@article{ref1,
title="Pre-sleep arousal and fear of sleep in trauma-related sleep disturbances: a cluster-analytic approach",
journal="Clinical psychology in Europe",
year="2020",
author="Werner, Gabriela G. and Danböck, Sarah K. and Metodiev, Stanislav and Kunze, Anna E.",
volume="2",
number="2",
pages="e2699-e2699",
abstract="BACKGROUND: Trauma-related sleep disturbances constitute critical symptoms of posttraumatic stress disorder (PTSD), but sleep symptoms often reside even after successful trauma-focused psychotherapy. Therefore, currently unattended factors - like fear of sleep (FoS) - might play a crucial role in the development and maintenance of residual sleep disturbances. However, it is unclear whether trauma-exposed individuals exhibit different symptomatic profiles of sleep disturbances that could inform individualized therapeutic approaches and eventually enhance treatment efficacy. <br><br>METHOD: In a large online study, a two-step cluster analysis and a hierarchical cluster analysis using Ward's method were performed to explore subgroups among trauma-exposed individuals (N = 471) in terms of FoS, different aspects of trauma-related sleep disturbances (e.g., insomnia symptoms, nightmares, arousal), and PTSD symptoms. These variables were compared between resulting clusters using ANOVAs and Scheffé's post-hoc tests. <br><br>RESULTS: The hierarchical cluster analysis supported 3- and 4-cluster solutions. The 3-cluster solution consisted of one &quot;healthy&quot; (n = 199), one &quot;subclinical&quot; (n = 223), and one &quot;clinical&quot; (n = 49) cluster, with overall low, medium, and high symptomatology on all used variables. In the 4-cluster solution, the clinical cluster was further divided into two subgroups (n = 38, n = 11), where one cluster was specifically characterized by elevated somatic pre-sleep arousal and high levels of FoS. <br><br>CONCLUSIONS: A subgroup of trauma-exposed individuals with PTSD and sleep disturbances suffers from increased pre-sleep arousal and FoS, which has been suggested as one possible explanation for residual sleep disturbances. In these patients, FoS might be a relevant treatment target.<p /> <p>Language: en</p>",
language="en",
issn="2625-3410",
doi="10.32872/cpe.v2i2.2699",
url="http://dx.doi.org/10.32872/cpe.v2i2.2699"
}