Insomnia causes sleep misperception

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Human brain sends inhibitory neurons that  reduce conscious awareness to get to a point of deep sleep. Normal sleepers often feel like they’ve fallen asleep before their brain is in a state of sleep, but people with insomnia have opposite feeling. A recent study by BYU psychology professor Daniel Kay suggests a dysfunction in the inhibition process could prevent those with insomnia from falling asleep.

Patients with insomnia appear to be asleep, their eyes are closed and their brain is in a characteristic sleep pattern, but when they wake up they may think they are awake. Sleep misperception is based on the assumption that sleep is categorical, either being asleep or being awake and that when you’re asleep you don’t have consciousness. It is possible to be consciously aware that the brain is in a sleep pattern. To help the participants feel comfortable enough to fall asleep, they slept at the lab for two nights before the study.

The participants were monitored with polysomnography, the gold-standard objective measure of sleep, and once their brain-wave patterns had been in a state of sleep for 10 minutes, a radioactive tracer was injected in their arm. The tracer, attached to glucose molecules, was taken into active brain neurons. After 20 minutes, the researchers woke the participants and took a scan of their brain. When patients reported being awake longer than polysomnography measured, they had greater activity in regions of the brain associated with conscious awareness during non-rapid eye movement sleep.

When good sleepers reported going to sleep before polysomnographic sleep occurred, they too had greater brain activity in the same regions. Patients with insomnia and normal sleepers may experience an inhibition process while falling asleep, patients with insomnia may not perceive being asleep until their brain has a large increase in inhibitory activity in brain regions involved in conscious awareness.

Good sleepers, likewise, may experience going to sleep before the objective measure due to greater inhibitory processes in consciousness centers of the brain, in patients with insomnia reducing conscious awareness during sleep may be impaired. One of the strategies for targeting these processes may be mindfulness meditation. It may help the patients inhibit cognitive processes that are preventing  sleep experience.

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