Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Nov 20;8(1):34.
doi: 10.1186/s40345-020-00198-x.

Misperception of sleep in bipolar disorder: an exploratory study using questionnaire versus actigraphy

Henrik Myhre Ihler  1 , Manon Meyrel  2   3 , Vincent Hennion  2 , Julia Maruani  2   3   4 , Gregory Gross  4   5   6 , Pierre A Geoffroy  3   7 , Trine Vik Lagerberg  8 , Ingrid Melle  8 , Frank Bellivier  2   3   4 , Jan Scott  3   9 , Bruno Etain  2   3   4
Affiliations

Misperception of sleep in bipolar disorder: an exploratory study using questionnaire versus actigraphy

Henrik Myhre Ihler et al. Int J Bipolar Disord. .

Abstract

Background: The concept of misperception of sleep refers to the estimated discrepancy between subjective and objective measures of sleep. This has been assessed only in a few prior studies in individuals with Bipolar Disorder (BD) as compared to Healthy Controls (HC) and with mixed results.

Methods: We assessed a sample of 133 euthymic individuals with BD and 63 HC for retrospective subjective (Pittsburgh Sleep Quality Index) and objective (21 days of actigraphy recording) measures of total sleep time, sleep latency and sleep efficiency. We first investigated the correlations between these subjective and objective measures in the two groups. We then compared individuals with BD and HC for the absolute values of the differences between subjective and objective sleep parameters, used as a proxy of the magnitude of misperception of sleep. Finally, we undertook regression analyses to assess associations between clinical groups, core demographics, clinical factors and misperception of sleep.

Results: The correlation coefficients between subjective and objective measures of sleep did not differ between groups (total sleep time: rho = .539 in BD and rho = .584 in HC; sleep latency: rho = .190 in BD and rho = .125 in HC; sleep efficiency: rho = .166 in BD and rho = .222 in HC). Individuals with BD did not differ from HC in the magnitude of misperception of total sleep time, sleep latency nor sleep efficiency. Individuals with BD type 1 misperceived their sleep efficiency significantly more than individuals with BD type 2, with no further difference between BD type 1 and BD type 2 regarding sleep latency and sleep duration misperceptions. Three factors (age, symptoms of obstructive sleep apnea, and mild depressive symptoms), were the main contributors to the magnitude of misperception of sleep.

Conclusions: Misperception of sleep was not associated with a diagnosis of BD. In this sample, mild depressive symptoms, older age, or symptoms of obstructive sleep apnea may be related to greater sleep misperception. In that case, the reliability of subjective measures may decrease as the misperception of sleep increases. This study may help guide clinicians in selecting the best approach for assessing sleep (objective versus subjective measures) in individuals with BD.

Keywords: Bipolar disorder; Misperception of sleep; Sleep duration; Sleep efficiency; Sleep latency.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

References

    1. Armitage R, Trivedi M, Hoffmann R, Rush AJ. Relationship between objective and subjective sleep measures in depressed patients and healthy controls. Depression Anxiety. 1997;5(2):97–102. doi: 10.1002/(SICI)1520-6394(1997)5:2<97::AID-DA6>3.0.CO;2-2. - DOI - PubMed
    1. Baandrup L, Jennum PJ. A validation of wrist actigraphy against polysomnography in patients with schizophrenia or bipolar disorder. Neuropsychiatr Dis Treat. 2015;11:2271–2277. doi: 10.2147/NDT.S88236. - DOI - PMC - PubMed
    1. Basit H, Damhoff TC, Huecker MR. Sleeplessness And Circadian Disorder. StatPearls. Treasure Island (FL)2020. - PubMed
    1. Boudebesse C, Geoffroy PA, Bellivier F, Henry C, Folkard S, Leboyer M, et al. Correlations between objective and subjective sleep and circadian markers in remitted patients with bipolar disorder. Chronobiol Int. 2014;31(5):698–704. doi: 10.3109/07420528.2014.895742. - DOI - PubMed
    1. Brochard H, Godin O, Geoffroy PA, Yeim S, Boudebesse C, Benizri C, et al. Metabolic syndrome and actigraphy measures of sleep and circadian rhythms in bipolar disorders during remission. Acta Psychiatr Scand. 2018;138(2):155–162. doi: 10.1111/acps.12910. - DOI - PubMed

LinkOut - more resources