The Role of Emotion Regulation Difficulties in the Relation Between Insomnia and Depressive Symptoms

Background Emotion regulation (ER) difficulties have been reported to be more severe in individuals with insomnia symptoms compared with controls, which in turn might explain the experience of depressive symptoms in these individuals. To our knowledge, no study has directly tested this hypothesis; therefore, we aimed to examine the indirect association between possible insomnia disorder and depressive symptoms through ER difficulties. Method One hundred and seven individuals with possible insomnia disorder and 268 controls (based on a cutoff score on the Sleep Condition Indicator) completed measures of ER difficulties and depressive symptoms. Results As expected, individuals with possible insomnia disorder showed more severe depressive symptoms and ER difficulties compared with controls. Moreover, there was a significant indirect association between possible insomnia disorder and depressive symptoms through overall ER difficulties. Conclusion ER difficulties were more severe in individuals with possible insomnia disorder and were further associated with more severe depressive symptoms. We speculate that by adding interventions aimed to develop ER abilities, Cognitive Behavioral Therapy for Insomnia (CBT-I) could become a more effective intervention for individuals with insomnia symptoms and associated emotional difficulties. Limitations We used cross-sectional measures in our models of indirect associations.