Abstract
People with Insomnia Disorder tend to underestimate their sleep compared with polysomnography or actigraphy, a phenomenon known as paradoxical insomnia or sleep-state misperception. Previous studies suggested that night-to-night variability could be an important feature differentiating subtypes of misperception. This study aimed for a data-driven definition of misperception subtypes revealed by multiple sleep features including night-to-night variability. We assessed features describing the mean and dispersion of misperception and objective and subjective sleep duration from 7-night diary and actigraphy recordings of 181 people with Insomnia Disorder and 55 people without sleep complaints. A minimally collinear subset of features was submitted to latent class analysis for data-driven subtyping. Analysis revealed three subtypes, best discriminated by three of five selected features: an individual’s shortest reported subjective sleep duration; and the mean and standard deviation of misperception. These features were on average 5.4, −0.0 and 0.5 hr in one subtype accommodating the majority of good sleepers; 4.1, −1.4 and 1.0 hr in a second subtype representing the majority of people with Insomnia Disorder; and 1.7, −2.2 and 1.5 hr in a third subtype representing a quarter of people with Insomnia Disorder and hardly any good sleepers. Subtypes did not differ on an individual’s objective sleep duration mean (6.9, 7.2 and 6.9 hr) and standard deviation (0.8, 0.8 and 0.9 hr). Data-driven analysis of naturalistic sleep revealed three subtypes that markedly differed in misperception features. Future studies may include misperception subtype to investigate whether it contributes to the unexplained considerable individual variability in treatment response.
Original language | English |
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Article number | e12937 |
Pages (from-to) | 1-9 |
Number of pages | 9 |
Journal | Journal of Sleep Research |
Volume | 29 |
Issue number | 1 |
Early online date | 31 Oct 2019 |
DOIs | |
Publication status | Published - Feb 2020 |
Funding
This work was supported by Project NeuroSIPE 10738, of the Dutch Technology Foundation STW, which is part of the Netherlands Organization for Scientific Research (NWO) and partly funded by the Ministry of Economic Affairs, Agriculture and Innovation; by the Bial Foundation grants 190/16 and 252/12; and by the European Research Council (ERC) grants ERC‐2014‐AdG‐671084 INSOMNIA and ERC‐2016‐PoC‐737634‐INSOMNIA BEAT IT.
Funders | Funder number |
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ERC-2014-AdG-671084 INSOMNIA | |
ERC-2016-PoC-737634-INSOMNIA BEAT | |
Ministry of Economic Affairs, Agriculture and Innovation | |
Netherlands Organization for Scientific Research | |
Horizon 2020 Framework Programme | 671084, 737634 |
European Research Council | |
Nederlandse Organisatie voor Wetenschappelijk Onderzoek | |
Stichting voor de Technische Wetenschappen | |
Fundação Bial | 252/12, 190/16 |
Ministerie van Economische Zaken, Landbouw en Innovatie |
Keywords
- clustering analysis
- objective insomnia
- subjective insomnia
- subjective−objective sleep discrepancy