Is insomnia a neurophysiological disorder? The role of sleep EEG microstructure.
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.
Parrino
Liborio
L
Department of Neuroscience, Sleep Disorders Center, University of Parma, Parma, Italy.
Ferrillo
Franco
F
Smerieri
Arianna
A
Spaggiari
Maria Cristina
MC
Palomba
Vincenzo
V
Rossi
Mariano
M
Terzano
Mario Giovanni
MG
D000928:Antidepressive Agents / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D004569:Electroencephalography / Q000379:methods*; D006801:Humans; D009422:Nervous System Diseases / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D017286:Polysomnography / Q000379:methods*; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*
D000928:Antidepressive Agents