@article{Werner_Danböck_Metodiev_Kunze_2020, title={Pre-Sleep Arousal and Fear of Sleep in Trauma-Related Sleep Disturbances: A Cluster-Analytic Approach}, volume={2}, url={https://cpe.psychopen.eu/index.php/cpe/article/view/2699}, DOI={10.32872/cpe.v2i2.2699}, abstractNote={<p><strong>Background:</strong> Trauma-related sleep disturbances constitute critical symptoms of posttraumatic stress disorder (PTSD), but sleep symptoms often reside even after successful trauma-focused psychotherapy. Therefore, currently unattended factors – like fear of sleep (FoS) – might play a crucial role in the development and maintenance of residual sleep disturbances. However, it is unclear whether trauma-exposed individuals exhibit different symptomatic profiles of sleep disturbances that could inform individualized therapeutic approaches and eventually enhance treatment efficacy.<br><strong>Method: </strong>In a large online study, a two-step cluster analysis and a hierarchical cluster analysis using Ward’s method were performed to explore subgroups among trauma-exposed individuals (N = 471) in terms of FoS, different aspects of trauma-related sleep disturbances (e.g., insomnia symptoms, nightmares, arousal), and PTSD symptoms. These variables were compared between resulting clusters using ANOVAs and Scheffé’s post-hoc tests.<br><strong>Results:</strong> The hierarchical cluster analysis supported 3- and 4-cluster solutions. The 3-cluster solution consisted of one “healthy” (n = 199), one “subclinical” (n = 223), and one “clinical” (n = 49) cluster, with overall low, medium, and high symptomatology on all used variables. In the 4-cluster solution, the clinical cluster was further divided into two subgroups (n = 38, n = 11), where one cluster was specifically characterized by elevated somatic pre-sleep arousal and high levels of FoS.<br><strong>Conclusions:</strong> A subgroup of trauma-exposed individuals with PTSD and sleep disturbances suffers from increased pre-sleep arousal and FoS, which has been suggested as one possible explanation for residual sleep disturbances. In these patients, FoS might be a relevant treatment target.</p&gt;}, number={2}, journal={Clinical Psychology in Europe}, author={Werner, Gabriela G. and Danböck, Sarah K. and Metodiev, Stanislav and Kunze, Anna E.}, year={2020}, month={Jun.}, pages={1-20} }