Wake High-Density Electroencephalographic Spatiospectral Signatures of Insomnia

Abstract Study Objectives: Although daytime complaints are a defining characteristic of insomnia, most EEG studies evaluated sleep only. We used high-density electroencephalography to investigate wake resting state oscillations characteristic of insomnia disorder (ID) at a fine-grained spatiospectral resolution. Methods: A case-control assessment during eyes open (EO) and eyes closed (EC) was performed in a laboratory for human physiology. Participants (n = 94, 74 female, 21-70 y) were recruited through www.sleepregistry.nl: 51 with ID, according to DSM-5 and 43 matched controls. Exclusion criteria were any somatic, neurological or psychiatric condition. Group differences in the spectral power topographies across multiple frequencies (1.5 to 40 Hz) were evaluated using permutation-based inference with Threshold-Free Cluster-Enhancement, to correct for multiple comparisons. Results: As compared to controls, participants with ID showed less power in a narrow upper alpha band (11-12.7 Hz, peak: 11.7 Hz) over bilateral frontal and left temporal regions during EO, and more power in a broad beta frequency range (16.3-40 Hz, peak: 19 Hz) globally during EC. Source estimates suggested global rather than cortically localized group differences. Conclusions: The widespread high power in a broad beta band reported previously during sleep in insomnia is present as well during eyes closed wakefulness, suggestive of a round-the-clock hyperarousal. Low power in the upper alpha band during eyes open is consistent with low cortical inhibition and attentional filtering. The fine-grained HD-EEG findings suggest that, while more feasible than PSG, wake EEG of short duration with a few well-chosen electrodes and frequency bands, can provide valuable features of insomnia. Significance Whereas round-the-clock hyperarousal is considered characteristic of insomnia, its representation in wake EEG is insufficiently known. We compared the spatiospectral properties of high-density wake EEG of 51 people with insomnia and 43 matched controls without sleep complaints. Just as previously reported during sleep, people with insomnia show widespread increased beta power during eyes closed wakefulness. During eyes open, their EEG moreover shows relatively little power in a narrow band in the upper-alpha range. The low correlation between these two features suggests they may reflect distinct processes, respectively high arousal and low inhibition. Future studies may employ these measures to evaluate subtypes of insomnia and relevance for variability in profiles of complaints about sleep and daytime functioning