Sleep latency and duration estimates among sleep disorder patients: variability as a function of sleep disorder diagnosis, sleep history, and psychological characteristics.
OBJECTIVE
Insomnia patients often report greater sleep disturbance than found via polysomnography; yet the specific patient factors related to such sleep time misperceptions are poorly understood. We sought to characterize the extent to which a diverse group of patients complaining of insomnia (n=104) misperceive overnight total sleep time and sleep latency, and to identify patient factors associated with these variations.


METHODS
Cross-sectional.


METHODS
University based sleep disorders center.


METHODS
Sleep disorder groups consisted of patients with psychophysiological insomnia (n=19), sleep state misperception (n=8), insomnia with depressive disorder (n=11), insomnia secondary to Axis I psychiatric disorder other than depression (n=21), periodic limb movement disorder (n=24), and obstructive sleep apnea (n=21).


RESULTS
Patients completed a sleep history questionnaire and the MMPI, underwent overnight diagnostic polysomnographic assessment, and then estimated their total sleep time and sleep latency the subsequent morning. On average, patients overestimated sleep latency, but were equally likely to underestimate vs. overestimate total sleep time. Sleep time misperception was associated with longer periods of wakefulness following sleep onset, greater self-perceived sleep impairment, as well as several psychological dimensions.


CONCLUSIONS
Patient factors, including sleep quality, perceptions of habitual sleep time, and current psychopathology, potentially influence sleep time estimation. Whereas psychological factors may lead to exaggeration of sleep disturbance among some patients, sleep quality itself may also influence the congruence between subjective and objective indices of sleep.
Vanable
P A
PA
University of Chicago, USA. pvanable@psych.syr.edu
Aikens
J E
JE
Tadimeti
L
L
Caruana-Montaldo
B
B
Mendelson
W B
WB
D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008950:MMPI; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D020189:Nocturnal Myoclonus Syndrome / Q000175:diagnosis / Q000523:psychology; D017286:Polysomnography; D011930:Reaction Time; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000523:psychology; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis* / Q000523:psychology; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000523:psychology