Psychological functioning measures in patients with primary insomnia and sleep state misperception

Dittoni S, Mazza M, Losurdo A, Testani E, Di Giacopo R, Marano G,Di Nicola M, Farina B, Mariotti P, Mazza S, Della Marca G.Psychological functioning measures in patients with primary insomniaand sleep state misperception.Acta Neurol Scand 2013: DOI: 10.1111/ane.12078.© 2013 John Wiley & Sons A/SObjective – Sleep state misperception (SSM) is a term used in theInternational Classification of Sleep Disorders to indicate people whomistakenly perceive their sleep as wakefulness. SSM is a form ofprimary insomnia. The aim of this study was to record psychologicalfunctioning measures (anxiety, depression, ability to feel pleasure,obsessive–compulsive traits) in a population of patients with primaryinsomnia and to evaluate the relationship between these measures andthe patients’ perception of their sleep. Materials and Methods –Seventy-six consecutive patients with primary insomnia were enrolled:34 men and 42 women, mean age 53.9 13.1. Sleep study includedthe following: Pittsburgh Sleep Quality Index, Epworth SleepinessScale, Berlin’s Questionnaire and home-based polysomnography.Psychometric evaluation included the following: Self-AdministeredAnxiety Scale, Beck’s Depression Inventory, Maudsley’s ObsessiveCompulsive Inventory, Snaith–Hamilton Pleasure Scale, EatingAttitude Test. Results – All patients with insomnia had psychometricscores higher than the general population, but very few patients, inboth groups, had anxiety or depression scores consistent with severemood or anxiety disorders. Comparisons between subjective andobjective scores confirmed that most sleep parameters wereunderestimated. Patients with SSM had lower anxiety scores ascompared to patients without SSM. Conclusions – The study did notsucceed in identifying any predictor of sleep misperception.We speculate that a group of patients, rather than being extremelyworried by their insomnia, may have a sort of agnosia of their sleep.