Sleep Medicine
Volume 2, Issue 2 , Pages 125-133, March 2001

First night effect and reverse first night effect in older adults with primary insomnia: does anxiety play a role?

  • Brant W Riedel

      Affiliations

    • University of Memphis Center for Community Health, 5350 Poplar Avenue, Suite 550, Memphis, TN 38119, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1-901-678-1677; fax: +1-901-678-1675
  • ,
  • Carolyn F Winfield

      Affiliations

    • University of Memphis Department of Psychology, Memphis, TN 38152, USA
  • ,
  • Kenneth L Lichstein

      Affiliations

    • University of Memphis Department of Psychology, Memphis, TN 38152, USA
    • Methodist Healthcare of Memphis, Memphis, TN 38104, USA

Received 3 February 2000; received in revised form 15 June 2000; accepted 15 June 2000.

Abstract 

Objective: The main objective was to examine first night effect (FNE) and reverse first night effect (RFNE) in older insomniacs and the role played by anxiety in these processes.

Background: RFNE has been documented in a middle-aged sample of insomniacs, but little research has been done on RFNE or FNE in older insomniacs. Also, a relationship between anxiety and FNE has not been established.

Methods: Participants were 77 older adults with primary insomnia (57 females, 20 males). Two consecutive nights of polysomnography (PSG) were conducted, and the state form of the State-Trait Anxiety Inventory was completed each night. Sleep diaries were completed the morning after each (PSG) and for 2 weeks at home.

Results: Most participants exhibited a FNE (57%) rather than a RFNE (26%). State anxiety was elevated on PSG night 1 relative to PSG night 2 in the FNE group but not the RFNE group, and the FNE group reported greater home total sleep time. Among FNE participants, self-reported total sleep and sleep efficiency were significantly higher on PSG night 2 than at home.

Conclusions: Most older insomniacs show a FNE, but a portion exhibit a RFNE. Elevated anxiety on PSG night 1 may play a role in FNE.

Keywords:  First night effect, Reverse first night effect, Polysomnography, Insomnia, Anxiety, Older adults

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

PII: S1389-9457(00)00054-X

Sleep Medicine
Volume 2, Issue 2 , Pages 125-133, March 2001