Pain-related beliefs about sleep as a predictor of insomnia symptoms and treatment acceptability

Abstract

Objective: Dysfunctional beliefs about sleep and pain are common among individuals experiencing recurrent pain and may inadvertently maintain insomnia symptoms. Thus, the present study sought to determine the level at which pain-related beliefs about sleep may predict insomnia and assess whether pain-related beliefs about sleep predict attitudes towards insomnia treatment above other known factors.

Patients/methods: Data consisted of 999 individuals (M age = 44.18, 45.75% male) who participated in an online study about sleep and health across the lifespan. Beliefs about sleep and pain were measured via the pain-related beliefs and attitudes scale (PBAS) while insomnia and pain were assessed using the insomnia severity index (ISI) and a visual analogy scale, respectively. Attitudes towards insomnia treatment was measured using the insomnia treatment acceptability scale (ITAS).

Results and conclusion: A score of 6.10 out of 10 on PBAS optimized sensitivity (66.40%) and specificity (66.90%) for insomnia classification. Pain-related beliefs about sleep predicted treatment acceptability of both behavioral (β = .46, p <. 001) and pharmacological treatments (β = 0.50, p < .001) over and above insomnia symptoms, pain severity, or sleep-self efficacy. Results underscore the importance of cognitive-behavioral factors as it relates to insomnia among individuals with comorbid pain and are relevant to the developments of models which seek to understand attitudes towards insomnia treatment.

Keywords: Dysfunctional beliefs; Insomnia; Recurrent pain; Treatment acceptability.