24-HOUR METABOLIC-RATE IN INSOMNIACS AND MATCHED NORMAL SLEEPERS

Groups of 10 objectively defined insomniacs and age-, sex- and weight- matched normal sleepers were evaluated on sleep, performance, mood, pe rsonality and metabolic measures over a 36-hour sleep laboratory stay. Insomniacs were defined to have increased wake time during the night but also had decreased stage 2 and rapid eye movement sleep. As expect ed insomniacs reported increased confusion, tension and depression and decreased vigor on the profile of mood states mood scale throughout t he evaluation period as compared to the normals. Insomniacs also had d ecreased memory ability on the short-term memory test and the MAST. Th ese performance and mood differences were not secondary to sleepiness because the insomniacs also had significantly increased multiple sleep latency test (MSLT) values throughout the evaluation period. In conju nction with the consistent mood, performance and MSLT differences duri ng the day and the sleep differences at night, whole body VO2, measure d at intervals across the day and throughout one night of sleep, was c onsistently elevated at all measurement points in the insomniacs as co mpared to the normals. The nocturnal increase in metabolic rate remain ed even after metabolic values from periods during the night containin g wake time or arousals were eliminated from the data set. It was conc luded that patients who report chronic insomnia may suffer from a more general disorder of hyperarousal (as measured here by a 24-hour incre ase in metabolic rate) that may be responsible for both the daytime sy mptoms and the nocturnal poor sleep. Future studies need to explore 24 -hour insomnia treatment strategies that decrease hyperarousal.