Perception of sleep in patients with insomnia - part 3: how to change it - 2nd revised version

• Applicant: Professor Dr. Dieter Riemann
• Subject Area: Clinical Psychiatry, Psychotherapy, Child and Adolescent Psychiatry
• Term: since 2013
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 233892690

The first two periods of this investigation into sleep perception (PerSleep I + II) fo-cused on good sleepers (GSC) and patients with insomnia disorder (ID) who all slept for four nights in the sleep laboratory. The subjective perception of sleep is altered in insomnia, i. e. patients with insomnia perceive their wakefulness during sleep as more prolonged and underestimate their sleep duration in contrast to good sleepers. Good sleepers tend to underestimate their nocturnal wake times and overestimate their sleep duration. PerSleep I revealed that patients with insomnia, in contrast to good sleepers. perceive, when awoken out of REM sleep, this state more frequently as wake than sleep. Good sleepers clearly experienced REM sleep as a sleep state. PerSleep II examined event-related potentials to continuously played tones during the whole night. The aim was to find in which stage of information processing group differences exist and whether they explain the differences in sleep perception be-tween both groups. As main result, reduced P2 amplitudes were identified in insomnia patients compared to good sleepers specifically in phasic REM sleep. It is concluded that phasic REM sleep reflects a specific vulnerability in patients with insomnia during sensory afferences, contributing to the perception to be awake instead of sleeping. PERSLEEP III wants to investigate whether it is possible to experimentally manipulate the perception of sleep. To this end, 100 patients with insomnia will be subjected to two conditions, an “insomnia condition” and a “distraction & thought suppression condition”. In the insomnia condition patients with insomnia will be subjected to the topic of insomnia (audiobook, ca. 60 min.) and asked to concentrate on the topic, whereas in the other condition they should distract themselves and try not to think of their insomnia (audiobook, ca. 60. min.). We assume that the distraction & thought suppression condition will actually increase arousal prior to sleep and in-crease sleep misperception. On the other hand, the insomnia condition is supposed to reduce arousal prior to sleep and in consequence also to decrease misperception of sleep.

• DFG Programme: Research Grants
• Co-Investigator: Dr. Bernd Feige