How to quantify sleepiness during an attempt to sleep?

Abstract

Background. Sleepiness assessment tools were mostly developed for detection of an elevated sleepiness level in the condition of sleep deprivation and several medical conditions. However, sleepiness occurs in various other conditions including the transition from wakefulness to sleep during an everyday attempt to get sleep. Objective. We examined whether objective sleepiness indexes can be implicated in detection of fluctuations in sleepiness level during the polysomnographically-monitored attempt to sleep, i.e. in the absence of self-reports on perceived sleepiness level throughout such an attempt. Approach. The polysomnographic signals were recorded in the afternoon throughout 106 90 min napping attempts of 53 university students (28 females). To calculate two objective sleepiness indexes, the electroencephalographic (EEG) spectra were averaged on 30 s epochs of each record, assigned to one of 5 sleep–wake stages, and scored using either the frequency weighting curve for sleepiness substate of wake state or loadings of each frequency on the 2nd principal component of variation in the EEG spectrum (either sleepiness score or PC2 score, respectively). Main results. We showed that statistically significant fluctuations in these two objective sleepiness indexes during epochs assigned to wake stage can be described in terms of the changes in verbally anchored levels of subjective sleepiness assessed by scoring on the 9-step Karolinska Sleepiness Scale. Significance. The results afford new opportunities to elaborate importance of intermediate substates between wake and sleep states for sleep–wake dynamics in healthy individuals and patients with disturbed sleep.