Epidemiology of Sleep: Age, Gender, and Ethnicity

By Kenneth L. Lichstein; H. Heith Durrence et al. | Go to book overview
ratory setting alters sleep, as shown by disturbed sleep the first night in the laboratory (i.e., first night effect; Kales & Kales, 1984) and laboratory-home recording comparisons (Edinger et al., 1997; Stepnowsky, Moore, & Dimsdale, 2003). With the ease and confidence of a stand-up comic, the sleep technician instructs the individual to sleep naturally. Heisenberg didn't know how good he had it.We could prove that PSG alters sleep by comparing it to a known accurate measure of sleep, but PSG is the gold standard against which other methods of sleep assessment are judged. Considering commonplace alternatives to PSG, the worthiness of actigraphy, inferring sleep from limb inactivity, or self-report (SR) sleep is evaluated by how closely they match PSG data. Of course, the matches are never perfect and assignment of fault is in part determined by convention (i.e., because PSG is objective, it is always best) and in part by philosophy of science (e.g., greater faith is assigned SR sleep in the unperturbed natural environment because it maximizes ecological validity).Perhaps we shall never know sleep, only representations of it blurred by intrusive and/or fuzzy measures. Certainly for the present, no method of measuring sleep spares the subject of our interest. The best we could aspire to is to choose a method whose profile of strengths and shortcomings seems to closely fit the circumstances and goals of a particular clinical or research evaluation. In these endeavors, we should be humbled by the implications of Heisenberg's admonition that at all times, the relationship between sleep data and sleep is uncertain.
GOALS OF THE PRESENT EPIDEMIOLOGICAL SURVEY
This epidemiological study relied on self-report (SR) data because we wanted to collect information on a large sample and using PSG or, to a lesser extent, actigraphy would have increased the survey cost enormously, would have placed a greater inconvenience burden on participants, causing greater difficulty in recruiting the desired sample, and would have dramatically extended the length of an already lengthy study due to the limited availability of assessment instrumentation.SR data have the advantages of:
Being an inexpensive, convenient source of data.
Not altering the normal sleep setting.
Not altering normal sleep routines.
Being the best available measure of subjective sleep perception.

-2-

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Epidemiology of Sleep: Age, Gender, and Ethnicity
Table of contents

Table of contents

  • Title Page *
  • Contents vii
  • Preface ix
  • 1 - Goals and Distinctive Characteristics of This Survey 1
  • 2 - A Review of Epidemiological Studies of Insomnia and Sleep 9
  • 3 - Methods of This Survey 42
  • 4 - An Archive of Normal Sleep 73
  • Appendix 113
  • 5 - An Archive of Insomnia 152
  • 6 - An Archive of the Sleep of African Americans 177
  • 7 - Summary of Main Findings 202
  • Appendix A - Alphabetical Listing of Abbreviations and Acronyms 217
  • References 219
  • Author Index 229
  • Subject Index 235
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