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Abstract Details

Does Treatment for Insomnia Improve Sleep State Misperception?
Sleep
P11 - Poster Session 11 (11:45 AM-12:45 PM)
14-001
To determine whether discrepancies between objective polysomnography (PSG) data and subjective sleep assessments were impacted by lemborexant (LEM) treatment in adults with insomnia. 
Discrepancies often exist between patient-reported (subjective) and PSG-assessed (objective) sleep data, yet few insomnia studies have examined the effects of treatment on sleep state misperception.
E2006-G000-304: 1-month, randomized, double-blind study of LEM 5mg (LEM5), LEM 10mg (LEM10), placebo (PBO), and zolpidem extended-release (ZOL) 6.25mg in participants with insomnia disorder aged ≥55 years. Participants were classified into misperception index quartiles (Qs) based on differences between baseline (BL) PSG and sleep diary values. Participants in Q1 reported falling asleep slower or having more wakefulness during sleep than on PSG, whereas participants in Q4 reported falling asleep faster or having less wakefulness than on PSG. Post-treatment values for PSG- and diary-based parameters were compared at the beginning/end of treatment.

1006 participants were randomized to treatment (LEM5, n=266; LEM10, n=269; ZOL, n=263; PBO, n=208) and divided into Q1-4 by degree of misperception at BL. Latency to persistent sleep (LPS) and wake after sleep onset (WASO) in the 4 treatment groups did not differ substantively in Q1-Q3 at BL; however, BL Q4 values were significantly larger. Whereas BL values for subjective sleep onset latency (sSOL) and subjective WASO (sWASO) in the 4 treatment groups did not differ substantively in Q2-Q4, BL Q1 values were larger than other groups. Regardless of treatment group, differences from BL between LPS and sSOL and WASO and sWASO became closer over time. Differences between PSG and diary data became closest in participants reporting greater subjective values (Q4). Q2 and Q3 had little change in discrepancy, whereas large differences remained in Q1.
While many participants with insomnia became more accurate in reporting their sleep parameters with treatment, sleep state misperception persisted in many individuals despite improvement in sleep. 
Authors/Disclosures
Dinesh Kumar
PRESENTER 		Dinesh Kumar has received personal compensation for serving as an employee of Eisai Inc.
Jocelyn Y. Cheng, MD, FAAN (Eisai Inc.) Dr. Cheng has received personal compensation for serving as an employee of Eisai Inc.
Margaret Moline Margaret Moline has received personal compensation for serving as an employee of EISAI, INC.. Margaret Moline has received intellectual property interests from a discovery or technology relating to health care. Margaret Moline has received personal compensation in the range of $0-$499 for serving as a review, loan repayment program with NIH.