Article2001

Sleep in the Laboratory and Sleep at Home II: Comparisons of Middle-Aged Insomnia Sufferers and Normal Sleepers

Jack D. Edinger · Lori A. Bastian · Gail R. Marsh · Dorothy Daile · T. Victor Hope · Edmund Shaw +1 more

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Abstract

STUDY OBJECTIVES: The study compared adaptation responses and sleep pattern differences shown by normal sleepers and insomnia sufferers during lab (LPSG) and home (HPSG) polysomnography. DESIGN: A counter-balanced, matched-group design was used. Participants underwent 3 consecutive nocturnal LPSG's and 3 consecutive nocturnal PSG's in their homes (HPSG's). SETTING: The sleep disorders laboratories at affiliated VA and university medical centers. PARTICIPANTS: Thirty-five (18 women) middle-aged (40 to 59 years) noncomplaining normal sleepers and an age-matched sample of 33 (17 women) individuals who met structured interview criteria for persistent primary insomnia were the study participants. MEASUREMENTS AND RESULTS: A series of multivariate and univariate analyses were conducted with 9 common sleep parameters to address study objectives. Bed partner influences were controlled by conducting separate sets of analyses for those with and without routine home bed partners. The interaction of participant type (normal vs. insomnia), sleep setting, and PSG sequence (HPSG 1st vs. LPSG 1st) affected first night values of sleep efficiency and stage 2 sleep among those without routine bed partners, and REM latency and sleep efficiency among those with routine bed partners. Analyses which controlled for first night and sequencing effects showed a significant participant type x sleep setting interaction among those with bed partners. These latter analyses suggested that LPSG's may underestimate the home sleep time of insomnia sufferers and overestimate the sleep continuity of normal sleepers, at least among those who routinely sleep with a bed partner. CONCLUSIONS: The nocturnal recording site may influence adaptation effects and sleep pattern differences noted between insomnia sufferers and normal sleepers.

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References

1968A manual for standardized terminology, techniques and scoring system for sleep stages in human subjects 1989Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention?1985Insomnia and Its Treatment 1987Treatment of Chronic Insomnia by Restriction of Time in Bed 1997Prevalence, burden, and treatment of insomnia in primary care 1997Insomnia in Young Men and Subsequent Depression: The Johns Hopkins Precursors Study 1992The Zurich Study 1997Prevalence of DSM-IV diagnostic criteria of insomnia: Distinguishing insomnia related to mental disorders from sleep disorders

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