Differences in anxiety levels among symptoms of insomnia. The HUNT study

Bragantini, Daniela; Sivertsen, Børge; Gehrman, Philip; Lydersen, Stian; Güzey, Ismail Cüneyt

doi:10.1016/j.sleh.2019.01.002

Cited by 27 publications

(35 citation statements)

References 23 publications

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“…However experiencing these two symptoms at the same time produced significantly higher average HADS-D score (M = 5.0). As previously suggested (Bragantini et al, 2019), this combination of symptoms might affect sleep length more than other patterns and therefore produce more severe consequences (Vgontzas et al, 2013). In a previous article, we reported a similar results also for the anxiety subscale of HADS (HADS-A) (Bragantini et al, 2019).…”

Section: Discussionsupporting

confidence: 84%

“…As previously suggested (Bragantini et al, 2019), this combination of symptoms might affect sleep length more than other patterns and therefore produce more severe consequences (Vgontzas et al, 2013). In a previous article, we reported a similar results also for the anxiety subscale of HADS (HADS-A) (Bragantini et al, 2019). This suggests that experiencing sleep onset problems together with terminal insomnia reflects a more severe psychological distress than for other patterns of symptoms.…”

Section: Discussionsupporting

confidence: 83%

“…On the other hand, the (Baguley, 2009) percentage of people reporting all three symptoms of insomnia was significantly lower in the HADS-D "Normal" group (13%). In general, maintenance insomnia seems to be a more common complaint than other symptoms (Canivet et al, 2014;Bragantini et al, 2019;Taylor et al, 2005) but is associated to lower psychological distress in this and our previous study on anxiety (Bragantini et al, 2019). Accordingly, artificially produced sleep fragmentation seems to have only a limited effect on increasing cortisol levels both at night and the morning after (Späth-Schwalbe et al, 1991;Hucklebridge et al, 2000).…”

Section: Discussionsupporting

confidence: 52%

“…The selection work-flow of this study can be found here (Bragantini et al, 2019). Of the total HUNT 3 participants, five individuals had no valid answers for the variables relevant for this study.…”

Section: Methodsmentioning

confidence: 99%

“…This risk was higher than for other nocturnal symptoms of insomnia (Canivet et al, 2014). In a recent study we reported that difficulties initiating sleep alone plays a leading role in rising anxiety levels and different combinations of symptoms concur with different strengths of anxiety symptoms (Bragantini et al, 2019). Moreover, magnetic resonance imaging (MRI) studies seems to support biological differences for individual insomnia symptoms, as orbitofrontal grey matter appeared reduced only in patients experiencing early morning awakenings (Stoffers et al, 2012).…”

Section: Introductionmentioning

confidence: 95%

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Epidemiological differences in levels of depressive signs among nocturnal symptoms of insomnia; results from the HUNT study

Bragantini

Sivertsen

Gehrman

et al. 2020

Sleep Science Practice

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Background: Insomnia is a sleep disorder characterized by multiple nocturnal symptoms (sleep onset, maintenance and terminal insomnia). However, these symptoms are assumed to have the same weight in the diagnosis and consequences of insomnia. In particular, little is known regarding whether these nocturnal symptoms are equally related to depression. In this study, we compared level of depressive signs among individuals reporting different patterns of nocturnal symptoms of insomnia. Methods: We used data from the large population-based HUNT3 study. The final sample included 7933 individuals (4317 cases, 3616 controls). Signs of depression were measured using the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D), while the three nocturnal symptoms of insomnia were assessed using a Likert-like scale ("Never", "Sometimes", "Several times a week"). Individuals reporting to experience at least one symptom of insomnia "Several times a week" were grouped according to their pattern of reported symptoms and their HADS-D levels compared.Results: Participants reporting sleep onset insomnia combined with terminal insomnia had the highest depression score (M = 5.4, SD = 3.4), but reporting maintenance insomnia in addition does not increase the HADS-D scores any further (M = 5.2, SD = 3.6). Accordingly, sleep maintenance insomnia alone had the lowest score (M = 3.4, SD = 2.9). Conclusions:We found several differences among patterns of symptoms of insomnia but not all of them are clinically relevant. Further studies in clinical samples may help reveal relevant differences among patterns of symptoms, which may aid in refining interventions for concomitant depression and insomnia.

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Section: Discussionsupporting

confidence: 84%