Abstract
This study aimed to investigate the relationship between somatic symptom disorder (SSD) and sleep disorders, following three research questions: (1) How are these disorders correlated? (2) What are the comorbidities reported in these patients? and (3) What are the most effective pharmacological and non-pharmacological treatments for both conditions? PubMed, Scopus, OVID, Medline, and ProQuest databases were searched for relevant articles published between 1957–2020. Search terms included “somatic symptoms disorder”, “sleep disorders”, “insomnia”, “somatoform”, “somatization”, “therapeutic”, “psychotherapy”, and alternative, formerly used terms for SSD. Forty papers were finally included in the study. Prevalence of insomnia in SSD patients ranged between 20.4–48%, with this being strongly correlated to somatic symptoms and psychosocial disability. The most relevant comorbidities were generalized anxiety disorder, depression, fatigue, negative mood, substance use, orthorexia, alexithymia, anorexia, weight loss, poor eating habits, and acute stress disorder. Patients receiving antidepressant therapy reported significant improvements in insomnia and somatic symptoms. In terms of non-pharmacological interventions, cognitive-behavioral therapy (CBT) showed improvements in sleep outcomes, while the Specialized Treatment for Severe Bodily Distress Syndromes (STreSS) may represent an additional promising option. Future research could include other medical and psychosocial variables to complete the picture of the relationship between sleep disorders and somatic symptoms.
Highlights
In normal individuals, somatic symptoms and sleep disorders are two common conditions that are often connected to acute stress exposure, often in demanding workrelated contexts [1]
Papers taken into consideration were peer-reviewed articles, systematic reviews, and meta-analyses corresponding to a level of evidence greater than five in the hierarchy set by the Cen-Healthcare 2021, 9, 1128 tre for Evidence-Based Medicine [26] and including the terms “somatic symptoms disorder”, “sleep disorders”, “insomnia”, “somatoform”, “somatization”, “therapeutic”, and “psychotherapy” alongside alternative, formerly used terms for symptom disorder (SSD) (“somatization disorder”, “medically unexplained symptoms”, “bodily distress syndrome”, “multisomatoform disorder”, and “non-organic pain”)
In terms of the correlations between somatic symptoms in SSD and sleep disorders, our findings indicate that patients displaying both conditions have more substantial complaints and worse overall outcomes
Summary
Somatic symptoms and sleep disorders are two common conditions that are often connected to acute stress exposure, often in demanding workrelated contexts [1] If persistent, both symptoms can impact quality of life and may require the use of individual counseling and/or organizational supportive systems dedicated to stress prevention and relief [2,3]. The potential of creating a veritable vicious circle between the somatic and sleep disorders, with important effects on the patients’ quality of life, highlights the need to understand the possible role of sleep disorders in the evolution and exacerbation of symptoms among patients with SSD. This relationship should be investigated from the perspective of the potential role of additional factors, such as psychiatric comorbidities (depression and anxiety), which may frequently occur in this kind of patient [16,17]
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