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Monitoring for Sleep-Related Threat: A Pilot Study of the Sleep Associated Monitoring Index (SAMI)

From the Department of Experimental Psychology, University of Oxford, England (C.N.S., A.G.H.); and Department of Psychiatry, University of Oxford, England (A.G.H.).

Address reprint requests to: Allison G. Harvey, BSc, MClin Psych, PhD, University of Oxford, Department of Experimental Psychology, South Parks Road, Oxford, OX1 3UD, England. Email: allison.harvey{at}psy.ox.ac.uk

OBJECTIVE: The aims of this pilot study were: 1) to establish the reliability and validity of a new self-report instrument designed to index monitoring for sleep-related threat; 2) to determine the presence of ten monitoring types proposed in a recent cognitive model of insomnia and to examine the relationship between monitoring for sleep-related threat and severity of sleep disturbance; and 3) to explore the association between monitoring and the established constructs of amplification and self-focus.

METHODS: Participants (N = 400) completed the Sleep Associated Monitoring Index (SAMI) and the Pittsburgh Sleep Quality Index (PSQI) (1). Based on the PSQI score, the sample was split into two groups to compare normal sleepers (NS) and individuals with a clinically significant sleep disturbance (CSSD). A subset of the sample completed the SAMI and a battery of questionnaires to examine convergent validity between monitoring, amplification, and self-focus.

RESULTS: Individuals in the CSSD group had higher SAMI scores than the NS group and the SAMI correlated positively with severity of sleep disturbance as indexed by the PSQI. A principal components analysis extracted 8 components accounting for 69% of the variance. The 30-item SAMI demonstrated high validity, consistency, and reliability. Scores on the SAMI were moderately positively correlated with scores on measures of amplification and self-focus.

CONCLUSIONS: Preliminary evidence suggests that the SAMI offers a valid and reliable instrument to index monitoring before and after treatment for sleep disturbance. The implications for the presence of monitoring for sleep-related threat in chronic insomnia are discussed.

Key Words: insomnia, • monitoring, • selective attention, • sleep.

Abbreviations: CSSD = clinically significant sleep disturbance;; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders (4^th edition);; NS = normal sleepers.

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