Sleep and wake are shared and transmitted between individuals with insomnia and their bed-sharing partners

Abstract

Patients with insomnia frequently report disturbing, or being disturbed by, their bedpartner. We aimed to (1) characterize how individuals with insomnia and their bedpartners influence each other’s sleep and (2) identify characteristics predicting vulnerability to wake transmission. Fifty-two couples (aged 19–82 years), where one individual was diagnosed with insomnia, participated. Sleep/wake patterns were monitored via actigraphy and sleep diaries for seven nights. Minute-by-minute sleep and wake concordance (simultaneous sleep/wake epochs), number of wake transmissions received (awakenings immediately preceded by wakefulness in the bedpartner), percent wake transmissions received (percentage of total awakenings that were transmitted), and percent of bedpartner’s wake minutes resistant to transmission (ability to sleep through bedpartner wakefulness) were calculated. Mixed-effects modeling assessed within-couple bedtime and chronotype differences as predictors of dyadic sleep. We described rates of sleep concordance (MPatient = 63.8%, MPartner = 65.6%), wake concordance (MPatient = 6.6%, MPartner = 6.6%), total transmissions received (MPatient = 5.5, MPartner = 6.9 per night), percent transmissions received (MPatient = 18.5%, MPartner = 23.4% of total awakenings), and percent minutes resistant (MPatient = 56.4%, MPartner = 58.6% of bedpartner’s wake time). Partners received wake transmissions at 1.25 times the rate of patients. Percent transmissions received was increased in couples with concordant bedtimes and individuals with later chronotype than their bedpartner. Patterns of chronotype and bedtime order predicting percent minutes resistant to transmission differed across the length of the rest interval. Transmission provides a novel characterization of how bedpartners influence sleep and provide insight into mechanisms of insomnia generation and maintenance. Understanding modifiable risk factors may provide ways to personalize insomnia treatments. Clinical Trial Researching Effective Sleep Treatments (Project REST), ANZCTR Registration: ACTRN12616000586415

A machine learning model for multi-night actigraphic detection of chronic insomnia: development and validation of a pre-screening tool

“…On the contrary, SE and TST are constantly higher for healthy individuals in comparison to those with CI. These findings align with other reported sleep laboratory studies [ 15 , 16 ]. Differentiating sleep and wake with the absence of movement using a single wrist-worn actigraphy sensor is a long-standing problem.…”

“…It has been previously shown that bed partners affect each other's sleep [ 15 , 45 ]; however, the overall model performance (accuracy: 80%, sensitivity: 76%, specificity: 82%) highlights the efficacy of the proposed approach and the significance of multi-night monitoring for automated decision-making, which is seldom seen in actigraphy research. Further, the proposed model will add to the current state-of-the-art insomnia research by providing an objective data-driven assessment method to enhance the decision support for clinicians and sleep researchers with potential utility as a pre-screening device.…”

“…Furthermore, the fact our healthy population were the bed partners of the subjects with insomnia is a strength of our design. It has been shown one bed partner affects the sleep of the other, especially with respect to passing wake episodes between them [ 15 , 24 ]. Given that, the performance (accuracy, sensitivity and specificity) reported here are very encouraging as the first steps.…”

“…Subjects were recruited through online advertisements, radio, print media and via referrals from a psychologist, sleep clinics or general practitioner (GP) in Melbourne, Australia. The subjects were recruited as part of a larger ongoing clinical trial (Project REST; Australian New Zealand Clinical Trials Registry Registration: ACTRN12616000586415), to study partner-associated behavioural interventions in insomnia [ 15 , 22 ]. The study was approved by the human research ethics committee of Monash University.…”

“…The couple was not enrolled if either partner was ineligible. In our previous studies, we have found that actigraphy-measured sleep was extremely similar in the partners of those with insomnia and the individuals in the couples where both partners were normal sleepers [ 15 , 24 ]. However, although insignificantly, one bed partner can indeed affect the sleep of the other bed partner and, therefore, if our algorithms can separate the two groups in this more challenging situation, they were likely to do even better when individuals are truly independent.…”