title: Objective vs. subjective measurements of sleep in depressed insomniacs: first night effect or reverse first night effect?
abstract: OBJECTIVE
  This study examined changes in sleep parameters between the laboratory and the home setting before and after laboratory monitoring in depressed insomniacs undergoing treatment.
  
  
  METHODS
  This study was a post hoc analysis of a double-blind, randomized, placebo-controlled clinical trial performed with 60 depressed, insomniac outpatients. Patients underwent actigraphic monitoring along with sleep diaries over a continuous 2-week period. After one week of baseline monitoring, subjects spent one night in the laboratory with concurrent actigraphic and PSG monitoring with sleep diaries. Actigraphic monitoring and sleep diaries were continued for another week at home, along with initiation of open-label fluoxetine (FLX).
  
  
  RESULTS
  Actigraphically recorded laboratory sleep during the night in the laboratory was found to be improved relative to actigraphically recorded sleep at home, with less wake time and greater sleep time and sleep efficiency occurring in the laboratory. In contrast, sleep diaries indicated a slight worsening of sleep in the laboratory compared to home, with significantly more awakenings in the laboratory compared to the week at home before and after the laboratory night.
  
  
  CONCLUSIONS
  The differences between objective and subjective sleep measurements seen in depressed insomniacs may be influenced by the monitoring setting and measurement modality.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier: NCT00247624.
authors.affiliation: Department of Psychiatry and Behavioral Medicine, Wake Forest University Health Sciences, Winston-Salem, NC 27157, USA. cmccall@wfubmc.edu
authors.forename: Catherine
authors.initials: C
authors.lastname: McCall
authors.forename: W Vaughn
authors.initials: WV
authors.lastname: McCall
mesh_terms: D056044:Actigraphy; D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D053961:Azabicyclo Compounds / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000150:complications* / Q000188:drug therapy; D004311:Double-Blind Method; D000069582:Eszopiclone; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use; D017286:Polysomnography; D012647:Self-Assessment; D012890:Sleep / Q000502:physiology; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000188:drug therapy / Q000523:psychology; D055815:Young Adult
chemical_list: D018687:Antidepressive Agents, Second-Generation; D053961:Azabicyclo Compounds; D006993:Hypnotics and Sedatives; D010879:Piperazines; D005473:Fluoxetine; D000069582:Eszopiclone