0335 Polysomnography in Insomnia Disorder

Abstract

Introduction: A recent meta-analysis compared polysomnograms (PSGs) of people with insomnia to healthy controls; results showed short sleep time and reduced slow-wave and REM sleep in insomnia. Among people with insomnia, studies have shown morbidity associated with insomnia is found primarily in people with PSG short sleep. Here we characterize the distribution and nature of PSG sleep among people diagnosed with DSM-V insomnia disorder. Methods: Insomnia disorder (DSM-V) subjects, aged 23-61 yrs, (n=67, 63 females), absent other sleep disorders, unstable medical or psychiatric disorders or drug dependency volunteered for a clinical trial. The final enrollment step involved collection of a standard 8-hr PSG evaluating sleep disturbance among trial participants. PSGs were scored following ASSM criteria, by reliable scorers, for sleep efficiency (SE), latency to persistent sleep (LPS), wake after sleep onset (WASO) and percent sleep stages (N1, N2 N3, and NR). Results: There was wide variation in SE ranging from 40-97% with a mean of 82% and a median of 84% (6.5 hrs sleep). The SE distribution was divided into quartiles (worst - best; Q1: ≤ 76.8%; Q2: 77>84.2%; Q3: 84.3% >90.7%; Q4: ≥91%). As might be expected, LPS (F=9.82, p < 77% were associated with reduced N3% and NR% and increased N1% (p 84%. Conclusion: People meeting DSM-V diagnostic criteria for insomnia disorder display a broad range of PSG-defined sleep disturbance with 50% having SE of less than 84%. SE of <77% (6.2 hrs) is associated with reduced N3% and NR% and increased N1%.