Date of Award


Document Type

Open Access Thesis

Degree Name

Doctor of Psychology (PsyD)



First Advisor

Jim Theisen, PhD, LP

Second Advisor

Abby Hughes-Scalise, PhD, LP

Third Advisor

Marcia Bennett, Ph.D.


The pursuit of healthy sleep in the United States often involves the use of prescription medications that were never intended for long-term treatment of insomnia. The use of medication to address sleep difficulty has multiple sources, including the medical system and a consumer driven economy within the United States. Behavioral interventions for insomnia have been increasing in availability and effectiveness over time, but medication use continues to be a first-line treatment for sleep problems. The focus of the current paper is the exploration of relationships between sedative use, sleep difficulties, and negative cognition in a sample of 104 adult participants who endorsed a history of sleep problems (mean age 55.6 years, 46.2% male) from the Midlife in the United States (MIDUS), a national study of health and well-being (History & overview of MIDUS, 2011; University of Wisconsin, 2017a; University of Wisconsin 2017b). Specifically, it was hypothesized that sedative use would be correlated with increased negative cognition. Negative cognition has been theorized to contribute to the development of insomnia, the disorder the medication was intended to alleviate. Those reporting sedative use reported more sleep difficulties than those not taking sedatives, though these groups did not differ on reported negative cognitions. No correlation was found between negative cognition and sleep difficulties for those reporting sedative use. For those not reporting sedative use, increased negative cognition was correlated with increased sleep difficulties. The lack of evidence for a relationship between negative cognition and self-reported insomnia for those who used medication could suggest that sedative use may minimize the relationship between negative cognitions and sleep difficulties. Clinical implications of the findings support non-pharmacological treatments in the reduction of negative cognition associated sleep difficulties.


SC 11.PsyD.2023.Larsen.AL