The Discrepancy-Cognitive Arousal Model of Insomnia Among the General Population

Abstract

Background and Objective We aimed to explore the Discrepancy-Cognitive Arousal model among the general population, applying the discrepancy between desired time in bed and desired total sleep time (DBST index), dysfunctional beliefs about sleep, and sleep-related metacognitive processes. Methods An anonymous online survey study was conducted among the general population between January 10 and 18, 2022. The survey form included a questionnaire for demographic characteristics and rating scales such as Insomnia Severity Index (ISI), Dysfunctional Beliefs and Attitudes about Sleep–16 items (DBAS-16), and Metacognition Questionnaire for Insomnia–14 items (MCQI-14). In addition, questions for measuring participants’ DBST index were included. Results A total of 374 participants’ responses were analyzed. The ISI score was predicted by the DBST index (β = 0.11, p = 0.008), DBAS-16 (β = 0.37, p < 0.001), and MCQI-14 (β = 0.30, p < 0.001) in the linear regression analysis. In the mediation model, the DBST index directly predicted insomnia severity, and dysfunctional beliefs about sleep and sleep-related metacognitive processes mediated this relationship. Conclusion We observed that the Discrepancy-Cognitive Arousal model of insomnia was feasible among the general population.

Keywords

• metacognition
• insomnia
• sleep
• attention
• dbst index