Sleep efficiency

Sleep efficiency (SE) is the ratio between the time a person spends asleep, and the total time dedicated to sleep (i.e. both sleeping and attempting to fall asleep or fall back asleep). It is given as a percentage.[1] SE of 80% or more is considered normal/healthy with most young healthy adults displaying SE above 90%.[2] SE can be determined with a polysomnograph and is an important parameter of a sleep study.[3]

Sleep efficiency is often described as the ratio between time spent asleep ("total sleep time (TST)"), and time spent "in bed" ("time in bed (TIB)"), however, TIB does not encompass "non-sleep-related activities" performed in bed (e.g. reading, watching television, etc.) as the phrase may seem to suggest.[1]

Clinical significance

Apparently long sleep duration may in fact be a sign of low sleep efficiency.[4] SE is significantly reduced in insomnia; SE is therefore an important clinical parameter in clinical investigations of insomnia.[1] SE declines with age and low SE is common in the elderly.[5] Furthermore, lower values of SE are often observed in sleep studies on pregnant populations and are mostly explained by the increased awakening periods after sleep onset (''wake after sleep onset (WASO)'').[6]

Research

Reduced SE was found to be associated with increased frequency of nightmares in one study.[7]

Some studies have reported a beneficial effect of exercise on SE in participants affected by insomnia. However, a meta-analysis of four studies (with a total of 186 participants) did not find exercise to significantly affect SE in people with insomnia.[8]

A study on subjects from contemporary African and South American hunter-gatherer ethnic groups found that their SE was comparable to SE in industrial societies.[9]

References
  1. Reed, David L.; Sacco, William P. (2016-02-15). "Measuring Sleep Efficiency: What Should the Denominator Be?". Journal of Clinical Sleep Medicine. 12 (2): 263–266. doi:10.5664/jcsm.5498. ISSN 1550-9389. PMC 4751425. PMID 26194727.
  2. "Interpreting A Sleep Study". Sleep WA. Retrieved 2021-05-17.
  3. Shrivastava, Deepak; Jung, Syung; Saadat, Mohsen; Sirohi, Roopa; Crewson, Keri (2014-11-25). "How to interpret the results of a sleep study". Journal of Community Hospital Internal Medicine Perspectives. 4 (5): 24983. doi:10.3402/jchimp.v4.24983. ISSN 2000-9666. PMC 4246141. PMID 25432643.
  4. Chaput, Jean-Philippe; Dutil, Caroline; Sampasa-Kanyinga, Hugues (2018-11-27). "Sleeping hours: what is the ideal number and how does age impact this?". Nature and Science of Sleep. 10: 421–430. doi:10.2147/NSS.S163071. ISSN 1179-1608. PMC 6267703. PMID 30568521.
  5. Desjardins, Sophie; Lapierre, Sylvie; Hudon, Carol; Desgagné, Alain (2019-02-15). "Factors involved in sleep efficiency: a population-based study of community-dwelling elderly persons". Sleep. 42 (5). doi:10.1093/sleep/zsz038. ISSN 0161-8105. PMC 6519908. PMID 30768200.
  6. Wilson, Danielle L.; Barnes, Maree; Ellett, Lenore; Permezel, Michael; Jackson, Martin; Crowe, Simon F. (February 2011). "Decreased sleep efficiency, increased wake after sleep onset and increased cortical arousals in late pregnancy: Decreased sleep efficiency in late pregnancy". Australian and New Zealand Journal of Obstetrics and Gynaecology. 51 (1): 38–46. doi:10.1111/j.1479-828X.2010.01252.x. PMID 21299507. S2CID 1125445.
  7. Lin, Yi-Qi; Lin, Ze-Xin; Wu, Yong-Xi; Wang, Lin; Zeng, Zhao-Nan; Chen, Qiu-Yang; Wang, Ling; Xie, Xiao-Liang; Wei, Shi-Chao (2021-01-20). "Reduced Sleep Duration and Sleep Efficiency Were Independently Associated With Frequent Nightmares in Chinese Frontline Medical Workers During the Coronavirus Disease 2019 Outbreak". Frontiers in Neuroscience. 14: 631025. doi:10.3389/fnins.2020.631025. ISSN 1662-4548. PMC 7855305. PMID 33551736.
  8. Banno, Masahiro; Harada, Yudai; Taniguchi, Masashi; Tobita, Ryo; Tsujimoto, Hiraku; Tsujimoto, Yasushi; Kataoka, Yuki; Noda, Akiko (2018-07-11). "Exercise can improve sleep quality: a systematic review and meta-analysis". PeerJ. 6: e5172. doi:10.7717/peerj.5172. ISSN 2167-8359. PMC 6045928. PMID 30018855.
  9. Yetish, Gandhi; Kaplan, Hillard; Gurven, Michael; Wood, Brian; Pontzer, Herman; Manger, Paul R.; Wilson, Charles; McGregor, Ronald; Siegel, Jerome M. (2015-11-02). "Natural Sleep and Its Seasonal Variations in Three Pre-industrial Societies". Current Biology. 25 (21): 2862–2868. doi:10.1016/j.cub.2015.09.046. ISSN 0960-9822. PMC 4720388. PMID 26480842.


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