Sleep and Circadian Neuroscience Institute (SCNi), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
Oxford Health NHS Foundation Trust, Oxford, UK.
J Sleep Res. 2018 Dec;27(6):e12726. doi: 10.1111/jsr.12726. Epub 2018 Jul 10.
This study investigated whether providing sham feedback about sleep to individuals with insomnia influenced daytime symptom reports, sleep-related attentional bias and psychomotor vigilance. Sixty-three participants meeting DSM-5 criteria for insomnia disorder were recruited from the community. Following baseline assessments and actigraphy briefing, participants were randomised to receive next-day sham feedback on sleep quality ("positive" vs. "negative" sleep efficiency condition). Feedback was delivered at habitual rise-time using an integrated actigraphy-diary watch to simulate wearable device behaviour. Participants completed symptom reports immediately before receiving feedback, and at 12:00 and 15:00 hr, using the experience sampling method. Following this they returned to the laboratory in the evening to complete symptom reports and computerised tests of sleep-related attentional bias and basic psychomotor vigilance. Participants randomised to negative feedback (n = 32) evidenced impaired daytime function (decreased alert cognition [d = 0.79], increased sleepiness/fatigue [d = 0.55]) in the evening compared with those given positive feedback (n = 31). Within-day trajectories revealed that the positive-feedback group, relative to the negative-feedback group, displayed a significantly greater increase in positive mood and alert cognition (from rise-time to 12:00 hr), and significantly greater decrease in sleepiness/fatigue. There were no significant between-group differences on measures of sleep-related attentional bias [d = 0.20] or psychomotor vigilance [d = 0.12]. This controlled experiment shows that sham feedback about sleep biases appraisal of daytime symptoms, highlighting a pathway connecting sleep misperception with daytime features of insomnia. Findings have important implications for wearable devices that claim to measure "objective" sleep yet may provide inaccurate data relative to gold-standard measurement.
本研究旨在探讨为失眠症患者提供虚假的睡眠反馈是否会影响日间症状报告、与睡眠相关的注意力偏向和精神运动警觉性。从社区中招募了 63 名符合 DSM-5 失眠症标准的参与者。在基线评估和活动记录仪简介后，参与者被随机分配接受次日关于睡眠质量的虚假反馈（“积极”与“消极”睡眠效率条件）。反馈使用集成的活动记录仪-日记表在习惯的起床时间发送，以模拟可穿戴设备的行为。参与者在接受反馈之前、12:00 和 15:00 立即使用体验采样法完成症状报告。在此之后，他们在晚上返回实验室完成症状报告和与睡眠相关的注意力偏向和基本精神运动警觉性的计算机测试。随机分配到负反馈组（n=32）的参与者在晚上表现出日间功能受损（警觉认知下降[ d=0.79]，嗜睡/疲劳增加[ d=0.55]），而接受正反馈的参与者（n=31）则表现出日间功能受损。日内轨迹显示，与负反馈组相比，正反馈组在积极情绪和警觉认知方面（从起床时间到 12:00 小时）显著增加，而嗜睡/疲劳显著减少。在与睡眠相关的注意力偏向[ d=0.20]或精神运动警觉性[ d=0.12]的测量方面，两组之间没有显著差异。这项对照实验表明，关于睡眠的虚假反馈会影响对日间症状的评估，突出了睡眠感知错误与失眠日间特征之间的联系途径。这些发现对声称测量“客观”睡眠的可穿戴设备具有重要意义，因为这些设备提供的不准确数据可能与金标准测量相比存在差异。
