Insomnia related to dysthymia: Polysomnographic and psychometric comparison with normal controls and acute therapeutic trials with trazodone

Utilizing polysomnography (PSG) and psychometry, objective and subjective s leep and awakening quality was investigated in 11 patients (mean age 50 +/- 14) with nonorganic insomnia (F 51.0) related to dysthymia (F 34.1) as com pared with 11 age- and sex-matched normal controls. Patients demonstrated d ecreased sleep efficiency and sleep stage S2 as well as increased sleep lat ency to S1, S2 and S3, wakefulness within the total sleep period, number of awakenings, S1 and REM sleep. There was no intergroup difference in REM la tency. Subjective sleep quality and the total score of the Self-Assessment Scale for Sleep and Awakening Quality (SSA) were deteriorated as were eveni ng and morning well-being, mood, affectivity and drowsiness. Noopsychic mea sures showed deteriorated numerical memory, fine motor activity and reactio n time variability. In a placebo-controlled crossover design study, the acu te effects of 100 mg trazodone(1), a serotonin reuptake inhibitor with a se dative action due to 5HT(2) and a, receptor blockade, were investigated in the patients. As compared with placebo, trazodone induced an increase in sl ow-wave sleep (S3 + 4), a lengthening of REM latency, a decrease in REM sle ep and a normalization of the periodic leg movement (PLM) index. In the mor ning, there was a minimal increase in somatic complaints and a decrease in critical flicker frequency and systolic blood pressure. In conclusion, our study demonstrated that dysthymia induced significant changes in objective and subjective sleep and awakening quality, which were counteracted by 100 mg trazodone, thus suggesting a key-lock principle in the treatment of nono rganic insomnia related to dysthymia with this drug. Copyright 2001 S. Ka r ger AG, Basel.