불면증 환자에서 수면시간에 대한 주관적 지각과 객관적 소견의 불일치
Mismatch between Subjective Perception and Objective Findings on Sleep Time in Insomnia Patients
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Objectives：Polysomnography in insomnia patients has often revealed a mismatch between the subjective perception and the objective findings of sleep time. We aimed to examine this mismatch and investigate the characteristics associated with the mismatch in insomnia patients. Methods：In 121 insomnia patients, findings of nocturnal polysomnography, responses to a subjective questionnaire after sleep, and medical records were reviewed. The patients were classified into two groups-total sleep time (TST) underestimation group(N=56) and TST non-underestimation group(N=65)-depending on the presence of a 2-h difference between the subjective and the objective TSTs. The demographic characteristics, type of insomnia, use of sleep-promoting medication, polysomnography findings, and subjective reports were compared between the two groups. Results：Nocturnal polysomnography showed significantly longer TST(p＜0.001) and shorter sleep latency(p＜ 0.001) than the subjectively reported values. In comparison with the TST non-underestimation group, the TST underestimation group were significantly older(p=0.043) ; more likely to have longer TST(p=0.012), shorter sleep latency (p=0.002), and a smaller proportion of slow-wave sleep(p＜0.001) in the polysomnographic analysis ; and more likely to show shorter TST(p＜0.001) and shallower sleep(p＜0.001) in the subjectively reported values. Conclusions：We found a significant mismatch between the subjective perception and the objective findings of sleep time as determined using polysomnography in insomnia patients. Underestimation of sleep time may be more closely associated with the proportion of slow-wave sleep, which reflects sleep depth, than with objective TST.
Abstract
Objectives：Polysomnography in insomnia patients has often revealed a mismatch between the subjective perception and the objective findings of sleep time. We aimed to examine this mismatch and investigate the characteristics associated with the mismatch in insomnia patients. Methods：In 121 insomnia patients, findings of nocturnal polysomnography, responses to a subjective questionnaire after sleep, and medical records were reviewed. The patients were classified into two groups-total sleep time (TST) underestimation group(N=56) and TST non-underestimation group(N=65)-depending on the presence of a 2-h difference between the subjective and the objective TSTs. The demographic characteristics, type of insomnia, use of sleep-promoting medication, polysomnography findings, and subjective reports were compared between the two groups. Results：Nocturnal polysomnography showed significantly longer TST(p＜0.001) and shorter sleep latency(p＜ 0.001) than the subjectively reported values. In comparison with the TST non-underestimation group, the TST underestimation group were significantly older(p=0.043) ; more likely to have longer TST(p=0.012), shorter sleep latency (p=0.002), and a smaller proportion of slow-wave sleep(p＜0.001) in the polysomnographic analysis ; and more likely to show shorter TST(p＜0.001) and shallower sleep(p＜0.001) in the subjectively reported values. Conclusions：We found a significant mismatch between the subjective perception and the objective findings of sleep time as determined using polysomnography in insomnia patients. Underestimation of sleep time may be more closely associated with the proportion of slow-wave sleep, which reflects sleep depth, than with objective TST.
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