Accuracy of sleep perceptions among insomnia sufferers and normal sleepers
ABSTRACT To examine the distribution, consistency, and correlates of sleep time perceptions in primary insomnia sufferers and normal sleepers across settings (laboratory and home).
Fifty-two middle-aged and older insomnia sufferers and 49 matched normal sleepers underwent multiple nights of laboratory and home polysomnography (PSG) and provided concurrent subjective estimates of their sleep. Descriptive statistics, cluster analyses, and inferential tests were used to examine the nature of sleep time perceptions, identify subgroups with distinctive patterns such as perceptions, and explore factors that may contribute to these subgroups' distinctive sleep perceptions.
Consistent with previous studies, the insomnia sufferers, as a group, showed a greater tendency to underestimate the time they slept than did the normal sleepers, but the accuracy of sleep time perceptions varied widely within each sample. Correlational analyses showed that study participants in each sample showed a moderate level of consistency in how accurately they estimated sleep time across nights. Subsequent cluster analyses conducted to identify subgroups with distinctive patterns of sleep time perceptions yielded four subgroups within the insomnia sample and three subgroups within the normal sleeper sample. Although the sleep setting significantly affected sleep perceptions for one insomnia subgroup, both laboratory and home objective-subjective sleep comparisons provided similar impressions regarding the relative accuracy of each subgroup's nocturnal sleep/wake perceptions. Finally, varying patterns of subgroup differences were noted across several common psychometric measures.
The underestimation of sleep time is not a generic characteristic that separates all insomnia sufferers from normal sleepers. Sleep setting, personality traits, and perhaps constitutional factors appear to influence perceptions of sleep and wake time duration.
SourceAvailable from: Elisabeth Hertenstein[Show abstract] [Hide abstract]
ABSTRACT: Differences between subjective sleep perception and sleep determined by polysomnography (PSG) are prevalent, particularly in patients with primary insomnia, indicating that the two measures are partially independent. To identify individualized treatment strategies, it is important to understand the potentially different mechanisms influencing subjective and PSG-determined sleep. The aim of this study was to investigate to what extent three major components of insomnia models, i.e. sleep effort, dysfunctional beliefs and attitudes about sleep, and presleep arousal, are associated with subjective insomnia severity and PSG- determined sleep. A sample of 47 patients with primary insomnia according to DSM-IV criteria and 52 good sleeper controls underwent 2 nights of PSG and completed the Glasgow Sleep Effort Scale, the Dysfunctional Beliefs and Attitudes about Sleep Scale, the Pre-Sleep Arousal Scale and the Insomnia Severity Index. Regression analyses were conducted to investigate the impact of the three predictors on subjective insomnia severity and PSG- determined total sleep time. All analyses were adjusted for age, gender, depressive symptoms and group status. The results showed that subjective insomnia severity was associated positively with sleep effort. PSG-determined total sleep time was associated negatively with somatic presleep arousal and dysfunctional beliefs and attitudes about sleep. This pattern of results provides testable hypotheses for prospective studies on the impact of distinct cognitive and somatic variables on subjective insomnia severity and PSG-determined total sleep time. © 2015 European Sleep Research Society.Journal of Sleep Research 03/2015; DOI:10.1111/jsr.12293 · 2.95 Impact Factor
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ABSTRACT: Objective: Disturbed sleep during pregnancy is associated with adverse obstetric outcomes and less mental well-being. In pregnant women with a mental disorder, who frequently suffer from sleep problems, it is unknown whether predominantly objective or subjective sleep quality is more affected. To clarify this, we compared objective and subjective parameters of sleep quality between patients and healthy controls during pregnancy. Methods: This observational study was embedded in an ongoing study among pregnant women with a mental disorder at the department of Psychiatry of Erasmus University Medical Center Rotterdam, the Netherlands. We compared 21 pregnant women with a confirmed mental disorder with 33 healthy controls (gestational age, 23-29 weeks). To measure objective parameters of sleep quality, all participants continuously wore a wrist actigraph for 7 days and nights. Subjective sleep quality was retrospectively assessed using the Pittsburgh Sleep Quality Index (PSQI) and on a daily basis with the Subjective Sleep Quality-scale (SSQ). Differences in parameters of sleep between patients and controls were tested using a multivariate linear regression analysis adjusted for parity, gestational age, educational level, and employment status. Results: Objective parameters of sleep quality and subjective sleep quality as assessed by the PSQI did not differ significantly between patients and controls. Daily sleep reports showed that, relative to controls, patients had a significantly worse average SSQ-score (5.2 vs. 7.6, adjusted beta = 0.12, 95% CI = 0.03-0.53, p < 0.01). Conclusions: Our exploratory study suggests that perceived sleep quality reported on a daily basis by pregnant women with a mental disorder is worse than the sleep quality as measured by wrist actigraphy.Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine 09/2014; 10(10). DOI:10.5664/jcsm.4118 · 2.93 Impact Factor
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ABSTRACT: Introduction: Elite athletes frequently undergo periods of intensified training (IT) within their normal training program. These periods can lead athletes into functional overreaching, characterized by high perceived fatigue, impaired sleep and performance. As whole body cryostimulation (WBC) has been proven an effective recovery method in the short term (<76 hours), we investigated whether daily WBC sessions during IT could prevent exercise and sleep-related signs of overreaching. Methods: After a normal training week (BASE), 10 elite synchronized swimmers performed two 2-week IT periods in randomized crossover fashion, using WBC daily (ITWBC), or not (ITCON), separated by 9 days of light training. 400m swim time trials were performed at BASE and after each IT, to quantify blood lactate ([La-]B), heart rate (HR400), salivary alpha amylase ([[alpha]-amylase]s400) and cortisol ([cortisol]s400) responses. Swimmers wore a wrist actigraph nightly to monitor sleep patterns. Results: 400m swim speed, [La-]B400 and [[alpha]-amylase]s400 decreased from BASE to ITCON, while no significant changes were found after ITWBC. Decreased swim speed was correlated to decreased HR400 and [cortisol]s400. During ITCON, significant decreases in actual sleep duration (-21+/-7 min) and sleep efficiency (-1.9+/-0.8%) were observed, with increased sleep latency (+11+/-5 min)and fatigue compared to BASE, while these variables did not change during ITWBC. Using a qualitative statistical analysis, we observed that daily WBC use resulted in a 98%, 59%, 66% and 78% chance of preserving these respective variables compared to ITCON. Conclusion: WBC use during IT helped mitigate the signs of F-OR observed during ITCON, such as reduced sleep quantity, increased fatigue, impaired exercise capacity. These results support the daily use of WBC by athletes seeking to avoid F-OR during key periods of competition preparation.Medicine & Science in Sports & Exercise 10/2014; DOI:10.1249/MSS.0000000000000546 · 4.46 Impact Factor