Study objectives: To determine if heat loss capacity of sleep onset insomniacs was different from that of healthy sleepers.

Design: Measure skin temperature responses following brief exposure to a warm peripheral thermal challenge (PTC).

Setting: Sleep research laboratory in South Australia.

Participants: Eight primary insomniacs with sleep onset insomnia according to DSM-IV-TR criteria (SOI; 5 male, 3 female; mean age +/- SEM = 35.2 +/- 4.2 years) and ten healthy sleeping control subjects (HS; 7 male, 3 female; mean age = 28.2 +/- 2.8 years).

Interventions: Two PTC conditions in counterbalanced order on non-consecutive days. During each condition, the subject's non-dominant forearm and hand were immersed for 3 minutes in Warm (45 degrees C) or Control water (i.e. same as the subject's non-dominant index finger temperature just prior to immersion, range 30-35 degrees C).

Measurements and results: HS had a significantly higher maximum finger temperature response after immersion than SOI (P < 0.05). Expressed relative to Control PTC temperatures, the Warm PTC caused a significant increase in mean finger temperature for HS of 4.1 +/- 0.8 degrees C, compared with SOI of 0.9 +/- 0.4 degrees C. A significant negative relationship was observed between maximum finger temperature response and self-reported sleep onset latencies (R = -0.57, P < 0.05). There were no main effects of sleep status (SOI vs. HS) or interactions by time, in skin temperatures measured at either the back of hands or feet.

Conclusions: SOI were observed to have significantly attenuated thermoregulatory responses to a mild positive thermal challenge, providing evidence that impaired heat loss capacity from the periphery is associated with sleep onset insomnia.