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Prospective comparison of subjective arousal during the pre‐sleep period in primary sleep‐onset insomnia and normal sleepers
Author(s) -
ROBERTSON JENNIFER A.,
BROOMFIELD NIALL M.,
ESPIE COLIN A.
Publication year - 2007
Publication title -
journal of sleep research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.297
H-Index - 117
eISSN - 1365-2869
pISSN - 0962-1105
DOI - 10.1111/j.1365-2869.2007.00579.x
Subject(s) - arousal , bedtime , psychology , evening , insomnia , sleep onset , audiology , bedroom , sleep (system call) , polysomnography , morning , clinical psychology , developmental psychology , psychiatry , medicine , electroencephalography , neuroscience , physics , civil engineering , astronomy , computer science , engineering , operating system
Summary Psychophysiological insomnia (PI) is the most common insomnia subtype, representing 12–15% of all sleep centre referrals. Diagnostic guidelines describe PI as an intrinsic sleep disorder involving both hyperarousal and learned sleep‐preventing associations. Whilst evidence for the first component is reasonably compelling, evidence for learned (conditioned) sleep effects is markedly lacking. Indeed, to date no study has attempted to capture directly the conditioned arousal effect assumed to characterize the disorder. Accordingly, the present study explored variations in subjective arousal over time in 15 PI participants (sleep onset type) and 15 normal sleepers (NS). Self‐report measures of cognitive arousal, somatic arousal and sleepiness were taken at three time points: 3 h before bedtime (early to mid‐evening); 1 h before bedtime (late evening); and in the bedroom at lights out (bedtime) across four, 24‐h cycles. Fluctuations in mean arousal and sleepiness values, and in day‐to‐day variation were examined using analyses of variance. Participants with PI were significantly more cognitive aroused and significantly less sleepy relative to NS, within the bedroom environment. These results support the tenet of conditioned mental arousal to the bedroom, although competing explanations cannot be ruled out. Results are discussed with reference to extant insomnia models.