There is preliminary evidence that poor sleep quality is associated with emotional problems following loss, including symptoms of prolonged grief disorder (PGD) and depression. We conducted two studies to improve existing knowledge about the role of sleep difficulties in recovery from loss. Study 1 that relied on self-reported data from a heterogeneous sample of 177 bereaved individuals replicated prior findings of a linkage between increased sleep difficulties and increased PGD severity. This study also suggested that sleep difficulties are more strongly associated with depression than with PGD. In Study 2, we examined whether prior evidence that sleep complaints are a residual symptom of PGD treatment could be replicated in a sample of 43 bereaved individuals who underwent cognitive behavioural therapy for PGD. Outcomes showed that, although sleep difficulties declined significantly during this cognitive behavioural therapy, after this therapy, over half of all patients still had sleep difficulties above the average sleep difficulties observed in the general Dutch population. 1. Introduction A growing body of empirical studies has shown that an estimated 5 to 10% of people confronted with the death of a loved one develop psychological problems that include generalized anxiety, posttraumatic stress disorder (PTSD), depression, and prolonged grief disorder (PGD) (for reviews see [1, 2]). PGD is characterized by persistent yearning for the deceased, preoccupation with the loss, bitterness, and difficulties to accept the loss [1–3]. A number of empirical studies have shed light on risk factors for PGD and associated disorders following loss; for instance, in a recent review, Burke and Neimeyer [4] conclude that low levels of social support, the loss having a violent cause, being a spouse or parent of the deceased, insecure attachment, and high neuroticism were among the most important prospective predictors of poor bereavement outcome. Relatively few studies have yet examined sleep difficulties as a risk factor for postloss psychopathology. Notably, poor sleep quality is a risk factor for different forms of psychopathology, including depression and PTSD [5–7]. A small but growing literature has shown that poor sleep quality is also associated with emotional problems following loss. For instance, several studies have found a positive association between elevated symptom-levels of PGD and more severe sleep disturbances (e.g., [8–10]). Of particular interest is that Germain et al. [11] found that, among bereaved individuals who underwent successful treatment
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