Insomnia is a condition that affects one’s ability to sleep at night consequently leading to poor functioning during the day. Insomnia is viewed as a problem due to its impact not only on the individual but also to the society in general. These negative impacts include; treatment costs, work absenteeism, low productivity and likelihood of causing accidents at work. Lack of sleep does not necessarily mean that one is sick but when the sleeplessness is associated with stress, this results to what is termed as acute insomnia. People suffering from acute insomnia fail to sleep as sleep predisposes one to vulnerability as far as threatening situations are concerned. It is only after the stressing agent has been eliminated that one can return to healthy sleeping patterns. This is not however the case with chronic insomnia as other processes with sleep interfering nature are activated causing the inability for sleep to normalize even after the stressor has been dissipated (Yang, et al 1094).
Purpose
This study is aimed at bringing a better understanding of the fact that not all transient cases of insomnia advance into chronic insomnia. The study carries out an investigation into the possible factors contributing to this kind of a scenario. The study makes a comparison between patients with chronic insomnia and individuals with normal sleeping patterns but with high to low transient insomnia vulnerability by analyzing such factors as arousal to sleep, dysfunctional beliefs and safety behaviors related to sleep (Yang, et al 1094).
Participants
The sample for the study consisted of 50 patients suffering from chronic insomnia of which 16 were male and 34 were female. The average age for this subgroup was 44.3 years (SD=10.6). The other participant subgroup was made up of 102 individuals with normal sleeping patterns out of whom 29 were male and 73 were female. The mean age for this subgroup was 45.92 years (SD=8.4). All viable participants scored less than 19 against the center for epidemiologic studies depression (CES-D) scale and/or less than13 against the Beck anxiety inventory (BAI) scale. The subgroup of normal sleepers was further split into two groups namely LV and HV. The LV group comprised 31 females and 21 males while the HV group was made up of 36 females and 15 males. Members of the LV group had a score of 16 or less on the FIRST scale while those in the HV group scored more than 16 on the same (Yang, et al 1097).
Methodology
Each of the potential participants underwent a clinical psychological evaluation to prove against comorbid disorders that may affect the validity of the study. The subjects were screened for depression, anxiety disorders and other sleep related problems by use of the CES-D, BAI and Pittsburg sleep quality inventory (PSQI) evaluation scales. These measures in addition played the role of control variables affecting the emotional balance of the individuals. The successful candidates proceeded with the self-rating measures which comprised the FIRST questionnaire, the insomnia severity index (ISI), the sleep related behaviors questionnaire (SRBQ) and the pre-sleep arousal scale (PSAS). The participants were required to provide an informed consent prior to completion of the various questionnaires (Yang, et al 1097).
Comparison of the background information among the three subgroups of participants was done by use of one way ANOVAs. After identifying significant main effects, further comparisons were made using the Tukey’s honestly significant difference approach. Later MANCOVAs and ANCOVAs using BAI and CES-D as the covariates were carried out on the rating scales for the three subgroups. The ISI scores were also analyzed by use of Pearson’s partial correlations. Other factors associated with sleep were separated determined for the insomnia patients as well as the normal sleepers using the BAI and CES-D measurers as control factors. Further, a two-stage hierarchical multiple regression analysis was carried out. The first stage involved entering the BAI and CES-D scores into the regression model as a measure to control emotional disturbance effects. The second stage involved a correlation of psychological and behavioral sleep related variables with scores of ISI as entered in a stepwise manner into the model to have a clear prediction of their degree of contribution to insomnia (Yang, et al 1099).
Findings
The results of the study indicate that the CI group had higher ratings for insomnia severity as compared to the HV and LV groups. There was however no significant difference between the ratings of the HV and the LV groups. It has also been found out that the vulnerability of sleep to stressful situations is not necessarily a reflection of a single aspect of how severe insomnia is owing to the fact that there was no significant difference between the FIRST scores between CI and HV subjects. Further, the study reveals that sleep can be disrupted by increase in any level of cognitive pre-sleep arousal. In addition, it is clear that insomnia can be perpetuated by a condition of helplessness and worries that are specific to sleep as the results show no effect of emotional issues on insomnia severity. Moreover, safety behaviors related to sleep have been found to influence transient insomnia as well as chronic insomnia as explained by the fact that these behaviors were found to appear at a higher frequency in CI individuals as compared to individuals with normal sleep as well as higher frequency in the HV group of normal sleepers than the LV group of the same (Yang, et al 1103).
Strengths
The study has been able to achieve its objectives due to various strengths in its design. To begin with the duration of time provided for the study was substantially adequate to allow for extensive data collection and subsequent analysis. The sample size was also considerably adequate for this kind of a study. In addition the use of participants who are older makes it easier to compare the results with the previous study that had used relatively young subjects. Moreover, there was use of control variables to achieve statistical control in order to improve the validity of the results (Yang, et al 1104).
Limitations
Despite the various indications of the results to support the study hypotheses, there are a number of limitations to its validity. To begin with, causal relationships of some aspects of the study have not been clearly established. There is also a weakness in the categorization of the subjects into the specific groups due to inadequate differentiation. In addition, the use of clinical interviews and subjective ratings as the mode of evaluation is a weak approach in as far as cases associated with high rates of comorbidity are concerned with insomnia being one of these cases (Yang, et al 1104).
Recommendations
In order to further validate the results it is recommended that the design be modified to establish causal relationships that exist among the variables. An evaluation approach that would provide clearer distinction for the subject especially in the CI and HV categories would be a big plus towards a more solid conclusion on the results.
Conclusion/summary
The study has been successful in that its objectives have been met. The factors that are responsible for the advancement of transient insomnia to chronic insomnia have been established. This study can play a major role in prevention of critical insomnia and providing guidelines on how to cope with transient sleep problems.
Work cited
Yang, Chien-Ming, Lin Shih-Chun and Cheng, Chung-Ping. Transient insomnia versus chronic insomnia: A Comparison Study of Sleep-Related Psychological/Behavioral Characteristics. 2013. Wiley.
