Biomedical subjects

Jack D Edinger

Publications and source records attributed to Jack D Edinger.

23 records · Page 2Linked to original sources

PubMed2003

Accuracy of sleep perceptions among insomnia sufferers and normal sleepers.

OBJECTIVE: To examine the distribution, consistency, and correlates of sleep time perceptions in primary insomnia sufferers and normal sleepers across settings (laboratory and home). METHODS: Fifty-two middle-aged and older insomnia sufferers and 49 matched normal sleepers underwent multiple nights of laboratory and home polysomnography (PSG) and provided concurrent subjective estimates of their sleep. Descriptive statistics, cluster analyses, and inferential tests were used to examine the nature of sleep time perceptions, identify subgroups with distinctive patterns such as perceptions, and explore factors that may contribute to these subgroups' distinctive sleep perceptions. RESULTS: Consistent with previous studies, the insomnia sufferers, as a group, showed a greater tendency to underestimate the time they slept than did the normal sleepers, but the accuracy of sleep time perceptions varied widely within each sample. Correlational analyses showed that study participants in each sample showed a moderate level of consistency in how accurately they estimated sleep time across nights. Subsequent cluster analyses conducted to identify subgroups with distinctive patterns of sleep time perceptions yielded four subgroups within the insomnia sample and three subgroups within the normal sleeper sample. Although the sleep setting significantly affected sleep perceptions for one insomnia subgroup, both laboratory and home objective-subjective sleep comparisons provided similar impressions regarding the relative accuracy of each subgroup's nocturnal sleep/wake perceptions. Finally, varying patterns of subgroup differences were noted across several common psychometric measures. CONCLUSIONS: The underestimation of sleep time is not a generic characteristic that separates all insomnia sufferers from normal sleepers. Sleep setting, personality traits, and perhaps constitutional factors appear to influence perceptions of sleep and wake time duration.

Analysis of Variance↗

PubMed2003

Daytime testing after laboratory or home-based polysomnography: comparisons of middle-aged insomnia sufferers and normal sleepers.

Many studies have shown only modest differences between insomnia sufferers and matched, non-complaining normal controls in regard to their levels of daytime sleepiness and diurnal performances. The current study was conducted to determine whether such daytime comparisons might be affected by the setting (home vs. sleep lab) in which study participants sleep on the nights before such testing. The study used a counter-balanced, matched-group design in which participants underwent three consecutive nocturnal polysomnographs (PSG) conducted either in the sleep lab or in their homes prior to undergoing daytime multiple sleep latency test (MSLT) and computer-administered performance testing. The study participants were 35 (18 women and 17 men) middle-aged (40-59 years) non-complaining normal sleepers and 33 middle-aged insomnia sufferers (17 women and 16 men) who met structured interview criteria for persistent primary insomnia. Use of a hierarchical linear statistical model showed only insomnia sufferers who underwent nocturnal home PSG were more alert on the MSLT than were normal sleepers who underwent lab PSG. However, these insomnia sufferers showed a greater propensity toward attention lapses on selected reaction time tests than did either of the two normal control groups (i.e. either those who slept in the lab or those who slept at home). The results suggest the nocturnal sleep setting (home vs. lab) may affect subsequent MSLT and performance test comparisons of insomnia sufferers and normal sleepers.

Adult↗

PubMed2003

Subtyping primary insomnia: is sleep state misperception a distinct clinical entity?

Among the range of primary insomnia subtypes, those assigned such labels as subjective insomnia or sleep state misperception historically have been among the most intriguing yet challenging to understand and manage clinically. Such patients who produce seemingly normal polysomnograms often present rather compelling and, at times, dramatic sleep complaints. Our earliest formal sleep nosology included a separate diagnostic category for such individuals, but little research has been devoted to this insomnia subtype in the 20 years since this classification scheme was proposed. As a result, use of diagnoses such as subjective insomnia or sleep state misperception have remained controversial. The current article reviews this controversy and highlights the major criticisms forged against subdividing primary insomnia into objective and subjective subtypes. Subsequently, the relative merits of these criticisms are considered in view of early and recent findings vis-à-vis the subjective/objective insomnia dichotomy. Although available data are not conclusive, there appears to be sufficient evidence to suggest subjective and objective insomnia subtypes may suffer from distinctive forms of sleep-related pathophysiology. We conclude by advocating continued study of the subjective insomnia phenomenon and by providing specific directions for relevant future research.

Diagnosis, Differential↗

PubMed2003

Cognitive and behavioral anomalies among insomnia patients with mixed restless legs and periodic limb movement disorder.

This study examined whether patients who have periodic limb movement disorder (PLMD), with or without comorbid restless legs syndrome (RLS), display the sleep-disruptive cognitive and behavioral anomalies found among primary insomnia sufferers. Archival data from a Sleep History Questionnaire, home-based polysomnography, and a sleep log were obtained for matched RLS/PLMD, primary insomnia, and noncomplaining volunteer samples. Statistical comparisons showed that the RLS/PLMD and primary insomnia samples differed significantly from the normal sleepers in regard to their propensities for certain sleep disruptive habits, perceived difficulties controlling pre-sleep cognitive activity, and their subjective sleep appraisals. These findings suggest RLS/PLMD patients display many of the cognitive and behavioral anomalies thought to perpetuate primary insomnia. Hence, behavioral interventions may be warranted for RLS/PLMD patients.

Adult↗

PubMed2002

NREM sleep EEG frequency spectral correlates of sleep complaints in primary insomnia subtypes.

STUDY OBJECTIVES: To determine whether the frequency spectrum of the sleep EEG is a physiologic correlate of 1) the degree to which individuals with persistent primary insomnia (PPI) underestimate their sleep time compared with the traditionally scored polysomnogram (PSG) and 2) the sleep complaints in PPI subjects who have relatively long traditionally scored PSG sleep times and relatively greater underestimation of sleep time. DESIGN: We compared EEG frequency spectra from REM and NREM sleep in PPI subjects subtyped as subjective insomnia sufferers (those with relatively long total sleep time and relative underestimation of sleep time compared with PSG), and objective insomnia sufferers (those with relatively short PSG total sleep time) with EEG frequency spectra in normals. We also studied the correlation between these indices and the degree of underestimation of sleep. Further, we determined the degree to which sleep EEG indexes related to sleep complaints. SETTING: Duke University Medical Center Sleep Laboratory. PARTICIPANTS: Normal (N=20), subjective insomnia (N=12), and objective insomnia (N=18) subjects. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Lower delta and greater alpha, sigma, and beta NREM EEG activity were found in the patients with subjective insomnia but not those with objective insomnia, compared with the normal subjects. These results were robust to changes in the subtyping criteria. No effects were found for REM spectral indexes. Less delta non- REM EEG activity predicted greater deviation between subjective and PSG estimates of sleep time across all subjects. For the subjective insomnia subjects, diminished low-frequency and elevated higher frequency non- REM EEG activity was associated with their sleep complaints. CONCLUSIONS: NREM EEG frequency spectral indexes appear to be physiologic correlates of sleep complaints in patients with subjective insomnia and may reflect heightened arousal during sleep.

Adult↗