Temporal changes in the discrepancy between subjective and objective sleep: an in-home electroencephalography study

Area of Science:

• Neuroscience
• Sleep Medicine
• Psychology

Background:

• Sleep misperception is traditionally linked to neurophysiological or psychological factors.
• Previous evidence often relies on limited single-night or lab-based assessments.
• This limitation raises questions about whether misperception reflects stable pathology or measurement issues.

Purpose of the Study:

• To investigate if sleep misperception changes across consecutive nights.
• To identify distinct phenotypes of sleep misperception based on variability.
• To utilize repeated in-home electroencephalography (EEG) for objective sleep assessment.

Main Methods:

• Eighty-three adults (40-64 years) underwent 7 nights of in-home EEG monitoring.
• Daily sleep questionnaires (OSA-MA) were completed to assess subjective sleep.
• Sleep misperception was quantified using the Sleep Perception Index (SPI).
• Night-to-night variability in sleep parameters was analyzed using coefficients of variation (CV).

Main Results:

• Sleep misperception decreased over consecutive nights, especially in overestimators.
• Overestimators showed greater variability in total sleep time compared to concordant estimators.
• Underestimators exhibited higher variability in sleep efficiency and N3 delta power.
• Daily diary assessments (OSA-MA) were more effective than retrospective measures for detecting discrepancies.

Conclusions:

• Sleep misperception is a dynamic phenomenon that can change with repeated measurement.
• Variability patterns suggest misperception relates to instability in sleep quantity/quality, not a single cause.
• Multi-night, in-home monitoring offers a more accurate approach to assessing sleep perception.