Insomnia, nightmares, and fear of sleep in trauma-affected treatment-seeking refugees and asylum seekers: Latent profiles and differences in psychopathology and postmigration living difficulties.

OBJECTIVE

Sleep disturbances are common and persistent in trauma-affected refugees and asylum seekers. Yet, research has mostly focused on insomnia, therefore, (trauma-associated) sleep disturbances like nightmares and fear of sleep are underrepresented in the literature. This study aimed to uncover sleep-symptom profiles (regarding insomnia, nightmares, and fear of sleep) and underlying differences regarding psychopathology and refugee-specific factors.

METHOD: Two hundred two trauma-affected treatment-seeking refugees and asylum seekers were assessed at a psychosocial treatment center. Data were analyzed using latent profile analysis. Emerging profiles were compared regarding group differences of depression, anxiety, and PTSD symptoms, quality of life, and relevant postmigration living difficulties (e.g., asylum status, accommodation, occupation) using exploratory group comparisons.

RESULTS

The burden of sleep disturbances and psychopathology was high. Latent profile analysis revealed three profiles: (a) severe insomnia, nightmares, and high fear of sleep (41%); (b) moderate to severe insomnia and nightmares but low fear of sleep (47%); and (c) low to moderate insomnia without nightmares or fear of sleep (12%). The most affected profile had higher levels of psychopathology, insecure asylum status, and collective accommodation, while the least affected profile included more individuals in youth welfare and private housing.

CONCLUSIONS

This study identified distinct sleep-disturbance profiles among trauma-affected treatment-seeking refugees from a diverse background. Additional fear of sleep emerged as highly prevalent, posing potential challenges for clinical practice. Furthermore, collective accommodation and insecure asylum status were closely associated with aggravated sleep impairment and psychopathology. Our findings emphasize the need for a detailed assessment to align patients' needs and appropriate treatment approaches. (PsycInfo Database Record (c) 2026 APA, all rights reserved).