Feige Bernd, Al-Shajlawi Anam, Nissen Christoph, Voderholzer Ulrich, Hornyak Magdolna, Spiegelhalder Kai, Kloepfer Corinna, Perlis Michael, Riemann Dieter
Department of Psychiatry and Psychotherapy, University Medical Center, Freiburg, Germany.
J Sleep Res. 2008 Jun;17(2):180-90. doi: 10.1111/j.1365-2869.2008.00651.x.
Primary insomnia (PI) is characterized by low subjective sleep quality which cannot always be verified using polysomnography (PSG). To shed light on this discrepancy, subjective estimates of sleep and PSG variables were compared in patients with PI and good sleeper controls (GSC). 100 patients with PI (age: 42.57 +/- 12.50 years, medication free for at least 14 days) and 100 GSC (41.12 +/- 13.99 years) with a sex distribution of 46 men and 54 women in each group were included. Both PSG and questionnaire variables showed clear impairments of sleep quality in PI compared with GSC. The arousal index within total sleep time was increased, which was mainly because of a strong increase within rapid eye movement (REM) sleep. Subjectively, more PI than GSC subjects estimated wake times longer than obtained from PSG. Linear modeling analysis of subjective wake time in terms of PSG parameters revealed that in addition to PSG defined wake time, REM sleep time contributed significantly to subjective wake time. This REM sleep contribution was larger for PI than for GSC subjects. The findings suggest that REM sleep-related processes might contribute to subjectively disturbed sleep and the perception of waking time in patients with PI.
原发性失眠（PI）的特点是主观睡眠质量低，而多导睡眠图（PSG）并不总能证实这一点。为了阐明这种差异，对PI患者和良好睡眠者对照组（GSC）的睡眠主观估计和PSG变量进行了比较。纳入了100例PI患者（年龄：42.57±12.50岁，至少14天未服药）和100例GSC（41.12±13.99岁），每组中男性46例，女性54例。与GSC相比，PSG和问卷变量均显示PI患者的睡眠质量明显受损。总睡眠时间内的觉醒指数增加，这主要是由于快速眼动（REM）睡眠期间的强烈增加。主观上，PI患者中估计的清醒时间比PSG记录的更长的人数多于GSC患者。根据PSG参数对主观清醒时间进行线性建模分析发现，除了PSG定义的清醒时间外，REM睡眠时间对主观清醒时间有显著贡献。PI患者的这种REM睡眠贡献比GSC患者更大。研究结果表明，与REM睡眠相关的过程可能导致PI患者主观睡眠障碍和对清醒时间的感知。
