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Temperament and character in primary insomnia

Published online by Cambridge University Press:  16 April 2020

Zara de Saint Hilaire*
Affiliation:
Sleep Laboratory, University Hospital of Geneva, Belle-idée, 2 chemin Petit Bel-Air, 1225, Chêne-Bourg, Switzerland
Judith Straub
Affiliation:
Sleep Laboratory, University Hospital of Geneva, Belle-idée, 2 chemin Petit Bel-Air, 1225, Chêne-Bourg, Switzerland
Antoine Pelissolo
Affiliation:
Service de psychiatrie adulte, Groupe Hospitalier Pitié-Salpêtrière, 47-83, bd de l'Hopital, 75651Paris, France
*
*Corresponding author. E-mail address: zara.deSaint-Hilaire@hcuge.ch (Z. de Saint Hilaire).
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Abstract

Recent studies by Cloninger suggest that the temperament dimension of harm avoidance might be related to serotonergic activity. Since serotonergic mechanisms equally play a major role in sleep regulation, we decided to use Cloninger’s psychobiological model of temperament and character to assess whether there is a link between psychophysiologic insomnia and specific personality traits. Chronic insomnia is a common complaint in modern society, and it is still controversial whether insomniacs share specific personality traits. Thirty-two chronic insomniacs (<50 years) were studied. They underwent polysomnography for two consecutive nights and filled out the 226-item self-questionnaire of Temperament and Character Inventory as well as the Hospital Anxiety and Depression scale. (1) Harm avoidance for all subscores was significantly higher in insomniac patients when compared with controls; (2) self-directedness scores were lower in insomniacs; (3) sleep latency was positively correlated to harm avoidance; (4) HA1 (anticipatory worry) was negatively correlated to REM latency. Temperament and Character Inventory is a useful tool in the investigation of chronic insomnia. Serotonergic mechanisms might explain the high incidence of harm avoidance as personality trait in psychophysiologic insomniac patients. Further studies are needed to see whether harm avoidance could be a psychological vulnerability marker for primary insomnia and be used as predictor of SSRI treatment responders.

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Original article

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