Does REM sleep contribute to subjective wake time in primary insomnia? A comparison of polysomnographic and subjective sleep in 100 patients.

Department of Psychiatry and Psychotherapy, University Medical Center, Freiburg, Germany.
Journal of Sleep Research (Impact Factor: 2.95). 07/2008; 17(2):180-90. DOI: 10.1111/j.1365-2869.2008.00651.x
Source: PubMed

ABSTRACT Primary insomnia (PI) is characterized by low subjective sleep quality which cannot always be verified using polysomnography (PSG). To shed light on this discrepancy, subjective estimates of sleep and PSG variables were compared in patients with PI and good sleeper controls (GSC). 100 patients with PI (age: 42.57 +/- 12.50 years, medication free for at least 14 days) and 100 GSC (41.12 +/- 13.99 years) with a sex distribution of 46 men and 54 women in each group were included. Both PSG and questionnaire variables showed clear impairments of sleep quality in PI compared with GSC. The arousal index within total sleep time was increased, which was mainly because of a strong increase within rapid eye movement (REM) sleep. Subjectively, more PI than GSC subjects estimated wake times longer than obtained from PSG. Linear modeling analysis of subjective wake time in terms of PSG parameters revealed that in addition to PSG defined wake time, REM sleep time contributed significantly to subjective wake time. This REM sleep contribution was larger for PI than for GSC subjects. The findings suggest that REM sleep-related processes might contribute to subjectively disturbed sleep and the perception of waking time in patients with PI.

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    Sleep Medicine 10/2014; 15(10). DOI:10.1016/j.sleep.2014.05.025 · 3.10 Impact Factor
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    ABSTRACT: BackgroundNormal sleep continuity and architecture show remarkable inter-individual variability. Previous studies suggest that brain morphology may explain inter-individual differences in sleep variables.MethodThirty-eight healthy subjects spent two consecutive nights at the sleep laboratory with polysomnographic monitoring. Furthermore, high-resolution T1-weighted MRI datasets were acquired in all participants. EEG sleep recordings were analyzed using standard sleep staging criteria and power spectral analysis. Using the FreeSurfer software for automated segmentation, 174 variables were determined representing the volume and thickness of cortical segments and the volume of subcortical brain areas. Regression analyses were performed to examine the relationship with polysomnographic and spectral EEG power variables.ResultsThe analysis did not provide any support for the a-priori formulated hypotheses of an association between brain morphology and polysomnographic variables. Exploratory analyses revealed that the thickness of the left caudal anterior cingulate cortex was positively associated with EEG beta2 power (24–32 Hz) during REM sleep. The volume of the left postcentral gyrus was positively associated with periodic leg movements during sleep (PLMS).ConclusionsThe function of the anterior cingulate cortex as well as EEG beta power during REM sleep have been related to dreaming and sleep-related memory consolidation, which may explain the observed correlation. Increased volumes of the postcentral gyrus may be the result of increased sensory input associated with PLMS. However, due to the exploratory nature of the corresponding analyses, these results have to be replicated before drawing firm conclusions.
    PLoS ONE 10/2014; 9(10):e109336. DOI:10.1371/journal.pone.0109336 · 3.53 Impact Factor
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