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Reverse first night effect in insomnia.

P J Hauri1, E M Olmstead

  • 1Sleep Disorders Center, Mayo Clinic, Rochester, Minnesota 55905.

Sleep
|April 1, 1989
PubMed
Summary
This summary is machine-generated.

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Insomnia patients exhibiting a reverse first night effect (FNE) may accurately perceive their sleep on subsequent nights. This challenges single-night sleep study interpretations for individuals with defensive traits.

Area of Science:

  • Sleep Medicine
  • Psychophysiology

Background:

  • The first night effect (FNE) is a common phenomenon in sleep studies where individuals exhibit altered sleep patterns on the initial night.
  • Reverse FNE, where sleep is worse on the first night and improves, is less understood.

Purpose of the Study:

  • To evaluate the characteristics of insomniacs with a reverse first night effect (FNE).
  • To compare individuals with strong normal FNE and strong reverse FNE.

Main Methods:

  • Analysis of 89 insomniacs evaluated between 1975-1980.
  • Assessment of sleep efficiency, sleep latency, REM sleep percentage, and REM latency.
  • Comparison of 20 subjects with normal FNE and 20 with reverse FNE.
  • Psychometric evaluation using the Minnesota Multiphasic Personality Inventory (MMPI).

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Main Results:

  • Reverse FNE patients accurately assessed sleep latency on nights 2 and 3, unlike normal FNE patients.
  • Reverse FNE patients scored higher on MMPI K (defensiveness) and Pa (paranoia) scales.
  • Reverse FNE patients reported lower depression and anxiety, with higher sensation-seeking and boredom susceptibility.

Conclusions:

  • Single-night laboratory sleep evaluations may not fully capture an insomniac's sleep disorder.
  • Caution is advised when labeling insomniacs as having "subjective complaint without objective findings," particularly those who are defensive, guarded, and sensation-seeking.