for both psychophysiologic and idiopathic insomnia patients.
“there is a rationale for using CBT with both PI and IdI patients.”
Quote in the paperNot yet classified1 of 4 sources checked- cites [44] Morin, 2006, Psychological and behavioral treatment of insomnia: update of the recent evidence (1998-2004), Sleep source
Section 4.2 reports CBT treatment involving patients with psychophysiologic insomnia, and Section 5 concludes that CBT is a well-established treatment for insomnia. The copy does not identify patients with idiopathic insomnia or make a recommendation specific to them, so the claim's application to both named groups is not fully supported. The supplied passages and retrieved passages have no page numbers. (LLM, conf=0.84)
Experimental — accuracy not yet measured - cites [45] Riemann, 2009, The treatments of chronic insomnia: a review of benzodiazepine receptor agonists and psychological and behavioral therapies, Sleep Med Rev source
- cites [46] 2005, NIH state-of-the-science conference statement on manifestations and management of chronic insomnia in adults, NIH Consens Sci Statements
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites [47] Wilson, 2010, British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders, J Psychopharmacology source
- Finding§ Illness perception
In Study 2, both groups viewed their sleep problems as chronic and were uncertain about treatability and control.
“mean scores suggest that both groups tended to view their insomnia as variable and outside of their control, and had doubts about its treatability.”
Quote in the paperNot yet classified - Finding§ Illness perception
In Study 2, the idiopathic insomnia group perceived their insomnia as more permanent than the psychophysiologic insomnia group.
“perceived their insomnia to have greater permanency than did the PI group ( t (59) = 2.18, P = 0.033).”
Quote in the paperNot yet classified - Finding§ Coping strategies
The idiopathic insomnia group reported using humor to cope more often than the psychophysiologic insomnia group.
“patients with IdI rated using humor to cope significantly more often than those with PI ( t (59) = -2.73,”
Quote in the paperNot yet classified
- Finding§ Behavioral sensitivity
People with psychophysiologic insomnia had higher behavioral inhibition, indicating greater threat sensitivity than people with idiopathic insomnia.
“the PI group scored higher than the IdI group on the BIS scale ( t (38) = 4.04, P < 0.001) indicating higher levels of threat sensitivity in PI.”
Quote in the paperNot yet classified - Finding§ Treatment acceptability
The idiopathic insomnia group rated acceptance therapy as more acceptable than the psychophysiologic insomnia group.
“for the acceptance-based approach to insomnia, however, there was a significant effect, with the IdI group rating this intervention as acceptable relative to the PI group's lower ratings ( t (61) = 2.40, P = 0.02).”
Quote in the paperNot yet classified - Finding§ Sleep effort
Study 1 found that the psychophysiologic insomnia group endorsed more sleep effort and sleep-related worry than the idiopathic insomnia group.
“Specifically, PI endorsed 'putting too much effort into sleeping' ( F (2) = 4.41, P = 0.019), being 'anxious about sleeping before going to bed' ( F (2) = 3.87, P = 0.030) and 'worrying about the consequences of not sleeping' ( F (2) = 3.34, P = 0.046) more strongly than did IdI.”
Quote in the paperNot yet classified - Finding§ Coping strategies
The idiopathic insomnia group also used self-distraction more often than the psychophysiologic insomnia group, though this did not survive correction for multiple comparisons.
“The only other strategy that differentiated between group was self-distraction, which also was used more often by patients with IdI than by those with PI ( t (59) = -2.72, P = 0.009]. These findings fail to achieve significance after conservative adjustment for multiple comparisons (critical value: P < 0.004).”
Quote in the paperNot yet classified - Finding§ Comparative Investigation of the Psychophysiologic and Idiopathic Insomnia Disorder Phenotypes: Psychologic Characteristics, Patients' Perspectives, and Implications for Clinical Management
The authors suggest that acceptance-based therapy may be appropriate for some people with idiopathic insomnia.
“their distinctive characteristics appear to suggest that an acceptance-based therapy may also be appropriate for some people with IdI.”
Quote in the paperNot yet classified - Finding§ Comparative Investigation of the Psychophysiologic and Idiopathic Insomnia Disorder Phenotypes: Psychologic Characteristics, Patients' Perspectives, and Implications for Clinical Management
The authors conclude that many psychologic similarities exist between idiopathic and psychophysiologic insomnia, and that both groups prefer behavioral treatment.
“Many similarities between IdI and PI were observed across psychologic measures, and both groups exhibited a preference for behavioral treatment.”
Quote in the paperNot yet classified - Finding§ Sleep effort
Study 1 broadly confirmed the hypothesis that psychophysiologic insomnia involves greater threat sensitivity and more pronounced sleep-related focus than idiopathic insomnia.
“The results from Study 1, therefore, broadly confirm the hypothesis that people with PI exhibit greater levels of threat sensitivity in general and a more pronounced sleep-related focus than people with IdI.”
Quote in the paperNot yet classified - Finding§ Illness cognition
Both groups showed similar levels of acceptance and helplessness on the illness cognition measure.
“there were no significant differences between participants with PI and IdI. Likewise, there were no differences between groups on the ICQ helplessness scale (both P > 0.05).”
Quote in the paperNot yet classified - Finding§ DISCUSSION
The authors speculate that acceptance-based therapy could be a second-line treatment for psychophysiologic insomnia and a first-line treatment for idiopathic insomnia.
“there is a rationale for considering an acceptance-based therapy as a second-line intervention for PI patients who have not responded to CBT; and potentially, as a first-line treatment for IdI.”
Quote in the paperNot yet classified - Background§ INTRODUCTION
The paper says psychophysiologic insomnia develops in adulthood and may be linked to precipitating events or stressors.
“PI develops in adulthood, may be linked to identifiable precipitating events and/or stressors, and comprises both psychologic and physiologic features”
Quote in the paperNot yet classified0 of 1 sources checked- cites [5] 2005, International Classification of Sleep Disorders: Diagnostic and Coding Manual
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Background§ Submitted for publication May, 2011 Submitted in final revised form September, 2011 Accepted for publication September, 2011
The paper says idiopathic insomnia may be resistant to treatment.
“It has been suggested that IdI may be resistant to treatment.”
Quote in the paperNot yet classified0 of 1 sources checked- cites [6] Edinger, 1988, Cluster analysis of insomniacs' MMPI profiles: relation of subtypes to sleep history and treatment outcome, Psychosom Med source
- Background§ Submitted for publication May, 2011 Submitted in final revised form September, 2011 Accepted for publication September, 2011
The authors note that conceptualizations of insomnia development and maintenance fit more closely with psychophysiologic insomnia than with idiopathic insomnia.
“conceptualizations of insomnia development and maintenance seem to fit more closely with PI than they do with IdI.”
Quote in the paperNot yet classified0 of 5 sources checked- cites [7] Spielman, 1987, Treatment of chronic insomnia by restriction of time in bed, Sleep source
- cites [8] Perlis, 1997, Psychophysiological insomnia: the behavioural model and a neurocognitive perspective, J Sleep Res source
- cites [9] Espie, 2002, Insomnia: conceptual issues in the development, persistence, and treatment of sleep disorder in adults, Annu Rev Psychol source
- cites [10] Espie, 2006, The attention-intention-effort pathway in the development of psychophysiologic insomnia: a theoretical review, Sleep Med Rev source
- cites [11] Harvey, 2002, A cognitive model of insomnia, Behav Res Ther source
- Method§ Comparative Investigation of the Psychophysiologic and Idiopathic Insomnia Disorder Phenotypes: Psychologic Characteristics, Patients' Perspectives, and Implications for Clinical Management
Study 1 used a cross-sectional, two-group comparison design in a specialized sleep research center.
“Design: Cross-sectional, two-group comparison studies.”
Quote in the paperNot yet classified - Method§ Comparative Investigation of the Psychophysiologic and Idiopathic Insomnia Disorder Phenotypes: Psychologic Characteristics, Patients' Perspectives, and Implications for Clinical Management
The study set out to compare psychologic characteristics and treatment preferences in idiopathic insomnia relative to psychophysiologic insomnia.
“Two consecutive studies were designed to investigate psychologic characteristics and treatment preferences of people with idiopathic insomnia (IdI) relative to psychophysiologic insomnia (PI).”
Quote in the paperNot yet classified - Background§ Submitted for publication May, 2011 Submitted in final revised form September, 2011 Accepted for publication September, 2011
The authors state that idiopathic insomnia is a lifelong complaint with a chronic course and few periods of sustained remission.
“IdI is a lifelong complaint with a chronic course and few periods of sustained remission.”
Quote in the paperNot yet classified - Method§ Design
Study 2 used the same cross-sectional, two-group comparison design.
“Cross-sectional, two-group comparison of PI and IdI.”
Quote in the paperNot yet classified - Background§ Submitted for publication May, 2011 Submitted in final revised form September, 2011 Accepted for publication September, 2011
The paper notes that idiopathic insomnia affects fewer than 10% of people presenting with insomnia complaints.
“the condition is relatively uncommon and affects fewer than 10% of those presenting with insomnia complaints.”
Quote in the paperNot yet classified0 of 1 sources checked- cites [1] Ohayon, 2002, Epidemiology of insomnia: what we know and what we still need to learn, Sleep Med Review source
Statistics recomputed
Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.
- Consistentt(38) = 4.04reported p < .001 · recomputed p < .001
“t (38) = 4.04, p < .001”
- ConsistentF(2, 37) = 7.98reported p = .001 · recomputed p = .001
“F(2,37) = 7.98, p = .001”
- ConsistentF(7, 31) = 3.4reported p = .008 · recomputed p = .008
“F(7, 31) = 3.40, p = .008”
- Consistentt(38) = 9.1reported p < .0001 · recomputed p < .001
“t (38) = 9.1, p < .0001”
- Consistentt(38) = 5.01reported p < .001 · recomputed p < .001
“t (38) = 5.01, p < .001”
- Consistentt(59) = 2.18reported p = .033 · recomputed p = .033
“t (59) = 2.18, p = .033”
- Consistentt(59) = -2.72reported p = .009 · recomputed p = .009
“t (59) = -2.72,p = .009”
- Consistentt(61) = 2.4reported p = .02 · recomputed p = .019
“t (61) = 2.40, p = .02”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Minimum illness-cognition score is misstated
MinorEach subscale has six items scored from 1 to 4, so its minimum score is 6, not 4. The stated maximum of 24 is consistent with six items.
Reported 4 · recomputed 6
“A high score indicates less helplessness/more control. Items are rated ranging from 1 (agree) to 4 (disagree) (subscale score range = 4-24)”
Treatment-test degrees of freedom imply a larger sample
MinorStudy 2 lists 31 participants with PI and 30 with IdI. Paired tests within those groups would have 30 and 29 degrees of freedom, respectively, rather than the reported 31 and 30; the reported between-group t-test likewise uses 61 rather than the expected 59 degrees of freedom.
“behavioral versus pharmacologic: t (31) = 3.30; P = 0.003; behavioral versus acceptance: t (31) = 5.03; P < 0.001] and the IdI group (behavioral versus pharmacologic: t (30) = 3.45; P = 0.002; behavioral versus acceptance: t (30) = 2.79; P = 0.01)”
“| | (n = 31) | (n = 30) |”
Cites
The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989) · Psychiatry Research · doi:10.1016/0165-1781(89)90047-4 · Cited by 35,234 · see citing works
An inventory for measuring clinical anxiety: Psychometric properties.
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.56.6.893 · Cited by 14,407 · see citing works
Validation of the Insomnia Severity Index as an outcome measure for insomnia research
Bastien, C. (2001) · Sleep Medicine · doi:10.1016/s1389-9457(00)00065-4 · Cited by 8,067 · see citing works
Beck, A. T., Steer, R. A., & Brown, G. (2011) · PsycTESTS Dataset · doi:10.1037/t00742-000 · Cited by 7,535 · see citing works
You want to measure coping but your protocol’ too long: Consider the brief cope
Carver, C. S. (1997) · International Journal of Behavioral Medicine · doi:10.1207/s15327558ijbm0401_6 · Cited by 7,361 · see citing works
Carver, C. S., & White, T. L. (1994) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.67.2.319 · Cited by 7,306 · see citing works
(1999) · Cited by 5,934 · see citing works
The International Classification of Sleep Disorders
Daroff, R. B. (1991) · Neurology · doi:10.1212/wnl.41.1.160 · Cited by 5,025 · see citing works
Gray, J. A. (1982) · Behavioral and Brain Sciences · doi:10.1017/s0140525x00013066 · Cited by 4,477 · see citing works
The International Classification of Sleep Disorders
Greenblatt, D. (1992) · Archives of Neurology · doi:10.1001/archneur.1992.00530270020006 · Cited by 4,406 · see citing works
Epidemiology of insomnia: what we know and what we still need to learn
Ohayon, M. M. (2002) · Sleep Medicine Reviews · doi:10.1053/smrv.2002.0186 · Cited by 3,743 · see citing works
The revised illness perception questionnaire (IPQ-R)
Moss-Morris, R., Weinman, J., Petrie, K., Horne, R., Cameron, L., & Buick, D. (2002) · Psychology & Health · doi:10.1080/08870440290001494 · Cited by 2,949 · see citing works
International Classification of Sleep Disorders
Thorpy, M. (2017) · Sleep Disorders Medicine · doi:10.1007/978-1-4939-6578-6_27 · Cited by 2,505 · see citing works
The International Classification of Sleep Disorders: Diagnostic and Coding Manual
(1991) · Annals of Internal Medicine · doi:10.7326/0003-4819-115-5-413_1 · Cited by 2,416 · see citing works
(2012) · Springer eBooks · doi:10.1007/springerreference_179754 · Cited by 2,095 · see citing works
Harvey, A. G. (2002) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(01)00061-4 · Cited by 1,790 · see citing works
Compassion fatigue: Psychotherapists’ chronic lack of self care.
Figley, C. R. (2002) · Journal of Clinical Psychology · doi:10.1002/jclp.10090 · Cited by 1,614 · see citing works
Psychological and behavioral treatment of insomnia: update of the recent evidence (1998-2004)
Morin, C. M., Bootzin, R. R., Buysse, D. J., Edinger, J. D., Espie, C. A., & Lichstein, K. L. (2006) · Sleep · doi:10.1093/sleep/29.11.1398 · Cited by 1,345 · see citing works
Self-citationEdinger, J. D., Bonnet, M. H., Bootzin, R. R., Doghramji, K., Dorsey, C. M., Espie, C. A., Jamieson, A. O., McCall, W. V., Morin, C. M., & Stepanski, E. J. (2004) · Sleep · doi:10.1093/sleep/27.8.1567 · Cited by 1,039 · see citing works
Self-citationTreatment of Chronic Insomnia by Restriction of Time in Bed
(1987) · Sleep · doi:10.1093/sleep/10.1.45 · Cited by 948 · see citing works
Dysfunctional Beliefs and Attitudes about Sleep (DBAS): Validation of a Brief Version (DBAS-16)
Morin, C. M., Vallières, A., & Ivers, H. (2007) · SLEEP · doi:10.1093/sleep/30.11.1547 · Cited by 865 · see citing works
Psychophysiological insomnia: the behavioural model and a neurocognitive perspective
PERLIS, M. L., GILES, D. E., MENDELSON, W. B., BOOTZIN, R. R., & WYATT, J. K. (1997) · Journal of Sleep Research · doi:10.1046/j.1365-2869.1997.00045.x · Cited by 795 · see citing works
Psychological adjustment to chronic disease
de Ridder, D., Geenen, R., Kuijer, R., & van Middendorp, H. (2008) · The Lancet · doi:10.1016/s0140-6736(08)61078-8 · Cited by 759 · see citing works
Functional Neuroimaging Evidence for Hyperarousal in Insomnia
Nofzinger, E. A., Buysse, D. J., Germain, A., Price, J. C., Miewald, J. M., & Kupfer, D. J. (2004) · American Journal of Psychiatry · doi:10.1176/appi.ajp.161.11.2126 · Cited by 752 · see citing works
Health Psychology: Psychological Adjustment to Chronic Disease
Stanton, A. L., Revenson, T. A., & Tennen, H. A. (2006) · Annual Review of Psychology · doi:10.1146/annurev.psych.58.110405.085615 · Cited by 688 · see citing works
Beyond unfavorable thinking: the illness cognition questionnaire for chronic diseases
Evers, A. W. M., Kraaimaat, F. W., van Lankveld, W., Jongen, P. J. H., Jacobs, J. W. G., & Bijlsma, J. W. J. (2001) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.69.6.1026 · Cited by 657 · see citing works
Wilson, S., Nutt, D., Alford, C., Argyropoulos, S., Baldwin, D., Bateson, A., Britton, T., Crowe, C., Dijk, D.-J., Espie, C., et al. (2010) · Journal of Psychopharmacology · doi:10.1177/0269881110379307 · Cited by 634 · see citing works
Self-citationEspie, C. A. (2002) · Annual Review of Psychology · doi:10.1146/annurev.psych.53.100901.135243 · Cited by 596 · see citing works
Self-citationBijttebier, P., Beck, I., Claes, L., & Vandereycken, W. (2009) · Clinical Psychology Review · doi:10.1016/j.cpr.2009.04.002 · Cited by 566 · see citing works
Espie, C. A., Broomfield, N. M., MacMahon, K. M. A., Macphee, L. M., & Taylor, L. M. (2006) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2006.03.002 · Cited by 532 · see citing works
Self-citationStahl, S. M., Iversen, S. D., & Goodman, E. C. (1989) · International Clinical Psychopharmacology · doi:10.1097/00004850-198910000-00009 · Cited by 486 · see citing works
Riemann, D., & Perlis, M. L. (2009) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2008.06.001 · Cited by 477 · see citing works
Espie, C. A. (2009) · SLEEP · doi:10.1093/sleep/32.12.1549 · Cited by 422 · see citing works
FRANKL, V. E. (1946) · Cited by 385 · see citing works
Bonnet, M. H., & Arand, D. L. (1997) · Sleep Medicine Reviews · doi:10.1016/s1087-0792(97)90012-5 · Cited by 363 · see citing works
A prospective study of acceptance of pain and patient functioning with chronic pain
McCracken, L. M., & Eccleston, C. (2005) · Pain · doi:10.1016/j.pain.2005.08.015 · Cited by 341 · see citing works
Espie, C. A., Inglis, S. J., Tessier, S., & Harvey, L. (2001) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(99)00157-6 · Cited by 339 · see citing works
Self-citationThe neuropsychology of emotion and personality.
Gray, J. A. (1987) · Cited by 300 · see citing works
Campbell-Sills, L., Liverant, G. I., & Brown, T. A. (2004) · Psychological Assessment · doi:10.1037/1040-3590.16.3.244 · Cited by 280 · see citing works
Ong, J. C., Shapiro, S. L., & Manber, R. (2008) · Behavior Therapy · doi:10.1016/j.beth.2007.07.002 · Cited by 268 · see citing works
Towards a valid, reliable measure of sleep effort
BROOMFIELD, N. M., & ESPIE, C. A. (2005) · Journal of Sleep Research · doi:10.1111/j.1365-2869.2005.00481.x · Cited by 224 · see citing works
Self-citationTreatment preference and patient satisfaction in chronic insomnia
Vincent, N., & Lionberg, C. (2001) · SLEEP · doi:10.1093/sleep/24.4.411 · Cited by 221 · see citing works
Patients' acceptance of psychological and pharmacological therapies for insomnia
Morin, C. M., Gaulier, B., Barry, T., & Kowatch, R. A. (1992) · SLEEP · doi:10.1093/sleep/15.4.302 · Cited by 211 · see citing works
(2009) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/foc.7.4.foc538 · Cited by 208 · see citing works
Hubley, A. M. (2014) · Springer eBooks · doi:10.1007/978-94-007-0753-5_156 · Cited by 202 · see citing works
Ong, J. C., Shapiro, S. L., & Manber, R. (2008) · EXPLORE · doi:10.1016/j.explore.2008.10.004 · Cited by 148 · see citing works
Yook, K., Lee, S.-H., Ryu, M., Kim, K.-H., Choi, T. K., Suh, S. Y., Kim, Y.-W., Kim, B., Kim, M. Y., & Kim, M.-J. (2008) · Journal of Nervous & Mental Disease · doi:10.1097/nmd.0b013e31817762ac · Cited by 134 · see citing works
Well-being in patients with chronic fatigue syndrome: the role of acceptance
Van Damme, S., Crombez, G., Van Houdenhove, B., Mariman, A., & Michielsen, W. (2006) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2006.04.015 · Cited by 128 · see citing works
Britton, W. B., Haynes, P. L., Fridel, K. W., & Bootzin, R. R. (2010) · Psychosomatic Medicine · doi:10.1097/psy.0b013e3181dc1bad · Cited by 125 · see citing works
Hauri, P., & Olmstead, E. (1980) · Sleep · doi:10.1093/sleep/3.1.59 · Cited by 117 · see citing works
The Role of Acceptance and Mindfulness in the Treatment of Insomnia
Lundh, L.-G. (2005) · Journal of Cognitive Psychotherapy · doi:10.1891/jcop.19.1.29.66331 · Cited by 112 · see citing works
Paradoxical intention and insomnia: an experimental investigation
Ascher, L. M., & Turner, R. M. (1979) · Behaviour Research and Therapy · doi:10.1016/0005-7967(79)90015-9 · Cited by 99 · see citing works
Mindfulness-Based Cognitive Therapy for Persistent Insomnia: A Pilot Study
Heidenreich, T., Tuin, I., Pflug, B., Michal, M., & Michalak, J. (2006) · Psychotherapy and Psychosomatics · doi:10.1159/000091778 · Cited by 97 · see citing works
Reynolds, C. F., Kupfer, D. J., Buysse, D. J., Coble, P. A., & Yeager, A. (1991) · American Journal of Psychiatry · doi:10.1176/ajp.148.4.432 · Cited by 93 · see citing works
A cluster analysis of insomnia
Hauri, P. J. (1983) · Sleep · doi:10.1093/sleep/6.4.326 · Cited by 90 · see citing works
Edinger, J. D., Stout, A. L., & Hoelscher, T. J. (1988) · Psychosomatic Medicine · doi:10.1097/00006842-198801000-00010 · Cited by 84 · see citing works
Kohn, L., & Espie, C. A. (2005) · SLEEP · doi:10.1093/sleep/28.1.104 · Cited by 72 · see citing works
Self-citationDalrymple, K. L., Fiorentino, L., Politi, M. C., & Posner, D. (2010) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-010-9145-1 · Cited by 58 · see citing works
Acceptance and Commitment Therapy
Hayes, S. C., & Pierson, H. (2006) · Encyclopedia of Cognitive Behavior Therapy · doi:10.1007/0-306-48581-8_1 · Cited by 35 · see citing works
Adult Psychophysiologic Insomnia and Positive History of Childhood Insomnia
Philip, P., & Guilleminault, C. (1996) · SLEEP · doi:10.1093/sleep/19.suppl_3.s16 · Cited by 18 · see citing works
A prospective study of acceptance of chronic pain in relation to patient functioning
McCracken, L. M., & Eccleston, C. (2005) · Journal of Pain · doi:10.1016/j.jpain.2005.01.212 · Cited by 2 · see citing works
Flagged first, then by citations
5 of the 66 references couldn’t be matched to a known paper.
Research works printed but not linked: 3
- Spielman, 1987, Treatment of chronic insomnia by restriction of time in bed, Sleep, 10, 45
- Morin, 2006, Psychological and behavioral treatment of insomnia: update of the recent evidence (1998-2004), Sleep, 29, 1398, 10.1093/sleep/29.11.1398 · DOI · Paper page
- Riemann, 2009, The treatments of chronic insomnia: a review of benzodiazepine receptor agonists and psychological and behavioral therapies, Sleep Med Rev, 13, 205, 10.1016/j.smrv.2008.06.001 · DOI · Paper page
Cited by
Sorted by citations
Zachariae, R., Lyby, M. S., Ritterband, L. M., & O'Toole, M. S. (2016) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2015.10.004 · Cited by 704 · see citing works
Espie, C. A., Kyle, S. D., Williams, C., Ong, J. C., Douglas, N. J., Hames, P., & Brown, J. S. L. (2012) · Sleep · doi:10.5665/sleep.1872 · Cited by 550 · see citing works
Self-citationCampbell, T., Garland, S., Johnson, J., Savard, J., Gehrman, P., Perlis, M., & Carlson, L. (2014) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s47790 · Cited by 250 · see citing works
“87 90 Conclusions regarding patient preference, however, await rigorously designed and adequately powered trials.”
Bullis, J. R., Boettcher, H., Sauer‐Zavala, S., Farchione, T. J., & Barlow, D. H. (2019) · Clinical Psychology: Science and Practice · doi:10.1111/cpsp.12278 · Cited by 216 · see citing works
Insomnia heterogeneity: Characteristics to consider for data-driven multivariate subtyping
Benjamins, J. S., Migliorati, F., Dekker, K., Wassing, R., Moens, S., Blanken, T. F., Lindert, B. H. W. T., Mook, J. S., & Someren, E. J. W. V. (2016) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2016.10.005 · Cited by 179 · see citing works
Sleep disorders during childhood: a practical review
Ophoff, D., Slaats, M., Boudewyns, A. N., Glazemakers, I., Hoorenbeeck, K. V., & Verhulst, S. L. (2018) · European Journal of Pediatrics · doi:10.1007/s00431-018-3116-z · Cited by 139 · see citing works
Insomnia With Short Sleep Duration
Vgontzas, A. N., & Fernández‐Mendoza, J. (2013) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2013.04.009 · Cited by 73 · see citing works
Hertenstein, E., Thiel, N., Lüking, M., Külz, A. K., Schramm, E., Baglioni, C., Spiegelhalder, K., Riemann, D., & Nissen, C. (2014) · Psychotherapy and Psychosomatics · doi:10.1159/000365173 · Cited by 63 · see citing works
Bothelius, K., Jernelöv, S., Fredrikson, M., McCracken, L. M., & Kaldo, V. (2015) · SLEEP · doi:10.5665/sleep.5170 · Cited by 39 · see citing works
Failure of fear extinction in insomnia: An evolutionary perspective
Perogamvros, L., Castelnovo, A., Samson, D. R., & Dang‐Vu, T. T. (2020) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2020.101277 · Cited by 37 · see citing works
Treating Insomnia: A Review of Patient Perceptions Toward Treatment
Cheung, J. M. Y., Bartlett, D. J., Armour, C. L., & Saini, B. (2015) · Behavioral Sleep Medicine · doi:10.1080/15402002.2014.981818 · Cited by 34 · see citing works
Crawford, M., Chirinos, D. A., Iurcotta, T., Edinger, J. D., Wyatt, J. K., Manber, R., & Ong, J. C. (2017) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.6666 · Cited by 28 · see citing works
“…categories have included insomnia disorder sub - types, such as psychophysiological, paradoxical, or idiopathic insomnia, insomnia related to a mental disorder, which has been associated with different disease characteristics, 45–47 treatment perceptions, 47,48 and treatment responses.”
Validity and reliability of the Turkish version of the Glasgow Sleep Effort Scale
Uygur, Ö. F., Uygur, H., Chung, S., Ahmed, O., Demiröz, D., Aydın, E. F., & Hurşıtoğlu, O. (2022) · Sleep Medicine · doi:10.1016/j.sleep.2022.06.022 · Cited by 27 · see citing works
Kim, S. M., Park, J. M., Seo, H., Kim, J., Noh, J., & Kim, H. L. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-058032 · Cited by 19 · see citing works
Zhou, F., Yang, Y., Wang, Y.-Y., Rao, W., Zhang, S.-F., Zeng, L., Zheng, W., Ng, C. H., Ungvari, G. S., Zhang, L., et al. (2020) · Psychiatric Quarterly · doi:10.1007/s11126-020-09820-8 · Cited by 21 · see citing works
Fighting Insomnia and Battling Lethargy: The Yin and Yang of Palliative Care
Davis, M. P., & Goforth, H. W. (2014) · Current Oncology Reports · doi:10.1007/s11912-014-0377-1 · Cited by 17 · see citing works
Psychometric properties of Glasgow Sleep Effort Scale in Portuguese language.
Meia-Via, M. S., Marques, D. R., Espie, C. A., da Silva, C. F., & Gomes, A. A. (2015) · Psychological Assessment · doi:10.1037/pas0000178 · Cited by 18 · see citing works
“, 2013) or patients with other sleep problems (Espie et al., 2012).”
BackgroundSelf-citationData-driven cluster analysis of insomnia disorder with physiology-based qEEG variables
McCloskey, S., Jeffries, B., Koprinska, I., Miller, C. B., & Grunstein, R. R. (2019) · Knowledge-Based Systems · doi:10.1016/j.knosys.2019.07.034 · Cited by 17 · see citing works
Third-Wave Therapies for Insomnia
Taylor, H. L., Hailes, H. P., & Ong, J. C. (2015) · Current Sleep Medicine Reports · doi:10.1007/s40675-015-0020-1 · Cited by 16 · see citing works
Gerstmayr, M., Ilk, N., Jahn‐Schmid, B., Sleytr, U. B., & Bohle, B. (2009) · International Archives of Allergy and Immunology · doi:10.1159/000199718 · Cited by 15 · see citing works
‘Folk Theories’ About the Causes of Insomnia
Harvey, A. G., Soehner, A. M., Lombrozo, T., Bélanger, L., Rifkin, J. B., & Morin, C. M. (2013) · Cognitive Therapy and Research · doi:10.1007/s10608-013-9543-2 · Cited by 10 · see citing works
“haps there would also be difference for patients with a childhood-onset versus adulthood-onset (Espie et al. 2012).”
BackgroundSleep effort and its measurement: A scoping review
Marques, D. R., Pires, L., Broomfield, N. M., & Espie, C. A. (2024) · Journal of Sleep Research · doi:10.1111/jsr.14206 · Cited by 9 · see citing works
Self-citationMosavat, S. H., Mirzaei, H. R., Mofid, B., et al. (2021) · Journal of Complementary and Integrative Medicine · doi:10.1515/jcim-2021-0181 · Cited by 8 · see citing works
Dias, S. F., Gomes, A. A., Espie, C. A., & Marques, D. R. (2023) · Sleep and Vigilance · doi:10.1007/s41782-023-00229-4 · Cited by 8 · see citing works
Self-citationComorbid Insomnia and Sleep Disordered Breathing
Glidewell, R. N. (2013) · Current Treatment Options in Neurology · doi:10.1007/s11940-013-0259-0 · Cited by 5 · see citing works
Cognitive Behavioural Therapy for Insomnia : How, for Whom and What about Acceptance?
Bothelius, K. (2015) · KTH Publication Database DiVA (KTH Royal Institute of Technology) · Cited by 2 · see citing works
Acceptance and Commitment Therapy (ACT) for Insomnia
Johann, A. F., & Hertenstein, E. (2022) · Wiley eBooks · doi:10.1002/9781119891192.ch18 · Cited by 4 · see citing works
Boinon, D., Journiac, J., Charles, C., Fasse, L., Savard, J., & Dauchy, S. (2018) · Psycho-Oncologie · doi:10.3166/pson-2018-0037 · Cited by 2 · see citing works
Mental Health and Cognitive Behavioral Therapy
Kasemsap, K. (2021) · IGI Global eBooks · doi:10.4018/978-1-7998-8544-3.ch026 · Cited by 1 · see citing works
Garland, S. N. (2012) · Libraries and Cultural Resources (University of Calgary) · doi:10.5072/prism/27123 · Cited by 1 · see citing works
Empirically testing the neurocognitive model of insomnia
Sharman, R. L. (2014) · Northumbria Research Link (Northumbria University)
Watson, E. (2016) · The Scholarship East Carolina University's Institutional Repository (East Carolina University)
Mental Health and Cognitive Behavioral Therapy
Kasemsap, K. (2017) · Advances in psychology, mental health, and behavioral studies (APMHBS) book series · doi:10.4018/978-1-5225-3241-5.ch001
Accardo, J. (2018) · Springer eBooks · doi:10.1007/978-3-319-98414-8_5
Spiegelhalder, K., & Riemann, D. W. (2020) · Springer Reference Medizin · doi:10.1007/978-3-642-54672-3_90-1
Spiegelhalder, K., & Riemann, D. W. (2025) · Springer Reference Medizin · doi:10.1007/978-3-662-65186-5_90
Scott, H., Gehrman, P., & Perlis, M. L. (2025) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780197602751.013.17
- Authors
- Espie, C. A., Barrie, L. M., & Forgan, G. S.
- Affiliations
- University of Glasgow (GB)
- Corresponding author
- Espie, Colin A.
- ORCID
- Espie, Colin A.
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-03
- Volume
- 35
- Issue
- 3
- Pages
- 385-393
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC3274340
- OpenAlex
- W2007322699
- Cited by
- 38
- References
- 66
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 1 · 2022: 3 · 2021: 2 · 2020: 3 · 2019: 2 · 2018: 3 · 2017: 2 · 2016: 2 · 2015: 7 · 2014: 4 · 2013: 3 · 2012: 2
- FWCI
- 6.86
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- SLEEP (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
- 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
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Keywords
- insomnia phenotypes, behavioral inhibition, sleep effort, illness perception, coping styles, treatment preferences, acceptance-based therapy, pharmacotherapy
- MeSH terms
- Adaptation, Psychological, Adult, Arousal, Cognition, Cross-Sectional Studies, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Patient Acceptance of Health Care, Phenotype, Self Concept, Cohort Studies
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read (extract-v1) on 2026-09-24.
Cited sources are checked by gpt-6-sol.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
