The Consensus Sleep Diary (CSD) is a standardized, prospective tool for tracking nightly subjective sleep. The current study evaluated the validity and utility of the CSD, with consideration for challenges inherent to psychometric evaluation of diary measures. Results showed that the CSD indices differentiated good sleepers from those with insomnia and were associated with similar objective indices and a subjective insomnia severity measure. The ability to detect treatment improvements after cognitive behavior therapy for insomnia (CBT-I) was tested by comparing pre- and post-CBT-I CSD indices with a subjective rating of insomnia symptom severity. Improvement in insomnia symptom severity was significantly related to improvement on the CSD indices. Completion rate of the CSD amongst participants across all 14 days was 99.8%. These findings provide support for the validity, clinical utility, and usability of the CSD.

Insomnia-related sleep problems are common in borderline personality disorder (BPD) and exacerbate the core of BPD, emotion dysregulation. Insomnia is elicited and maintained through behaviors that disrupt both the homeostatic and circadian sleep systems. However, it is unclear which homeostatic or circadian insomnia behaviors characterize BPD and exacerbate emotion dysregulation, thus warranting clinical attention in this population. This study therefore investigated whether homeostatic (i.e., abnormalities in time in bed and sleep efficiency [SE]) and circadian (i.e., abnormalities in risetime variability and chronotypes) behaviors characterize and exacerbate emotion dysregulation in BPD group relative to healthy control (HC) and generalized anxiety disorder (GAD) groups. Participants from the community who met criteria for BPD, GAD, or no psychological disorders (HCs) were recruited and completed measures of emotion dysregulation. They also completed measures of daily homeostatic and circadian insomnia behaviors for 14 days. Generalized estimating equations revealed that the GAD group exhibited lower SE than HCs, and there was a marginally significant effect wherein the BPD group exhibited delayed risetimes relative to the GAD group. Moreover, higher time in bed predicted elevated emotion dysregulation in HCs but lower emotion dysregulation in the GAD group. Higher SE predicted higher emotion dysregulation in BPD. These results suggest that the influence of insomnia behaviors on emotion dysregulation is heterogeneous. Idiographic assessments of the influence of insomnia behaviors on emotion dysregulation are advised.

Past research found that individuals with poor sleep report and physiologically exhibit greater fear of the dark (FOD) than good sleepers (Carney et al., 2013). The presence of FOD in individuals with insomnia disorder (ID) would have important implications to our understanding of ID and its treatment. Thus, the present study compared individuals with ID to good sleepers (N = 50) on objective and subjective FOD, and explored the FOD construct through participant interviews. Contrary to expectations, ID and good sleeper groups did not differ on FOD measures. Cognitive arousal and trauma history were related to reported dark discomfort. For those with ID, experiences in the dark were characterized by greater sleep effort and pre-sleep arousal generally, but not dark-specific fear per se. For those who were fearful of the dark we posit that there may be a trauma-activated pathway to arousal. Implications and avenues for future research are discussed.

Past research found that individuals with poor sleep report and physiologically exhibit greater fear of the dark (FOD) than good sleepers (Carney et al., 2013). The presence of FOD in individuals with insomnia disorder (ID) would have important implications to our understanding of ID and its treatment. Thus, the present study compared individuals with ID to good sleepers (N = 50) on objective and subjective FOD, and explored the FOD construct through participant interviews. Contrary to expectations, ID and good sleeper groups did not differ on FOD measures. Cognitive arousal and trauma history were related to reported dark discomfort. For those with ID, experiences in the dark were characterized by greater sleep effort and pre-sleep arousal generally, but not dark-specific fear per se. For those who were fearful of the dark we posit that there may be a trauma-activated pathway to arousal. Implications and avenues for future research are discussed.