Excitatory versus inhibitory impairments in insomnia patients: An ERP study

According to the neurocognitive perspective on insomnia, conditioned arousal results in impairment of information processing, as such interfering with normal sleep processes. In the present study, evening event-related potentials N100 and P200 were evaluated to assess hyperarousal in patients with insomnia and controls. 13 patients (mean age=40.8) with polysomnographically verified sleep disruptions and 11 good sleepers (mean age=45.4) were included. An auditory oddball paradigm was administered the evening of the polysomnography. N100 and P200 mean amplitudes and peak latencies at Fz and Cz were analyzed as a measure of respectively general arousability and inhibition of information processing. Patients experiencing insomnia were characterized by decreased P200 amplitudes compared to good sleepers. No significant differences were found for N100 amplitudes and latencies of both ERP waves. These results suggest that this group of patients with objectified insomnia is characterized by an arousal impairment. However, there was no evidence of hyperarousal, considering the normal N100 amplitudes. On the other hand, the inhibition of information processing was distorted. As such, the impairment of de-arousal or de-activation in insomnia is put forward as an additional factor within the arousal model. •The concept of arousal has an excitatory branch and an inhibitory branch.•Arousal impairments are evaluated by the auditory N100 or P200 ERP components.•Insomniacs can be characterized by inhibitory impairments reflected by the P200.•Inhibitory impairments in arousal can be related to the process of de-activation.•Insomniacs experience difficulties with inhibiting auditory information processing.