Study Of Sleep State Perception In Insomniacs And Patients With OSAHS: Characters And Related Factors

[Objective] To observe the characters and related factors of sleep state perception (SSP) between normal sleepers and patients with insomnia and obstructive sleep apnea hypopnea syndrome (OSAHS). Moreover, to figure out the difference of SSP in insomniacs who undergone various interference measures. And then, attempt to interpret the conceivable mechanism of SSP as well as underlying impacts to them.[Methods] Two independent parts are designed for insomniacs and OSAHS patients with their control respectively. For insomniacs, the study include the SSP reported by patients self with sleep diary (morning questionnaire) and the objective measures obtained by polysomnography (PSG). To analyze the subjective measures from SSP with the PSG and to discover the traits of insomniac's SSP. Meanwhile, scale tools are involved to this study for investigation of potential related factors. Furthermore, the repeated measures reported after different therapy group were analyzed again for variability. For OSAHS patients, the same methods are used for collection of data and procedure of analysis. The statistics include independent or related sample analysis and correlation coefficient.[Results] Certain results listed below can be confirmed in this article. A) There is an subjective error of SSP can be found in insomniacs, represented not only in the aspect of time perception, but also in the global assessment of sleep quality. Both of them change closely with one accord. B) The insomniac's sleep state miscalculation reflects mainly to overestimate their sleep deficiency, which include overestimation of sleep latency and wake times after sleep onset as well as underestimation of total sleep time and sleep efficiency, but the global underestimation of sleep absence may be existed. C) All of interferences in this study may decrease the miscalculation, however, cognitive-behavior therapy represents optimal effect than others because of psychological effort or behavior activity contributed to mislead SSP. D) Anxiety is important impact factor to miscalculation of SSP, inversely, anxiety is also influenced by miscalculation. E) Good sleeper still present negotiate sleep state perception like the insomniacs, but with mild degree. F) Patients with OSAHS still reflect SSP errors, not only in time perception but also in global assessment. G) Patients suffering from OSAHS represent their SSP with underestimation of sleep latency and wake times after sleep onset. H) Chronic and repeated nocturnal hypoxia, especially indicated by lowest mean saturation, as well as apnea hypopnea index, arousal index impact the assessment of SSP obviously. Simultaneously, they correlate with sleepiness in the daytime. I) Comparing with OSAHS patients, insomniacs manifest not only objective increase of wake times after sleep onset, but also subjective assessment errors in wake times, moreover, exaggerate the subjective sleep latency. Oppositely, patients with OSAHS still have increase of wake times in fact, but underestimate it and sleep latency.[Conclusion] Miscalculation of SSP is a normal phenomenon but is prominent in insomniacs with exaggeration of sleep disorders. Likewise, the miscalculation is still observed in patients with OSAHS, but not in the same change. Their overestimation of wake times after sleep onset and underestimation of sleep latency play a role in the attempt to interpret the mechanism of SSP's variability and support to construe the wake-sleep system with experimental data. Diverse causes may influence the results of SSP, however, complex psychological or behavior activity may play a senior role in adjustment mechanism. Furthermore, what is the effect in SSP by theory of time perception should be paid more attention in future study.