International Journal of Clinical Psychiatry 2017, 5(2): 25-31 DOI: 10.5923/j.ijcp.20170502.01 Insomnia and Dysfunctional Beliefs and Attitudes about Sleep among Elderly Persons in Abeokuta, Nigeria Adefolakemi Ogundele 1 , Maroh Ighoroje 1,* , Olukayode Abayomi 2 1 Neuropsychiatric Hospital, Abeokuta, Nigeria 2 Department of Psychiatry, Ladoke Akintola University Teaching Hospital, Ogbomoso, Nigeria Abstract Objective: Insomnia is a common health complaint among the elderly. Sleep problems in this group are often accompanied by maladaptive sleep-related cognitions. However the relationship between dysfunctional beliefs and attitudes about sleep to insomnia and depression in the elderly has not been explored in this environment. Methods: It was a cross sectional study carried out among 212 elderly persons in the community. Individuals with a past history of mental illness were excluded. Respondents were administered the Dysfunctional Beliefs and Attitudes about Sleep Questionnaire (DBAS-16), Insomnia Severity Index (ISI) questionnaire, the Geriatric Depression Scale (GDS). Results: The mean age of respondents were 70.1±7.1 years, 81.6% were males, 23.6% used medication to aid sleep, while 16.0% slept for < 4 hours per night. Insomnia and depressive symptoms were present in 53.3% and 23.6% of the respondents respectively. Presence of insomnia (t = 5.19, df = 210, p < 0.001), depressive symptomatology (t = 2.52, df =210, p = 0.013) and use of medication to aid sleep (t = 2.436, df = 210, p = 0.016) was significantly associated higher total DBAS scores. The multiple linear regression showed that the presence of insomnia (p < 0.001, ß = 21.93) was the most significant predictor variable of dysfunctional beliefs and attitude about sleep. Conclusions: Faulty sleep beliefs are present among the elderly in Nigeria and may be driven by poor sleep. The clinical implication is that these cognitions should be identified and modified in the management of insomnia in this age group. Keywords Dysfunctional beliefs and attitudes about sleep, Insomnia, Depression, Elderly, Nigeria 1. Introduction 1.1. Background Insomnia is a common health complaint among elderly people. It has been estimated to affect between 25-30% of the older population [1, 2]. The diagnostic and statistical manual of mental disorders, 5th Edition, defines insomnia as a predominant complaint of dissatisfaction with sleep quantity or quality, along with difficulty initiating or maintaining sleep, which causes clinically significant distress or impairment in important areas of functioning (i.e., social, occupational, behavioral, etc.) [3]. Negative consequences of insomnia in late life include decreased quality of life, high risk for heart diseases, high risk of falls, increased psychological difficulties, increased economic and social costs, increase use and abuse of tranquilizers and mortality [4]. Often sleep problems in the older age groups are precipitated and maintained by maladaptive sleep-related * Corresponding author: mgi4life@yahoo.com (Maroh Ighoroje) Published online at http://journal.sapub.org/ijcp Copyright © 2017 Scientific & Academic Publishing. All Rights Reserved cognitions (e.g., faulty beliefs and appraisals, unrealistic expectations and perceptual bias) [5, 6]. Dysfunctional beliefs associated with worry about the negative consequences of insomnia and hopelessness about the fear of losing control over sleep have been identified as the most critical factors in differentiating chronic insomnia from transient insomnia [7]. These dysfunctional sleep-related cognitions may be influenced by the presence of physical and psychological disorders such as chronic pain and mood disorders [8, 9]. The importance of targeting sleep-related beliefs and attitudes in the treatment of insomnia is highlighted by the fact that more adaptive beliefs and attitudes about sleep following treatment are associated with better maintenance of sleep improvements at follow-ups [6, 10]. 1.2. Rationale Previous studies on sleep disorders have been conducted among the elderly population in Nigeria [2, 11, 12]. But these were largely limited to profile and prevalence studies. Despite increasing recognition of the importance of cognitive factors in the etiology of insomnia, no past work has investigated the dysfunctional sleep related beliefs and attitudes among the elderly population in this country. This study will fill this dearth of information.