Information Processing at Sleep Onset and During Sleep in Patients With Insomnia
| Status: | Completed |
|---|---|
| Conditions: | Insomnia Sleep Studies |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 25 - 45 |
| Updated: | 4/21/2016 |
| Start Date: | June 2008 |
| End Date: | July 2010 |
Chronic insomnia is thought to occur as a result of hyperarousal. While there is a wealth of
data to support this position, there is a lack of research to define how hyperarousal
interferes with sleep initiation, maintenance, and the perception of sleep quality and
quantity. We propose to use Event-related Potential (ERP) techniques to evaluate information
processing at sleep onset and during sleep. ERP measures of information processing have been
well established in good sleepers; they have not been, however, applied to the problem of
insomnia. The goal of the project is to examine the premise that the occurrence and severity
of insomnia is fundamentally related to a neurobiologic preparedness to "attend to" and
"identify" environmental stimuli. Following an extensive screening, patients with insomnia
and good sleepers will participate in two experimental conditions, requiring that they spend
four nights in the sleep laboratory over a two week period. ERP data will be gathered prior
to, following, and during sleep.
The ultimate objectives for this line of research are to determine 1) if insomnia is
associated with a failure to inhibit information processing at sleep onset and/or during
sleep, 2) if the failure to inhibit information processing at sleep onset and/or during
sleep is associated with the occurrence and/or severity of insomnia symptoms, 3) what brain
regions are functioning differently so as to give rise to information processing
abnormalities, and 4) the extent to which pharmacologic and/or Cognitive Behavioral
treatment for insomnia alters information processing abnormalities and/or the associated
brain activity.
data to support this position, there is a lack of research to define how hyperarousal
interferes with sleep initiation, maintenance, and the perception of sleep quality and
quantity. We propose to use Event-related Potential (ERP) techniques to evaluate information
processing at sleep onset and during sleep. ERP measures of information processing have been
well established in good sleepers; they have not been, however, applied to the problem of
insomnia. The goal of the project is to examine the premise that the occurrence and severity
of insomnia is fundamentally related to a neurobiologic preparedness to "attend to" and
"identify" environmental stimuli. Following an extensive screening, patients with insomnia
and good sleepers will participate in two experimental conditions, requiring that they spend
four nights in the sleep laboratory over a two week period. ERP data will be gathered prior
to, following, and during sleep.
The ultimate objectives for this line of research are to determine 1) if insomnia is
associated with a failure to inhibit information processing at sleep onset and/or during
sleep, 2) if the failure to inhibit information processing at sleep onset and/or during
sleep is associated with the occurrence and/or severity of insomnia symptoms, 3) what brain
regions are functioning differently so as to give rise to information processing
abnormalities, and 4) the extent to which pharmacologic and/or Cognitive Behavioral
treatment for insomnia alters information processing abnormalities and/or the associated
brain activity.
Inclusion Criteria for Psychophysiologic Insomnia (PI)
These subjects will meet RDC criteria for Psychophysiologic insomnia. In addition, the
complaint of disturbed sleep will have at least one of the following minimal
characteristics:
- > 30 min. sleep-onset latency (SL) (Initial Insomnia)
- >2 awakenings per night (>15 min. ea.) and/or wake after sleep-onset (WASO) of > 30
min (Middle Insomnia)
Total Sleep Time (TST) will not exceed 6 hours [unless the Sleep Efficiency (SE) quotient
is < 80%] and the problem frequency must be > 4 nights/week (Severe Insomnia) with a
problem duration > 6 months (Chronic Insomnia)B .
Inclusion Criteria for Good Sleeper Subjects
- Report that they obtain enough sleep and that their sleep is restorative
- Have a score of less than 10 on the Epworth Sleepiness Scale (ESS)50-52
- Have a score of less than 15 on the Ford Insomnia Response to Stress Test (FIRST)53
- Have a score of less than 7 on the Insomnia Severity Index (ISI)54
- Report retrospectively and prospectively < 15 minutes to fall asleep and "wake after
sleep onset time" of < 15 minutes and a total sleep time > 6 hoursA
A These profiles will be evident at both intake (based on retrospective reports) and as an
average from the two weeks of baseline diaries (based on prospective sampling).
Exclusion Criteria for All Subjects
• Unstable medical illness or acute or history of psychiatric illness (except GAD or MDD -
Allowed provided that these have resolved and not recurred within 5 years) As ascertained
with self report questionnaires, a clinical History, a physical exam and a clinical
chemistry profile.
To assure that the insomnia is not secondary to these factors
- Symptoms suggestive of sleep disorders other than insomnia To assure that the
insomnia is not secondary to these factors
- Polysomnographic data indicating sleep disorders other than insomnia To assure that
the insomnia is not secondary to these factors
- History of head injury with a sustained loss of consciousness To help assure that the
EEG measures are unconfounded by brain damage
- Evidence of active illicit substance use or fitting criteria for alcohol abuse or
dependence To assure that the insomnia is not secondary to these factors
- Use of CNS active medications including antidepressants and hypnotics (within 2 weeks
or 5 half-lives) To help assure that the EEG measures are unconfounded by medication
effects such as the "BZ artifact".
- Inadequate language comprehension To assure the quality of self report data as all
the measures are in English.
- Pregnancy Excluded owing to the hormonal changes that occur with pregnancy
- Left Handedness To control for EEG differences related to handedness
- Nicotine Use To assure that the insomnia is not secondary to these factors
- Caffeine use that exceeds 2 beverages per day or occurs past 5pm in the evening.
To assure that the insomnia is not secondary to these factors
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