Masaki Minori, Tsumoto Saki, Tani Akihiro, Tominaga Morie, Seol Jaehoon, Chiba Shigeru, Miyanishi Kazuya, Nishida Kei, Kawana Fusae, Amemiya Takashi, Hiei Tetsuro, Kanbayashi Takashi, Yanagisawa Masashi
International Institute for Integrative Sleep Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan.
Ph.D. Program in Humanics, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan.
Proc Natl Acad Sci U S A. 2025 Jan 21;122(3):e2412895121. doi: 10.1073/pnas.2412895121. Epub 2025 Jan 16.
Sleep insufficiency and sleep disorders pose serious health challenges. This study aimed to determine the potential discrepancy between subjective and objective sleep assessments, including the latter made by physicians, by analyzing a 421-participant dataset in Japan comprising multiple nights of in-home sleep electroencephalogram (EEG) data and questionnaire responses on sleep habits or subjective experiences. We employed logistic regression models to examine which subjective and objective sleep parameters physicians are paying attention to when assessing sleep insufficiency, insomnia, sleep quality, and sleep apnea. Questionnaire responses, including subjective sleep assessments, exhibited poor performance predicting physicians' assessments, whereas objective data demonstrated good predictive performance, indicating a discrepancy between subjective and objective sleep assessments. Although the in-home sleep EEG measurements had minimal first night effects, incorporating measurements over multiple nights can improve the detection of objective insomnia. Moreover, we found that participants with severe sleep insufficiency overestimated their sleep duration, whereas those with subjective insomnia but without objective insomnia underestimated it. Additionally, subjective sleep quality reflected sleep efficiency but not the frequency of short awakenings or objective sleep depth. In particular, the effects of apnea on objective sleep quality were not subjectively perceived. Collectively, our findings suggest that subjective sleep assessments alone are insufficient for evaluating sleep health and that health checkups and advice based on sleep EEG measurements may be useful in improving sleep habits and for early detection of sleep disorders.
睡眠不足和睡眠障碍对健康构成严重挑战。本研究旨在通过分析日本一个包含421名参与者的数据集来确定主观和客观睡眠评估之间的潜在差异，该数据集包括多晚的家庭睡眠脑电图（EEG）数据以及关于睡眠习惯或主观体验的问卷调查回复。我们使用逻辑回归模型来研究医生在评估睡眠不足、失眠、睡眠质量和睡眠呼吸暂停时关注哪些主观和客观睡眠参数。包括主观睡眠评估在内的问卷调查回复在预测医生评估方面表现不佳，而客观数据则显示出良好的预测性能，表明主观和客观睡眠评估之间存在差异。尽管家庭睡眠EEG测量的首夜效应最小，但纳入多晚的测量可以提高对客观失眠的检测。此外，我们发现严重睡眠不足的参与者高估了他们的睡眠时间，而那些有主观失眠但没有客观失眠的参与者则低估了睡眠时间。此外，主观睡眠质量反映了睡眠效率，但没有反映短暂觉醒的频率或客观睡眠深度。特别是，呼吸暂停对客观睡眠质量的影响没有被主观感知到。总体而言，我们的研究结果表明，仅靠主观睡眠评估不足以评估睡眠健康，基于睡眠EEG测量的健康检查和建议可能有助于改善睡眠习惯并早期发现睡眠障碍。
