TY - JOUR
T1 - Insomnia Severity and Degree of Dysfunction
T2 - What Is to Be Learned When These Domains are Discordant?
AU - Boyle, Julia T.
AU - Vargas, Ivan
AU - Rosenfield, Bradly
AU - Grandner, Michael A.
AU - Perlis, Michael L.
N1 - Funding Information:
The project described was supported by Award Number K24AG055602 (Michael L. Perlis, Ph.D., PI) from the National Institute on Aging (NIA). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIA. We would like to thank the members of the Behavioral Sleep Medicine Program at the University of Pennsylvania for making these data available and for their collaboration. More, we wish to acknowledge that it was Art Spielman that, in the last decade of his career, stressed the need to account “sleep need” and developed an instrument for this purpose, though it was not subjected to the rigors of validation or made available as via a publication. Finally, we wish to stress that thinking about sleep in terms of the “trinity” (opportunity, ability and need), is a useful thing in and of itself for case conceptualization (regardless of the measures available).
Publisher Copyright:
© 2021 Taylor & Francis Group, LLC.
PY - 2022
Y1 - 2022
N2 - Objective/Background: Illness severity and resultant dysfunction are often linearly related and tightly coupled (concordant). Some percentage of individuals, however, exhibit discordant associations (high illness severity and low dysfunction [HL] or low illness severity and high dysfunction [LH]). In the present study, a sample of subjects with insomnia complaints were evaluated to determine what percentage of subjects exhibited discordant associations. Participants: Archival data were drawn from a community-based sample (n = 4,680; 61.8% female; Ages 18–105). Methods: Median splits were calculated for illness severity and daytime dysfunction and each individual was typed as High (H) or Low (L) for the concordant (HH and LL) and discordant domains (HL and LH). Results: Given this typology, 61% were classified as concordant and 39% were classified as discordant. Of these, 38% were sub-typed as HH, 23% as LL, 26% as LH, and 13% as HL. Conclusions: We propose that some of the discordance may be ascribable to a mismatch between sleep need and sleep ability. Those “who need a lot, may suffer a lot, in the face of only a little (LH)”, whereas those “who need a little, may suffer only a little, in the face of a lot (HL)”.
AB - Objective/Background: Illness severity and resultant dysfunction are often linearly related and tightly coupled (concordant). Some percentage of individuals, however, exhibit discordant associations (high illness severity and low dysfunction [HL] or low illness severity and high dysfunction [LH]). In the present study, a sample of subjects with insomnia complaints were evaluated to determine what percentage of subjects exhibited discordant associations. Participants: Archival data were drawn from a community-based sample (n = 4,680; 61.8% female; Ages 18–105). Methods: Median splits were calculated for illness severity and daytime dysfunction and each individual was typed as High (H) or Low (L) for the concordant (HH and LL) and discordant domains (HL and LH). Results: Given this typology, 61% were classified as concordant and 39% were classified as discordant. Of these, 38% were sub-typed as HH, 23% as LL, 26% as LH, and 13% as HL. Conclusions: We propose that some of the discordance may be ascribable to a mismatch between sleep need and sleep ability. Those “who need a lot, may suffer a lot, in the face of only a little (LH)”, whereas those “who need a little, may suffer only a little, in the face of a lot (HL)”.
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U2 - 10.1080/15402002.2021.1895794
DO - 10.1080/15402002.2021.1895794
M3 - Article
C2 - 33818194
AN - SCOPUS:85103623509
VL - 20
SP - 164
EP - 172
JO - Behavioral Sleep Medicine
JF - Behavioral Sleep Medicine
SN - 1540-2002
IS - 2
ER -