Abstract Introduction Anxiety and insomnia are positively bidirectionally related (Xue et al., 2025). However, culturally specific expressions of anxiety are understudied among South Asians. Since South Asians experience distress somatically and standardized anxiety measures lack somatic emphasis, underreporting can occur (Karasz et al., 2013). Tension is a culturally relevant measure of anxiety that captures somatization (Weaver α = 0.91), and GAD-7 (7 items; α = 0.91). Results We conducted an exploratory analysis testing the relation between self-reported insomnia (Tension Scale) and somatic/psychological symptoms from the Tension Scale and GAD-7, applying false discovery rate corrections. Reported insomnia correlated positively with most Tension symptoms (p 0.05); Emotional (sadness, anxiousness, anger, helplessness r = 0.29 – 0.43), Somatic (stomach issues, headaches, pain in body, chest pains, breathlessness, dizziness, shakiness, coldness, hair turning white/falling out, loss of control of hands/feet, and period problems r = 0.24 – 0.40), and Cognitive/Behavioral (trouble concentrating, feelings of running away, tiredness, and wanting to be alone r = 0.36 – 0.50), but not vaginal discharge, feeling hot, sexual problems and homesickness. Reported insomnia correlated positively with most GAD-7 symptoms (p 0.05); fear something awful may happen, non-stop worry, nervousness, restlessness, difficulty relaxing, and excessive worry (r = 0.28 – 0.42), but not irritability. Conclusion Across anxiety measures, self-reported insomnia was significantly associated with somatic and psychological symptoms. The GAD-7 lacks somatic emphasis which the Tension scale encapsulates. The relation between somatic anxiety symptoms and self-reported insomnia suggests physiological concerns to target when addressing sleep related issues. Somatization in South Asians are better captured by the Tension scale than the GAD-7. Future studies should investigate causality of sleep pathology and somatic symptoms. Support (if any) Cleveland State University’s Graduate Student Research Award (2024-2025).
Gupta et al. (Fri,) studied this question.