Insomnia as an interaction between sleep-interfering and sleep-interpreting processes

The present paper reviews theories and empirical research concerning the role of psychological processes in insomnia. It is argued that two kinds of psychological processes are involved in insomnia: sleep-interfering processes and sleep-interpreting processes. A theoretical model is sketched, where it is argued that psychological vulnerability factors may predispose the individual to (1) respond with sleep-interfering processes to stressful life events, and to (2) engage in dysfunctional sleep-interpreting processes. Examples of the first kind of variables are arousability, slow recuperation after stress, worrying. and emotional conflicts in relation to significant others; examples of the latter are sleep-related beliefs, attitudes, and perfectionistic standards. (C) 2000 Elsevier Science Inc. All rights reserved.