Are insomniacs sleepy during the day? A pupillometric assessment.

A biodevelopmental model of insomnia is articulated specifying coordinated nighttime (disturbed sleep pattern) and daytime (no excessive daytime sleepiness) characteristics defining an insomnoid classification in at-risk groups: short sleepers and older adults. Pupillometry is proposed as a useful means of discriminating degree of daytime sleepiness to aid in the differential diagnosis of insomnia and insomnoid states, and the present study tested the discriminative validity of this approach. Noninsomniac (n = 34) and insomniac (n = 29) college students submitted to four 10 min pupillometry sessions tracking daytime sleepiness from morning arising to bedtime. Pupil diameter proved to be an able discriminator of these two groups though substantial overlap of the two distributions was also noted. The results supported the sensitivity of pupillometry in detecting daytime sleepiness, but yielded alternative interpretations. We observed statistical differentiation in insomniac and noninsomniac daytime sleepiness, but substantial, functional overlap between these groups. Assessment and treatment implications arising from the biodevelopmental model were hypothesized.

[1]  J. Stevens.  Applied Multivariate Statistics for the Social Sciences , 1986 .

[2]  I. E. Loewenfeld,et al.  Pupillary Movements During Acute and Chronic Fatigue A New Test for the Objective Evaluation of Tiredness , 1963 .

[3]  M. Carskadon,et al.  Guidelines for the multiple sleep latency test (MSLT): a standard measure of sleepiness. , 1986, Sleep.

[4]  K. Lichstein.  Sleep compression treatment of an insomnoid , 1988 .

[5]  Miles Le,et al.  Sleep and aging. , 1980 .

[6]  I. E. Loewenfeld,et al.  DISINTEGRATION OF CENTRAL AUTONOMIC REGULATION DURING FATIGUE AND ITS REINTEGRATION BY PSYCHOSENSORY CONTROLLING MECHANISMS , 1952, The Journal of nervous and mental disease.

[7]  M. Pressman,et al.  Senile miosis: the possible contribution of disordered sleep and daytime sleepiness. , 1986, Journal of gerontology.

[8]  Carolyn J. Hursch,et al.  Electroencephalography (EEG) of human sleep : clinical applications , 1974 .

[9]  Phenomenology of sleep among insomniacs and good sleepers: Wakefulness experience when cortically asleep. , 1981 .

[10]  C. Pollak,et al.  Patterns of daytime sleepiness in narcoleptics and normals: a pupillometric study. , 1984, Electroencephalography and clinical neurophysiology.

[11]  I. E. Loewenfeld,et al.  Disintegration of central autonomic regulation during fatigue and its reintegration by psychosensory controlling mechanisms. II. Reintegration; pupillographic studies. , 1952, The Journal of nervous and mental disease.

[12]  M. Pressman,et al.  Relationship of autonomic nervous system activity to daytime sleepiness and prior sleep. , 1989, Sleep.

[13]  H. Halstead.  Sleep and Aging: A Research Based Guide to Sleep in Later Life , 1988 .

[14]  W. Dement,et al.  Daytime alertness in relation to mood, performance, and nocturnal sleep in chronic insomniacs and noncomplaining sleepers. , 1984, Sleep.

[15]  W. Dement,et al.  Sleepiness in insomnia: evaluation and treatment. , 1982, Sleep.

[16]  R. McGuire.  Progress in clinical psychology , 1965 .

[17]  H. Schmidt.  Pupillometric assessment of disorders of arousal. , 1982, Sleep.

[18]  K. N. Ogle,et al.  The pupillogram and narcolepsy , 1969, Neurology.

[19]  P. Lavie.  Ultradian rhythms in alertness — A pupillometric study , 1979, Biological Psychology.

[20]  W. Dement,et al.  Quantification of sleepiness: a new approach. , 1973, Psychophysiology.

[21]  N. Jacobson,et al.  Psychotherapy outcome research: Methods for reporting variability and evaluating clinical significance , 1984 .

[22]  R. Bootzin,et al.  A comparison of progressive relaxation and autogenic training as treatments for insomnia. , 1974, Journal of abnormal psychology.

[23]  P Badia,et al.  Sleep fragmentation and daytime sleepiness. , 1984, Sleep.