Sleep-Wake Survival Dynamics in People with Insomnia

Lieke WA Hermans,1 Marta Regis,2 Pedro Fonseca,1,3 Bertram Hoondert,4 Tim RM Leufkens,3 Sebastiaan Overeem,1,4 Merel M van Gilst1,4 1Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands; 2Department of Mathematics and Computer Science, Eindhoven Univer...

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Autores principales:	Hermans LWA, Regis M, Fonseca P, Hoondert B, Leufkens TRM, Overeem S, van Gilst MM
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	insomnia survival analysis sleep fragmentation Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
Acceso en línea:	https://doaj.org/article/249f8c72eef74de3a2f9085192f50841
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spelling	oai:doaj.org-article:249f8c72eef74de3a2f9085192f508412021-12-02T15:52:24ZSleep-Wake Survival Dynamics in People with Insomnia1179-1608https://doaj.org/article/249f8c72eef74de3a2f9085192f508412021-03-01T00:00:00Zhttps://www.dovepress.com/sleep-wake-survival-dynamics-in-people-with-insomnia-peer-reviewed-article-NSShttps://doaj.org/toc/1179-1608Lieke WA Hermans,1 Marta Regis,2 Pedro Fonseca,1,3 Bertram Hoondert,4 Tim RM Leufkens,3 Sebastiaan Overeem,1,4 Merel M van Gilst1,4 1Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands; 2Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, the Netherlands; 3Philips Research, Eindhoven, the Netherlands; 4Sleep Medicine Center Kempenhaeghe, Heeze, the NetherlandsCorrespondence: Lieke WA HermansDepartment of Electrical Engineering, Eindhoven University of Technology, De Zaale, 5600, MB Eindhoven, the NetherlandsEmail l.w.a.hermans@tue.nlIntroduction: Assessing objective measures of sleep fragmentation could yield important features reflecting impaired sleep quality in people with insomnia. Survival analysis allows the specific examination of the stability of NREM sleep, REM sleep and wake. The objective of this study was to assess the differences between survival dynamics of NREM sleep, REM sleep and wake between people with insomnia and healthy controls.Methods: We analyzed retrospective polysomnography recordings from 86 people with insomnia and 94 healthy controls. For each participant, survival dynamics of REM sleep, NREM sleep and wake were represented using Weibull distributions. We used lasso penalized parameter selection in combination with linear regression to analyze the difference between participant groups with respect to the Weibull scale and shape parameters, while correcting for age, sex, total sleep time and relevant interaction effects.Results: Significant effects of group were found for the NREM scale parameter, and for the wake scale and shape parameters. Results indicated that people with insomnia had less stable NREM sleep and more stable wake after sleep onset compared to healthy controls. Additionally, the altered distribution of wake segment lengths indicated an increased difficulty to fall asleep after longer awakenings in the insomnia group. However, these differences were mainly observed in younger participants. Significant effects of group for the survival parameters of REM sleep were not found.Conclusion: As illustrated by our results, survival analysis can be very useful for disentangling different types of sleep fragmentation in people with insomnia. For instance, the current findings suggest that people with insomnia have an increased fragmentation of NREM sleep, but not necessarily of REM sleep. Additional research into the underlying mechanisms of NREM sleep fragmentation could possibly lead to a better understanding of impaired sleep quality in people with insomnia, and consequently to improved treatment.Keywords: insomnia, survival analysis, sleep fragmentationHermans LWARegis MFonseca PHoondert BLeufkens TRMOvereem Svan Gilst MMDove Medical Pressarticleinsomniasurvival analysissleep fragmentationPsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol Volume 13, Pp 349-360 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	insomnia survival analysis sleep fragmentation Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
spellingShingle	insomnia survival analysis sleep fragmentation Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495 Hermans LWA Regis M Fonseca P Hoondert B Leufkens TRM Overeem S van Gilst MM Sleep-Wake Survival Dynamics in People with Insomnia
description	Lieke WA Hermans,1 Marta Regis,2 Pedro Fonseca,1,3 Bertram Hoondert,4 Tim RM Leufkens,3 Sebastiaan Overeem,1,4 Merel M van Gilst1,4 1Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands; 2Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, the Netherlands; 3Philips Research, Eindhoven, the Netherlands; 4Sleep Medicine Center Kempenhaeghe, Heeze, the NetherlandsCorrespondence: Lieke WA HermansDepartment of Electrical Engineering, Eindhoven University of Technology, De Zaale, 5600, MB Eindhoven, the NetherlandsEmail l.w.a.hermans@tue.nlIntroduction: Assessing objective measures of sleep fragmentation could yield important features reflecting impaired sleep quality in people with insomnia. Survival analysis allows the specific examination of the stability of NREM sleep, REM sleep and wake. The objective of this study was to assess the differences between survival dynamics of NREM sleep, REM sleep and wake between people with insomnia and healthy controls.Methods: We analyzed retrospective polysomnography recordings from 86 people with insomnia and 94 healthy controls. For each participant, survival dynamics of REM sleep, NREM sleep and wake were represented using Weibull distributions. We used lasso penalized parameter selection in combination with linear regression to analyze the difference between participant groups with respect to the Weibull scale and shape parameters, while correcting for age, sex, total sleep time and relevant interaction effects.Results: Significant effects of group were found for the NREM scale parameter, and for the wake scale and shape parameters. Results indicated that people with insomnia had less stable NREM sleep and more stable wake after sleep onset compared to healthy controls. Additionally, the altered distribution of wake segment lengths indicated an increased difficulty to fall asleep after longer awakenings in the insomnia group. However, these differences were mainly observed in younger participants. Significant effects of group for the survival parameters of REM sleep were not found.Conclusion: As illustrated by our results, survival analysis can be very useful for disentangling different types of sleep fragmentation in people with insomnia. For instance, the current findings suggest that people with insomnia have an increased fragmentation of NREM sleep, but not necessarily of REM sleep. Additional research into the underlying mechanisms of NREM sleep fragmentation could possibly lead to a better understanding of impaired sleep quality in people with insomnia, and consequently to improved treatment.Keywords: insomnia, survival analysis, sleep fragmentation
format	article
author	Hermans LWA Regis M Fonseca P Hoondert B Leufkens TRM Overeem S van Gilst MM
author_facet	Hermans LWA Regis M Fonseca P Hoondert B Leufkens TRM Overeem S van Gilst MM
author_sort	Hermans LWA
title	Sleep-Wake Survival Dynamics in People with Insomnia
title_short	Sleep-Wake Survival Dynamics in People with Insomnia
title_full	Sleep-Wake Survival Dynamics in People with Insomnia
title_fullStr	Sleep-Wake Survival Dynamics in People with Insomnia
title_full_unstemmed	Sleep-Wake Survival Dynamics in People with Insomnia
title_sort	sleep-wake survival dynamics in people with insomnia
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/249f8c72eef74de3a2f9085192f50841
work_keys_str_mv	AT hermanslwa sleepwakesurvivaldynamicsinpeoplewithinsomnia AT regism sleepwakesurvivaldynamicsinpeoplewithinsomnia AT fonsecap sleepwakesurvivaldynamicsinpeoplewithinsomnia AT hoondertb sleepwakesurvivaldynamicsinpeoplewithinsomnia AT leufkenstrm sleepwakesurvivaldynamicsinpeoplewithinsomnia AT overeems sleepwakesurvivaldynamicsinpeoplewithinsomnia AT vangilstmm sleepwakesurvivaldynamicsinpeoplewithinsomnia
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Sleep-Wake Survival Dynamics in People with Insomnia

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