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Sleep changes in the disorder of insomnia: A meta-analysis of polysomnographic studies

Baglioni, Chiara, Regen, Wolfram, Teghen, Armand, Spiegelhalder, Kai, Feige, Bernd, Nissen, Christoph, Riemann, Dieter·2014·Sleep Medicine Reviews

DOI 10.1016/j.smrv.2013.04.001

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Abstract

Insomnia is a highly prevalent health problem worldwide. Primary insomnia (PI), i.e., insomnia not due to another disorder or substance use, represents a model to elucidate the pathophysiology of sleep. However, prior research in patients with PI has failed to demonstrate consistent abnormalities in the state-of-the-art assessment of sleep (polysomnography). The aim of this meta-analysis was to clarify whether there are identifiable polysomnographic sleep changes that correspond to the subjective complaints of patients with PI. Medline and PsycInfo databases were searched from 1994 to 2012. Effects were calculated as standardized mean differences. Studies were pooled with the random-effects metaanalytic model. Twenty-three studies met inclusion criteria. In total, 582 patients with PI and 485 good sleeper controls (GSC) were evaluated. The results showed that patients with PI present a disruption of sleep continuity and a significant reduction of slow wave sleep (SWS) and rapid eye movement (REM) sleep compared to GSC. The observed changes in sleep architecture, i.e., reductions in SWS and REM sleep, hitherto did not count among the typical polysomnographic findings in patients with PI. An advanced knowledge of the polysomnographic changes in PI may add to foster the understanding of the pathophysiology of sleep and its bi-directional relationships with somatic and mental disorders.

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Authors: Baglioni, C., Regen, W., Teghen, A., Spiegelhalder, K., Feige, B., Nissen, C., & Riemann, D.
Affiliations: University of Freiburg (DE)
Corresponding author: Baglioni, Chiara
ORCID: Baglioni, Chiara
Spiegelhalder, Kai
Feige, Bernd
Nissen, Christoph
Riemann, Dieter
Venue: Sleep Medicine Reviews
Publisher: Elsevier BV
Published: 2014-06
Volume: 18
Issue: 3
Pages: 195-213
ISSN: 1087-0792 (ISSN-L)
DOI: 10.1016/j.smrv.2013.04.001
OpenAlex: W1979055237
Cited by: 386
References: 83
Citations by year: 2026: 23 · 2025: 47 · 2024: 36 · 2023: 55 · 2022: 26 · 2021: 33 · 2020: 38 · 2019: 27 · 2018: 19 · 2017: 22 · 2016: 24 · 2015: 22 · 2014: 11
FWCI: 3.38
Type: journal article
Language: en
Open access: closed
Locations: Sleep Medicine Reviews (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
Keywords: primary insomnia, sleep architecture, slow-wave sleep, REM sleep, sleep continuity, polysomnography findings, sleep pathophysiology
MeSH terms: Arousal, Humans, Sleep Initiation and Maintenance Disorders, Reference Values, Sleep, Sleep, REM, Polysomnography

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Sleep changes in the disorder of insomnia: A meta-analysis of polysomnographic studies

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