Sleep associated monitoring on awakening mediates the relationship between cutaneous body image dissatisfaction and insomnia symptoms

Abstract

Introduction: This study examined the relationship between dissatisfaction with cutaneous body image and insomnia symptoms, incorporating the mediating role of monitoring for signs of poorsleep on awakening and throughout the day. Methods: Two hundred twenty-one participants completed The Insomnia Severity Index, Cutaneous Body Image Scale, and subscales of the Sleep Associated Monitoring Index. Results: The results demonstrated that insomnia symptoms were significantly associated with a greater dissatisfaction with cutaneous body image. Moreover, this relationship was partially mediated by sleep associated monitoring on awakening, but not throughout the day. Conclusions: These findings provide further understanding of the potential mechanisms underlying negative self-perceptions of physical appearance in insomnia.

Sleep-Related Attentional Bias for Faces Depicting Tiredness in Insomnia: Evidence From an Eye-Tracking Study

“…1,2 Indeed, individuals with insomnia often report selectively attending to bodily sensations on waking and throughout the day for signs of impairment, which include tiredness (ie, sore head, heavy eyes) as a result of a poor night's sleep. [18][19]32 Here, the current results expand on previous research 13 by providing objective support for the notion that individuals with insomnia display a tendency to monitor faces, with a specific focus around the eye region, for cues associated with tiredness (ie, hanging eyelids, dark circles, wrinkles, and lines around the eyes). Indeed, greater emphasis placed on these cues upon awakening and during the day to confirm the nature of their sleep disturbance would certainly serve to fuel worry, arousal, and distress as described in cognitive models of insomnia.…”

“…17 Self-reports show that individuals with insomnia attend to bodily sensations, on waking and throughout the day, for signs of physical impairment including tiredness and fatigue (ie, sore and heavy eyes) that may occur as a result of a poor night's sleep. 18,19 Considering the prominence of the face in projecting tiredness cues to perceivers, [20][21][22][23] Akram and colleagues 13 used eye tracking to examine how individuals with insomnia observe faces in relation to tiredness. When asked to explore and examine their own and other people's faces, the authors determined that people with insomnia were quicker to direct their initial attention to and maintain overall attention toward areas of the face associated with tiredness while viewing their own and other people's faces.…”

Qualitative Examination of Daytime Monitoring and Selective Attention in Insomnia

“…The present outcomes also demonstrate that people with insomnia report consciously selectively attending to sleeprelated cues on awakening, and for some this behaviour extends throughout the day. Whilst this notion is supported by previous research [23,29], the present data provide patient-level insight concerning the function of such behaviour. On awaking, the primary function of selective attention for internal (i.e., body sensations) and external (facial appearance, the clock) was to evaluate the quality and length of sleep obtained.…”

“…The current outcomes also provide insight into the previously determined relationship between insomnia and cut dissatisfaction with cutaneous body image and facial appearance [29,34], [35] by providing a patient level account of this potentially mediating factor. As mentioned in the introduction, insomnia is partly maintained by selective attention and monitoring for cues that indicate the presence of a poor night's sleep [4][5][6].…”

The face of tiredness in insomnia from the self‐perspective: A focus on attentional and interpretative biases

“…This may be explained from a cognitive perspective, specifically in terms of biases of attention, which may consequently influence interpretation. Individuals with insomnia report selectively attending to, and monitoring, bodily sensations on waking and throughout the day for signs of a poor night's sleep, fatigue and tiredness (i.e., sore head, heavy eyes, poor facial complexation), which has been evidenced as mediated by the extent of sleep-related monitoring on awakening (Akram, 2017;Semler & Harvey, 2004). As the face is used in social perception to portray one's internal state to others (Allison, Puce, & McCarthy, 2000), we may theorize that those with insomnia attend to other people's facial attributes of tiredness, evaluating these features and drawing comparisons to their own.…”