Role of nocturnal cognitive arousal in the complaint of insomnia among older adults.

Self-reported cognitive activity has been hypothesized to contribute directly to problematic sleep. We evaluated this formulation by examining nocturnal sleep parameters, daytime functioning and psychological adjustment cross-sectionally (N = 183) in four groups of older adults: good and poor sleepers with high and low cognitive arousal. Results indicate that when sleep quality was controlled for, individuals with high and low nocturnal cognitive arousal did not differ on either nocturnal or daytime aspects of the insomnia complaint. They were, however, less well adjusted psychologically. The pattern of findings suggests that high cognitive arousal contributes indirectly to the overall insomnia experience through its association with psychological maladjustment, rather than interfering with sleep per se. Treatment of late-life insomnia should include assessment and, possibly, clinical management of psychological adjustment.