Abstract
The link between perfectionism and poor sleep has been intensively debated, and previous
studies on perfectionism-sleep associations have yielded mixed results. Recent research
suggests that the two-dimensional perfectionism model, differentiating perfectionistic
concerns (centered around concerns over imperfections) and perfectionistic strivings
(centered around excessively high personal standards), may reconcile previously inconclusive
findings, as both dimensions might be differentially related to sleep. Thus, to clarify
the perfectionism-sleep link, this meta-analysis investigated relations of perfectionistic
concerns and strivings with two well-established self-report measures of poor sleep.
A systematic literature search yielded 55 effect sizes from 15 studies (N = 10,275) for inclusion in this meta-analysis. Perfectionistic concerns correlated
positively with the Insomnia Severity Index (r+ = 0.221, 95% CI [0.102, 0.333], p = .004) and the Pittsburgh Sleep Quality Index (r+ = 0.248, 95% CI [0.172, 0.321], p < .001). Perfectionistic strivings correlated positively, albeit less strongly, with
the Insomnia Severity Index (r+ = 0.114, 95% CI [0.039, 0.189], p = .010), but not significantly with the Pittsburgh Sleep Quality Index (r+ = 0.028, 95% CI [-0.026, 0.082], p = .247). These meta-analytic findings indicate that perfectionistic concerns are
substantially linked to poor sleep, whereas the relation of perfectionistic strivings
with sleep is less evident. Although the identified associations were less robust
for perfectionistic strivings than for perfectionistic concerns, previously used labels
like “positive” or “adaptive” appear inappropriate for perfectionistic strivings in
the context of sleep.
Keywords
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References
- Epidemiology of insomnia: prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors.Sleep Med. 2006; 7: 123-130https://doi.org/10.1016/j.sleep.2005.08.008
- Societal costs of insomnia.Sleep Med Rev. 2010; 14: 379-389https://doi.org/10.1016/j.smrv.2010.01.003
- Association between insomnia and job stress: a meta-analysis.Sleep Breath. 2018; 22: 1221-1231https://doi.org/10.1007/s11325-018-1682-y
- The role of personality traits in insomnia.Sleep Med Rev. 2010; 14: 61-68https://doi.org/10.1016/j.smrv.2009.07.007
- Perfectionism and adolescent sleep quality: the mediating role of repetitive negative thinking.J Health Psychol. 2019; 24 (*): 1626-1636https://doi.org/10.1177/1359105317693914
- Perfectionism mediates the relationship between insomnia and depressive symptoms.Sleep Biol Rhythms. 2013; 11 (*): 90-98https://doi.org/10.1111/sbr.12009
- No perfect sleep! A systematic review of the link between multidimensional perfectionism and sleep disturbance.J Sleep Res. 2022; : e13548https://doi.org/10.1111/jsr.13548
- Diagnostic and Statistical Manual of Mental Disorders.5th ed. American Psychiatric Association, Arlington, VA2013
- Recommendations for a standard research assessment of insomnia.Sleep. 2006; 29: 1155-1173https://doi.org/10.1093/sleep/29.9.1155
- The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research.Psychiatry Res. 1989; 28: 193-213https://doi.org/10.1016/0165-1781(89)90047-4
- Validation of the insomnia severity index as an outcome measure for insomnia research.Sleep Med. 2001; 2: 297-307https://doi.org/10.1016/S1389-9457(00)00065-4
- A systematic review of instruments for the assessment of insomnia in adults.Nat Sci Sleep. 2020; 12: 377-409https://doi.org/10.2147/NSS.S250918
- A meta-analysis of diagnostic accuracy of three screening tools for insomnia.J Psychosom Res. 2016; 87: 85-92https://doi.org/10.1016/j.jpsychores.2016.06.010
- Cognitive and behavioral therapies in the treatment of insomnia: a meta-analysis.Sleep Med Rev. 2018; 38: 3-16https://doi.org/10.1016/j.smrv.2017.02.001
- The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response.Sleep. 2011; 34: 601-608https://doi.org/10.1093/sleep/34.5.601
- Sleep patterns and insomnia in young adults: a national survey of Norwegian university students.J Sleep Res. 2019; 28: e12790https://doi.org/10.1111/jsr.12790
- Prioritizing sleep health: Public health policy recommendations.Perspect Psycholl Sci. 2015; 10: 733-737https://doi.org/10.1177/1745691615598509
- Insomnia and risk of mortality from all-cause, cardiovascular disease, and cancer: systematic review and meta-analysis of prospective cohort studies.Sleep Med Rev. 2019; 48101215https://doi.org/10.1016/j.smrv.2019.101215
- Insomnia as a predictor of mental disorders: a systematic review and meta-analysis.Sleep Med Rev. 2019; 43: 96-105https://doi.org/10.1016/j.smrv.2018.10.006
- Untreated insomnia increases all-cause health care utilization and costs among Medicare beneficiaries.Sleep, 42, zsz007. American Psychiatric Association, Arlington, VA2019https://doi.org/10.1093/sleep/zsz007
- Insomnia as an interaction between sleep-interfering and sleep-interpreting processes.J Psychosom Res. 2000; 49: 299-310https://doi.org/10.1016/S0022-3999(00)00150-1
- A behavioral perspective on insomnia treatment.Psychiatr Clin NAm. 1987; 10: 541-553https://doi.org/10.1016/S0193-953X(18)30532-X
- The effect of evening bright light in delaying the circadian rhythms and lengthening the sleep of early morning awakening insomniacs.Sleep. 1993; 16: 436-443https://doi.org/10.1093/sleep/16.5.436
- Biological and clinical insights from genetics of insomnia symptoms.Nat Genet. 2019; 51: 387-393https://doi.org/10.1038/s41588-019-0361-7
- Personality and sleep quality: evidence from four prospective studies.Health Psychol. 2018; 37: 271-281https://doi.org/10.1037/hea0000577
- Perfectionism and maladjustment: an overview of theoretical, definitional, and treatment is-sues.in: Hewitt P.L. Flett G.L. Perfectionism: Theory, Research, and Treatment. American Psychological Association, Washington, DC2002: 5-31
- Perfectionism is increasing over time: a meta-analysis of birth cohort differences from 1989 to 2016.Psychol Bull. 2019; 145: 410-429
- Neurosis and Human Growth.Norton, New York1950https://doi.org/10.1001/jama.1951.02920200064035
- The dimensions of perfectionism.Cogn Ther Res. 1990; 14: 449-468https://doi.org/10.1007/BF01172967
- Dimensions of perfectionism in unipolar depression.J Abnorm Psychol. 1991; 100: 98-101https://doi.org/10.1037/0021-843X.100.1.98
- The revised almost perfect scale.Measurement Eval Couns Dev. 2001; 34: 130-145https://doi.org/10.1080/07481756.2002.12069030
- A new measure of perfectionism: the perfectionism inventory.J Personal Assess. 2004; 82: 80-91https://doi.org/10.1207/s15327752jpa8201_13
- Positive conceptions of perfectionism: approaches, evidence, challenges.Personal Soc Psychol Rev. 2006; 10: 295-319https://doi.org/10.1207/s15327957pspr1004_2
- Measures of perfectionism.in: Boyle G.J. Saklofske D.H. Matthews G. Measures of Personality and Social Psychological Constructs. Elsevier, San Diego, CA2015: 595-618
- Is perfectionism good, bad, or both? Examining models of the perfectionism construct.Personal Individ Differ. 2004; 36: 1373-1385https://doi.org/10.1016/S0191-8869(03)00235-6
- Multidimensional perfectionism and burnout: a meta-analysis.Personal Soc Psychol Rev. 2016; 20: 269-288https://doi.org/10.1177/1088868315596286
- A meta-analysis of perfectionism and academic achievement.Educ Psychol Rev. 2019; 31: 967-989https://doi.org/10.1007/s10648-019-09484-2
- A meta-analytic and conceptual update on the associations between procrastination and multidimensional perfectionism.Eur J Personal. 2017; 31: 137-159https://doi.org/10.1002/per.2098
- The perniciousness of perfectionism: a meta-analytic review of the perfectionism–suicide relationship.J Personal. 2018; 86: 522-542https://doi.org/10.1111/jopy.12333
- The relationship between perfectionism and psychopathology: a meta-analysis.J ClinPsychol. 2017; 73: 1301-1326https://doi.org/10.1002/jclp.22435
- A dual process model of perfectionism based on reinforcement theory.Behav Modif. 1998; 22: 372-390https://doi.org/10.1177/01454455980223010
- On the distinction between personal standards perfectionism and excellencism: a theory elaboration and research agenda.Perspect Psychol Sci. 2019; 14: 197-215https://doi.org/10.1177/1745691618797940
- Positive versus negative perfectionism in psychopathology: a comment on Slade and Owens's dual process model.Behav Modif. 2006; 30: 472-495https://doi.org/10.1177/0145445506288026
- A comparative examination of the correlates of self-oriented perfectionism and conscientious achievement striving in male cricket academy players.Psychol Sport Exerc. 2010; 11: 162-168https://doi.org/10.1016/j.psychsport.2009.11.001
- Healthy perfectionism” is an oxymoron!: Reflections on the psychology of perfectionism and the sociology of science.J Second Gift Educ. 2000; 11: 197-208https://doi.org/10.4219/jsge-2000-631
- Is perfectionism a vulnerability factor for depressive symptoms, a complication of depressive symptoms, or both? A meta-analytic test of 67 longitudinal studies.Clin Psychol Rev. 2021; 101982https://doi.org/10.1016/j.cpr.2021.101982
- Practice of Sleep Medicine - Sleep Disorders in Children and Adults.Springer, Cham, Switzerland2021
- Dysfunctional sleep-related cognition and anxiety mediate the relationship between multidimensional perfectionism and insomnia symptoms.Cogn Process. 2020; 21 (*): 141-148https://doi.org/10.1007/s10339-019-00937-8
- Perfectionism related to self-reported insomnia severity, but not when controlled for stress and emotion regulation.Neuropsychiatr Dis Treat. 2015; 11 (*): 263-271https://doi.org/10.2147/NDT.S74905
- Sleeping perfectly? Trait perfectionism, perceived stress, and sleep quality.Personal Individ Differ. 2020; 167 (*)110244https://doi.org/10.1016/j.paid.2020.110244
- Perfectionism and insomnia in adolescents: the role of vulnerability to stress and gender.J Adolesc. 2020; 85 (*): 70-79https://doi.org/10.1016/j.adolescence.2020.10.003
- Classroom environment and perceived sleep disturbance in adolescents: test of the mediating and moderating roles of perfectionism.Curr Psychol. 2020; 39 (*): 1732-1739https://doi.org/10.1007/s12144-018-9872-0
- Does publication bias inflate the apparent efficacy of psychological treatment for major depressive disorder? A systematic review and meta-analysis of US National Institutes of Health-funded trials.Plos One. 2015; 10e0137864https://doi.org/10.1371/journal.pone.0137864
- The Psychology of Perfectionism.Routledge/Taylor & Francis Group, Abingdon, UK/New York2018
- Picture perfect—how seeking perfection influences sleep and romantic relationships.Somnologie. 2018; 22 (*): 163-167https://doi.org/10.1007/s11818-018-0172-6
- Being kind to self is being kind to sleep? A structural equation modelling approach evaluating the direct and indirect associations of self-compassion with sleep quality, emotional distress and mental well-being.Curr Psychol. 2022; (*): 1-14https://doi.org/10.1007/s12144-021-02661-z
- Perfectionism and polysomnography-determined markers of poor sleep.J Clin Sleep Med. 2017; 13: 1319-1326https://doi.org/10.5664/jcsm.6806
- Cognitive behavioural therapy for insomnia does not appear to have a substantial impact on early markers of cardiovascular disease: a preliminary randomized controlled trial.J Sleep Res. 2020; 29 (*): e13102https://doi.org/10.1111/jsr.13102
- Robust variance estimation in meta-regression with dependent effect size estimates.Res Synth Methods. 2010; 1: 39-65https://doi.org/10.1002/jrsm.5
Fisher, Z., Tipton, E., & Zhipeng, H. (2017). robumeta: Robust variance meta-regression. R package version 2.0. Available at: https://cran.r-project.org/package=robumeta. Accessed 22, August 2022.
- R: A Language and Environment for Statistical Computing.R Foundation for Statistical Computing, 2021 (Available at:) (Accessed 22, August 2022)
- Meta-analysis with robust variance estimation: expanding the range of working models.Prev Sci. 2021; : 1-14https://doi.org/10.1007/s11121-021-01246-3
- Combining estimates of effect size.in: Cooper H. Hedges L.V. Valentine J.C. The Handbook of Research Synthesis and Meta-analysis. Russell Sage Foundation, New York2009: 257-277
- Methods of Meta-analysis: Correcting Error and Bias in Research Findings.2nd ed. Sage, Thousand Oaks, CA2004
- Contour-enhanced meta-analysis funnel plots help distinguish publication bias from other causes of asymmetry.J Clin Epidemiol. 2008; 61: 991-996https://doi.org/10.1016/j.jclinepi.2007.11.010
- Trim and fill: a simple funnel plot-based method of testing and adjusting for publication bias in meta-analysis.Biometrics. 2000; 56: 455-463https://doi.org/10.1111/j.0006-341X.2000.00455.x
- Conducting meta-analyses in R with the metafor package.J Stat Softw. 2010; 36: 1-48https://doi.org/10.18637/jss.v036.i03
- A historical review of publication bias.Res Synth Methods. 2020; 11: 725-742https://doi.org/10.1002/jrsm.1452
- Bias in meta-analysis detected by a simple, graphical test.BMJ ClinRes. 1997; 315: 629-634https://doi.org/10.1136/bmj.316.7129.469
- P value–driven methods were underpowered to detect publication bias: analysis of Cochrane review meta-analyses.J Clin Epidemiol. 2020; 118: 86-92https://doi.org/10.1016/j.jclinepi.2019.11.011
- Effect size guidelines for individual differences researchers.Personal Individ Differ. 2016; 102: 74-78https://doi.org/10.1016/j.paid.2016.06.069
- Neuroticism, rumination, negative affect, and sleep: examining between-and within-person associations.Personal Individ Differ. 2018; 123: 217-222https://doi.org/10.1016/j.paid.2017.11.023
- Association between personality traits and sleep quality in young Korean women.Plos One. 2015; 10e0129599https://doi.org/10.1371/journal.pone.0129599
- Multidimensional Perfectionism and the big five personality traits: a meta-analysis.Eur J Personal. 2019; 33: 176-196https://doi.org/10.1002/per.2186
- Perfectionistic tendencies in insomnia patients' behavior during psychometric testing.Behav Sleep Med. 2015; 13: 387-394https://doi.org/10.1080/15402002.2014.919918
- Insomnia disorder subtypes derived from life history and traits of affect and personality.Lancet Psychiatry. 2019; 6: 151-163https://doi.org/10.1016/S2215-0366(18)30464-4
- Does perfectionism increase the risk for dropout from cognitive behavioral therapy for insomnia?.J Clin Sleep Med. 2018; 14: 487-488https://doi.org/10.5664/jcsm.7012
- Cognitive-Behavioral Treatment of Perfectionism.Guilford, New York2014
- A proposed framework for preventing perfectionism and promoting resilience and mental health among vulnerable children and adolescents.Psychol Sch. 2014; 51: 899-912https://doi.org/10.1002/pits.21792
- Personality and healthy sleep: the importance of conscientiousness and neuroticism.Plos One. 2014; 9: e90628https://doi.org/10.1371/journal.pone.0090628
- Small sample adjustments for robust variance estimation.PsycholMethods. 2015; 20: 375-393https://doi.org/10.1037/met0000011
- How should discrepancy be assessed in perfectionism research? A psychometric analysis and proposed refinement of the Almost Perfect Scale–Revised.J Psychoeduc Assess. 2016; 34: 718-732https://doi.org/10.1177/0734282916651382
- Addressing concerns about how perfectionistic discrepancy should be measured with the Revised Almost Perfect Scale.Assessment. 2019; 26: 432-444https://doi.org/10.1177/1073191117702241
- Gender difference in the prevalence of insomnia: a meta-analysis of observational studies.Front Psychiatry. 2020; 11577429https://doi.org/10.3389/fpsyt.2020.577429
- Combined effects, total unique effects and relative weights of perfectionism.Personal IndividDiffer. 2021; 183111136https://doi.org/10.1016/j.paid.2021.111136
- Insomnia and personality-A network approach.Brain Sci. 2017; 7: 28https://doi.org/10.3390/brainsci7030028
- Convergent and discriminant validation by the multitrait-multimethod matrix.Psychol Bull. 1959; 56: 81-105https://doi.org/10.1037/h0046016
- Objective sleep and personality.J Clin Sleep Med. 2018; 14: 485-486https://doi.org/10.5664/jcsm.7010
- Anxiety mediates the relationship between perfectionism and insomnia symptoms: a longitudinal study.Plos One. 2015; 10 (*)e0138865https://doi.org/10.1371/journal.pone.0138865
- Dimensions of perfectionism and tinnitus distress.Psychol Health Med. 2005; 10 (*): 78-87https://doi.org/10.1080/13548500512331315389
- Fit to perform: an investigation of higher education music students’ perceptions, attitudes, and behaviors toward health.Front Psychol. 2017; 8 (*): 1558https://doi.org/10.3389/fpsyg.2017.01558
- The efficacy of randomized controlled trials of cognitive behaviour therapy for perfectionism: a systematic review and meta-analysis.Cogn Behav Ther. 2022; 51: 170-184https://doi.org/10.1080/16506073.2021.1952302
- The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: A systematic review and meta-analysis.Sleep Med Rev. 2016; 25: 52-73https://doi.org/10.1016/j.smrv.2015.01.009
- Too imperfect to fall asleep: perfectionism, pre-sleep counterfactual processing, and insomnia.Front Psychol. 2018; 9 (*): 1288https://doi.org/10.3389/fpsyg.2018.01288
- MIPS: Multidimensional Inventory of Perfectionism in Sport (English Version). School of Psychology.University of Kent, Kent, UK2006
- The relationship of perfectionism with psychological symptoms in cancer patients and the contributing role of hyperarousability and coping.PsycholHealth. 2017; 32 (*): 381-401https://doi.org/10.1080/08870446.2016.1273354
Palo S, Das M. Perfectionist? You don't need to sleep: An interplay of daytime sleepiness and task performance. Journal of Rational-Emotive & Cognitive-Behavior Therapy 2021;39:145–162. https://doi.org/10.1007/s10942-020-00362-3
Vincent NK, Walker JR. Perfectionism and chronic insomnia. J Psychosom Res 2000;49:349–354. https://doi.org/10.1016/S0022-3999(00)00175-6
Article info
Publication history
Published online: November 15, 2022
Accepted:
September 28,
2022
Received in revised form:
August 24,
2022
Received:
May 9,
2022
Identification
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© 2022 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.
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- The joy of repetition: Perfectionism and poor sleep Comment on "Multidimensional perfectionism and poor sleep: A meta-analysis of bivariate associations"Sleep Health: Journal of the National Sleep FoundationVol. 9Issue 2
- PreviewAccording to Spielman's influential 3P model, disturbed sleep is influenced by various predisposing, precipitating, and perpetuating factors. These may be behavioral, biological, environmental, or psychological in nature.1 Personality is considered a predisposing, and potentially perpetuating, factor. Indeed, literature concurs disturbed sleep to be associated with increased neuroticism, internalization, anxious concerns, and perfectionism.2 The experience of multidimensional perfectionism (ie, disposition for excessive critical self-evaluation and high standards for oneself) appears to be the most frequently examined, and most prominent personality characteristic associated with poor sleep.
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