Role of thoughts during nocturnal awake times in the insomnia experience of older adults

The frequency of difficulty initiating and maintaining sleep increases with age. Yet, not all poor sleepers complain of insomnia. Our cognitive model of insomnia predicts that sleep complaints in poor sleepers are a function of negative thinking during nocturnal wakefulness as well as of poor sleep quality. To test descriptive aspects of the model, we examined the content and valence of thoughts listed or endorsed by two large samples of older adults. We compared positive and negative thoughts reported by good sleepers and by 2 types of poor sleepers: those experiencing either high or low distress about their insomnia. Thought listing and inventory results both support the model: negative thought frequencies were closely related to poor sleep, distress about insomnia, and poor daytime psychological adjustment. The findings provide an empirical basis for the modification of maladaptive cognitions as potentially important in therapeutic intervention for insomnia.