Abstract
Introduction
Low sleep efficiency is a clinically valuable marker of poor sleep, especially in insomnia. Less is known about real-world associations between sleep efficiency and other sleep disorders symptoms.
Methods
Participants completed an online sleep health screener (https://sleephealthscreen.com). This consists of the Sleep Disorders Symptom Check List (SDSCL), as well as several other questions establishing demographics and respondent characteristics. All responses are anonymous. All consecutive responses to the questionnaire were included, following cleaning for duplicate and invalid entries. Responses to symptom items were recoded as “Never,” “Sometimes (< 3 times per week)” or “Often (3 or more times per week).” Sleep efficiency was calculated as [TST/TIB]*100 for self-reported habitual values. Regression analyses were adjusted for age, sex, race/ethnicity, work hours, employment, and presence of a bed partner.
Results
A total of 3,030 individuals provided complete data. Higher sleep efficiency was associated with insufficient sleep Sometimes (+1.59%) and sleepiness Sometimes (+2.0%). Lower sleep efficiency was observed for those who report insufficient sleep Often (-2.5%), sleep irregularity Sometimes and Often (-2.0% and -8.1%, respectively), difficulty falling asleep Sometimes and Often (-3.6% and -16.3%, respectively), difficulty staying asleep Sometimes and Often (-3.6% and -17.5%, respectively), and difficulty with early morning awakenings Sometimes and Often (-3.3% and –15.3%, respectively), fatigue Often (-7.3%), phase advance Sometimes and Often (-2.3% and -3.1%, respectively), phase delay Sometimes and Often (-1.5% and -4.0%, respectively), snoring Often (-1.9%), dry mouth Often (-3.7%), uncomfortable sensations in legs at night Often (-5.7%), urge to move legs at night Sometimes and Often (-1.7% and -5.2%, respectively), frequent awakenings Sometimes and Often (-3.4% and -13.4%, respectively), cataplexy-like symptoms Often (--5.8%), sleep hallucinations Sometimes and Often (-2.5% and -4.9%, respectively), nightmares Sometimes and Often (-2.0% and -5.0%, respectively), sudden awakenings Sometimes and Often (-3.4% and -6.9%, respectively), parasomnia-like symptoms Often (-2.3%), sleep interfering with functioning Sometimes and Often (-5.3% and -11.0%, respectively). Loud snoring, observed breathing pauses, waking up choking or gasping, sleep paralysis, and bruxism were not associated with sleep efficiency.
Conclusion
Sleep efficiency is negatively associated with a wide range of sleep disorders symptoms, beyond insomnia.
Support (if any)
R01MD011600, R01MH135978