title: The impact of sleep-related attentional bias on polysomnographically measured sleep in primary insomnia.
abstract: OBJECTIVE
  Although sleep-related attentional bias has been shown to be evident in primary insomnia, the association with objectively measured sleep has not been investigated. In the present study, we used polysomnography (PSG) to fill this void.
  
  
  METHODS
  Patients with primary insomnia and healthy controls were studied using a visual dot probe task (VDP) and an emotional Stroop task (EST). Additionally, polysomnography was carried out in a sub-sample (n = 22) of patients in the subsequent night.
  
  
  METHODS
  Department of Psychiatry and Psychotherapy of the University of Freiburg Medical Center.
  
  
  METHODS
  Thirty patients with primary insomnia and 30 matched healthy controls.
  
  
  METHODS
  N/A.
  
  
  RESULTS
  Patients with primary insomnia demonstrated a significant sleep-related attentional bias compared to controls in the EST but no significant group effects were found for the VDP. VDP attentional bias scores were positively correlated with measures of sleep pressure, including total sleep time, sleep efficiency, and the amount of slow wave sleep. EST attentional bias scores were not correlated with subsequent PSG parameters, and we did not observe a correlation between attentional bias scores on the two tasks.
  
  
  CONCLUSIONS
  The unexpected relationship between increased attentional bias, in the VDP task, and improved markers of sleep duration and continuity, may be indicative of a homeostatic craving for sleep in those with high attentional bias. This awaits further testing in multiple night studies, to shed light on the mechanisms and implications of sleep-related attentional bias.
authors.affiliation: University of Freiburg Medical Center, Department of Psychiatry and Psychotherapy, Freiburg, Germany. kai.spiegelhalder@uniklinik-freiburg.de
authors.forename: Kai
authors.initials: K
authors.lastname: Spiegelhalder
authors.forename: Simon D
authors.initials: SD
authors.lastname: Kyle
authors.forename: Bernd
authors.initials: B
authors.lastname: Feige
authors.forename: Martin
authors.initials: M
authors.lastname: Prem
authors.forename: Christoph
authors.initials: C
authors.lastname: Nissen
authors.forename: Colin A
authors.initials: CA
authors.lastname: Espie
authors.forename: Dieter
authors.initials: D
authors.lastname: Riemann
mesh_terms: D000328:Adult; D000368:Aged; D001288:Attention; D003118:Color Perception; D003463:Cues; D004192:Discrimination, Psychological; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009949:Orientation; D010364:Pattern Recognition, Visual; D017286:Polysomnography; D011930:Reaction Time; D012660:Semantics; D012890:Sleep; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000523:psychology*; D057190:Stroop Test; D055815:Young Adult