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VOLUME 31, ISSUE 12

EEG SPECTRAL ANALYSIS IN PRIMARY INSOMNIA
EEG Spectral Analysis in Primary Insomnia: NREM Period Effects and Sex Differences

Daniel J. Buysse, MD1; Anne Germain, PhD1; Martica L. Hall, PhD1; Douglas E. Moul, MD, MPH2; Eric A. Nofzinger, MD1; Amy Begley, MA1; Cindy L. Ehlers, PhD3; Wesley Thompson, PhD1,4; David J. Kupfer, MD1

1Neuroscience Clinical and Translational Research Center and Sleep Medicine Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA; 2Department of Psychiatry, Louisiana State University, Shreveport, LA; 3Scripps Research Institute, La Jolla, CA; 4Department of Statistics, University of Pittsburgh, Pittsburgh, PA



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Study Objectives:

To compare NREM EEG power in primary insomnia (PI) and good sleeper controls (GSC), examining both sex and NREM period effects; to examine relationships between EEG power, clinical characteristics, and self-reports of sleep.
Design: Overnight polysomnographic study.

Setting:

Sleep laboratory.

Participants:

PI (n = 48; 29 women) and GSC (n = 25; 15 women).

Interventions: None.

Measurements:

EEG power from 1-50 Hz was computed for artifactfree sleep epochs across four NREM periods. Repeated measures
mixed effect models contrasted differences between groups, EEG frequency bands, and NREM periods. EEG power-frequency curves were modeled using regressions with fixed knot splines.

Results:

Mixed models showed no significant group (PI vs. GSC) differences; marginal sex differences (delta and theta bands); significant differences across NREM periods; and group*sex and group*NREM period interactions, particularly in beta and gamma bands. Modeled power-frequency curves showed no group difference in whole-night NREM, but PI had higher power than GSC from 18-40 Hz in the first NREM period. Among women, PI had higher 16 to 44-Hz power than
GSC in the first 3 NREM periods, and higher 3 to 5-Hz power across all NREM periods. PI and GSC men showed no consistent differences in EEG power. High-frequency EEG power was not related to clinical or subjective sleep ratings in PI.

Conclusions:

Women with PI, but not men, showed increased high-frequency and low-frequency EEG activity during NREM sleep compared to GSC, particularly in early NREM periods. Sex and NREM period may moderate quantitative EEG differences between PI and GSC.

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