Information Processing at Sleep Onset and During Sleep in Patients With Insomnia

Inclusion criteria

for Psychophysiologic Insomnia (PI)

These subjects will meet RDC criteria for Psychophysiologic insomnia. In addition, the complaint of disturbed sleep will have at least one of the following minimal characteristics:

• > 30 min. sleep-onset latency (SL) (Initial Insomnia)
• >2 awakenings per night (>15 min. ea.) and/or wake after sleep-onset (WASO) of > 30 min (Middle Insomnia)

Total Sleep Time (TST) will not exceed 6 hours [unless the Sleep Efficiency (SE) quotient is < 80%] and the problem frequency must be > 4 nights/week (Severe Insomnia) with a problem duration > 6 months (Chronic Insomnia)B .

Inclusion criteria

for Good Sleeper Subjects

• Report that they obtain enough sleep and that their sleep is restorative
• Have a score of less than 10 on the Epworth Sleepiness Scale (ESS)50-52
• Have a score of less than 15 on the Ford Insomnia Response to Stress Test (FIRST)53
• Have a score of less than 7 on the Insomnia Severity Index (ISI)54
• Report retrospectively and prospectively < 15 minutes to fall asleep and "wake after sleep onset time" of < 15 minutes and a total sleep time > 6 hoursA

A These profiles will be evident at both intake (based on retrospective reports) and as an average from the two weeks of baseline diaries (based on prospective sampling).

Exclusion criteria

for All Subjects

• Unstable medical illness or acute or history of psychiatric illness (except GAD or MDD - Allowed provided that these have resolved and not recurred within 5 years) As ascertained with self report questionnaires, a clinical History, a physical exam and a clinical chemistry profile.

To assure that the insomnia is not secondary to these factors

• Symptoms suggestive of sleep disorders other than insomnia To assure that the insomnia is not secondary to these factors
• Polysomnographic data indicating sleep disorders other than insomnia To assure that the insomnia is not secondary to these factors
• History of head injury with a sustained loss of consciousness To help assure that the EEG measures are unconfounded by brain damage
• Evidence of active illicit substance use or fitting criteria for alcohol abuse or dependence To assure that the insomnia is not secondary to these factors
• Use of CNS active medications including antidepressants and hypnotics (within 2 weeks or 5 half-lives) To help assure that the EEG measures are unconfounded by medication effects such as the "BZ artifact".
• Inadequate language comprehension To assure the quality of self report data as all the measures are in English.
• Pregnancy Excluded owing to the hormonal changes that occur with pregnancy
• Left Handedness To control for EEG differences related to handedness
• Nicotine Use To assure that the insomnia is not secondary to these factors
• Caffeine use that exceeds 2 beverages per day or occurs past 5pm in the evening.

To assure that the insomnia is not secondary to these factors