Subjective Estimates of Sleep Differ From Polysomnographic Measurements in Obstructive Sleep Apnea Patients

McCall, W. Vaughn; Turpin, Elisabeth; Reboussin, David M.; Jd, Edinger; Haponik, Edward F.

doi:10.1093/sleep/18.8.646

Cited by 57 publications

(30 citation statements)

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“…Individuals of lower perceived social standing may have greater worry and rumination over concerns of employment and financial security, more maladaptive coping styles to manage stressors, or increased vigilance due to neighborhood disorder that may impede sleep and, in turn, confer greater susceptibility to adverse health consequences Buysse et al, 2008;Cohen et al, 2008;Hill et al, 2009;McCall, Turpin, Reboussin, Edinger, & Haponik, 1995;NSF, 2009;Silva et al, 2007). Perseverative cognition, including worry or rumination, may lead to difficulties initiating sleep (i.e., longer sleep latency), maintaining an adequate amount of sleep (i.e., sleep duration), and obtaining enough restorative sleep (i.e., sleep quality) to feel refreshed and energized upon awakening (i.e., daytime sleepiness; cf.…”

Section: Discussionmentioning

confidence: 99%

Objective and Subjective Socioeconomic Gradients Exist for Sleep Quality, Sleep Latency, Sleep Duration, Weekend Oversleep, and Daytime Sleepiness in Adults

Jarrin

McGrath

Silverstein

et al. 2013

Behavioral Sleep Medicine

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Socioeconomic gradients exist for multiple health outcomes. Lower objective socioeconomic position (SEP), whether measured by income, education, or occupation, is associated with inadequate sleep. Less is known about whether one's perceived ranking of their social status, or subjective SEP, affects sleep. This study examined whether a subjective socioeconomic gradient exists for sleep while controlling for objective SEP. Participants (N = 177; age, M = 45.3 years, SD = 6.3 years) completed the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, MacArthur Ladder, and other self-report measures to assess sleep and objective SEP. Subjective SEP trumped objective SEP as a better predictor of sleep duration, daytime sleepiness, and weekend oversleep. These findings highlight the need to expand our framework to better understand the mechanisms underlying socioeconomic gradients and sleep.It is well established that a socioeconomic gradient exists for multiple health outcomes, even after adjusting for known risk factors. Adults of lower socioeconomic position (SEP) report more frequent acute and chronic physical (e.g., insomnia) and mental problems (e.g., depression), as well as poorer quality of life, compared to adults of higher SEP (Adler et al

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Section: Discussionmentioning

confidence: 99%

Objective and Subjective Socioeconomic Gradients Exist for Sleep Quality, Sleep Latency, Sleep Duration, Weekend Oversleep, and Daytime Sleepiness in Adults

Jarrin

McGrath

Silverstein

et al. 2013

Behavioral Sleep Medicine

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“…This could imply that the AHI obtained from recording time, not from sleeping time, underestimates the true AHI. However, when comparing subjective and polysomnographically determined sleep in SAHS patients, MCCALL et al [25] reported that patients underestimate the time of sleep. In addition, DOUGLAS et al [3] showed that SAHS can be as accurately defined by apnoeaszhypopnoeas per time in bed as per time asleep.…”

Section: Discussionmentioning

confidence: 99%

Influence of setting on unattended respiratory monitoring in the sleep apnoea/hypopnoea syndrome

Lloberes¹,

Sampol²,

Lévy³

et al. 2001

Eur Respir J

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The high demand for full polysomnography and the better quality of sleep at home are the main reasons for performing home sleep studies. Home respiratory monitoring has been evaluated in several studies, but the influence of setting on the results of unattended respiratory monitoring has not been assessed to date.Unattended monitoring of respiratory variables at home and in the sleep laboratory was conducted in 35 consecutive patients with suspected sleep apnoea/hypopnoea syndrome. Respiratory variables during sleep, rate of successful studies and patient preference were compared.The data acquisition failure rate was 2.8% in the sleep laboratory and 5.7% at home. The mean difference between apnoea/hypopnoea indices (AHI) obtained from home and laboratory studies was -0.21¡8 (95% confidence interval 3.27-2.84). Using the method comparison approach of Bland and Altman, the limits of agreement of the mean difference between AHI home and AHI laboratory were -16.7 and 17.1. No difference was observed between the studies in time spent in different body positions. When patients were asked where they would prefer to repeat the sleep study, 53% replied at home, 28% in hospital and 19% showed no preference.It was concluded that the setting of unattended respiratory monitoring (home or sleep laboratory) influences neither the number of valid studies nor the results of the respiratory parameters measured; most patients, however, preferred home studies.

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“…4 Some patients with obstructive sleep apnea (OSA) may also exhibit misperception, though perhaps not to the same extent as those with insomnia symptoms. [5][6][7] Several hypotheses have arisen regarding the basis for misperception, although a unified explanation remains elusive. For example, misperception has been linked with anxiety and mood, 3,8 personality traits, and sleep physiology measures such as electroencephalogram patterns of alpha-delta sleep or cyclic alternating pattern and high frequency electroencephalography (EEG) content.…”

Section: Introductionmentioning

confidence: 99%

Sleep Fragmentation Does Not Explain Misperception of Latency or Total Sleep Time

Saline

Goparaju

Bianchi

2016

Journal of Clinical Sleep Medicine

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Study Objectives: Perception of sleep-wake times may differ from objective measures, although the mechanisms remain elusive. Quantifying the misperception phenotype involves two operational challenges: defining objective sleep latency and treating sleep latency and total sleep time as independent factors. We evaluated a novel approach to address these challenges and test the hypothesis that sleep fragmentation underlies misperception. Methods: We performed a retrospective analysis on patients with or without obstructive sleep apnea during overnight diagnostic polysomnography in our laboratory (n = 391; n = 252). We compared subjective and objective sleep-wake durations to characterize misperception. We introduce a new metric, sleep during subjective latency (SDSL), which captures latency misperception without defining objective sleep latency and allows correction for latency misperception when assessing total sleep time (TST) misperception. Results:The stage content of SDSL is related to latency misperception, but in the opposite manner as our hypothesis: those with > 20 minutes of SDSL had less N1%, more N3%, and lower transition frequency. After adjusting for misperceived sleep during subjective sleep latency, TST misperception was greater in those with longer bouts of REM and N2 stages (OSA patients) as well as N3 (non-OSA patients), which also did not support our hypothesis. Conclusions: Despite the advantages of SDSL as a phenotyping tool to overcome operational issues with quantifying misperception, our results argue against the hypothesis that light or fragmented sleep underlies misperception. Further investigation of sleep physiology utilizing alternative methods than that captured by conventional stages may yield additional mechanistic insights into misperception. I NTRO DUCTI O NAssessment of sleep often includes subjective reports of sleepwake durations, in clinical practice as well as epidemiological studies of sleep duration.1 However, when concurrent objective sleep measurements are available, it is not uncommon to observe that the subjective responses may differ. Underestimation of total sleep time has been previously observed in healthy adults under experimental circumstances, as well as insomnia patients during polysomnography (PSG).2-4 This phenomenon, sometimes termed misperception, may manifest as either overestimating sleep latency (SL) or underestimating total sleep time (TST), or both.4 Some patients with obstructive sleep apnea (OSA) may also exhibit misperception, though perhaps not to the same extent as those with insomnia symptoms. 5-7Several hypotheses have arisen regarding the basis for misperception, although a unified explanation remains elusive. For example, misperception has been linked with anxiety and mood, 3,8 personality traits, and sleep physiology measures such as electroencephalogram patterns of alpha-delta sleep or cyclic alternating pattern and high frequency electroencephalography (EEG) content. [9][10][11][12][13] In addition, we previously investigated possible relat...

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Subjective Estimates of Sleep Differ From Polysomnographic Measurements in Obstructive Sleep Apnea Patients

Cited by 57 publications

References 0 publications

Objective and Subjective Socioeconomic Gradients Exist for Sleep Quality, Sleep Latency, Sleep Duration, Weekend Oversleep, and Daytime Sleepiness in Adults

Objective and Subjective Socioeconomic Gradients Exist for Sleep Quality, Sleep Latency, Sleep Duration, Weekend Oversleep, and Daytime Sleepiness in Adults

Influence of setting on unattended respiratory monitoring in the sleep apnoea/hypopnoea syndrome

Sleep Fragmentation Does Not Explain Misperception of Latency or Total Sleep Time

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