Skip to main content
NCBI home page
Neuroscience Bulletin logoLink to Neuroscience Bulletin
. 2008 Feb 1;23(4):236–240. doi: 10.1007/s12264-007-0035-9

Objective and subjective measures for sleep disorders

睡眠障碍中的主观及客观评价方法

Lin Zhang 1, Zhong-Xin Zhao 1,✉
PMCID: PMC5550587  PMID: 17687399

Abstract

Subjective and objective measures of sleep structure or quality could help to characterize the chronic sleep disturbances, with relation to patients’ risk factor profiles and co-morbidities. Studies have shown that discrepancies can occur between subjective data regarding sleep disturbances and the impact of insomnia and objective assays, and surrogate markers of sleep and sleep disturbances. Both objective and subjective measures should be incorporated into clinic studies. It seems likely that sleep quality is represented by a combination of more than one subjective sleep parameter. Objective and subjective assessments of sleep quality may relate to different parameters. Future studies incorporated both subjective and objective measures could help to address the sleep disorders.

Keywords: objective measures, subjective measures, sleep disorders

References

  • [1].Leger D. Insomnia and quality of life. Insomnia. 2003;1:29–32. [Google Scholar]
  • [2].Keklund G., Akerstedt T. Objective components of individual differences in subjective sleep quality. J Sleep Res. 1997;6:217–220. doi: 10.1111/j.1365-2869.1997.00217.x. [DOI] [PubMed] [Google Scholar]
  • [3].Akerstedt T., Hume K., Minors D., Waterhouse J. The subjective meaning of good sleep, an intraindividual approach using the Karolinska Sleep Diary. Percep Mot Skills. 1994;79(1Pt1):287–296. doi: 10.2466/pms.1994.79.1.287. [DOI] [PubMed] [Google Scholar]
  • [4].Dalton E.J., Rotondi D., Levitan R.D., Kennedy S.H., Brown G.M. Use of slow-release melatonin in treatment-resistant depression. J Psychiatry Neurosci. 2000;25:48–52. [PMC free article] [PubMed] [Google Scholar]
  • [5].Leentjens A.F., Marinus J., Van Hilten J.J., Lousberg R., Verhey F.R. The contribution of somatic symptoms to the diagnosis of depressive disorder in Parkinson’s disease: a discriminant analytic approach. J Neuropsychiatry Clin Neurosci. 2003;15:74–77. doi: 10.1176/jnp.15.1.74. [DOI] [PubMed] [Google Scholar]
  • [6].Koren D., Arnon I., Lavie P., Klein E. Sleep complaints as early predictors of posttraumatic stress disorder: a 1-year prospective study of injured survivors of motor vehicle accidents. Am J Psychiatry. 2002;159:855–857. doi: 10.1176/appi.ajp.159.5.855. [DOI] [PubMed] [Google Scholar]
  • [7].Hatoum H.T., Kong S.X., Kania C.M., Wong J.M., Mendelson W.B. Insomnia, health-related quality of life and healthcare resource consumption. A study of managed-care organization enrollees. Pharmacoeconomics. 1998;6:629–637. doi: 10.2165/00019053-199814060-00004. [DOI] [PubMed] [Google Scholar]
  • [8].Leger D., Scheuermaier K., Philip P., Paillard M., Guilleminault C. SF-36: evaluation of quality of life in severe and mild insomniacs compared with good sleepers. Psychosom Med. 2001;63:49–55. doi: 10.1097/00006842-200101000-00006. [DOI] [PubMed] [Google Scholar]
  • [9].Schubert C.R., Cruickshanks K.J., Dalton D.S., Klein B.E., Klein R., Nondahl D.M. Prevalence of sleep problems and quality of life in an older population. Sleep. 2002;25:889–893. [PubMed] [Google Scholar]
  • [10].Rosenthal L.D., Meixner R.M. Psychological status and levels of sleepiness-alertness among patients with insomnia. CNS Spectr. 2003;8:114–118. doi: 10.1017/s1092852900018332. [DOI] [PubMed] [Google Scholar]
  • [11].Means M.K., Lichstein K.L., Epperson M.T., Johnson C.T. Relaxation therapy for insomnia: night time and day time effects. Behav Res Ther. 2000;38:665–678. doi: 10.1016/S0005-7967(99)00091-1. [DOI] [PubMed] [Google Scholar]
  • [12].Schwartz J.R., Feldman N.T., Fry J.M., Harsh J. Efficacy and safety of modafinil for improving daytime wakefulness in patients treated previously with psychostimulants. Sleep Med. 2003;4:43–49. doi: 10.1016/s1389-9457(02)00240-x. [DOI] [PubMed] [Google Scholar]
  • [13].Ancoli-Israel S., Cole R., Alessi C., Chambers M., Moorcroft W., Pollak C.P. The role of actigraphy in the study of sleep and circadian rhythms. Sleep. 2003;26:342–392. doi: 10.1093/sleep/26.3.342. [DOI] [PubMed] [Google Scholar]
  • [14].Kerkhof G., van Vianen B. Circadian phase estimation of chronic insomniacs relates to their sleep characteristics. Arch Physiol Biochem. 1999;107:383–392. doi: 10.1076/apab.107.2.136.4342. [DOI] [PubMed] [Google Scholar]
  • [15].Littner M., Kushida C.A., Anderson W.M., Bailey D., Berry R.B., Davila D.G., et al. Practice parameters for the role of actigraphy in the study of sleep and circadian rhythms: an update for 2002. Sleep. 2003;26:337–341. doi: 10.1093/sleep/26.3.337. [DOI] [PubMed] [Google Scholar]
  • [16].Nofzinger E.A., Buysse D.J., Germain A., Price J.C., Miewald J.M., Kupfer D.J. Functional neuroimaging evidence for hyperarousal in insomnia. Am J Psychiatry. 2004;161:2126–2128. doi: 10.1176/appi.ajp.161.11.2126. [DOI] [PubMed] [Google Scholar]
  • [17].Nofzinger E.A., Nichols T.E., Meltzer C.C., Price J., Steppe D.A., Miewald J.M., et al. Changes in forebrain function from waking to REM sleep in depression: preliminary analyses of [18F] FDG PET studies. Psychiatry Res. 1999;91:59–78. doi: 10.1016/S0925-4927(99)00025-6. [DOI] [PubMed] [Google Scholar]
  • [18].Lamphere J., Roehrs T., Vogel G., Koshorek G., Fortier J., Roth T. The chronic efficacy of midazolam. Int Clin Psychopharmacol. 1990;5:31–39. doi: 10.1097/00004850-199001000-00003. [DOI] [PubMed] [Google Scholar]
  • [19].Drake C.L., Rice M.F., Roehrs T.A., Rosenthal L., Guido P., Roth T. Scoring reliability of the multiple sleep latency test in a clinical population. Sleep. 2000;23:911–913. [PubMed] [Google Scholar]
  • [20].Chesson A., Hartse K., Anderson W.M., Davila D., Johnson S., Littner M., et al. Practice parameters for the evaluation of chronic insomnia. An American Academy of Sleep Medicine report. Standards of Practice Committee of the American Academy of Sleep Medicine. Sleep. 2000;23:237–241. [PubMed] [Google Scholar]
  • [21].Terzano M.G., Parrino L. Evaluation of the EEG cyclic alternating pattern during sleep in insomniacs and controls under placebo and acute treatment with zolpidem. Sleep. 1992;15:64–70. doi: 10.1093/sleep/15.1.64. [DOI] [PubMed] [Google Scholar]
  • [22].Terzano M.G., Parrino L., Spaggiari M.C., Palomba V., Rossi M., Smerieri A. CAP variables and arousals as sleep electroencephalogram markers for primary insomnia. Clin Neurophysiol. 2003;114:1715–1723. doi: 10.1016/S1388-2457(03)00136-6. [DOI] [PubMed] [Google Scholar]
  • [23].Terzano MG. Diagnostic tools for sleep disorders: the role of polysomnography (PSG), cyclic alternating pattern (CAP) and actimetry. Insomnia. 2004;2:4–5. [Google Scholar]
  • [24].Stepanski E., Koshorek G., Zorick F., Glinn M., Roehrs T., Roth T. Characteristics of individuals who do or do not seek treatment for chronic insomnia. Psychosomatics. 1989;30:421–427. doi: 10.1016/S0033-3182(89)72248-9. [DOI] [PubMed] [Google Scholar]
  • [25].Hajak G., Rodenbeck A., Staedt J., Bandelow B., Huether G., Ruther E. Nocturnal plasma melatonin levels in patients suffering from chronic primary insomnia. J Pineal Res. 1995;19:116–122. doi: 10.1111/j.1600-079X.1995.tb00179.x. [DOI] [PubMed] [Google Scholar]
  • [26].Savard J., Laroche L., Simard S., Ivers H., Morin C.M. Chronic insomnia and immune functioning. Psychosom Med. 2003;65:211–221. doi: 10.1097/01.PSY.0000033126.22740.F3. [DOI] [PubMed] [Google Scholar]
  • [27].Merica H., Blois R., Gaillard J.M. Spectral characteristics of sleep EEG in chronic insomnia. Eur J Neurosci. 1998;10:1826–1834. doi: 10.1046/j.1460-9568.1998.00189.x. [DOI] [PubMed] [Google Scholar]
  • [28].Nofzinger E.A., Mintun M.A., Price J., Meltzer C.C., Townsend D., Buysse D.J., et al. A method for the assessment of the functional neuroanatomy of human sleep using FDG PET. Brain Res Brain Res Protoc. 1998;2:191–198. doi: 10.1016/S1385-299X(97)00042-1. [DOI] [PubMed] [Google Scholar]
  • [29].Kupfer D.J., Frank E., McEachran A.B., Grochocinski V.J. Delta sleep ratio. A biological correlate of early recurrence in unipolar affective disorder. Arch Gen Psychiatry. 1990;47:1100–1105. doi: 10.1001/archpsyc.1990.01810240020004. [DOI] [PubMed] [Google Scholar]
  • [30].Armitage R., Trivedi M., Hoffmann R., Rush A.J. Relationship between objective and subjective sleep measures in depressed patients and healthy controls. Depress Anxiety. 1997;5:97–102. doi: 10.1002/(SICI)1520-6394(1997)5:2<97::AID-DA6>3.0.CO;2-2. [DOI] [PubMed] [Google Scholar]
  • [31].Schneider-Helmert D. Do we need polysomnography in insomnia? Schweiz Rundsch Med Prax. 2003;92:2061–2066. doi: 10.1024/0369-8394.92.48.2061. [DOI] [PubMed] [Google Scholar]
  • [32].Tang N.K.Y., Harvey A.G. Correcting distorted perception of sleep in insomnia: a novel behavioural experiment? Behav Res Ther. 2004;42:27–39. doi: 10.1016/S0005-7967(03)00068-8. [DOI] [PubMed] [Google Scholar]
  • [33].Roth T., Ancoli-Israel S. Daytime consequences and correlates of insomnia in the United States: results of the 1991 National Sleep Foundation Survey. II. Sleep. 1999;22(Suppl2):S354–S358. [PubMed] [Google Scholar]
  • [34].Szelenberger W., Niemcewicz S. Severity of insomnia correlates with cognitive impairment. Acta Neurobiol Exp (Warsaw) 2000;60:373. doi: 10.55782/ane-2000-1356. [DOI] [PubMed] [Google Scholar]
  • [35].Stepanski E., Koshorek G., Zorick F., Glinn M., Roehrs T., Roth T. Characteristics of individuals who do or do not seek treatment for chronic insomnia. Psychosomatics. 1989;30:421–427. doi: 10.1016/S0033-3182(89)72248-9. [DOI] [PubMed] [Google Scholar]
  • [36].Day R., Guido P., Helmus T., Fortier J., Roth T., Koshorek G., et al. Self-reported levels of sleepiness among subjects with insomnia. Sleep Med. 2001;2:153–157. doi: 10.1016/S1389-9457(00)00040-X. [DOI] [PubMed] [Google Scholar]
  • [37].Roth T. The relationship between psychiatric diseases and insomnia. Int J Clin Pract Suppl. 2001;116:3–8. [PubMed] [Google Scholar]
  • [38].Buysse D.J. Insomnia, depression and aging. Assessing sleep and mood interactions in older adults. Geriatrics. 2004;59:47–52. [PubMed] [Google Scholar]
  • [39].Perlis M.L., Smith M.T., Cacialli D.O., Nowakowski S., Orff H. On the comparability of pharmacotherapy and behavior therapy for chronic insomnia. Commentary and implications. J Psychosom Res. 2003;54:51–59. doi: 10.1016/S0022-3999(02)00547-0. [DOI] [PubMed] [Google Scholar]
  • [40].Johnson E.O., Roehrs T., Roth T., Breslau N. Epidemiology of alcohol and medication as aids to sleep in early adulthood. Sleep. 1998;21:178–186. doi: 10.1093/sleep/21.2.178. [DOI] [PubMed] [Google Scholar]
  • [41].Hajak G., Cluydts R., Allain H., Estivill E., Parrino L., Terzano M.G., et al. The challenge of chronic insomnia: is non-nightly hypnotic treatment a feasible alternative? Eur Psychiatry. 2003;18:201–208. doi: 10.1016/S0924-9338(03)00089-0. [DOI] [PubMed] [Google Scholar]
  • [42].Roehrs T., Bonahoom A., Pedrosi B., Rosenthal L., Roth T. Disturbed sleep predicts hypnotic self-administration. Sleep Med. 2002;3:61–66. doi: 10.1016/S1389-9457(01)00125-3. [DOI] [PubMed] [Google Scholar]
  • [43].Argyropoulos S.V., Hicks J.A., Nash J.R., Bell C.J., Rich A.S., Nutt D.J., et al. Correlation of subjective and objective sleep measurements at different stages of the treatment of depression. Psychiatry Res. 2003;120:179–190. doi: 10.1016/S0165-1781(03)00187-2. [DOI] [PubMed] [Google Scholar]

Articles from Neuroscience Bulletin are provided here courtesy of Springer

RESOURCES