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Physiological Activation in Patients With Sleep State Misperception

Bonnet, M. H. PhD; Arand, D. L. PhD

Original Articles

Objective: Sleep State Misperception insomnia has been commonly viewed as a perceptual or psychological problem. It was hypothesized that Sleep State Misperception insomnia, like psychophysiological insomnia, could be associated with increased physiological activation, here indexed by whole body metabolic rate.

Method: Groups of nine patients with Sleep State Misperception insomnia and age-, sex-, and weight-matched normal sleepers were evaluated on sleep, performance, mood, personality, and metabolic measures over a 36-hour sleep laboratory stay.

Results: Sleep State Misperception insomniacs had a subjective history of poor sleep and perceived their laboratory sleep as poor but had electroencephalogram (EEG) parameters that did not differ statistically from matched normal controls. Sleep State Misperception insomniacs had abnormal MMPI values and were subjectively more confused, tense, depressed, and angry than matched normals. Sleep State Misperception insomniacs also had a significantly increased 24-hour metabolic rate, compared with matched normals.

Conclusions: The overall increase in whole body oxygen use was less than that seen in psychophysiological insomniacs but was consistent with the view that Sleep State Misperception insomnia may be a mild version or a precursor to psychophysiological insomnia.

From the Dayton Department of Veterans Affairs Medical Center, Wright State University, and Kettering Medical Center, Dayton, Ohio.

This work was supported by a Merit Review Grant from the Department of Veterans Affairs and the Sleep-Wake Disorders Research Institute.

Address reprint requests to: Michael H. Bonnet, PhD (151N), Neurology Service, Department of Veterans Affairs Medical Center, 4100 W. Third St., Dayton, OH 45428.

Received for publication March 4, 1996; revision received October 10, 1996.

Copyright © 1997 by American Psychosomatic Society
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