Physiological Sleep Features Associated With Dimensions of Daily Dysfunction in Insomnia

Daily dysfunction is a key criterion of insomnia, but its underlying structure and relationship with objective sleep physiology remain unclear. This study aimed to identify the dimensions of subjective daily dysfunction using exploratory factor analysis (EFA) in individuals with insomnia and to examine its association with polysomnography (PSG) macroarchitecture, electroencephalographic (EEG) spectral power and odds ratio product (ORP)-based sleep depth in individuals with and without insomnia. We hypothesized that more severe daily dysfunction would be associated with poorer sleep continuity, higher high-frequency EEG activity and lighter sleep depth. The final sample included 859 adults (50.1% female; mean age 44.2 ± 14.1 years) in the Sleep Apnea Global Interdisciplinary Consortium (SAGIC) without obstructive sleep apnea (OSA) or shift work, including 368 with insomnia. EFA supported a single factor underlying the nine daily dysfunction items, which were combined into a total score. In univariate linear regression analyses adjusted for age, sex and site, higher beta-1 power and several ORP measures were nominally associated with more severe daily dysfunction, but none of them survived correction for multiple comparisons. No significant predictor-by-group interactions were observed. Across three levels of sleep physiology-PSG macroarchitecture, spectral power, and continuous sleep depth-no sleep measure was associated with daily dysfunction after correction for multiple comparisons. PSG macroarchitecture and sleep EEG-derived measures may not fully capture daily dysfunction. Future studies could examine whether within-night sleep dynamics are more informative than whole-night averages.

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Publication Details

Journal
Journal of Sleep Research
Published
2026-11-05
DOI
https://doi.org/10.1111/jsr.70482
Primary Topic
Sleep and related disorders
Type
article
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article

Physiological Sleep Features Associated With Dimensions of Daily Dysfunction in Insomnia

Elin Helga Thorarinsdottir, Ning‐Hung Chen, Nigel McArdle, Sergio Brasil Tufik et al.
Journal of Sleep Research
Sleep and related disorders
article

Physiological Sleep Features Associated With Dimensions of Daily Dysfunction in Insomnia

Elin Helga Thorarinsdottir, Ning‐Hung Chen, Nigel McArdle, Sergio Brasil Tufik, Richard J. Schwab, Brendan T Keenan, Ulysses J. Magalang, Greg Maislin, Qing Yun Li, Thomas Penzel, Allan I Pack, Philip Gehrman, Ruda Lee, Peter A. Cistulli, Philip de Chazal, Bethany Gerardy, Fang Han, Bhajan Singh, Magdy K. Younes
article en

Abstract

Daily dysfunction is a key criterion of insomnia, but its underlying structure and relationship with objective sleep physiology remain unclear. This study aimed to identify the dimensions of subjective daily dysfunction using exploratory factor analysis (EFA) in individuals with insomnia and to examine its association with polysomnography (PSG) macroarchitecture, electroencephalographic (EEG) spectral power and odds ratio product (ORP)-based sleep depth in individuals with and without insomnia. We hypothesized that more severe daily dysfunction would be associated with poorer sleep continuity, higher high-frequency EEG activity and lighter sleep depth. The final sample included 859 adults (50.1% female; mean age 44.2 ± 14.1 years) in the Sleep Apnea Global Interdisciplinary Consortium (SAGIC) without obstructive sleep apnea (OSA) or shift work, including 368 with insomnia. EFA supported a single factor underlying the nine daily dysfunction items, which were combined into a total score. In univariate linear regression analyses adjusted for age, sex and site, higher beta-1 power and several ORP measures were nominally associated with more severe daily dysfunction, but none of them survived correction for multiple comparisons. No significant predictor-by-group interactions were observed. Across three levels of sleep physiology-PSG macroarchitecture, spectral power, and continuous sleep depth-no sleep measure was associated with daily dysfunction after correction for multiple comparisons. PSG macroarchitecture and sleep EEG-derived measures may not fully capture daily dysfunction. Future studies could examine whether within-night sleep dynamics are more informative than whole-night averages.

Journal of Sleep Research
The University of Sydney (AU), University of Iceland (IS), Shanghai Jiao Tong University (CN), Royal North Shore Hospital (AU), Ruijin Hospital (CN), Sir Charles Gairdner Hospital (AU), The Ohio State University Wexner Medical Center (US), Chang Gung Memorial Hospital (TW), Taoyuan Chang Gung Memorial Hospital (TW), Linkou Chang Gung Memorial Hospital (TW), Peking University People's Hospital (CN), Philadelphia VA Medical Center (US), West Australian Sleep Disorders Research Institute (AU), University of Manitoba (CA), The Ohio State University (US), Charité - Universitätsmedizin Berlin (DE), University of Pennsylvania (US), Universidade Federal de São Paulo (BR)
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Sleep and related disorders
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