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Despite its high prevalence and burden, insomnia is often trivialized, under-diagnosed, and under-treated in practice. Little information is available on the subjective experience and perceived consequences of insomnia, help-seeking behaviors, and treatment preferences. The use of qualitative approaches (e.g., ethnography, phenomenology, grounded theory) may help gain a better understanding of this sleep disorder. The present paper summarizes the evidence derived from insomnia studies using a qualitative research methodology (e.g., focus group, semi-structured interviews). A systematic review of the literature was conducted using PsycINFO and Medline databases. The review yielded 22 studies and the quality of the methodology of each of them was evaluated systematically using the critical appraisal skills programme (CASP) appraisal tool. Selected articles possess at least a very good methodological rigor and they were categorized according to their main focus: “Experience of insomnia”, “Management of insomnia” and “Medicalization of insomnia”. The main findings indicate that: 1) insomnia is often experienced as a 24-h problem and is perceived to affect several domains of life, 2) a sense of frustration and misunderstanding is very common among insomnia patients, which is possibly due to a mismatch between patients' and health care professionals' perspectives on insomnia and its treatment, 3) health care professionals pay more attention to sleep hygiene education and medication therapies and less to the patient's subjective experience of insomnia, and 4) health care professionals are often unaware of non-pharmacological interventions other than sleep hygiene education. An important implication of these findings is the need to develop new clinical measures with a broader scope on insomnia and more targeted treatments that take into account the patient's experience of insomnia. Greater use of qualitative approaches in future research may produce novel and more contextua

The couple relationship (marriage/cohabitation) is, for most adults, the primary social context of sleep. Although there is a growing literature on couples’ sleep, no qualitative cross-cultural study on this topic has yet been published. The aim of the present study was to explore the strategies used by adult couples with sleep difficulties from two different cultures, as well as the potential sociocultural variations related to these strategies. Six couples in Quebec City (Canada) and five couples in Fortaleza (Brazil), of which one or both partners experienced sleep difficulties, were recruited. Participants completed the Pittsburgh Sleep Quality Index, the Dyadic Adjustment Scale, and gave open-ended reports regarding their sleep every morning for a week. They also took part in an in-depth semistructured interview for couples. The interviews were transcribed verbatim and analyzed using the Critical Phenomenological Method. The participants’ strategies in the face of sleep difficulties fell into three modalities: individual, common and shared, and common and independent. Within these modalities, seven strategies were identified in both research sites: body and mind relaxation before sleep, stress reduction in daily life, reduction of sleep performance anxiety, respect of the partner’s sleep, intervention or drug use to induce sleep or to reduce diurnal sleepiness, diet monitoring, and naps. The present study reveals that the coping strategies used by partners are related not only to the individual, but can be shared, and are closely related to the sociocultural, economic and environmental contexts of their respective countries.

The couple relationship (marriage/cohabitation) is, for most adults, the primary social context of sleep. Although there is a growing literature on couples’ sleep, no qualitative cross-cultural study on this topic has yet been published. The aim of the present study was to explore the strategies used by adult couples with sleep difficulties from two different cultures, as well as the potential sociocultural variations related to these strategies. Six couples in Quebec City (Canada) and five couples in Fortaleza (Brazil), of which one or both partners experienced sleep difficulties, were recruited. Participants completed the Pittsburgh Sleep Quality Index, the Dyadic Adjustment Scale, and gave open-ended reports regarding their sleep every morning for a week. They also took part in an in-depth semistructured interview for couples. The interviews were transcribed verbatim and analyzed using the Critical Phenomenological Method. The participants’ strategies in the face of sleep difficulties fell into three modalities: individual, common and shared, and common and independent. Within these modalities, seven strategies were identified in both research sites: body and mind relaxation before sleep, stress reduction in daily life, reduction of sleep performance anxiety, respect of the partner’s sleep, intervention or drug use to induce sleep or to reduce diurnal sleepiness, diet monitoring, and naps. The present study reveals that the coping strategies used by partners are related not only to the individual, but can be shared, and are closely related to the sociocultural, economic and environmental contexts of their respective countries.