Yan Ma1,2, Michael R Goldstein3, Roger B Davis4, Gloria Y Yeh2,4. 1. Division of Interdisciplinary Medicine and Biotechnology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. 2. Osher Center for Integrative Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. 3. Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. 4. Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Abstract
STUDY OBJECTIVES: Although subjective-objective sleep discrepancy has long been observed in patients with insomnia, the profiles of this discrepancy are poorly understood. Further, sleep discrepancy in insomnia with sleep comorbidities remains underexplored. We sought to better characterize sleep discrepancy among patient groups with and without insomnia and comorbid conditions such as obstructive sleep apnea (OSA). METHODS: Using data from the Sleep Heart Health Study, we conducted a secondary analysis describing (1) the profile of self-reported and objective sleep measures in patients with insomnia (IS group; n = 73) and comorbid OSA (IS + OSA group; n = 143), compared with individuals with OSA only (OSA group; n = 296) and normal sleep control patients (NSC group; n = 126); (2) the comparative magnitude of sleep misperception between these 4 groups; and (3) the self-reported quality of life (QOL) in the 4 groups. RESULTS: Subjective-objective sleep discrepancy existed in all 4 groups, including the NSC group. Controlling for age, sex, mental health conditions, sleep apnea severity, and objectively measured sleep time, the presence of self-reported insomnia had the strongest association with sleep discrepancy. In patients with insomnia, sleep onset latency was overestimated (7.8 ± 36.8 min in the IS group; P < .001 when compared to the NSC and OSA groups), with the largest differences seen in the comorbid IS + OSA group (15.0 ± 56.8 min). Insomnia conferred the most negative impact on QOL, with the combined IS + OSA group reporting the lowest QOL. CONCLUSIONS: Self-reported insomnia is associated with sleep discrepancy and negative QOL. Those with comorbid OSA reported the greatest sleep discrepancy and the lowest QOL. Future research is warranted to further understand individual profiles of misperception and insomnia phenotypes. CITATION: Ma Y, Goldstein MR, Davis RB, Yeh GY. Profile of subjective-objective sleep discrepancy in patients with insomnia and sleep apnea. J Clin Sleep Med. 2021;17(11):2155-2163.
STUDY OBJECTIVES: Although subjective-objective sleep discrepancy has long been observed in patients with insomnia, the profiles of this discrepancy are poorly understood. Further, sleep discrepancy in insomnia with sleep comorbidities remains underexplored. We sought to better characterize sleep discrepancy among patient groups with and without insomnia and comorbid conditions such as obstructive sleep apnea (OSA). METHODS: Using data from the Sleep Heart Health Study, we conducted a secondary analysis describing (1) the profile of self-reported and objective sleep measures in patients with insomnia (IS group; n = 73) and comorbid OSA (IS + OSA group; n = 143), compared with individuals with OSA only (OSA group; n = 296) and normal sleep control patients (NSC group; n = 126); (2) the comparative magnitude of sleep misperception between these 4 groups; and (3) the self-reported quality of life (QOL) in the 4 groups. RESULTS: Subjective-objective sleep discrepancy existed in all 4 groups, including the NSC group. Controlling for age, sex, mental health conditions, sleep apnea severity, and objectively measured sleep time, the presence of self-reported insomnia had the strongest association with sleep discrepancy. In patients with insomnia, sleep onset latency was overestimated (7.8 ± 36.8 min in the IS group; P < .001 when compared to the NSC and OSA groups), with the largest differences seen in the comorbid IS + OSA group (15.0 ± 56.8 min). Insomnia conferred the most negative impact on QOL, with the combined IS + OSA group reporting the lowest QOL. CONCLUSIONS: Self-reported insomnia is associated with sleep discrepancy and negative QOL. Those with comorbid OSA reported the greatest sleep discrepancy and the lowest QOL. Future research is warranted to further understand individual profiles of misperception and insomnia phenotypes. CITATION: Ma Y, Goldstein MR, Davis RB, Yeh GY. Profile of subjective-objective sleep discrepancy in patients with insomnia and sleep apnea. J Clin Sleep Med. 2021;17(11):2155-2163.
Authors: Lieke W A Hermans; Tim R Leufkens; Merel M van Gilst; Tim Weysen; Marco Ross; Peter Anderer; Sebastiaan Overeem; Annemiek Vermeeren Journal: Sleep Med Date: 2019-02-06 Impact factor: 3.492
Authors: Elizabeth A DiNapoli; Marie Anne Gebara; Terry Kho; Meryl A Butters; Ariel G Gildengers; Steven M Albert; Mary Amanda Dew; Kirk I Erickson; Charles F Reynolds; Jordan F Karp Journal: J Geriatr Psychiatry Neurol Date: 2017-09-27 Impact factor: 2.680
Authors: S F Quan; B V Howard; C Iber; J P Kiley; F J Nieto; G T O'Connor; D M Rapoport; S Redline; J Robbins; J M Samet; P W Wahl Journal: Sleep Date: 1997-12 Impact factor: 5.849
Authors: Nathaniel F Watson; Vishesh Kapur; Lester M Arguelles; Jack Goldberg; Douglas F Schmidt; Roseanne Armitage; Dedra Buchwald Journal: Sleep Date: 2003-05-01 Impact factor: 5.849
Authors: Yeonsu Song; Raeanne C Moore; Dilip V Jeste; Mary-Lynn Brecht; Sonia Ancoli-Israel; Brent T Mausbach; Igor Grant Journal: J Clin Sleep Med Date: 2022-08-01 Impact factor: 4.324