title: Beyond the mean: A systematic review on the correlates of daily intraindividual variability of sleep/wake patterns.
abstract: Features of an individual's sleep/wake patterns across multiple days are governed by two dimensions, the mean and the intraindividual variability (IIV). The existing literature focuses on the means, while the nature and correlates of sleep/wake IIV are not well understood. A systematic search of records in five major databases from inception to November 2014 identified 53 peer-reviewed empirical publications that examined correlates of sleep/wake IIV in adults. Overall, this literature appeared unsystematic and post hoc, with under-developed theoretical frameworks and inconsistent methodologies. Correlates most consistently associated with greater IIV in one or more aspects of sleep/wake patterns were: younger age, non-White race/ethnicity, living alone, physical health conditions, higher body mass index, weight gain, bipolar and unipolar depression symptomatology, stress, and evening chronotype; symptoms of insomnia and poor sleep were associated with higher sleep/wake IIV, which was reduced following sleep interventions. The effects of experimentally reduced sleep/wake IIV on daytime functioning were inconclusive. In extending current understanding of sleep/wake patterns beyond the mean values, IIV should be incorporated as an additional dimension when sleep is examined across multiple days. Theoretical and methodological shortcomings in the existing literature, and opportunities for future research are discussed.
authors.affiliation: Monash Institute of Cognitive and Clinical Neurosciences, Monash School of Psychological Sciences, Faculty of Biomedical and Psychological Sciences, Monash University, Australia; Centre for Women's Mental Health, Royal Women's Hospital, Australia. Electronic address: bei.bei@monash.edu.
authors.forename: Bei
authors.initials: B
authors.lastname: Bei
authors.affiliation: Centre for Primary Care and Prevention, Mary MacKillop Institute for Health Research, Australian Catholic University, Australia.
authors.forename: Joshua F
authors.initials: JF
authors.lastname: Wiley
authors.affiliation: Melbourne School of Psychological Sciences, University of Melbourne, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Trinder
authors.affiliation: Stanford University School of Medicine, Department of Psychiatry and Behavioral Science, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Manber
mesh_terms: D000076103:Biological Variation, Individual; D006801:Humans; D012890:Sleep / Q000502:physiology*; D007319:Sleep Initiation and Maintenance Disorders / Q000503:physiopathology; D014851:Wakefulness / Q000502:physiology*
keywords: Day-to-day; Fluctuation; Health; Intraindividual; Mental health; Night-to-night; Sleep; Systematic review; Variability; Variation