Sleep Fragmentation Does Not Explain Misperception of Latency or Total Sleep Time
Austin Saline1, Balaji Goparaju1, Matt T Bianchi1,2
1Neurology Department, Massachusetts General Hospital, Boston, MA.
Summary
Sleep perception differs from objective measures. A new metric, sleep during subjective latency (SDSL), was developed but did not support the hypothesis that sleep fragmentation causes misperception of sleep-wake times.
Area of Science:
- Sleep Medicine
- Neuroscience
- Chronobiology
Background:
- Subjective perception of sleep-wake times often diverges from objective polysomnography findings.
- The underlying mechanisms of sleep misperception remain poorly understood.
- Accurate quantification of sleep misperception is challenging due to operational difficulties in defining objective sleep latency and total sleep time.
Purpose of the Study:
- To evaluate a novel approach for quantifying sleep misperception, addressing challenges in defining objective sleep latency and total sleep time.
- To test the hypothesis that sleep fragmentation is the primary driver of sleep misperception.
- To introduce and validate a new metric, sleep during subjective latency (SDSL), for characterizing latency and total sleep time misperception.
Main Methods:
- Retrospective analysis of 391 patients undergoing overnight polysomnography, including 252 with obstructive sleep apnea (OSA).
- Comparison of subjective and objective sleep-wake durations to identify and characterize misperception.
- Introduction and application of the sleep during subjective latency (SDSL) metric to assess latency misperception and correct for it when evaluating total sleep time (TST) misperception.
Main Results:
- The sleep during subjective latency (SDSL) metric showed a relationship with latency misperception, but contrary to the hypothesis: higher SDSL (>20 minutes) correlated with less N1%, more N3%, and lower sleep transition frequency.
- After accounting for SDSL, total sleep time (TST) misperception was more pronounced in patients with longer REM and N2 sleep bouts (OSA) and longer N3 sleep bouts (non-OSA).
- These findings did not support the hypothesis that light or fragmented sleep underlies sleep misperception.
Conclusions:
- The sleep during subjective latency (SDSL) metric offers advantages in phenotyping sleep misperception by overcoming operational challenges.
- The study's results do not support the hypothesis that sleep fragmentation or light sleep underlies the misperception of sleep-wake times.
- Further research employing methods beyond conventional sleep staging is needed to elucidate the mechanisms of sleep misperception.
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