Dados do Trabalho

Título

Differential diagnosis between insomnia with short sleep time and sleep misperception: the role of actigraphy

Introdução

Introduction: Actigraphy is a useful tool in the objective assessment of insomnia variables such as total sleep time (TST), wake after sleep onset (WASO), daytime napping, and sleep and wake times. This evaluation is of interest for the characterization of insomnia with objectively short sleep time (<6h) phenotype, associated with metabolic, cardiovascular and psychiatric comorbidities.

Objetivo

Objective: Primarily, describe characteristics of the sample of short sleep and sleep misperception, and secondarily describe comorbidities prevalence.

Métodos

Methodology: Retrospective survey of 29 actigraphy exams and patient records (2021-2024).

Resultados

Results: Our sample was classified according to the following Groups: 1 - insomnia with short total sleep time (TST<6h; 31%), 2 - insomnia (TST 6h>7h; 21%), 3 - sleep misperception (TST7h>9h; 41%), and 4 - paradoxical insomnia (TST>9h; 7%), groups 1 and 2 composing the sleep restriction (SR) sample.
Average age was of 54 years, 65,5% consisting of women and higher, statistically significant, risk for SR among men (OR=9,61 p=0,028).
Group 1 had average WASO of 83,89 minutes, Group 2 of 40,17 minutes and Group 3 of 56,33, while Group 4 had only 2 individuals with an average WASO of 35.5 minutes.
All Groups had a predominance of the intermediate chronotype, although among Groups we observed a higher prevalence of eveningness in Group 1 (33%), chronotype non-significantly associated with higher risk of SR.
Depression rates were higher in group 1 (44%), while occurred in 25% of individuals in group 3, with risk being non-signicantly higher if there was SR.
Hypertension occurred in 33% of individual in group 1 and in group 2, being present in 42% of individuals in group 3; while obstructive sleep apnea (OSA) had prevalence of 22%, 16,6% and 8% respectively, with higher non significant risk with SR.

Conclusões

Discussion and conclusions: Approximately 50% of the sample presents insomnia with TST>7h. Group 1 represents the most severe insomnia phenotype, with greater association with metabolic and psychiatric disorders, especially depression (44%). Group 2 represents traditional insomnia patients, a heterogeneous group, with different associated comorbidities and WASO times. In conclusion, the objective determination of TST through actigraphy made it possible to classify patients into 4 groups that present different characteristics and must be managed in different ways.

Palavras -chave

Key-words: Actigraphy, insomnia, short sleep duration, sleep misperception