Is insomnia a neurophysiological disorder? The role of sleep EEG microstructure

Brain Res Bull. 2004 Jun 30;63(5):377-83. doi: 10.1016/j.brainresbull.2003.12.010.

Abstract

Unlike other sleep disorders, such as sleep-related breathing disorders and periodic limb movement (PLM), the nature and severity of which are quantified by specific respiratory and motor indexes, no apparent organ dysfunction underlies several cases of insomnia (in particular primary insomnia), which can be objectively diagnosed only through the structural alterations of sleep. Polysomnography (PSG) investigation indicates that insomnia is the outcome of a neurophysiological disturbance that impairs the regulatory mechanisms of sleep control, including sleep duration, intensity, continuity and stability. In particular, analysis of sleep microstructure has permitted to establish that etiologic factors of different nature (including depressive disorders) exert a common destabilizing action on sleep, which is reflected in an increase of cyclic alternating pattern (CAP) rate. These premises allow us to attribute a more objective identity to insomnia, which risks otherwise to be considered as an unexplainable mental complaint. In conclusion, PSG remains the "gold standard" for measuring sleep, and especially insomnia.

Publication types

  • Review

MeSH terms

  • Antidepressive Agents / therapeutic use
  • Depressive Disorder, Major / complications
  • Depressive Disorder, Major / drug therapy
  • Depressive Disorder, Major / physiopathology
  • Electroencephalography / methods*
  • Humans
  • Nervous System Diseases / complications
  • Nervous System Diseases / drug therapy
  • Nervous System Diseases / physiopathology
  • Polysomnography / methods*
  • Sleep Initiation and Maintenance Disorders / complications
  • Sleep Initiation and Maintenance Disorders / drug therapy
  • Sleep Initiation and Maintenance Disorders / physiopathology*

Substances

  • Antidepressive Agents