| Purpose:(1)To study sleep characteristics in sleep state misperception and psychophysiological insomnia, to find clinically meaningful indicators and evidence of distinctions between the two different kinds of insomnia.(2) To study daytime functioning in sleep state misperception and psychophysiological insomnia, to find the correlation between daytime functioning and sleep architecture.Methods:(1) According to the second edition of International Classification of Sleep Disorders (ICSD-2) formulated by the American Academy of Sleep Medical Research Society, we selected28cases in sleep state misperception group and psychophysiological insomnia respectively.(2)Exclusion criteria:①Exclude insomnia caused by physical illness, alcohol or drug;②Exclude insomnia caused by mental disorders such as major depression or generalized anxiety;③Exclude sleep disorders caused by narcolepsy, circadian rhythm sleep disorders;④Exclude sleep apnea syndrome and other breathing-related sleep disorders;⑤Exclude patients<18-year-old, or>60years;⑥Exclude adjustment insomnia and idiopathic insomnia.(3)To study demographic characteristics and collect data about St. Mary’s Hospital Sleep Questionnaire, Pittsburgh Sleep Quality Index(PSQI), the Newly Developed Questionnaire for Worked Related Fatigue Feelings(WRFFQ) and polysomnography(PSG) of the sleep state misperception group and psychophysiological insomnia group.(4) A statistical difference was compared between the two groups. Measurement data used T test and enumeration data used χ2test.The quality of sleep involving total sleep time (TST), sleep latency (SL), sleep awakings et al about St Mary’s physician sleep questionnaires and PSG monitoring in each groups were analyzed by paired samples t-test to compare the subjective and objective assessment. Score of WRFFQ and sleep structure measured by PSG were analyzed with multiple linear regression analysis.Results:(1) Between the sleep state misperception group and the psychophysiological insomnia group, the differences in gender, age, marital status, education level, occupation and annual household income were not statistically significant (P>0.05).(2) St. Mary’s physician questionnaires showed that last-night total sleep time(LTST) of sleep state misperception group(227.143±55.03) were less than LTST (316.07±28.85) in psychophysiologic insomnia group. SL of sleep state misperception group (124.28±30.24) were longer than psychophysiologic insomnia group (70.75±14.94). However, the self-evaluation of the clarity of mind after early morning in sleep state misperception was (4.46±1.45), which was better than in psychophysiological insomnia group (2.96±0.74).(3)PSG detection showed, in sleep state misperception group, TST (476.82±12.71)), time of NREM II stage (218.64±17.78), time of NREM III stage(121.05±15.40), time of REM period (97.56±7.50) were longer than TST (307.46±37.50), time of NREM II stage(168.93±15.44), time of NREM III stage(55.91±15.94), time of REM stage (47.70±12.78) in psychophysiological insomnia group. And sleep state misperception group had a better sleep efficiency(SE)(91.90±1.89) than that of psychophysiological insomnia group (70.94±9.22). The SL(15.68±2.403), sleep awakenings (1.50±0.64) and time of NREM I (39.56±1.140) in sleep state misperception group were less than SL(70.75±2.823) sleep awaking (5.50±0.311), time of NREM I (57.78±1.581) in psycho-physiological insomnia group.(4)PSQI showed daytime dysfunction score of sleep state misperception group (0.11±0.32), which was less than the score of psychophysiological insomnia group (1.82±0.39). Daytime dysfunction factor score of the two groups had statistically significance (p<0.05).(5)WRFFQ in sleep state misperception group indicated the score of sleepiness factor (7.14±1.78),of the unpleasantness factor (13.14±2.37), of total scores(46.71±3.42), vs (19.61±1.62),(16.04±2.34),(62.57±4.42) in psychophysiological insomnia group. These scores in psychophysiological insomnia group were higher than sleep state misperception, showed statistically significant difference (p<0.05).(6) The total scores of WRFFQ was parameter estimated by multiple regression analysis with PSG results including TST (X1), SE (X2), awaking numbers (X3), SL (X4), time of NREM I (X5), NREM II(X6), NREM III(X7) and REM sleep time(X8). The stepwise regression equation of sleep state misperception group is y=63.93-0.142X7.The stepwise regression equation of psychophysiological insomnia group is y=68.545+0.702X3-0.182X7Conclusion:(1)Total sleep time, sleep efficiency, slow wave sleep(SWS) time of sleep state misperception group are longer than psychophysiological insomnia group in PSG results.(2)Subjective evaluation and objective results monitored by PSG were inconsistent in sleep state misperception group. The subjective assessment was worse. The subjective evaluation of sleep were consistent with results from PSG detection in psychophysiological insomnia group.(3)Daytime dysfunction, sleepiness and unpleasantness in psychophysiologic insomnia group was distinct, while daytime dysfunction in sleep state misperception group was not obvious.(4)Daytime dysfunction in sleep state misperception group was negatively correlated with time of NREMIII stage. Daytime dysfunction in psychophysiological insomnia group was negatively correlated with time of NREMIII stage,and positively correlated with awaking time after sleep, that is daytime fatigue was enhanced by decreased time of NREMIII and increased awaking time after sleep. |
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