Laboratoire de Psychologie des Cognitions, University of Strasbourg, Strasbourg, France; Department of Psychiatry, University Hospital of Strasbourg, Strasbourg, France.
INSERM U1114, Strasbourg, France.
Compr Psychiatry. 2021 Nov;111:152271. doi: 10.1016/j.comppsych.2021.152271. Epub 2021 Sep 17.
Cognitive arousal is thought to play a key role in insomnia disorder. However, although patients frequently complain about racing thoughts appearing at bedtime, studies have considered 'cognitive arousal' as a synonym of rumination and worry, but not as racing thoughts per se. The latter have been mainly linked to hypomanic/manic episodes of bipolar disorder (BD). Here we aimed at investigating self-reported racing thoughts in insomnia disorder, and their specific contribution to insomnia severity, as compared to worry and rumination.
72 adults with insomnia disorder, 49 patients with BD in a hypomanic episode and 99 healthy individuals completed the Racing and Crowded Thoughts Questionnaire (RCTQ). Mood symptoms were assessed in patients with insomnia disorder.
RCTQ scores were overall higher in insomnia disorder, especially in sleep-onset insomnia, compared to the hypomanic and healthy groups. Moreover, racing thoughts showed an increase in the evening and at bedtime in sleep-onset insomnia. Importantly, racing thoughts at bedtime, but not rumination and worry, were associated with insomnia severity.
Our results are the first to show that racing thoughts is a transdiagnostic symptom in mood and sleep disorders. Racing thoughts, not only rumination and worry, might contribute to the maintenance of sleep difficulties in insomnia. Clinical trials' registration number: NCT04752254.
认知唤醒被认为在失眠障碍中起着关键作用。然而，尽管患者经常抱怨在睡前出现思维奔逸，但研究将“认知唤醒”视为反刍和担忧的同义词，而不是思维奔逸本身。后者主要与双相情感障碍（BD）的轻躁狂/躁狂发作有关。在这里，我们旨在研究失眠障碍中自我报告的思维奔逸，以及与担忧和反刍相比，它们对失眠严重程度的具体贡献。
72 名失眠症患者、49 名轻躁狂发作的 BD 患者和 99 名健康个体完成了 Racing and Crowded Thoughts Questionnaire（RCTQ）。失眠症患者的情绪症状也进行了评估。
与轻躁狂组和健康组相比，RCTQ 评分在失眠组中总体较高，尤其是在入睡困难的失眠组中。此外，在入睡困难的失眠症中，思维奔逸在晚上和睡前都会增加。重要的是，只有睡前的思维奔逸，而不是反刍和担忧，与失眠严重程度有关。
我们的研究结果首次表明，思维奔逸是情绪和睡眠障碍的一种跨诊断症状。与反刍和担忧不同，思维奔逸可能会导致失眠患者的睡眠困难持续存在。临床试验注册号：NCT04752254。
