Multi-Night Home Assessment of Total Sleep Time Misperception in Obstructive Sleep Apnea with and Without Insomnia Symptoms
Total sleep time (TST) misperception has been reported in obstructive sleep apnea (OSA). However, previous findings on predictors were inconsistent and predominantly relied on single-night polysomnography, which may alter patients’ sleep perception. We leveraged advances in wearable sleep staging to...
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MDPI AG
2024-12-01
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| Series: | Clocks & Sleep |
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| Online Access: | https://www.mdpi.com/2624-5175/6/4/50 |
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| author | Jasmin Kuhn Laura R. B. Schiphorst Bernice M. Wulterkens Jerryll Asin Nanny Duis Sebastiaan Overeem Merel M. van Gilst Pedro Fonseca |
| author_facet | Jasmin Kuhn Laura R. B. Schiphorst Bernice M. Wulterkens Jerryll Asin Nanny Duis Sebastiaan Overeem Merel M. van Gilst Pedro Fonseca |
| author_sort | Jasmin Kuhn |
| collection | DOAJ |
| description | Total sleep time (TST) misperception has been reported in obstructive sleep apnea (OSA). However, previous findings on predictors were inconsistent and predominantly relied on single-night polysomnography, which may alter patients’ sleep perception. We leveraged advances in wearable sleep staging to investigate predictors of TST misperception in OSA over multiple nights in the home environment. The study included 141 patients with OSA, 75 without insomnia symptoms (OSA group), and 66 with insomnia symptoms (OSA-I group). Objective TST was measured using a previously validated wrist-worn photoplethysmography and accelerometry device. Self-reported TST was assessed using a digital sleep diary. TST misperception was quantified with the misperception index (MI), calculated as (objective − self-reported TST)/objective TST. MI values differed significantly between the OSA (median = −0.02, IQR = [−0.06, 0.02]) and the OSA-I group (0.05, [−0.02, 0.13], <i>p</i> < 0.001). Multilevel modeling revealed that the presence of insomnia symptoms (β = 0.070, <i>p</i> < 0.001) and lower daily reported sleep quality (β = −0.229, <i>p</i> < 0.001) were predictive of higher MI (TST underestimation), while a higher apnea–hypopnea index (AHI) was predictive of lower MI (TST overestimation; β = −0.001, <i>p</i> = 0.006). Thus, insomnia symptoms and AHI are associated with TST misperception in OSA patients, but in opposite directions. This association extends over multiple nights in the home environment. |
| format | Article |
| id | doaj-art-75c8ed5fa5b14b3eb75151a00f7ff4cf |
| institution | Kabale University |
| issn | 2624-5175 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Clocks & Sleep |
| spelling | doaj-art-75c8ed5fa5b14b3eb75151a00f7ff4cf2024-12-27T14:18:42ZengMDPI AGClocks & Sleep2624-51752024-12-016477778810.3390/clockssleep6040050Multi-Night Home Assessment of Total Sleep Time Misperception in Obstructive Sleep Apnea with and Without Insomnia SymptomsJasmin Kuhn0Laura R. B. Schiphorst1Bernice M. Wulterkens2Jerryll Asin3Nanny Duis4Sebastiaan Overeem5Merel M. van Gilst6Pedro Fonseca7Department of Electrical Engineering, Eindhoven University of Technology, 5612AP Eindhoven, The NetherlandsDepartment of Electrical Engineering, Eindhoven University of Technology, 5612AP Eindhoven, The NetherlandsDepartment of Electrical Engineering, Eindhoven University of Technology, 5612AP Eindhoven, The NetherlandsCenter for Sleep Medicine, Amphia Hospital, 4818CK Breda, The NetherlandsCenter for Sleep Medicine, Amphia Hospital, 4818CK Breda, The NetherlandsDepartment of Electrical Engineering, Eindhoven University of Technology, 5612AP Eindhoven, The NetherlandsDepartment of Electrical Engineering, Eindhoven University of Technology, 5612AP Eindhoven, The NetherlandsDepartment of Electrical Engineering, Eindhoven University of Technology, 5612AP Eindhoven, The NetherlandsTotal sleep time (TST) misperception has been reported in obstructive sleep apnea (OSA). However, previous findings on predictors were inconsistent and predominantly relied on single-night polysomnography, which may alter patients’ sleep perception. We leveraged advances in wearable sleep staging to investigate predictors of TST misperception in OSA over multiple nights in the home environment. The study included 141 patients with OSA, 75 without insomnia symptoms (OSA group), and 66 with insomnia symptoms (OSA-I group). Objective TST was measured using a previously validated wrist-worn photoplethysmography and accelerometry device. Self-reported TST was assessed using a digital sleep diary. TST misperception was quantified with the misperception index (MI), calculated as (objective − self-reported TST)/objective TST. MI values differed significantly between the OSA (median = −0.02, IQR = [−0.06, 0.02]) and the OSA-I group (0.05, [−0.02, 0.13], <i>p</i> < 0.001). Multilevel modeling revealed that the presence of insomnia symptoms (β = 0.070, <i>p</i> < 0.001) and lower daily reported sleep quality (β = −0.229, <i>p</i> < 0.001) were predictive of higher MI (TST underestimation), while a higher apnea–hypopnea index (AHI) was predictive of lower MI (TST overestimation; β = −0.001, <i>p</i> = 0.006). Thus, insomnia symptoms and AHI are associated with TST misperception in OSA patients, but in opposite directions. This association extends over multiple nights in the home environment.https://www.mdpi.com/2624-5175/6/4/50obstructive sleep apneasleep disordered breathinginsomniasleep perceptionsleep-wake cognitionphotoplethysmography |
| spellingShingle | Jasmin Kuhn Laura R. B. Schiphorst Bernice M. Wulterkens Jerryll Asin Nanny Duis Sebastiaan Overeem Merel M. van Gilst Pedro Fonseca Multi-Night Home Assessment of Total Sleep Time Misperception in Obstructive Sleep Apnea with and Without Insomnia Symptoms Clocks & Sleep obstructive sleep apnea sleep disordered breathing insomnia sleep perception sleep-wake cognition photoplethysmography |
| title | Multi-Night Home Assessment of Total Sleep Time Misperception in Obstructive Sleep Apnea with and Without Insomnia Symptoms |
| title_full | Multi-Night Home Assessment of Total Sleep Time Misperception in Obstructive Sleep Apnea with and Without Insomnia Symptoms |
| title_fullStr | Multi-Night Home Assessment of Total Sleep Time Misperception in Obstructive Sleep Apnea with and Without Insomnia Symptoms |
| title_full_unstemmed | Multi-Night Home Assessment of Total Sleep Time Misperception in Obstructive Sleep Apnea with and Without Insomnia Symptoms |
| title_short | Multi-Night Home Assessment of Total Sleep Time Misperception in Obstructive Sleep Apnea with and Without Insomnia Symptoms |
| title_sort | multi night home assessment of total sleep time misperception in obstructive sleep apnea with and without insomnia symptoms |
| topic | obstructive sleep apnea sleep disordered breathing insomnia sleep perception sleep-wake cognition photoplethysmography |
| url | https://www.mdpi.com/2624-5175/6/4/50 |
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