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Updated: Jul 17, 2026

Association Between Sleep Quality and Cognitive Symptoms in Patients with Major Depressive Disorder
Published on: April 26, 2024
Beliefs about sleep in disorders characterized by sleep and mood disturbance
Colleen E Carney1, Jack D Edinger, Rachel Manber
1Duke Insomnia and Sleep Research Program, Duke University Medical Center, Durham, NC 27710, USA. colleen.carney@duke.edu <colleen.carney@duke.edu>
Objectives:
Maladaptive sleep beliefs play an important role in primary insomnia, but their role in other disorders with concomitant sleep disruption has rarely been explored. Thus, this study investigated the link between insomnia and sleep beliefs in five groups (N=422): primary insomnia (PI), good sleepers (GS), fibromyalgia (FM), major depressive disorder (MDD), and Community Sleep Clinic patients with comorbid insomnia and mood disturbance (CSC).
Method:
Groups were compared on the Dysfunctional Beliefs and Attitudes about Sleep (DBAS-16) scale.
Results:
Unlike the GS group, the MDD, FM, and CSC groups had elevated DBAS-16 scores that were similar to, or more pathological than, those of primary insomnia sufferers. Only some of the differences were removed after controlling for depression.
Conclusion:
Like primary insomnia patients, other sleep-disturbed patient groups have problematic sleep beliefs. Depression was not sufficient to account for all elevations in beliefs. The presence of maladaptive sleep beliefs in these patients suggests that belief-targeted treatment might be helpful in alleviating sleep complaints.
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