Abstract
Subjective–objective discrepancy of sleep (SODS) might be related to the distorted perception of sleep deficit and hypersensitivity to insomnia-related stimuli. We investigated differences in brain activation to insomnia-related stimuli among insomnia patients with SODS (SODS group), insomnia patients without SODS (NOSODS group), and healthy controls (HC). Participants were evaluated for subjective and objective sleep using sleep diary and polysomnography. Functional magnetic resonance imaging was conducted during the presentation of insomnia-related (Ins), general anxiety-inducing (Gen), and neutral (Neu) stimuli. Brain reactivity to the contrast of Ins vs. Neu and Gen vs. Neu was compared among the SODS (n = 13), NOSODS (n = 15), and HC (n = 16) groups. In the SODS group compared to other groups, brain areas including the left fusiform, bilateral precuneus, right superior frontal gyrus, genu of corpus callosum, and bilateral anterior corona radiata showed significantly increased blood oxygen level dependent (BOLD) signal in the contrast of Ins vs. Neu. There was no brain region with significantly increased BOLD signal in the Gen vs. Neu contrast in the group comparisons. Increased brain activity to insomnia-related stimuli in several brain regions of the SODS group is likely due to these individuals being more sensitive to sleep-related threat and negative cognitive distortion toward insomnia.
Highlights
Insomnia disorder is a group of heterogeneous conditions, with each patient presenting with varying clinical characteristics and etiologies of insomnia[1]
Functional neuroimaging is a good methodology to investigate cognitive distortion, in examining selective attention to insomnia/sleep-related threats seen in paradoxical insomnia and insomnia disorder
We hypothesized that would be significantly increased brain reactivity to insomnia-related negative stimuli during functional magnetic resonance imaging (fMRI) in the subjective–objective discrepancy of sleep (SODS) group compared to the NOSODS and control groups
Summary
Insomnia disorder is a group of heterogeneous conditions, with each patient presenting with varying clinical characteristics and etiologies of insomnia[1]. Patients with sleep state misperception (SSM), referred to as paradoxical insomnia, have a significant discrepancy between subjective and objective sleep, tending to overestimate sleep latency while underestimating total sleep time (TST) relative to objective sleep measures (e.g., sleep measurements in polysomnography [PSG])[4]. According to a previous small sample study, the proportions of sleep stage percentages were similar between the SSM and objective insomnia groups, but differed from the normal subjects[8]. A previous study compared the PSG findings and selfreports of insomnia patients, and showed that less than 20% of insomnia patients had short sleep time or long sleep latency according to the PSG10. Functional neuroimaging is a good methodology to investigate cognitive distortion, in examining selective attention to insomnia/sleep-related threats seen in paradoxical insomnia and insomnia disorder.
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call