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The consensus sleep diary: quantitative criteria for primary insomnia diagnosis
Vincenzo Natale1, Damien Léger, Virginie Bayon
1From the Departments of Psychology (Natale, Erbacci, Tonetti) and Experimental (Martoni), Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy; Université Paris Descartes (Léger, Bayon), Sorbonne Paris Cité, APHP, Hôtel-Dieu de Paris, Centre du sommeil et de la vigilance, Paris, France; and Department of Psychology (Fabbri), Second University of Naples, Caserta, Italy.
Psychosomatic Medicine
|April 24, 2015
Summary
Quantitative criteria for the Consensus Sleep Diary effectively differentiate insomnia from normal sleep. Sleep efficiency (<87.5%) and terminal wakefulness (>15 minutes) were key indicators for identifying insomnia.
Area of Science:
- Sleep Medicine
- Psychiatry
- Behavioral Science
Background:
- Insomnia is a prevalent sleep disorder.
- Accurate differentiation between insomnia and normal sleep is crucial for effective treatment.
- The Consensus Sleep Diary is a commonly used tool, but quantitative criteria for its interpretation are needed.
Purpose of the Study:
- To establish quantitative criteria for the Consensus Sleep Diary.
- To differentiate individuals with primary insomnia from normal sleepers using these criteria.
Main Methods:
- Retrospective analysis of 295 sleep diaries from insomnia patients and 536 from normal sleepers.
- Evaluation of sleep parameters including time in bed, sleep onset latency, total sleep time, wake after sleep onset, sleep efficiency, number of awakenings, terminal wakefulness, and subjective rest.
- Calculation of optimal quantitative criteria using the Youden index and assessment of accuracy with receiver operating characteristic curves.
Main Results:
- Significant differences were observed in all sleep indices between insomnia patients and controls (p < .001).
- Optimal differentiation was achieved with sleep efficiency (<87.5%, AUC=0.92), terminal wakefulness (>15 minutes, AUC=0.83), wake after sleep onset (>20 minutes, AUC=0.81), and total sleep time (<390 minutes, AUC=0.80).
- Time in bed showed the least differentiating power (AUC=0.57).
Conclusions:
- The derived quantitative criteria for the Consensus Sleep Diary align with existing literature.
- The validated quantitative criteria confirm the utility of the sleep diary as a screening tool for primary insomnia.
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