Disturbed sleep and somatic complaints

We investigated sleep patterns in 20 patients with multiple vague but persistent somatic complaints, not due to any identifiable medical or neurologic disorder, and in whom psychiatric consultations had failed to identify a psychiatric diagnosis. Afternoon naps were recorded in 20 patients and in 10 controls without medical or psychiatric problems. Three-hour postprandial nap recordings were made of submental electromyogram, electrooculogram, and EEG with drowsiness, stages 1-4 NREM, and REM sleep, sleep latency (minutes), sleep efficiency (percent), and number of arousals with return of alpha activity compared in patients and controls by one-tailed t-test. No stage IV or REM sleep occurred in naps. Patients with multiple somatic complaints had less stage III and stage II sleep, and more wakefulness. Arousals were more frequent in the patient group; sleep latency was shorter but sleep efficiency was reduced in patients with multiple somatic complaints compared with controls. The findings suggest that patients with multiple somatic complaints not otherwise explicable by medical or psychiatric problems may have disturbed sleep, improvement of which may ameliorate somatic complaints. Sleep histories should be elicited in such patients, and sleep recordings may be of value in their evaluation; afternoon naps may be a cost-effective way of screening for remediable sleep disturbances in patients with persistent physical complaints of undeterminable cause.