The Dynamic Modell of Sleep Disorders - A Therapy-Tool for Cognitive Behavioral Therapy for Non-organic Sleep Disorders
American Journal of Psychiatry and Neuroscience
Volume 8, Issue 1, March 2020, Pages: 6-11
Received: Dec. 9, 2019; Accepted: Dec. 25, 2019; Published: Jan. 21, 2020
Views 308      Downloads 113
Carolin Marx-Dick, Institute for Clinical Psychology, Technical University, Dresden, Germany
Article Tools
Follow on us
The dynamic model of sleep disorders was carried out in the framework of the study of the dynamic of sleep disorders. On the basis of this circulation model, deficient sleep areas can be uncovered and a disturbance model can be developed together with the patients. Afterwards an individuell therapeutic rationale for breaking out of the "vicious circle" of sleep disturbances can be created. The study was a randomized controlled study. Test subjects suffered from non-organic insomnia. Also person suffering from psychological comorbidities were included. A total of 158 records were included in the calculations. The 5 expected factors "disturbed sleep", "fatigue during the day", "reduced performance", "worries" and "tension" could be extracted by factor analysis. Thus the "dynamic model of sleep disorders" could be mapped on the basis of the data of the SLEEP Quality Inventory. Overall, it can be said that all theoretically expected factors could be extracted on the basis of the factor analysis of the data. However, some factors showed weaknesses regarding a clean load of items. The following practical application of the model and the intervention showed that the model depicts only 2 levels of the behaviour and experience of the affected persons, the "psychophysiology and cognitions" as well as the "homeostatic principle". A third level of explication, "emotional dysregulation" has to be regarded in future.
Insomnia, Sleep Disorders, Kognitive Behavioral Therapy, CBT-I, Dynamic Modell
To cite this article
Carolin Marx-Dick, The Dynamic Modell of Sleep Disorders - A Therapy-Tool for Cognitive Behavioral Therapy for Non-organic Sleep Disorders, American Journal of Psychiatry and Neuroscience. Vol. 8, No. 1, 2020, pp. 6-11. doi: 10.11648/j.ajpn.20200801.12
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Van der Zweerde T, Bisdounis L, Kyle SD, Lancee J, Van STraten A. Cognitive behavioral therapy for insomnia: A meta-analysis of long-term effects in controlled studies. Sleep Med Rev. 2019 Aug 12; 48: 101208.
Kim SJ, Kim S, Jeon S, Leary EB, Barwick F, Mignot E. Factors associated with fatigue in patients with insomnia. J Psychiatr Res. 2019 Oct; 117: 24-30.
Achermann P, Borbély AA. Simultation of daytime vigilance by the additive interaction of a homeostatic and circadian process. Biol Cybern. 1994; 71: 115-21.
Riemann D, Spiegelhalder K, Vorderholzer U, Kaufmann R, Seer N, Klöpfer C, Hornyak M, Espie C, Perlis M. Primäre Insomnien: Neue Aspekte der Diagnostik und Differentialdiagnostik, Äthiologie und Pathophysiologie sowie Psychotherapie. Somnologie. 2007. 11: 57-71.
Findley LJ, Fabrizzio M, Toni G, Suratt P. Automobile crashes in patients with obstructive sleep apnea. Am Rev Respir Dis. 1988. 147: 56.
Knauth P. Schichtarbeit, Nachtarbeit. In: Triebig G, Kentner M, Schiele R (Hrsg). Arbeitsmedizin. Handbuch für Theorie und Praxis. Gentner, Stuttgart, 2003. S. 733-742.
Doran SM, Van Dongen HP, Dinges DF. Sustained attention performance during sleep deprivation: evidence of state instability. Arch Ital Biol. 2001 Apr; 139 (3): 253-67.
Silva EJ, Wang W, Ronda JM, Wyatt JK, Duffy JF. Circadian and wake-dependent influences on subjective sleepiness, cognitive throughput, and reaction time performance in older and young adults. Sleep. 2010 Apr; 33 (4): 481-90.
Wyatt JK, Ritz-De Cecco A, Czeisler CA, Dijk DJ. Circadian temperature and melatonin rhythms, sleep, and neurobehavioral function in humans living on a 20-h day. Am J Physiol. 1999 Oct; 277 (4 Pt 2): R1152-63.
Rohmert W. 1973. In: Schmidtke H (Ed.). Ergonomie 1. Hanser, München, S. 225-255.
Dawson D, Chapman J, Thomas MJ. Fatigue-proofing: a new approach to reducing fatigue-related risk using the principles of error management. Sleep Med Rev. 2012; 16: 167-75.
Borkovec TD, Shadick RN, Hopkins M. The nature of normal and pathological worry. In Rapee RM, Barlow DH (Eds.). Chronic Anxiety: Generalized anxiety disorder and mixed anxiety-depression. 1991; New York: Guilford Press.
Lewinsohn PM. A behavioral approach to depression. In Friedman RJ, Katz MM (Eds.). The psychology of depression: Contemporary theory and research. 1974; New York: John Wiley & Sons.
Seeligman MEP. Helplessness: On depression, development, and death. 1975; San Francisco: Freeman.
Ehlers A, Margraf J. Agoraphobien und Panikanfälle. In H. Reinecker (Hrsg.), Lehrbuch der Klinischen Psychologie. Modelle psychischer Störungen (S. 73-106). 1990; Göttingen: Hogrefe.
Borkovec TD, Hennings BL. The role of physiological attention-focusing in the relaxation treatment of sleep disturbance, general tension, and specific stress reaction. Behav Res Ther. 1978; 16 (1): 7-19.
Borkovec TD. Insomnia. J Consult Clin Psychol. 1982; 50 (6): 880-895.
Borkovec TD, Castello E. Efficacy of applied relaxation and cognitive-behavioral therapy in the treatment of generalized anxiety disorder. J Consult Clin Psychol. 1993; 61 (4): 611-619.
Stuck BA, Mauerer JT, Schredl M, Weeß HG. Praxis der Schlafmedizin. Springer, Heidelberg; 2009.
Pluess M, Conrad A, Wilhelm FH. Muscle tension in generalized anxiety disorder: a critical review of the literature. J Anxiety Disord. 2009; Jan; 23 (1): 1-11.
Marx C. Nichtorganische Schlafstörungen. Berlin: Springer; 2016.
Marx C. Die Dynamik der Schlafstörungen. Dissertation. 2016.
Roth T. Insomnia: Definition, Prevalence, Etiology, and Consequences. J Clin Sleep Med 2007; 3 (Suppl 5): 7-10.
Buysse DJ, Reynold CF, Monk TH, Berman SR, Kupfer DJ. 1989. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 28 (2): 193-213.
Palagini L, Bastien CH, Marazziti D, Ellis JG, Riemann D. The key role of insomnia and sleep loss in the dysregulation of multiple systems involved in mood disorders: A proposed model. J Sleep Res. 2019 Dec; 28 (6): e12841. doi: 10.1111/jsr.12841. Epub 2019 Apr 10.
Veale D, Poussin G, Benes F, Pepin JL, Levy P. Identification of quality of life concerns of patients with obstructive sleep apnoea at the time of initiation of continuous positive airway pressure: a discourse analysis. Qual Life Res. 2002 Jun; 11 (4): 389-99.
Cathébras PJ, Robbins JM, Kirmayer LJ, Hayton BC. Fatigue in primary care: prevalence, psychiatric comorbidity, illness behavior, and outcome. J Gen Intern Med. 1992 May-Jun; 7 (3): 276-86.
Johnson KA, Gordon CJ, Grunstein RR. Somatic symptoms are associated with Insomnia disorder but not Obstructive Sleep Apnoea or Hypersomnolence in traumatic brain injury. Neuro Rehabilitation. 2019 Nov 28. doi: 10.3233/NRE-192868 [Epub ahead of print].
Ji X, Bastien CH, Ellis JG, Hale L, Grandner MA. Disassembling insomnia symptoms and their associations with depressive symptoms in a community sample: the differential role of sleep symptoms, daytime symptoms, and perception symptoms of insomnia. Sleep Health. 2019 Aug; 5 (4): 376-381. doi: 10.1016/j.sleh.2018.12.009. Epub 2019 Mar 28.
Crönlein T. Schlafstörungen: Ein Gruppentherapieprogramm für den stationären Bereich. Göttingen: Hogrefe; 2013.
Hampton AJ, Hadjistavropoulos T, Gangon MM, Williams J, Clark D. The effects of emotion regulation strategies on the pain experience: a structural laboratory investigation. Pain; 2015; 156 (5): 868-879.
Whibley D, Braley TJ, Kratz AL, Murphy SL. Transient Effects of Sleep on Next-Day Pain and Fatigue in Older Adults With Symptomatic Osteoarthritis. J Pain. 2019 Nov; 20 (11): 1373-1382. doi: 10.1016/j.jpain.2019.04.011. Epub 2019 May 11.
Bláfoss R, Sundstrup E, Jakobsen MD, Bucht H, Garde AH, Andersen LL. Are Insomnia Type Sleep Problems Associated With a Less Physically Active Lifestyle? A Cross-Sectional Study among 7,700 Adults From the General Working Population. Front Public Health. 2019 May 14; 7: 117. doi: 10.3389/fpubh.2019.00117. eCollection 2019.
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
Tel: (001)347-983-5186