Trait and state anxiety, symptoms of insomnia and their influence on daytime functioning in adolescent girls

Kelmanson I.A.

doi:https://doi.org/10.17116/jnevro202412405266

Close metadata

OBJECTIVE

To investigate the relationship between symptoms of trait anxiety, state anxiety and symptoms of insomnia and the degree of their influence on daytime functioning disorders in adolescent girls.

MATERIAL AND METHODS

The study included 50 healthy adolescent girls, senior school students, aged 15—17 years, selected as simple random sample. Insomnia symptoms and their impact on daytime functioning were assessed using the SLEEP-50 (S-50) questionnaire. Trait and state anxiety were assessed using the Spielberger questionnaire. The method of path analysis was used to identify significant associations.

RESULTS

There was a positive association of the severity of daytime functioning disorders with the severity of insomnia symptoms (β=0.45; p<0.001) and the level of trait anxiety (β=0.34; p=0.004). Trait anxiety was also a significant predictor of state anxiety (p<0.001), with a direct relationship between these parameters (β=0.62). Positive covariation of insomnia symptoms severity and state anxiety was found (β=0.53; p<0.001).

CONCLUSION

Improving sleep quality and daytime functioning in adolescents with insomnia symptoms should take into account personality characteristics. High levels of trait anxiety increase the negative effects of insomnia on the impaired daytime functioning.

Keywords:

daytime functioning

insomnia

adolescents

anxiety

Authors:

Kelmanson I.A.

Almazov National Medical Research Centre;
Saint-Petersburg State Institute for Psychology and Social Work

ORCID: 0000-0002-4449-2786

Received:

01.02.2024

Accepted:

08.02.2024

Close metadata

References:

Kelmanson IA. Neurobiological prerequisites for the formation of increased risk of sleep disorders in adolescents. Vrach. 2019;30(9):11-17. (In Russ.). https://doi.org/10.29296/25877305-2019-09-02
Carskadon MA. Sleep in adolescents: the perfect storm. Pediatric clinics of North America. 2011;58(3):637-647. https://doi.org/10.1016/j.pcl.2011.03.003
Hysing M, Pallesen S, Stormark KM, et al.Lundervold AJ, Sivertsen B. Sleep patterns and insomnia among adolescents: a population-based study. Journal of Sleep Research. 2013;22(5):549-556. https://doi.org/10.1111/jsr.12055
Roberts RE, Roberts CR, Duong HT. Chronic Insomnia and Its Negative Consequences for Health and Functioning of Adolescents: A 12-Month Prospective Study. Journal of Adolescent Health. 2008;42(3):294-302. https://doi.org/10.1016/j.jadohealth.2007.09.016
American Academy of Sleep M. International classification of sleep disorders — third edition (ICSD-3). AASM Resour Libr. 2014;281:2313.
Johnson EO, Roth T, Schultz L, et al. Epidemiology of DSM-IV Insomnia in Adolescence: Lifetime Prevalence, Chronicity, and an Emergent Gender Difference. Pediatrics. 2006;117(2):e247-e256. https://doi.org/10.1542/peds.2004-2629
de Zambotti M, Goldstone A, Colrain IM, et al. Insomnia disorder in adolescence: Diagnosis, impact, and treatment. Sleep Medicine Reviews. 2018;39:12-24. https://doi.org/10.1016/j.smrv.2017.06.009
Falch-Madsen J, Wichstrøm L, Pallesen S, et al. Prevalence and stability of insomnia from preschool to early adolescence: a prospective cohort study in Norway. BMJ paediatrics open. 2020;4(1):e000660. https://doi.org/10.1136/bmjpo-2020-000660
Li SH, Graham BM, Werner-Seidler A. Gender Differences in Adolescent Sleep Disturbance and Treatment Response to Smartphone App-Delivered Cognitive Behavioral Therapy for Insomnia: Exploratory Study. JMIR Form Res. 2021;5(3):e22498. https://doi.org/10.2196/22498
Marver JE, McGlinchey EA. Sex differences in insomnia and risk for psychopathology in adolescence. Current Opinion in Psychology. 2020;34:63-67. https://doi.org/10.1016/j.copsyc.2019.09.004
Zhang B, Wing Y-K. Sex Differences in Insomnia: A Meta-Analysis. Sleep. 2006;29(1):85-93. https://doi.org/10.1093/sleep/29.1.85
Drake CL, Roehrs T, Roth T. Insomnia causes, consequences, and therapeutics: An overview. Depression and Anxiety. 2003;18(4):163-176. https://doi.org/10.1002/da.10151
Roth T. Insomnia: Definition, Prevalence, Etiology, and Consequences. Journal of Clinical Sleep Medicine. 2007;3(5 suppl):S7-S10. https://doi.org/10.5664/jcsm.26929
Käppler C, Hohagen F. Psychosocial aspects of insomnia. European Archives of Psychiatry and Clinical Neuroscience. 2003;253(1):49-52. https://doi.org/10.1007/s00406-003-0406-9
Dekker K, Blanken TF, Van Someren EJW. Insomnia and Personality — A Network Approach. Brain Sciences. 2017. https://doi.org/10.3390/brainsci7030028
Sassoon SA, de Zambotti M, Colrain IM, et al. Association between personality traits and DSM-IV diagnosis of insomnia in peri- and postmenopausal women. Menopause (New York, N.Y.). 2014;21(6):602-611. https://doi.org/10.1097/gme.0000000000000192
Hall M, Buysse DJ, Nowell PD, et al. Symptoms of Stress and Depression as Correlates of Sleep in Primary Insomnia. Psychosomatic Medicine. 2000;62(2):227-230.
Taylor DJ, Lichstein KL, Durrence HH, et al. Epidemiology of Insomnia, Depression, and Anxiety. Sleep. 2005;28(11):1457-1464. https://doi.org/10.1093/sleep/28.11.1457
Riemann D, Spiegelhalder K, Feige B, et al. The hyperarousal model of insomnia: A review of the concept and its evidence. Sleep Medicine Reviews. 2010;14(1):19-31. https://doi.org/10.1016/j.smrv.2009.04.002
Ree MJ, Harvey AG, Blake R, et al. Attempts to control unwanted thoughts in the night: development of the thought control questionnaire-insomnia revised (TCQI-R). Behaviour Research and Therapy. 2005;43(8):985-998. https://doi.org/10.1016/j.brat.2004.07.003
Basta M, Chrousos GP, Vela-Bueno A, et al. Chronic Insomnia and the Stress System. Sleep Medicine Clinics. 2007;2(2):279-291. https://doi.org/10.1016/j.jsmc.2007.04.002
Harvey C-J, Gehrman P, Espie CA. Who is predisposed to insomnia: A review of familial aggregation, stress-reactivity, personality and coping style. Sleep Medicine Reviews. 2014;18(3):237-247. https://doi.org/10.1016/j.smrv.2013.11.004
Kajeepeta S, Gelaye B, Jackson CL, et al. Adverse childhood experiences are associated with adult sleep disorders: a systematic review. Sleep Medicine. 2015;16(3):320-330. https://doi.org/10.1016/j.sleep.2014.12.013
Blake MJ, Trinder JA, Allen NB. Mechanisms underlying the association between insomnia, anxiety, and depression in adolescence: Implications for behavioral sleep interventions. Clinical Psychology Review. 2018;63:25-40. https://doi.org/10.1016/j.cpr.2018.05.006
Gau SF. Neuroticism and sleep-related problems in adolescence. Sleep. 2000;23(4):495-502.
Riedel BW, Lichstein KL. Insomnia and daytime functioning. Sleep Med Rev. 2000;4(3):277-298. https://doi.org/10.1053/smrv.1999.0074
Chambers MJ, Kim JY. The Role of State-Trait Anxiety in Insomnia and Daytime Restedness. Behavioral Medicine. 1993;19(1):42-46. https://doi.org/10.1080/08964289.1993.9937564
Chambers MJ, Alexander SD. Assessment and prediction of outcome for a brief behavioral insomnia treatment program. Journal of Behavior Therapy and Experimental Psychiatry. 1992;23(4):289-297. https://doi.org/10.1016/0005-7916(92)90051-J
Spoormaker VI, Verbeek I, van den Bout J, Klip EC. Initial Validation of the SLEEP-50 Questionnaire. Behavioral Sleep Medicine. 2005;3(4):227-246. https://doi.org/10.1207/s15402010bsm0304_4
Spielberger CD, Gorsuch RL, Lushene RE. Test manual for the State Trait Anxiety Inventory. Palo Alto, California: Consulting Psychologists Press; 1970.
Khanin YuL. A brief guide to the state and trate anxiety inventory by C.D. Spielberger. L.: LNIIFC; 1976. (In Russ.).
The jamovi project. jamovi. (Version 2.3), 2022. [Computer software]. https://www.jamovi.org.
Gana K, Broc G. Structural equation modeling with lavaan. London; Hoboken, NJ: ISTE Ltd; John Wiley & Sons, Inc; 2019.
Ellis PD. The essential guide to effect sizes: Statistical power, meta-analysis, and the interpretation of research results. Cambridge: Cambridge University Press; 2010.
Morin CM, Jarrin DC. Epidemiology of Insomnia. Sleep Medicine Clinics. 2013;8(3):281-297. https://doi.org/10.1016/j.jsmc.2013.05.002
Chung KF, Yeung WF, Ho FY. Insomnia identity and its correlates in adolescents. Sleep Breath. 2020;24(2):717-724. https://doi.org/10.1007/s11325-019-01913-4
Watson NF, Bertisch SM, Morin CM, et al. Do Insomnia Treatments Improve Daytime Function? J Clin Med. 2023;12(9):3089. https://doi.org/10.3390/jcm12093089
Bonnet MH, Arand DL. Hyperarousal and insomnia. Sleep Medicine Reviews. 1997;1(2):97-108. https://doi.org/10.1016/S1087-0792(97)90012-5
Chambers MJ, Keller B. Alert insomniacs: Are they really sleep deprived? Clinical Psychology Review. 1993;13(7):649-666. https://doi.org/10.1016/0272-7358(93)90031-G
Tang NKY, Harvey AG. Correcting distorted perception of sleep in insomnia: a novel behavioural experiment? Behaviour Research and Therapy. 2004;42(1):27-39. https://doi.org/10.1016/S0005-7967(03)00068-8
Wicklow A, Espie CA. Intrusive thoughts and their relationship to actigraphic measurement of sleep: towards a cognitive model of insomnia. Behaviour Research and Therapy. 2000;38(7):679-693. https://doi.org/10.1016/S0005-7967(99)00136-9
Harvey AG. A cognitive model of insomnia. Behaviour Research and Therapy. 2002;40(8):869-893. https://doi.org/10.1016/S0005-7967(01)00061-4
Edinger JD, Fins AI, Glenn DM, et al. Insomnia and the eye of the beholder: Are there clinical markers of objective sleep disturbances among adults with and without insomnia complaints? Journal of Consulting and Clinical Psychology. 2000;68(4):586-593. https://doi.org/10.1037/0022-006X.68.4.586
Kelmanson IA. Sleep quality, emotional and behavioral disturbances and eating behavior in adolescents with obesity: a network analysis model. S.S. Korsakov Journal of Neurology and Psychiatry. 2023;123(5-2).95-104. (In Russ.). https://doi.org/10.17116/jnevro202312305295
Kelmanson IA. Sleep disturbances and their co-occurrence with emotional and behavioural problems in elementary school children. Somnologie. 2019;23(4):281-290. https://doi.org/10.1007/s11818-019-00216-w