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Sleep Misperception and Associated Factors in Patients With Anxiety-Related Disorders and Complaint of Insomnia: A Retrospective Study

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Purpose Data on sleep parameters by polysomnography (PSG) in patients with anxiety-related disorders are limited. Although the disturbance and risk factors of sleep misperception have been implicated in psychopathology, its… Click to show full abstract

Purpose Data on sleep parameters by polysomnography (PSG) in patients with anxiety-related disorders are limited. Although the disturbance and risk factors of sleep misperception have been implicated in psychopathology, its role in anxiety-related disorders remains unclear. This retrospective study aimed to explore the characteristics and sleep parameters in patients with anxiety-related disorders and different sleep perception types, and to explore the associated factors for sleep misperception. Methods Patients with anxiety-related disorders who had complaint of insomnia for more than 3 months were collected at Wuhan Mental Health Center between December 2019 and July 2021. Patients underwent a two-night PSG monitoring and completed a self-reported sleep questionnaire. Behaviors were assessed using 30-item Nurses' Observation Scale for Inpatient Evaluation (NOSIE-30). Patients were divided into normal sleep perception (NSP), positive sleep perception abnormality [PSPA; overestimation of total sleep time (TST) >60 min], and negative sleep perception abnormality (NSPA; underestimation of TST >60 min) groups. PSG indicators and NOSIE-30 scores were compared among groups using the one-way analysis of variance and the Kruskal-Wallis test. Multiple linear regression analysis was performed to determine the associated factors for misperception index. Results The subjective and objective TST were 5.5 ± 1.9 h and 6.4 ± 1.7 h in 305 patients, respectively. Sixty-nine (22.6%) had PSPA, 80 (26.2%) had NSP, and 156 (51.1%) had NSPA. Subjective TST and objective sleep parameters were significantly different among groups. No statistical differences in NOSIE-30 subscale and total scores were observed among groups. Sex, rapid eye movement (REM)/TST (%), sleep efficiency, number of awakenings, Non-rapid eye movement of stage 2 sleep (NREM)/TST (%), REM spontaneous arousal times, sleep latency, diagnosis, social competence, and manifest psychosis were associated with sleep misperception. Conclusion Sleep misperception is common in patients with anxiety-related disorders. Various sleep perception types have different PSG profiles, but similar personal and social behaviors. These data may be helpful to conduct personalized treatment.

Keywords: related disorders; anxiety related; patients anxiety; sleep misperception

Journal Title: Frontiers in Neurology
Year Published: 2022

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