Authors: Leena Alharbi , Shaden Alzamil , Sarah Almofarij , Aisha Alshibli , Sarah Baljun , Sarah Alwaridah , Hessa Alkhalaf , Ghaida Alghubaywi , Aram Alsuhaibani , Tabinda Hasan

Abstract

Background: Misophonia is characterized by intense emotional and behavioral responses to specific sounds and may interfere with daily functioning. Its relationship with insomnia remains insufficiently studied, particularly among adults in Saudi Arabia.

Objectives: To examine DVMSQ-based misophonia symptom profiles, trigger phenomenology, functional impairment, and the association between misophonia and insomnia among Saudi adults participating in an online survey.

Methods:  A cross-sectional online survey was completed by 1,001 adults residing in Saudi Arabia. After removing three duplicate responses, 998 participants were included in the primary analysis. Misophonia was classified using the Duke-Vanderbilt Misophonia Screening Questionnaire as no profile, subclinical profile, or clinically significant profile. Insomnia Severity Index (ISI) was used to assess insomnia. Descriptive statistics, chi-square tests, multinomial and ordinal logistic regression and sensitivity analyses were conducted. Adjusted models included demographic, socioeconomic, mental-health, chronic-illness, and auditory variables.

Results: Of the participants, 61.1% had no misophonia screening profile, 15.1% had a subclinical profile, and 23.7% had a clinically significant profile. Chewing and nasal or sniffing sounds were the most frequently reported triggers. Common reactions included sound blocking, escape urges, concentration difficulty, irritation, anger, disgust, and avoidance. Moderate-to-severe insomnia symptoms were present in 28.7% of the sample. Compared with participants with no profile, those with clinically significant and subclinical profiles had higher adjusted odds of greater insomnia severity: adjusted OR = 3.19, 95% CI [2.37, 4.30], and adjusted OR = 1.59, 95% CI [1.13, 2.24], respectively. Female sex, younger age, and self-reported mental-health conditions were associated with clinically significant profiles.

Conclusions: More severe misophonia screening profiles were associated with greater insomnia severity. Longitudinal research using culturally validated measures and representative sampling is needed.

Keywords: Misophonia, insomnia, Saudi Arabia, sound intolerance, DVMSQ, cross-sectional study.