Article2007

ERP Evidence of Enhanced Excitatory and Reduced Inhibitory Processes of Auditory Stimuli During Sleep in Patients With Primary Insomnia

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Abstract

STUDY OBJECTIVES: Increased information processing around the onset of sleep and during sleep has been suggested as an important factor for the pathogenesis of insomnia. The purpose of the present study was to examine the processing of auditory information during sleep in patients with insomnia through the recording of event-related potentials (ERPs). DESIGN: A mixed design was used in which subject group was a between-subject factor and sleep stage and type of tone presented were within-subject factors. PARTICIPANTS: Fifteen patients with primary insomnia and 15 normal sleepers (controls) were studied. MEASUREMENTS AND RESULTS: An odd-ball paradigm was conducted to evoke ERPs throughout the night. Patients with insomnia showed larger N1 and smaller P2 to rare tones, smaller N350 to standard tones, and slower P900 to both tones during the first 5 minutes of continuous stage 2 sleep. No consistent ERP differences were detected between the 2 groups when the waveforms were averaged across the whole night. CONCLUSIONS: Patients with insomnia showed an enhancement in attention and a reduction in the inhibitory process that normally facilitates sleep onset in the beginning part of sleep. The results partially support the hyperarousal theory, ie, enhanced information processing during the initiation of sleep is a contributing factor for insomnia.

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References

1968A manual for standardized terminology, techniques and scoring system for sleep stages in human subjects 1997Psychophysiological insomnia: the behavioural model and a neurocognitive perspective 2004Functional Neuroimaging Evidence for Hyperarousal in Insomnia 1967Psychological and physiological differences between good and poor sleepers.2001Beta/Gamma EEG Activity in Patients with Primary and Secondary Insomnia and Good Sleeper Controls 2000Pre‐sleep cognitive activity: A comparison of sleep‐onset insomniacs and good sleepers 1976Recorded and Reported Sleep in Chronic Primary Insomnia 2000Intrusive thoughts and their relationship to actigraphic measurement of sleep: towards a cognitive model of insomnia

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