PHYSIOLOGICAL ACTIVATION IN PATIENTS WITH SLEEP STATE MISPERCEPTION

Objective: Sleep State Misperception insomnia has been commonly viewed as a perceptual or psychological problem. It was hypothesized that Sl eep State Misperception insomnia, like psychophysiological insomnia, c ould be associated with increased physiological activation, here index ed by whole body metabolic rate. Method: Groups of nine patients with Sleep State Misperception insomnia and age-, sex-, and weight-matched normal sleepers were evaluated on sleep, performance, mood, personalit y, and metabolic measures over a 36-hour sleep laboratory stay. Result s: Sleep Stale Misperception insomniacs had a subjective history of po or sleep and perceived their laboratory sleep as poor but had electroe ncephalogram (EEG) parameters that did not differ statistically from m atched normal controls. Sleep State Misperception insomniacs had abnor mal MMPI values and were subjectively more confused, tense, depressed, and angry than matched normals. Sleep State Misperception insomniacs also had a significantly increased 24-hour metabolic rate, compared wi th matched normals. Conclusions: The overall increase in whole body ox ygen use was less than that seen in psychophysiological insomniacs but was consistent with the view that Sleep State Misperception insomnia may be a mild version or a precursor to psychophysiological insomnia.