Abstract
Two groups of clinical patients with persistent insomnia (22 with psychophysiologic insomnia and 18 with insomnia associated with affective disorders) were evaluated in a sleep disorders unit. Cognitive and somatic aspects of pre-sleep arousal were evaluated by use of the pre-sleep arousal scale (PSAS). Further, general anxiety and depression during the day was evaluated by self-rating scales, and sleep was evaluated objectively with polysomnography and subjectively by use of a morning questionnaire. Results showed that in psychophysiologic insomnia cognitive and somatic aspects of pre-sleep arousal were significantly associated with both objectively recorded and subjectively estimated sleep latency and total sleep time. This suggests that in psychophysiologic insomnia pre-sleep arousal is linked to the pre-sleep period in agreement with the notion that excessive pre-sleep arousal contributes to the persistence of sleeping difficulties in these patients. Conversely, in psychiatric insomnia, pre-sleep arousal was significantly associated with general anxiety and depression but not with sleep, which suggests that pre-sleep arousal is linked to the underlying disorder in these patients.