Pre-sleep arousal and fear of sleep in trauma-related sleep disturbances: A cluster-analytic approach
Author(s) / Creator(s)
Werner, Gabriela G.
Danböck, Sarah K.
Metodiev, Stanislav
Kunze, Anna E.
Abstract / Description
Background: Trauma-related sleep disturbances constitute critical symptoms of posttraumatic stress disorder (PTSD), but sleep symptoms often reside even after successful trauma-focused psychotherapy. Therefore, currently unattended factors – like fear of sleep (FoS) – might play a crucial role in the development and maintenance of residual sleep disturbances. However, it is unclear whether trauma-exposed individuals exhibit different symptomatic profiles of sleep disturbances that could inform individualized therapeutic approaches and eventually enhance treatment efficacy. Method: In a large online study, a two-step cluster analysis and a hierarchical cluster analysis using Ward’s method were performed to explore subgroups among trauma-exposed individuals (N = 471) in terms of FoS, different aspects of trauma-related sleep disturbances (e.g., insomnia symptoms, nightmares, arousal), and PTSD symptoms. These variables were compared between resulting clusters using ANOVAs and Scheffé’s post-hoc tests. Results: The hierarchical cluster analysis supported 3- and 4-cluster solutions. The 3-cluster solution consisted of one “healthy” (n = 199), one “subclinical” (n = 223), and one “clinical” (n = 49) cluster, with overall low, medium, and high symptomatology on all used variables. In the 4-cluster solution, the clinical cluster was further divided into two subgroups (n = 38, n = 11), where one cluster was specifically characterized by elevated somatic pre-sleep arousal and high levels of FoS. Conclusions: A subgroup of trauma-exposed individuals with PTSD and sleep disturbances suffers from increased pre-sleep arousal and FoS, which has been suggested as one possible explanation for residual sleep disturbances. In these patients, FoS might be a relevant treatment target.
Keyword(s)
trauma-related sleep disturbances pre-sleep arousal insomnia nightmares fear of sleep posttraumatic stress disorder cluster analysisPersistent Identifier
Date of first publication
2020-06-30
Journal title
Clinical Psychology in Europe
Volume
2
Issue
2
Article number
Article e2699
Publisher
PsychOpen GOLD
Publication status
publishedVersion
Review status
peerReviewed
Is version of
Citation
Werner, G. G., Danböck, S. K., Metodiev, S., & Kunze, A. E. (2020). Pre-sleep arousal and fear of sleep in trauma-related sleep disturbances: A cluster-analytic approach. Clinical Psychology in Europe, 2(2), Article e2699. https://doi.org/10.32872/cpe.v2i2.2699
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Author(s) / Creator(s)Werner, Gabriela G.
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Author(s) / Creator(s)Danböck, Sarah K.
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Author(s) / Creator(s)Metodiev, Stanislav
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Author(s) / Creator(s)Kunze, Anna E.
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PsychArchives acquisition timestamp2022-04-14T11:19:31Z
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Made available on2022-04-14T11:19:31Z
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Date of first publication2020-06-30
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Abstract / DescriptionBackground: Trauma-related sleep disturbances constitute critical symptoms of posttraumatic stress disorder (PTSD), but sleep symptoms often reside even after successful trauma-focused psychotherapy. Therefore, currently unattended factors – like fear of sleep (FoS) – might play a crucial role in the development and maintenance of residual sleep disturbances. However, it is unclear whether trauma-exposed individuals exhibit different symptomatic profiles of sleep disturbances that could inform individualized therapeutic approaches and eventually enhance treatment efficacy. Method: In a large online study, a two-step cluster analysis and a hierarchical cluster analysis using Ward’s method were performed to explore subgroups among trauma-exposed individuals (N = 471) in terms of FoS, different aspects of trauma-related sleep disturbances (e.g., insomnia symptoms, nightmares, arousal), and PTSD symptoms. These variables were compared between resulting clusters using ANOVAs and Scheffé’s post-hoc tests. Results: The hierarchical cluster analysis supported 3- and 4-cluster solutions. The 3-cluster solution consisted of one “healthy” (n = 199), one “subclinical” (n = 223), and one “clinical” (n = 49) cluster, with overall low, medium, and high symptomatology on all used variables. In the 4-cluster solution, the clinical cluster was further divided into two subgroups (n = 38, n = 11), where one cluster was specifically characterized by elevated somatic pre-sleep arousal and high levels of FoS. Conclusions: A subgroup of trauma-exposed individuals with PTSD and sleep disturbances suffers from increased pre-sleep arousal and FoS, which has been suggested as one possible explanation for residual sleep disturbances. In these patients, FoS might be a relevant treatment target.en_US
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Publication statuspublishedVersion
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Review statuspeerReviewed
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CitationWerner, G. G., Danböck, S. K., Metodiev, S., & Kunze, A. E. (2020). Pre-sleep arousal and fear of sleep in trauma-related sleep disturbances: A cluster-analytic approach. Clinical Psychology in Europe, 2(2), Article e2699. https://doi.org/10.32872/cpe.v2i2.2699en_US
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ISSN2625-3410
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Persistent Identifierhttps://hdl.handle.net/20.500.12034/5140
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Persistent Identifierhttps://doi.org/10.23668/psycharchives.5744
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Language of contenteng
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PublisherPsychOpen GOLD
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Is version ofhttps://doi.org/10.32872/cpe.v2i2.2699
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Is related tohttps://doi.org/10.23668/psycharchives.3089
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Keyword(s)trauma-related sleep disturbancesen_US
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Keyword(s)pre-sleep arousalen_US
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Keyword(s)insomniaen_US
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Keyword(s)nightmaresen_US
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Keyword(s)fear of sleepen_US
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Keyword(s)posttraumatic stress disorderen_US
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Keyword(s)cluster analysisen_US
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Dewey Decimal Classification number(s)150
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TitlePre-sleep arousal and fear of sleep in trauma-related sleep disturbances: A cluster-analytic approachen_US
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DRO typearticle
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Article numberArticle e2699
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Issue2
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Journal titleClinical Psychology in Europe
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Volume2
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Visible tag(s)Version of Recorden_US