Reported Chronic Insomnia Is Independent of Poor Sleep as Measured by Electroencephalography

Rosa, Roger R.; Bonnet, Michael H.

doi:10.1097/00006842-200007000-00004

Cited by 144 publications

(86 citation statements)

References 24 publications

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“…Mean value heat and cold pain thresholds for frontal and thenar region, three tests on each side; Mann-Whitney U-test: (*)P = 0.05, *P < 0.05, **P < 0.01, ***P < 0.001. the groups (Table 2). It has been shown that a history of chronic insomnia does not predict poor EEG sleep (23). However, increased slow-wave sleep, as found in the present study among TTH and NSM patients, is one factor that usually indicates better sleep quality (24).…”

Section: Discussionsupporting

confidence: 45%

Sleep quality and arousal in migraine and tension-type headache: the headache-sleep study

et al. 2014

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Objectives -The present paper summarizes and compares data from our studies on subjective and objective sleep quality and pain thresholds in tension-type headache (TTH), migraine, and controls. Material and methods -In a blinded controlled explorative study, we recorded polysomnography (PSG) and pressure, heat, and cold pain thresholds in 34 controls, 20 TTH, and 53 migraine patients. Sleep quality was assessed by questionnaires, sleep diaries, and PSG. Migraineurs who had their recordings more than 2 days from an attack were classified as interictal while the rest were classified as either preictal or postictal. Interictal migraineurs (n = 33) were also divided into two groups if their headache onsets mainly were during sleep and awakening (sleep migraine, SM), or during daytime and no regular onset pattern (non-sleep migraine, NSM). TTH patients were divided into a chronic or episodic group according to headache days per month. Results -Compared to controls, all headache groups reported more anxiety and sleep-related symptoms. TTH and NSM patients reported more daytime tiredness and tended to have lower pain thresholds. Despite normal sleep times in diary, TTH and NSM had increased slow-wave sleep as seen after sleep deprivation. Migraineurs in the preictal phase had shorter latency to sleep onset than controls. Except for a slight but significantly increased awakening index SM, patients differed little from controls in objective measurements. Conclusions -We hypothesize that TTH and NSM patients on the average need more sleep than healthy controls. SM patients seem more susceptible to sleep disturbances. Inadequate rest might be an attack-precipitating-and hyperalgesia-inducing factor.

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Section: Discussionsupporting

confidence: 45%

Sleep quality and arousal in migraine and tension-type headache: the headache-sleep study

et al. 2014

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“…29,32 Psychological factors such as personality characteristics and mood disorders have been linked to misperception. 9,33,34 Aspects of sleep physiology have been associated with misperception, including hyperarousal, 35 alpha frequency intrusion into slow wave sleep, 11 and the cyclic alternating pattern 12 (but this has not been seen in other work). 36 In addition, in regards to the hyperarousal theory of insomnia, 35 insomnia patients have increased basal metabolic rate and longer sleep latencies during nap studies, among other physiological changes.…”

Section: Perception Of Total Sleep Timementioning

confidence: 99%

Sleep Fragmentation Does Not Explain Misperception of Latency or Total Sleep Time

Saline

Goparaju

Bianchi

2016

Journal of Clinical Sleep Medicine

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Study Objectives: Perception of sleep-wake times may differ from objective measures, although the mechanisms remain elusive. Quantifying the misperception phenotype involves two operational challenges: defining objective sleep latency and treating sleep latency and total sleep time as independent factors. We evaluated a novel approach to address these challenges and test the hypothesis that sleep fragmentation underlies misperception. Methods: We performed a retrospective analysis on patients with or without obstructive sleep apnea during overnight diagnostic polysomnography in our laboratory (n = 391; n = 252). We compared subjective and objective sleep-wake durations to characterize misperception. We introduce a new metric, sleep during subjective latency (SDSL), which captures latency misperception without defining objective sleep latency and allows correction for latency misperception when assessing total sleep time (TST) misperception. Results:The stage content of SDSL is related to latency misperception, but in the opposite manner as our hypothesis: those with > 20 minutes of SDSL had less N1%, more N3%, and lower transition frequency. After adjusting for misperceived sleep during subjective sleep latency, TST misperception was greater in those with longer bouts of REM and N2 stages (OSA patients) as well as N3 (non-OSA patients), which also did not support our hypothesis. Conclusions: Despite the advantages of SDSL as a phenotyping tool to overcome operational issues with quantifying misperception, our results argue against the hypothesis that light or fragmented sleep underlies misperception. Further investigation of sleep physiology utilizing alternative methods than that captured by conventional stages may yield additional mechanistic insights into misperception. I NTRO DUCTI O NAssessment of sleep often includes subjective reports of sleepwake durations, in clinical practice as well as epidemiological studies of sleep duration.1 However, when concurrent objective sleep measurements are available, it is not uncommon to observe that the subjective responses may differ. Underestimation of total sleep time has been previously observed in healthy adults under experimental circumstances, as well as insomnia patients during polysomnography (PSG).2-4 This phenomenon, sometimes termed misperception, may manifest as either overestimating sleep latency (SL) or underestimating total sleep time (TST), or both.4 Some patients with obstructive sleep apnea (OSA) may also exhibit misperception, though perhaps not to the same extent as those with insomnia symptoms. 5-7Several hypotheses have arisen regarding the basis for misperception, although a unified explanation remains elusive. For example, misperception has been linked with anxiety and mood, 3,8 personality traits, and sleep physiology measures such as electroencephalogram patterns of alpha-delta sleep or cyclic alternating pattern and high frequency electroencephalography (EEG) content. [9][10][11][12][13] In addition, we previously investigated possible relat...

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“…The disturbance and curtailment of sleep have also been shown to have an impact on metabolic parameters. Insomniacs have been shown to have higher 24-h ACTH levels and cortisol secretion (8,29), elevated urinary catecholamine concentrations (12), and higher sleep-to-awake ratio for metabolic parameters (13). In an experimental study by Spiegel et al (14), sleep debt had an impact on carbohydrate metabolism and endocrine function in young men.…”

Section: Statisticsmentioning

confidence: 99%

High Incidence of Diabetes in Men With Sleep Complaints or Short Sleep Duration

2005

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OBJECTIVE -The aim of this study was to investigate the possible relationship among sleep complaints, sleep duration, and the development of diabetes prospectively over a 12-year period in a middle-aged Swedish population. RESEARCH DESIGN AND METHODS-A random sample of 2,663 subjects aged 45-65 years living in mid-Sweden were sent a postal questionnaire including questions about sleep complaints, sleep duration, sociodemographic characteristics, behavioral risk factors, medical conditions, and depression (response rate 70.2%). Twelve years later, a new questionnaire with almost identical questions was sent to all the survivors (n ϭ 1,604) in 1995, and the questionnaire was answered by 1,244 subjects (77.6%).RESULTS -Men reporting new diabetes at follow-up more often reported short sleep duration (Յ5 h per night) (16.0 vs. 5.9%, P Ͻ 0.01), difficulties initiating sleep (16.0 vs. 3.1%, P Ͻ 0.001), and difficulties maintaining sleep (28.0 vs. 6.3%, P Ͻ 0.001) at baseline than men who did not develop diabetes. Women reporting new diabetes at follow-up reported long sleep duration (Ն9 h per night) more often at baseline than women not developing diabetes (7.9 vs. 2.4%, P Ͻ 0.05). In multiple logistic regression models, the relative risk (95% CI) for development of diabetes was higher in men with short sleep duration (2.8 [1.1-7.3]) or difficulties maintaining sleep (4.8 [1.9 -12.5]) after adjustment for age and other relevant risk factors. Short or long sleep duration or sleep complaints did not influence the risk of new diabetes in women.CONCLUSIONS -Difficulties maintaining sleep or short sleep duration (Յ5 h) are associated with an increased incidence of diabetes in men. Diabetes Care 28:2762-2767, 2005D iabetes is associated with increased frequency of sleep complaints (1-4), and this may be due to the disease itself as well as to physical complications of the disease (3,5). However, sleep disturbances may also play a primary role in the pathophysiology of diabetes. Data have demonstrated that individuals suffering from poor sleep have increased arousal and increased physiological activation (6 -13). Experimentally induced sleep debt has been found to be associated with increased activation in the hypothalamic-pituitary-adrenal axis as indexed by elevated evening cortisol levels and impaired glucose tolerance (14). These findings indicate that disturbance and curtailment of sleep may be risk factors for the development of insulin resistance. The insulin resistance syndrome, also known as the metabolic syndrome, is a cluster of risk factors for adult-onset diabetes, and it usually consists of obesity, dyslipidemia, hyperglycemia, and hypertension (15).In a sample of healthy middle-aged men in Sweden, Nilsson et al. (16) found that difficulties in falling asleep or regular use of hypnotic drugs was associated with development of diabetes when adjustment was made for several risk factors. A 10-year follow-up survey of women aged 30 -55 years enrolled in the Nurses Health Study in the U.S. has shown that both short ...

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Reported Chronic Insomnia Is Independent of Poor Sleep as Measured by Electroencephalography

Cited by 144 publications

References 24 publications

Sleep quality and arousal in migraine and tension-type headache: the headache-sleep study

Sleep quality and arousal in migraine and tension-type headache: the headache-sleep study

Sleep Fragmentation Does Not Explain Misperception of Latency or Total Sleep Time

High Incidence of Diabetes in Men With Sleep Complaints or Short Sleep Duration

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