Sleep Micro-Macro-structures in Psychophysiological Insomnia. PSG Study

Ali Ghermezian; Mohammad Nami; Reza Shalbaf; Reza Khosrowabadi; Mohammad Nasehi; Ali-Mohammad Kamali

doi:10.1007/s41782-023-00228-5

Sleep Micro-Macro-structures in Psychophysiological Insomnia. PSG Study

Sleep Vigil. 2023 Apr 16:1-9. doi: 10.1007/s41782-023-00228-5. Online ahead of print.

Authors

Ali Ghermezian^{1

2

3}, Mohammad Nami^{4

5

6

7}, Reza Shalbaf², Reza Khosrowabadi¹, Mohammad Nasehi^{2

8}, Ali-Mohammad Kamali^{9

3}

Affiliations

¹ Shahid Beheshti University, Shahid Shahriari Square, Evin, Tehran, Iran.
² Department of Cognitive Neuroscience, Institute for Cognitive Science Studies, Tehran, Iran.
³ Dana Brain Health Institute, Shiraz, Iran.
⁴ Brain, Cognition, and Behavior Unit at Dana Brain Health Institute, Shiraz, Iran.
⁵ Harvard Alumni for Mental Health dataset, Middle-East Ambassador, Dubai, UAE.
⁶ Iranian Academy of Neuroscience, Fars Chapter, Shiraz, Iran.
⁷ Society for Brain Mapping and Therapeutics, Brain Mapping Foundation, Los Angeles, CA USA.
⁸ Cognitive and Neuroscience research center(cnrc), Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
⁹ Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran.

Abstract

Study objectives: To address sleep micro-macro-structures in psychophysiological insomnia (PPI) as denoted by cyclic alternating pattern (CAP), Sleep spindles, and hyperarousal as microstructures and sleep characteristics such as sleep stages' variables, and heart rate as macrostructures.

Methods: Two statistical populations, with 20 participants in each, are addressed: good sleepers (GS) and patients with psychophysiological insomnia (PPI). The sleep polysomnography (PSG) for one night was performed and sleep macro-micro-structures extraction was implemented for each participant. Cyclic alternating patterns were scored manually and other structures were monitored by the original PSG's device software. Analytical methods are used to dissect the results.

Result: The findings imply: (a) psychophysiological insomnia is characterized by CAP differences from good sleepers which are associated with hyperarousal; (b) Regarding microstructure, more microarousals in sleep stages caused more number of wake index. (c) The ratio of sleep stages, sleep latency and heart rate as sleep macrostructure are significantly changed. (d) There is no significant difference between PPI and GS groups on spindles length in our research.

Conclusion: Regarding all sleep disorders and especially PPI, CAP variables, EEG arousals, and sleep spindles as microstructures and Total Sleep Time, Sleep Latency, number of waking, REM duration, and Heart Rate as macrostructures were found to be critical for the diagnosis of psychophysiological insomnia The analysis contributes to understanding better approaches in the quantitative specification of psychophysiological insomnia compare to good sleepers.

Keywords: Cyclic alternating pattern (CAP); Hyperarousal; Insomnia disorder (ID); Micro–Macro-structures; Psychophysiological insomnia (PPI); Sleep spindle.

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