Skip to main content
SpringerLink
Log in

Quantifizierte Arousal-Analyse bei Patienten mit einer psychophysiologischen Insomnie

Quantified arousal analysis in patients with psychophysiological insomnia

  • Published:
Somnologie - Schlafforschung und Schlafmedizin Aims and scope Submit manuscript

Zusammenfassung

Arousal sind sekundenkurze Frequenzbeschleunigungen im Elektroenzephalogramm des schlafenden Menschen. Viele Untersuchungen weisen auf einen Zusammenhang zwischen einem Arousal-gestörten Schlaf und einer eingeschränkten Tagesbefindlichkeit bei schlafgestörten Patienten hin. Seit 1992 existieren standardisierte Kriterien zur Bestimmung von Arousals der American Sleep Disorders Association (ASDA). Daten zur diesbezüglichen Feinstruktur des Schlafes bei Patienten mit einer Insomnie fehlen aber bisher. Wir untersuchten daher die Arousal-Muster unter Berücksichtigung der ASDA-Kriterien bei 25 Patienten mit einer psychophysiologischen Insomnie unterschiedlichen Alters und 10 gesunden Kontrollen. Junge Patienten zeigten einen signifikant (p≤0,01) höheren Arousal-Index pro Stunde Gesamtschlafzeit (18,3±6,3) als altersentsprechende Gesunde (10,5±3,1). Der Arousal-Index der Patienten stieg mit zunehmendem Alter leicht an (maximal 27,6±11,5). Bei allen Patienten war insbesondere der Anteil der nicht mit einer Bewegung einhergehenden Arousal erhöht. Der Schlaf der Insomniepatienten wird demnach durch eine Arousal-bedingte Fragmentierung gestört. Die Ergebnisse dieser explorativen und hypothesengenerienrenden Untersuchung legen nahe, dass das Modell eines generellen pscyhophysiologischen Hyperarousal der psychophysiologischen Insomnie sich neurophysiologisch im vermehrten Auftreten von Arousal zeigt.

Summary

Arousals are transient, brief and abrupt frequency shifts in the electroencephalogram during sleep. A lot of studies considered that the impaired daytime functioning in patients with sleep disturbances may be caused by such sleep fragmentations. In 1992 the American Sleep Disorders Association (ASDA) defined criteria concerning the rating of arousals. Nevertheless, data on arousal patterns according to ASDA criteria in patients with insomnia are still missing. Therefore, we studied the arousal distribution according to ASDA criteria in 25 patients with psychophysiological insomnia divided into four age groups and 10 young healthy controls. Young patients showed a significantly increased arousal index per hour total sleep time (18.3±6.3) compared to age-matched controls (10.5±3.1, p≤0.01). Within the patient groups the arousal index increased with increasing age (maximal index: 27,6±11.5). All patients showed high percentages of non-movement related arousals. In spite of the explorative character of the presented study, the results indicate that the insomniacs' sleep is disturbed by arousal-related sleep fragmentation. The increased arousal frequency suggests to be a neurophysiological correlate of the postulated hyperarousal in psychophysiological insomnia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. American Sleep Disorders Association (ASDA): The International Classification of Sleep Disorders. American Sleep Disorders Association (Hrsg.) Rochester, 1990.

  2. American Sleep Disorders Association (ASDA): EEG arousals: Scoring rules and examples. Sleep 15: 173–184, 1992.

    Google Scholar 

  3. Boselli M, Parrino L, Smerieri A, Terzano MG: Effect of age on EEG arousals in normal sleep. Sleep 21: 351–357, 1998.

    PubMed  CAS  Google Scholar 

  4. Campell SS, Webb WB. The perception of wakefulness within sleep, Sleep 4: 177–183, 1981.

    Google Scholar 

  5. Cross EM, Chaffin WW: Use of the binomial theorem in interpreting results of multiple tests of significance. Educational and Psychological Measurement 42: 25–34, 1982.

    Google Scholar 

  6. Halasz P: Hierachy of micro-arousals and the microstructure of sleep. Neurophysiol Clin 28: 461–475, 1998.

    Article  PubMed  CAS  Google Scholar 

  7. Hauri P: Primary insomnia. In Kryger MH, Roth T, Dement WC (Hrsg.) Principles and practice of sleep medicine. WB Saunders Company, Philadelphia, pp 494–499, 1994.

    Google Scholar 

  8. Hauri P, Fisher J: Persistent psychophysiologic (learned) insomnia. Sleep 9: 38–53, 1986.

    PubMed  CAS  Google Scholar 

  9. Knab B, Engel RR. Perception of waking and sleeping: possible implications for the evaluation of insomnia. Sleep 11: 265–72, 1988.

    PubMed  CAS  Google Scholar 

  10. Kronholm E, Alanen E, Hyyppa MT: Sleep movements and poor sleep in patients with non-specific complaints—I. No first-night effect in poor and good sleepers. J Psychosom Res 31: 623–629, 1987.

    Article  PubMed  CAS  Google Scholar 

  11. Lammers S, Hajak G, Rodenbeck A, Sammeck R, Staedt J, Herrendorf G, Rüther E: Schlafkorrelierte Bewegungsanalyse mittels Motilitätsbett. In: Meier-Ewert K, Rüther E (Hrsg): Schlafmedizin. Gustav Fischer Verlag, Stuttgart, pp 187–188, 1993.

    Google Scholar 

  12. Loredo JS, Clausen JL, Ancoli-Israel S, Dimsdale JE: Night-to-night arousal variability and interscorer reliability of arousal measurements. Sleep 22: 916–920, 1999.

    PubMed  CAS  Google Scholar 

  13. Mathur R, Douglas NJ: Frequency of EEG arousals from nocturnal sleep in normal subjects. Sleep 18: 330–333, 1995.

    PubMed  CAS  Google Scholar 

  14. Mendelson WB, Garnett D, Gillin JC, Weingartner H: The experience of insomnia and daytime and nighttime functioning. Psychiatry Res. 12: 235–250, 1984.

    Article  PubMed  CAS  Google Scholar 

  15. Merica H, Blois R, Gaillard JM: Spectral characteristics of sleep EEG in chronic insomnia. Eur J Neurosci 10: 1826–1834 1998.

    Article  PubMed  CAS  Google Scholar 

  16. Penzel T, Hajak G, Hoffmann M, et al.: Empfehlungen zur Durchführung und Auswertung polysomnographischer Ableitungen im diagnostischen Schlaflabor. Z EEG-EMG 24: 65–70, 1993.

    Google Scholar 

  17. Perlis ML, Giles DE, Mendelson WB, Bootzin RR, Wyatt JK: Psychophysiological insomnia: the behavioural model and a neurocognitive perspective. J Sleep Res 6: 179–88, 1997.

    Article  PubMed  CAS  Google Scholar 

  18. Randerath WJ, Schwickert M, Kroll B, Dingemann A, Rühle K.-H., Arousals bei Patienten mit obstruktiven Schlafapnoe-Syndrom—Untersuchung zu Häufigkeit in Abhängigkeit von Lebensalter, Geschlecht und Schweregrad der Erkrankung. Somnologie 4: 7–12, 2000.

    Article  Google Scholar 

  19. Raschke F, Fischer J: “Arousal” in der Schlafmedizin. Somnologie 1: 59–64, 1997.

    Google Scholar 

  20. Rechtschaffen A, Kales A: A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects. US Govt. Printing Office, Washington DC, 1968.

    Google Scholar 

  21. Roehrs T, Merlotti L, Petrucelli N, Stepanski E, Roth T: Experimental sleep fragmentation. Sleep 17: 438–443, 1994.

    PubMed  CAS  Google Scholar 

  22. Schramm E, Riemann D: TCSD Intenationale Klassifikation der Schlafstörungen, Beltz, Weinheim, 1995.

    Google Scholar 

  23. Sobanski T, Feige B, Riemann D: Neuere Modellvorstellungen zu Ätiologie und Pathophysiologie der pychophysiologischen Insomnie. Somnologie 3: 247–253, 1999.

    Article  Google Scholar 

  24. Terzano MG, Parrino L: Evaluation of EEG cyclic alternating pattern during sleep in insomniacs and controls under placebo and acute treatment with zolpidem. Sleep 15: 64–70, 1992.

    PubMed  CAS  Google Scholar 

  25. Terzano MG, Parrino L: Effect of hypnotic drugs on sleep architecture. Pol J Pharmacol 46: 487–490, 1994.

    PubMed  CAS  Google Scholar 

  26. Terzano MG, Parrino L, Boselli M, Spaggiari MC, Di Giovanni G, Smerieri A. Sensitivity of cyclic alternating pattern to prolonged pharmacotherapy: a 5-week study evaluating zolpidem in insomniac patients. Clin Neuropharmacol, 20: 447–454, 1997.

    Article  PubMed  CAS  Google Scholar 

  27. World Health Organisation (WHO): Chapter V (F): Mental and behavioural disorders (including disorders of the psychophysiological development). Clinical descriptions and diagnostic guidelines. In: World Health Organisation (Hrsg.): Tenth Revision of the International Classification of Disorders. Genf. 1991.

  28. Zucconi M, Oldani A, Ferini-Strambi L, Calori G, Castronova C, Smirne S: EEG arousal pattern in habitual snorers with and without obstructive sleep apnoea (OSA). J Sleep Res 4: 107–112, 1995.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik und Poliklinik für Psychiatrie und Psychotherapie, Georg-August-Universität Göttingen, von-Siebold-Str. 5, 37075, Göttingen

    Andrea Rodenbeck, Eckart Rüther, Stefan Cohrs & Göran Hajak

Authors
  1. Andrea Rodenbeck
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eckart Rüther
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Stefan Cohrs
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Göran Hajak
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrea Rodenbeck.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rodenbeck, A., Rüther, E., Cohrs, S. et al. Quantifizierte Arousal-Analyse bei Patienten mit einer psychophysiologischen Insomnie. Somnologie 4, 55–60 (2000). https://doi.org/10.1046/j.1439-054x.2000.13100.x

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1046/j.1439-054x.2000.13100.x

Schlüsselwörter

Keywords

Search

Navigation