title: Patients with primary insomnia in the sleep laboratory: do they present with typical nights of sleep?
abstract: The validity of sleep laboratory investigations in patients with insomnia is important for researchers and clinicians. The objective of this study was to examine the first-night effect and the reverse first-night effect in patients with chronic primary insomnia compared with good sleeper controls. A retrospective comparison of a well-characterised sample of 50 patients with primary insomnia and 50 good sleeper controls was conducted with respect to 2 nights of polysomnography, and subjective sleep parameters in the sleep laboratory and the home setting. When comparing the first and second sleep laboratory night, a significant first-night effect was observed across both groups in the great majority of the investigated polysomnographic and subjective variables. However, patients with primary insomnia and good sleeper controls did not differ with respect to this effect. Regarding the comparison between the sleep laboratory nights and the home setting, unlike good sleeper controls, patients with primary insomnia reported an increased subjective sleep efficiency on both nights (in part due to a reduced bed time) and an increased subjective total sleep time on the second night. These results suggest that even the second sleep laboratory night does not necessarily provide clinicians and researchers with a representative insight into the sleep perception of patients with primary insomnia. Future studies should investigate whether these findings also hold for other patient populations.
authors: Division of Psychosomatic Medicine, Kantonspital St. Gallen, St. Gallen, Switzerland.
authors: Verena
authors: V
authors: Hirscher
authors: Department of Psychiatry and Psychotherapy, University of Freiburg Medical Center, Freiburg, Germany.
authors: Thomas
authors: T
authors: Unbehaun
authors: Department of Psychiatry and Psychotherapy, University of Freiburg Medical Center, Freiburg, Germany.
authors: Bernd
authors: B
authors: Feige
authors: Department of Psychiatry and Psychotherapy, University of Freiburg Medical Center, Freiburg, Germany.
authors: Christoph
authors: C
authors: Nissen
authors: Department of Psychiatry and Psychotherapy, University of Freiburg Medical Center, Freiburg, Germany.
authors: Dieter
authors: D
authors: Riemann
authors: Department of Psychiatry and Psychotherapy, University of Freiburg Medical Center, Freiburg, Germany.
authors: Kai
authors: K
authors: Spiegelhalder
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006798:Housing; D006801:Humans; D007753:Laboratories; D008297:Male; D017286:Polysomnography / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012890:Sleep / Q000502:physiology*; D007319:Sleep Initiation and Maintenance Disorders / Q000503:physiopathology* / Q000523:psychology*
keywords: first-night effect; polysomnography; primary insomnia; reverse first-night effect