Do alexithymia and negative affect predict poor sleep quality? The moderating role of interoceptive sensibility

Abstract

Objectives Emotion-related hyperarousal is an important core pathology of poor sleep. Studies investigating the interplay of alexithymia and affective experiences in determining sleep quality have yielded mixed results. To disentangle the inconsistency, this study examined the concurrent predictive power of alexithymia, and negative and positive affect, while incorporating interoceptive sensibility (IS) as a possible moderator. Methods A sample of 224 (70.10% were female) participants completed the Toronto Alexithymia Scale, Positive and Negative Affect Schedule, Pittsburgh Sleep Quality Index, Multidimensional Assessment of Interoceptive Awareness (MAIA), and Marlowe‐Crowne Social Desirability Scale (for controlling response bias) using paper and pencil. A two-stage cluster analysis of the MAIA was used to capture IS characteristics. Stepwise regression was conducted separately for each IS cluster. Results A three-group structure for IS characteristics was found. Higher alexithymia was predictive of poor sleep quality in the low IS group, while higher negative affect predicted poor sleep quality in the moderate and high IS groups. Additionally, alexithymia and positive affect were significantly different in the three IS groups, while negative affect and sleep quality were not. Conclusions Emotion and cognitive arousal may impact sleep quality differently in individuals with different levels of internal focusing ability, depending on physiological versus emotional self-conceptualization. The implications on pathological research, clinical intervention, study limitations and future directions are discussed.

Effect of fear of hypoglycaemia on sleep quality of patients with type 2 mellitus diabetes: The mediating role of alexithymia

“…People with alexithymia have atypical interoception–perception of ‘one's internal bodily state’ [ 48 ], and those with such perception under clinical observation may experience poor sleep quality [ 49 ]. Given the difficulty in identifying and describing their feelings, individuals with alexithymia exhibit an increased nocturnal arousal [ 50 ]. Poor awareness and ability to cope with emotions may increase the vulnerability of alexithymic individuals with T2DM to continuous stress, which can affect their sleep quality [ 51 ].…”

Insomnia and Alexithymia in Chinese Adolescents with Major Depressive Disorder: A Cross-Sectional Study of Sex Differences and Associations

“…48 For example, a study measured the interoceptive sensitivity using MAIA (Multidimensional Assessment of Interoceptive Awareness) and found that sleep quality was associated with alexithymia in people with low interoceptive sensitivity, while in people with moderate and high interoceptive sensitivity, sleep quality was associated with negative emotions. 49 Thus, alexithymia may induce varying consequences to the sleep quality of people with different levels of interoception sensitivity. We speculate that the sex differences in the interoceptive sensitivity of adolescents are sophisticated, which explains the discrepancy in the sex differences of the relationship between insomnia and alexithymia.…”