SNA 2013

Behaviourally induced insufficient sleep syndrome in a population of adult patients with sleep-disordered breathing.

ABSTRACT:

BACKGROUND

Behaviourally induced insufficient sleep syndrome (BIISS) or self-induced sleep restriction is a common cause of short sleep duration, sometimes caused by a mismatch between circadian rhythm and extrinsec socio-cultural factors. Its diagnosis requires the presence of excessive daytime sleepiness, short sleep periods and extended sleep periods when regular schedule is not maintained (weekends/holidays).

We describe the presence and clinic characteristics of BIISS in a population of patients with sleep disordered breathing referred for polysomnography.

METHODS AND RESULTS

BIISS was defined as a short sleep duration on weekdays (<7 hours), prolonged sleep periods on weekends (>/= 2 hours more than average weekdays sleep duration), severe daytime sleepiness (Epworth sleepiness scale >/=9) and absence of significant insomnia.

Data from 126 consecutive patients was obtained. Overall mean total sleep time was 285.37+/-74.49 minutes, with a mean sleep efficacy of 75.04+/-14.72%. ESS values were 9.51+/-4.80. We found moderate/severe depressive symptoms in 37.30% Obstructive sleep apnea-hypopnea syndrome (OSAHS) was present in 50% and clinically significant OSAHS in 26.98%.

In our study population, 10.30% patients fulfilled BIISS criteria. In BIISS group, moderate to severe depressive symptoms were detected in 53.85% of patients while 15.39% referred suicidal ideation. Thirty subjects of the BIISS group complained of morning headache, 15.39% had symptoms suggestive of restless legs syndrome and 7.69% had periodic limb movement disorder during polisomnographic recording. OSAHS was diagnosed in 30.77% and clinically significant OSAHS in 15.38%. No statistically significant differences between subjects with BIISS and others were found.

CONCLUSION

In conclusion, our results show a considerable number of subjects with BIISS criteria (10.3%), similar to previously published results of other working groups and support a relationship between depressive symptoms and BIISS. The present study is to our knowledge, the first that analyzes a Latin population and provides an approach to BIISS prevalence in the adult population.