Potential pathways from biopsychosocial risk factors to sleep loss due to worry: a population‐based investigation

Purpose Typologies of sleep problems have usually relied on identifying underlying causes or symptom clusters. The purpose of this paper is to explore the value of using the patient's own reasons for sleep disturbance. Design/methodology/approach Using secondary data analysis of a nationally representative psychiatric survey the patterning of the various reasons respondents provided for self‐reported sleep problems were examined. Over two thirds (69.3 per cent) of respondents could identify a specific reason for their sleep problem with worry (37.9 per cent) and illness (20.1 per cent) representing the most commonly reported reasons. And while women reported more sleep problems for almost every reason compared with men, the patterning of reasons by age showed marked variability. Sleep problem symptoms such as difficulty getting to sleep or waking early also showed variability by different reasons, as did the association with major correlates such as worry, depression, anxiety and poor health. Findings While prevalence surveys of “insomnia” or “poor sleep” often assume the identification of an underlying homogeneous construct, there may be grounds for recognising the existence of different sleep problem types, particularly in the context of the patient's perceived reason for the problem. Originality/value A typology based on reasons presents a different snapshot of the landscape of insomnia. Using patient's reasons to underpin a sleep nosology is an alternative way of sub‐dividing patients' symptoms which has some face validity given the “subjective” associations between reasons and symptoms.