ALERT INSOMNIACS - ARE THEY REALLY SLEEP-DEPRIVED

Alert insomnia, the complaint of insomnia in the absence of measurable daytime sleepiness, has presented a theoretical enigma to sleep disor ders professionals. Although it has been assumed that insomniacs are c hronically sleep deprived, their lack of daytime sleepiness contradict s this assumption. Insomnia patients frequently complain of fatigue an d other daytime symptoms that they attribute to poor nocturnal sleep. Yet, compared to noncomplaining controls, insomniacs have demonstrated neither daytime impairment nor a substantial deficit in nocturnal sle ep time. In this article, we examine the data pertinent to the questio n of whether alert insomniacs are in fact sleep deprived, and we consi der possible explanations for these findings. We also discuss the impl ications of these data for clinical management of these patients and f or future research on insomnia.