0411 Dysfunctional Beliefs About Sleep and Sleep Misperception in Adults with Insomnia Symptoms

Abstract Introduction In adults with insomnia, a common characteristic is a discrepancy between perceived and objectively measured sleep. The mechanisms of this discrepancy are not known but it may reflect increased cognitive arousal. Cognitive arousal can vary both in terms of quantity as well as content, with individuals with insomnia often reporting dysfunctional beliefs about sleep. However, the role of these separate components of cognitive arousal have not been investigated. The current pilot study aimed to explore these psychological factors and their impact on sleep misperception, with the hypothesis that higher levels of dysfunctional beliefs would be associated with greater negative sleep misperception in terms of underestimation of sleep time. Methods Participants with insomnia symptoms (N=32) completed the Dysfunctional Beliefs and Attitudes About Sleep (DBAS), Insomnia Severity Index (ISI), Patient-Reported Outcomes Measurement Information System Sleep Disturbance (PROMIS-Sleep Disturbance), and Pre-Sleep Arousal Scale (PSAS), along with a morning sleep diary corresponding after in-home polysomnography (PSG). PSG was scored according to standard guidelines to compute total sleep time (TST), sleep onset latency (SOL), and wake after sleep onset (WASO). Subjective estimates of these corresponding metrics were used to compute misperception scores (for example, diary-reported TST minus PSG-recorded TST). Pearson correlation coefficients were then computed to examine associations between psychological measures and sleep misperception severity. Results DBAS scores were negatively correlated with TST misperception (r=–.366, p = .047) but were not significantly correlated to SOL or WASO misperception. ISI scores were positively correlated with SOL misperception (r=.431, p = .014) and negatively correlated with WASO misperception (r=–.470, p = .007). PROMIS and PSAS scores were not significantly correlated to TST, SOL, or WASO misperception. Conclusion Findings suggest that individuals endorsing stronger dysfunctional sleep beliefs tended to underestimate their total sleep time, consistent with a negative correlation between DBAS scores and TST misperception. Additionally, broader insomnia severity was correlated to misperceptions of overestimating sleep latency times and underestimating wake after sleep onset times. Taken together, these patterns highlight the potential value of targeting maladaptive sleep-related cognitions within cognitive-behavioral interventions to help reduce distorted sleep perceptions and improve clinical outcomes. Support (if any) NIH/NHLBI 1R01HL173043