Associations Between Sleep State Misperception and Emotional States in Middle-Aged Adults: A Community-Based...

Several studies have explored sleep discrepancy as a key to understanding insomnia, linking it to attentional bias, arousal, distorted processing, depression, and anxiety. However, further research is needed to understand whether discrepancies in sleep perceptions observed in a community-dwelling middle-aged population, vulnerable to stress, were related to mood and other social factors. We used self-report questionnaires and smart watches to investigate the discrepancies between perception of sleep and objective data among 32 community-dwelling middle-aged individuals. We analyzed the relationship between sleep discrepancies and psychosocial factors and compared emotional state scores across different sleep tendencies to examine whether sleep discrepancy could serve as a potential indicator for identifying variations in psychological well-being. Emotional states associated with sleep discrepancy perception among middle-aged adults included tension-anxiety (TA) (r = -0.361), depression-dejection (r = -0.475), and total mood disturbance (TMD) (r = -0.287). In the regression model, sex, TMD, and self-rated health were significant predictors of perceived sleep discrepancy (adjusted R² = 0.392, F = 7.873, p = 0.001). Group comparisons showed that those with discrepancies between subjective and objective sleep measures had higher TA and Fatigue-Inertia levels compared with those with concordant subjective and objective sleep, and that age influenced these differences. These findings underscore the association between emotional states and sleep misperception. Sex, self-rated health, and TMD scores were independent predictors of sleep misperception index in middle-aged adults. Future longitudinal studies should clarify the causal relationship between the two and expand the possibilities of using actigraphy devices as tools for sleep monitoring and health prevention in daily settings.