S18 Abstracts of 3rd International Congress of the Association of Sleep Medicine (WASM) / Sleep Medicine 10, Suppl. 2 (2009) S1–S83 rent sleep and psychiatric disorders in a naturalist prospective study. Indi- viduals with comorbid major medical, psychiatric and substance abuse disor- ders were excluded from the study. The participants completed an overnight polysomnography (PSG) and self-reported pain and depression assessments. At 2, 4, 6, 8, 10, and 12 weeks after enrollment, the participants were ques- tioned via a phone survey with respect to their HCU, including the number and type of visits. The parameters of current primary insomnia (PI), PSG sleep efficiency (SE) and PSG sleep latency (SL) were examined in order to deter- mine if they were prospectively associated with frequency of healthcare vis- its (HCV). Results: An ANCOVA was conducted on HCV aggregated across all assess- ments with PI as the independent variable and age, TMD duration, pain severity and depression as covariables. A main effect for PI emerged, such that TMD patients with PI (3.2) had more than twice as many HCV as those without PI (1.3; p<0.05). In addition, PSG SE was correlated with a higher number of HCV (r= -0.38, p<0.05), while SL was not (r=0.22). After control- ling for the age, TMD duration, pain severity and depression covariables, the SE-HCV association was rendered non-significant (r= -0.22, p=0.15). Post- hoc analyses yielded non-significant zero-order and multivariate associa- tions between the other PSG indices and HCV. Conclusion: PI may be associated with an increased frequency of HCU, in- dependent of TMD duration, age, pain severity, and depression. These ob- servations are critical in light of the recent focus on the growing health care burden for those with chronic pain, such as TMD. Further research is required to determine whether, and through what mechanisms, treatment of insom- nia will attenuate the healthcare burden caused by TMD and possibly other idiopathic chronic pain syndromes. Acknowledgements: Work supported by NIH Grants NS47168 (MTS) and MH075884 (PJQ). 064 ACUPUNCTURE IN INSOMNIA AND ITS CONSEQUENCES IN POSTMENOPAUSAL WOMEN T.G. Kaiser-Pagliarini, H.C. Hachul, A.L. Maciel, F.T. Yagihara, S.A. Garbuio, A.O. Freire, S. Tufik, L.R.A. Bittencourt. UNIFESP Introduction: The frequency of insomnia increases as women approach and go through menopause. Insomnia has various secondary characteristics in- cluding anxiety, depression, and deficits in cognition, specifically in atten- tion and memory. Recent studies have use acupuncture therapy in post- menopausal women to treat hot flashes, but its efficacy has not been exam- ined with respect to insomnia. Objectives: The aim of this study was to evaluate the effectiveness of acupuncture therapy on insomnia and its consequences in post-menopause women. Methods: This study included 27 post-menopausal women presenting a di- agnosis of insomnia according to the DSM-IV criteria. The women were aged 50 to 67 years, had BMI ≤30 kg/m 2 , follicle-stimulating hormone (FSH) level ≥30 mlU/mL and had at least 1 year of amenorrhea. Further- more, subjects were not using antidepressants, hypnotics or hormonal re- placement therapy. This study was randomized, double-blind and placebo- controlled. Subjects were divided into three groups: control, acupuncture, and “sham” acupuncture. We performed 10 sessions of acupuncture and “sham” acupuncture during a period of 5 weeks. Polysomnography, cogni- tive tests (Stroop Test, story recall, trail test, cancel test), and questionnaires (Pittsburg Questionnaire, Beck depression, STAI, WHOQOL-Bref) were ap- plied before and after the treatment period, to all patients. Results: Anthropometric, polysomnographic, cognitive, and questionnaire data were similar among the groups (p>0.05). Comparison of baseline and post-treatment data showed that acupuncture resulted in significantly lower scores in the Pittsburg Questionnaire (mean ± SE: 15±0.6 vs. 11±0.8, re- spectively) (p=0.001). Conclusion: Acupuncture was effective in improving sleep quality in post- menopausal women, as assessed by the Pittsburg Questionnaire. Support: FAPESP/AFIP/CNPq 065 SLEEP QUALITY IS MAINTAINED IN INSOMNIA PATIENTS WHO INGEST CAFFEINE DURING THE DAY R.S. Kaminski, C.Z. Fiori, M.C. Lenz, D. Martinez. UFRGS Introduction: Caffeine has many effects on sleep, but the evidence for such effects is usually provenient from small samples and obtained in experimen- tal conditions. Information regarding the sleep effects of self-administered caffeine is not available. Objectives: To assess the effect of caffeine consumption during the day on sleep measured by routine polysomnography (PSG) in patients with chief complaint of insomnia. Methods: Before undergoing conventional full-night attended PSG to inves- tigate insomnia, volunteers answered a questionnaire disclosing the quantity of and the time at which they had ingested caffeine beverages during the day. Results: On the day of PSG, of 1015 patients with insomnia complaints (45.8% men), 896 (88.3% of the total) reported caffeine ingestion in doses ranging from 15 to 1470 mg and averaging 215±216 mg. The group that had consumed caffeine (group CC) showed insignificantly higher sleep effi- ciency (75.5±15.3%) than the group reporting no caffeine ingestion (group NC; 74.8±15.9%; p=0.6). Additionally, both groups had similar mean scores on the Epworth sleepiness scale and similar sleep latencies to stages N1, N2, N3, and REM, comparable numbers of movement arousals (CC: 129±102; NC: 140±126; p=0.4), long awakenings (>5 min) and amounts of wakeful- ness after sleep onset (group CC: 61±48 minutes; group NC: 58±44 minutes; p=0.5). The only significant difference observed in sleep stages was the du- ration of stage N3 (group CC: 55±27 minutes; group NC: 48±27 minutes; p=0.007). Sleep breathing disturbances, as indicated by the apnea-hypopnea index (group CC: 15±18/hour; group NC: 15±21/hour; p=0.7) and minimum SaO2 (group CC: 85±9%; group NC: 85±10%; p=0.9), were also analogous in both groups. Multiple linear and logistic regression analyses controlling for usual confounders did not reveal a factor able to predict caffeine consump- tion in insomniacs. Conclusions: Caffeine consumption does not seem to impair sleep quality in insomnia patients when they can regulate the dose. In insomnia patients who are caffeine users, a self-limitation on caffeine ingestion seems to be present that allows these patients to obtain positive effects while avoid- ing sleep consequences. Clinical trials in a large number of patients, includ- ing polysomnographic and quantifiable clinical outcomes, are necessary to support the universal medical recommendation to avoid caffeine in insom- nia. 066 INSOMNIA TREATMENT BY OLANZAPINE: IS SLEEP STATE MISPERCEPTION A PSYCHOTIC DISORDER? (A CASE REPORT) H. Khazaie 1 , L. Rezaei 1 , M. Tahmasian 1 , A. Ahmadi 2 , D.C. Schwebel 3 , M.B. Russo 4 . 1 Sleep Research Center, Department of Psychiatry, Kermanshah University of Medical Sciences (KUMS), Iran; 2 Department of Anesthesiology, Critical Care and Pain Management, Kermanshah University of Medical Sciences (KUMS), Iran & Department of Public Health Sciences, Division of Social Medicine, Karolinska Institute, Stockholm, Sweden; 3 Department of Psychology, University of Alabama at Birmingham, USA; 4 John A. Burns School of Medicine, University of Hawaii, USA Offering a new perspective on sleep state misperception, we describe a pa- tient who presented with sleep state misperception and was ultimately di- agnosed with delusional disorder. A 60-year-old woman with chief com- plaints of insomnia, agitation and suicidal ideation, was admitted to an inpa- tient psychiatric ward. Considering collaborative information from her fam- ily and a mental state examination, her primarily diagnosis was sleep state misperception, and she was treated for this diagnosis with benzodiazepine. Because she was unresponsive to the treatment, a full psychiatric evalua- tion and wrist actigraphy report were undertaken, resulting in a diagnosis of delusional disorder. She was started on olanzapine and, after six weeks, was discharged with good improvement. Sleep state misperception should not be considered just a sleep disorder but also a psychiatric disorder with psychotic symptoms. Further research is recommended. Keywords: sleep state misperception, delusional disorder, olanzapine, wrist actigraphy. 067 MEMORY CONSOLIDATION DURING SLEEP AND EEG SPECTRAL ANALYSIS IN PRIMARY INSOMNIA C. Kloepfer, B. Feige, C. Nissen, D. Riemann. University Medical Center Freiburg, Department of Psychiatry and Psychotherapy, Germany Introduction: Compelling evidence indicates that healthy sleep contributes to the consolidation of new memories.