Study On Sleep Perception And Daytime Function In Patients With Primary Insomnia

Objective: The symptoms of insomnia patients often include two major issues, sleep complaints and the impact of daytime function. We investigated the sleep perception (SP) and the daytime function in patients with primary insomnia(PI),and evaluated the relationship of the sleep perception and the daytime function ,to provide theoretical basis for the reasonable diagnosis and treatment of insomniacs.Measures: Subjects included 67 PI patients and 57 gender- and age-matched healthy controls. All subjects achieved overnight polysomnography(PSG) and followed by Multiple Sleep Latency Test (MSLT) and morning questionnaire to assess SP. SP was calculated by (Subjective sleep time/Objective sleep time *100%). A battery of daytime function evaluations, including Flinders Fatigue Scale (FFS), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI) and Epworth Sleepiness Scale (ESS), were collected. Pittsburgh Sleep Quality Index(PSQI) to assess the subjective sleep quality of PI patients.Results: PI patients exhibited significantly less SP percentage than that of controls (52.44±35.33% vs. 99.19±12.54%, p<0.01). PI patients had significantly greater score of PSQI than that of controls (p<0.01). Compared to controls, PI patients had significantly greater score of FFS, BDI,STAI (S-AI and T-AI) ( p<0.05) and MSLT (p<0.05) and less score of ESS (p<0.05)in the evaluation of daytime function. Among PI individuals, females had less percentage of SP percentage than males (44.0±34.3% vs. 65.2±33.6%,p<0.05),and SP percentage was negatively correlated to S-AI score (r= -0.251, p<0.05).Conclusion: This investigation proved that PI patients not only perceived significantly sleep state misperception during the night than controls, but also more impairment in function during the day, including more fatigue and more negative mood (depression and anxiety). PI patients did not show daytime sleepiness according to the subjective and objective assessment. Female seems to have more severe SP issues than male.Negative association between SP and state anxiety suggested that anxiety in terms of sleep perception has important implications.