Abstract
(1) Background: An unresolved phenomenon of insomnia disorder is a discrepancy between objectively measured sleep and subjective complaints. It has been shown that rapid eye movement (REM) sleep might be especially vulnerable to an altered perception. The present work aimed to investigate the link between physiological REM parameters and mentation characteristics in REM sleep. (2) Methods: 22 patients with insomnia and 23 good sleepers indicating at least one REM mentation within an awakening study were included. Multivariate analyses of variance (MANOVAs) were calculated to examine group differences and effects of mentation characteristics on number of arousals, REM density, and spectral power prior to awakenings. (3) Results: Increased perceived wakefulness was related to lower delta, theta, and alpha power in the minute prior to the REM awakenings. Nevertheless, no group differences regarding spectral power were found. With respect to number of arousals and REM density, no significant effects of mentation characteristics and no group differences were found. (4) Conclusions: Our results suggest that spectral power in REM sleep is linked with altered sleep perception. Reduced delta, theta, and alpha power might be a signature of this modified REM sleep associated with a high level of perceived wakefulness. Future awakening studies are necessary to further explore the link between physiological REM parameters and sleep perception.
Highlights
Insomnia disorder is a highly prevalent disorder worldwide [1]
That sleep mentation was rated more negatively by insomnia patients compared to good sleepers during rapid eye movement (REM) awakenings, we aimed to investigate the physiological correlates of mentation characteristics during REM sleep
Including only participants who indicated at least one mentation in the REM awakening night resulted in a subgroup of n = 45 participants (22 patients with insomnia disorder, 23 good sleeper controls (GSC)) in comparison to the original sample of n = 54 participants (27 per group) reported by Feige and colleagues [21]
Summary
Insomnia disorder is a highly prevalent disorder worldwide [1]. The disorder is characterized by a subjective report of having persistent difficulty with initiating/maintaining sleep or early morning awakening accompanied by daytime impairment [3]. Research has shown that insomnia disorder is associated with reduced quality of life [4] and an increased risk for developing cardiovascular disease [5] and mental disorders [6,7]. Many patients with insomnia disorder tend to underestimate their total sleep time and overestimate the time they are spending awake in bed [9,10,11]. Current pathophysiological models emphasize a heightened arousal in the cognitive, emotional, and physiological domains during night and day in patients with insomnia disorder that may help to explain the phenomenon of misperception [12,13,14]
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