Journal Article

0076 A Comparison of Resting Cerebral Blood Flow in Patients with Primary Insomnia and Good Sleeper Controls

H J Orff, C C Hays, E A Almklov, C E Wierenga and S P Drummond


Published on behalf of American Academy of Sleep Medicine

Volume 41, issue suppl_1, pages A30-A31
ISSN: 0161-8105
Published online April 2018 | e-ISSN: 1550-9109 | DOI:

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Insomnia is a common sleep disorder affecting approximately 10–30% of the population. Although numerous studies have investigated the impact of insomnia on psychosocial functioning, there have been few published studies evaluating the neurophysiologic implications of insomnia. Examining resting cerebral blood flow (rCBF) in patients with Primary Insomnia (PI) is particularly essential as it will aid in elucidating the impact of insomnia on the neurophysiologic response to cognitive challenge.


9 patients who met DSM-IV-TR criteria for PI and additional research criteria (≥30mins to fall and/or stay asleep, and either <6 hours total sleep time [TST] or sleep efficiency [SE] <85% on ≥3 nights per week for ≥6 months, with daytime complaint) were matched to 9 Good Sleeper (GS) controls for gender, age (+/-8yrs), and education level (+/-2yrs) All subjects underwent 1-week baseline evaluation, followed by 2-nights polysomnography (PSG), 1–2 nights at-home sleep, and an imaging protocol consisting of fMRI tasks and assessment of rCBF using arterial spin labeling (ASL). Groups were compared on PSG and rCBF using independent samples t-tests. Bivariate correlations were performed for PSG on rCBF in regions found to significantly differ between groups.


Based on second night (baseline) PSG, PIs had significantly less TST (388min vs 439min; p=.033), greater wake after sleep onset time (WASO:65min vs 21min; p=.009), and lower SE (83% vs 93%; p=.012). ASL analyses determined that PIs exhibited lower rCBF in frontal, insular, occipital, and subcortical regions (p’s<.01; uncorrected). Furthermore, increased WASO and poorer SE were found to be significantly associated with lower rCBF in the anterior insula (WASO:r=-.487, p=.04; SE:r=.481, p=.04) and putamen (WASO:r=-.488, p=.04; SE:r=.504, p=.03); higher percent Stage 1 sleep was associated with lower rCBF in the left inferior frontal gyrus (r=-.474, p=.05).


In this preliminary investigation, PIs exhibited a pattern of reduced rCBF in regions implicated in wide ranging functions including language and emotional processing and regulation of movement. Future research is needed to determine the short- and long-term implications of insomnia on neurophysiologic functioning.

Support (If Any)

NRSA-NIMH-MH077411-01(HJO); NSF-2015207525(CCH); VA-CSR&D-Merit-5I01CX000565(CEW).

Journal Article.  0 words. 

Subjects: Neurology ; Sleep Medicine ; Clinical Neuroscience ; Neuroscience

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