| Summary: | 碩士 === 國立政治大學 === 心理學研究所 === 101 === OBJECTIVE：In addition to the nocturnal symptoms, daytime dysfunction is a common problem in insomnia patients. There are only limited number of studies to explore the factors that may influence daytime function in insomnia patients,
particularly in mood disturbance. The Cognitive Model of Insomnia by Harvey (2004) suggests that the patients with insomnia tend to think about their sleep disturbance in
the morning and throughout the day. These excessive negatively toned cognitive activity will enhance the patients’ level of arousal, and make them monitoring the
impacts of sleep disturbances on daytime functioning throughout the day. The dysfunctional belief about sleep may further exacerbate the negatively toned cognitive activity. Such excessive daytime cognitive activities may be more the cause of their daytime dysfunction than their sleep disturbances, and may bring the distress of the patients. Therefore, the aim of this study is to explore the day-to-day association of sleep and mood state in insomnia patient, and to use the Cognitive Model of Insomnia as a framework to clarify the influence of dysfunctional beliefs and attitudes about sleep and the self-monitoring tendency of sleep-associated threat on the association between sleep and mood state, in order to further the understanding of pathological of insomnia.
METHOD：Forty insomnia patients (10 male and 30 female, mean age 43) participated in the study. Their daytime emotion function were measured using the ecological momentary assessment, by asking them to rate their mood state and to
submit the ratings immediately through text messages four times a day for a week. They were also asked to wear the actigraphy and to fill the sleep diary during the week. Moreover, participates were required to complete the Dysfunctional Beliefs and Attitude about Sleep Scale-16-item version and the Sleep-Associated Monitoring Index. Hieratical linear model was conducted for data analyses. Mood state ratings and subjective/objective sleep indicators were the variables for within-individual level analysis (level one), to examine whether the subjective/objective sleep indicators can predict the next day’s mood state; dysfunctional belief and self-monitoring of sleep-related threat included the variables for between individual level (level two), to examine whether these variables moderate the relationship of sleep and mood state.
RESULT：The data showed inconsistency results between the subjective and objective sleep indicators. Most of the subjective sleep indicators can predict the next day’s
mood state, particularly the amount of sleep time they subjectively experienced. On the other hand, only the total sleep time among the objective sleep indicators can predict negative mood the next day. Most objective sleep indicators failed to predict daytime emotion the next day's. In addition, the dysfunctional beliefs about sleep and the self-monitoring tendency for sleep-related threat can significantly predicted the negative affect, but do not play a role as moderators for the relationship of sleep indicators and mood state.
CONCLUSION：In patients with insomnia, the subjective experience rather than the objective measure of nighttime sleep is the major factor that determine their mood state the next day. The reduction of the actual amount of sleep may have negative impact on their mood through partial sleep deprivation. Also, when they have more dysfunctional beliefs about sleep, and the tendency for monitoring sleep-related threat, during the day, they may have more emotional disturbance during the day.The findings of the current study suggests that adjust the dysfunctional beliefs about
sleep and reduce the tendency for monitoring the sleep-related threat, and explore the factors that may influence the inconsistent of objective and subjective sleep index in
insomnia patients in subsequent studies, is expect to reduce emotional distress during the day, and increase the quality of life in insomnia patients
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