Sleep Med Psychophysiol.  1995 Jun;2(1):82-90.

Psychophysiologic States of Insomnia Patients: Pre-Sleep Arousal, Self Efficacy, Sleep Hygiene Awareness and Practice, Depression, and Anxiety

  • 1Deparment of Neuropsychiatry, Kangbuk Samsung Hospital, Seoul, Korea.


Insomnia is significantly influenced by the pre-sleep arousal, self efficacy, sleep hygiene, depression and anxiety. The authors tried to explore how these factors are related with the clinical features of sleep.
Fifty three patients diagnosed as insomnia by DSM-IV criteria were studied. They filled up the pre-sleep arousal scale(PSAS), sleep efficacy scale(SES), sleep hygiene awareness and practice scale, BDI, and state and trait anxiety scales.
1) The mean values of sleep-related variables were as follows : Sleep latency,136.89 minutes ; frequences of awakening during a night, 2.28 ; minutes to get back to sleep, 42.70 ; total sleep time, 180.19 minutes ; duration of illness, 72.00 months. 2) The mean scores of scales were as follows : PSAS(cognitive), 22.40 ; PSAS (somatic), 17.32 ; SES, 20.16 ; sleep hygiene knowledge, 25.96 ; caffeine knowledge, 59.78 ; sleep hygiene practice, 42.12 ; BDI 18.2 ; state anxiety, 41.24 ; trait anxiety ; 44.50. 3) In the subjects with superimposed depression, the mean frequency of awakening during a night and the mean pre-sleep arousal scale score were higher than in those without depression. 4) Frequency of awakening were correlated positively with a PSAS(a tight tense feeling in your muscle) and sleep hygiene awareness. PSAS(cognitive) were correlated positively with a PSAS(somatic). BDI correlated positively with a PSAS item(a jittery, nervous feeling in your body)and a SES item(not allow a poor night's sleep to interfere with daily activities). Anxiety scales were correlated positively with sleep hygiene practice scale sleep and PSAS were correlated negatively with SES.
The mean scores of PSAS, SES, sleep hygiene awareness and practice scale, BDI, state and trait anxiety scales of insomniacs were correlated either positively or negatively in insomnia patients. These factors seem to contribute to the development and maintenance of insomnia.


Insomnia; Pre-sleep arousal; Self efficacy; Sleep hygiene
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