Sleep Med Psychophysiol.  2021 Dec;28(2):70-77. 10.14401/KASMED.2021.28.2.70.

Association of Sleep Perception With Objective and Subjective Sleep Variables in Insomnia Patients

• Yoon G
• Oh SM
• Seo MC
• Lee MH
• Yoon SY
• Lee YJ

• KMID: 2524207
• DOI: http://doi.org/10.14401/KASMED.2021.28.2.70

Abstract

Objectives
Our study aims to investigate the clinical and polysomnographic variables associated with subjective sleep perception.
Methods
Among the patients who underwent nocturnal polysomnography (PSG) at the Center for Sleep and Chronobiology of Seoul National University Hospital from May 2018 to July 2019, 109 diagnosed with insomnia disorder based on DSM-5 were recruited for the study, and their medical records were retrospectively analyzed. Self-report questionnaires about clinical characteristics including Pittsburgh sleep quality index (PSQI), Beck depression inventory (BDI), and Epworth sleepiness scale (ESS) were completed. Subjective sleep quality was measured using variables of subjective total sleep time (subjective TST), subjective sleep onset latency (subjective SOL), subjective number of awakenings, morning feeling after awakening, and sleep discrepancy (subjective TST–objective TST) the morning after PSG. Pearson and Spearman correlation analyses were used to determine the factors associated with subjective sleep perception.
Results
In patients with insomnia, subjective TST was negatively correlated with Wake After Sleep Onset (WASO) (p = 0.001) and N1 sleep (p = 0.039) parameters on polysomnography. Also, it was negatively correlated with PSQI (p < 0.001) and BDI (p = 0.014) scores. Sleep discrepancy was negatively correlated with PSQI score (p = 0.018). Morning feeling was negatively correlated with PSQI (p = 0.019) and BDI (p < 0.001) scores.
Conclusion
Our results demonstrated that subjective sleep perception is associated with PSG variables (WASO and N1 sleep) and with PSQI and BDI scores. In clinical practice, it is helpful to assess and manage insomnia patients in consideration of objective sleep variables, subjective sleep quality, and depressed mood, which can influence subjective sleep perception.

Keyword

Insomnia disorder; Polysomnography; Sleep discrepancy; Sleep perception