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  • Title: Investigating racing thoughts in insomnia: A neglected piece of the mood-sleep puzzle?
    Author: Weiner L, Martz E, Kilic-Huck Ü, Siegel N, Bertschy G, Geoffroy PA, Weibel S, Bourgin P.
    Journal: Compr Psychiatry; 2021 Nov; 111():152271. PubMed ID: 34555554.
    Abstract:
    BACKGROUND: 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. METHODS: 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. RESULTS: 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. DISCUSSION: 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.
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