Clusters of insomnia disorder: An exploratory cluster analysis of objective sleep parameters reveals differences in neurocognitive functioning, quantitative EEG, and heart rate variability

Christopher B. Miller; Delwyn J. Bartlett; Anna E. Mullins; Kirsty L. Dodds; Christopher J. Gordon; Simon D. Kyle; Jong Won Kim; Angela L. D'Rozario; Rico S.C. Lee; Maria Comas; Nathaniel S. Marshall; Brendon J. Yee; Colin A. Espie; Ronald R. Grunstein

doi:10.5665/sleep.6230

Clusters of insomnia disorder: An exploratory cluster analysis of objective sleep parameters reveals differences in neurocognitive functioning, quantitative EEG, and heart rate variability

Christopher B. Miller, Delwyn J. Bartlett, Anna E. Mullins, Kirsty L. Dodds, Christopher J. Gordon, Simon D. Kyle, Jong Won Kim, Angela L. D'Rozario, Rico S.C. Lee, Maria Comas, Nathaniel S. Marshall, Brendon J. Yee, Colin A. Espie, Ronald R. Grunstein

Research output: Contribution to journal › Article › peer-review

47 Scopus citations

Abstract

Study Objectives: To empirically derive and evaluate potential clusters of Insomnia Disorder through cluster analysis from polysomnography (PSG). We hypothesized that clusters would differ on neurocognitive performance, sleep-onset measures of quantitative (q)-EEG and heart rate variability (HRV). Methods: Research volunteers with Insomnia Disorder (DSM-5) completed a neurocognitive assessment and overnight PSG measures of total sleep time (TST), wake time after sleep onset (WASO), and sleep onset latency (SOL) were used to determine clusters. Results: From 96 volunteers with Insomnia Disorder, cluster analysis derived at least two clusters from objective sleep parameters: Insomnia with normal objective sleep duration (I-NSD: n = 53) and Insomnia with short sleep duration (I-SSD: n = 43). At sleep onset, differences in HRV between I-NSD and I-SSD clusters suggest attenuated parasympathetic activity in I-SSD (P < 0.05). Preliminary work suggested three clusters by retaining the I-NSD and splitting the I-SSD cluster into two: I-SSD A (n = 29): defined by high WASO and I-SSD B (n = 14): a second I-SSD cluster with high SOL and medium WASO. The I-SSD B cluster performed worse than I-SSD A and I-NSD for sustained attention (P ≤ 0.05). In an exploratory analysis, q-EEG revealed reduced spectral power also in I-SSD B before (Delta, Alpha, Beta-1) and after sleep-onset (Beta-2) compared to I-SSD A and I-NSD (P ≤ 0.05). Conclusions: Two insomnia clusters derived from cluster analysis differ in sleep onset HRV. Preliminary data suggest evidence for three clusters in insomnia with differences for sustained attention and sleep-onset q-EEG. Clinical Trial Registration: Insomnia 100 sleep study: Australia New Zealand Clinical Trials Registry (ANZCTR) identification number 12612000049875. URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=347742.

Original language	English
Pages (from-to)	1993-2004
Number of pages	12
Journal	Sleep
Volume	39
Issue number	11
DOIs	https://doi.org/10.5665/sleep.6230
State	Published - 1 Nov 2016
Externally published	Yes

Keywords

And phenotyping
Cluster analysis
Insomnia Disorder
Polysomnography
Sleep

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10.5665/sleep.6230

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Miller, C. B., Bartlett, D. J., Mullins, A. E., Dodds, K. L., Gordon, C. J., Kyle, S. D., Kim, J. W., D'Rozario, A. L., Lee, R. S. C., Comas, M., Marshall, N. S., Yee, B. J., Espie, C. A., & Grunstein, R. R. (2016). Clusters of insomnia disorder: An exploratory cluster analysis of objective sleep parameters reveals differences in neurocognitive functioning, quantitative EEG, and heart rate variability. Sleep, 39(11), 1993-2004. https://doi.org/10.5665/sleep.6230

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title = "Clusters of insomnia disorder: An exploratory cluster analysis of objective sleep parameters reveals differences in neurocognitive functioning, quantitative EEG, and heart rate variability",

abstract = "Study Objectives: To empirically derive and evaluate potential clusters of Insomnia Disorder through cluster analysis from polysomnography (PSG). We hypothesized that clusters would differ on neurocognitive performance, sleep-onset measures of quantitative (q)-EEG and heart rate variability (HRV). Methods: Research volunteers with Insomnia Disorder (DSM-5) completed a neurocognitive assessment and overnight PSG measures of total sleep time (TST), wake time after sleep onset (WASO), and sleep onset latency (SOL) were used to determine clusters. Results: From 96 volunteers with Insomnia Disorder, cluster analysis derived at least two clusters from objective sleep parameters: Insomnia with normal objective sleep duration (I-NSD: n = 53) and Insomnia with short sleep duration (I-SSD: n = 43). At sleep onset, differences in HRV between I-NSD and I-SSD clusters suggest attenuated parasympathetic activity in I-SSD (P < 0.05). Preliminary work suggested three clusters by retaining the I-NSD and splitting the I-SSD cluster into two: I-SSD A (n = 29): defined by high WASO and I-SSD B (n = 14): a second I-SSD cluster with high SOL and medium WASO. The I-SSD B cluster performed worse than I-SSD A and I-NSD for sustained attention (P ≤ 0.05). In an exploratory analysis, q-EEG revealed reduced spectral power also in I-SSD B before (Delta, Alpha, Beta-1) and after sleep-onset (Beta-2) compared to I-SSD A and I-NSD (P ≤ 0.05). Conclusions: Two insomnia clusters derived from cluster analysis differ in sleep onset HRV. Preliminary data suggest evidence for three clusters in insomnia with differences for sustained attention and sleep-onset q-EEG. Clinical Trial Registration: Insomnia 100 sleep study: Australia New Zealand Clinical Trials Registry (ANZCTR) identification number 12612000049875. URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=347742.",

keywords = "And phenotyping, Cluster analysis, Insomnia Disorder, Polysomnography, Sleep",

author = "Miller, {Christopher B.} and Bartlett, {Delwyn J.} and Mullins, {Anna E.} and Dodds, {Kirsty L.} and Gordon, {Christopher J.} and Kyle, {Simon D.} and Kim, {Jong Won} and D'Rozario, {Angela L.} and Lee, {Rico S.C.} and Maria Comas and Marshall, {Nathaniel S.} and Yee, {Brendon J.} and Espie, {Colin A.} and Grunstein, {Ronald R.}",

year = "2016",

month = nov,

day = "1",

doi = "10.5665/sleep.6230",

language = "English",

volume = "39",

pages = "1993--2004",

journal = "Sleep",

issn = "0161-8105",

publisher = "Oxford University Press",

number = "11",

}

Miller, CB, Bartlett, DJ, Mullins, AE, Dodds, KL, Gordon, CJ, Kyle, SD, Kim, JW, D'Rozario, AL, Lee, RSC, Comas, M, Marshall, NS, Yee, BJ, Espie, CA & Grunstein, RR 2016, 'Clusters of insomnia disorder: An exploratory cluster analysis of objective sleep parameters reveals differences in neurocognitive functioning, quantitative EEG, and heart rate variability', Sleep, vol. 39, no. 11, pp. 1993-2004. https://doi.org/10.5665/sleep.6230

Clusters of insomnia disorder: An exploratory cluster analysis of objective sleep parameters reveals differences in neurocognitive functioning, quantitative EEG, and heart rate variability. / Miller, Christopher B.; Bartlett, Delwyn J.; Mullins, Anna E. et al.
In: Sleep, Vol. 39, No. 11, 01.11.2016, p. 1993-2004.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Clusters of insomnia disorder

T2 - An exploratory cluster analysis of objective sleep parameters reveals differences in neurocognitive functioning, quantitative EEG, and heart rate variability

AU - Miller, Christopher B.

AU - Bartlett, Delwyn J.

AU - Mullins, Anna E.

AU - Dodds, Kirsty L.

AU - Gordon, Christopher J.

AU - Kyle, Simon D.

AU - Kim, Jong Won

AU - D'Rozario, Angela L.

AU - Lee, Rico S.C.

AU - Comas, Maria

AU - Marshall, Nathaniel S.

AU - Yee, Brendon J.

AU - Espie, Colin A.

AU - Grunstein, Ronald R.

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Study Objectives: To empirically derive and evaluate potential clusters of Insomnia Disorder through cluster analysis from polysomnography (PSG). We hypothesized that clusters would differ on neurocognitive performance, sleep-onset measures of quantitative (q)-EEG and heart rate variability (HRV). Methods: Research volunteers with Insomnia Disorder (DSM-5) completed a neurocognitive assessment and overnight PSG measures of total sleep time (TST), wake time after sleep onset (WASO), and sleep onset latency (SOL) were used to determine clusters. Results: From 96 volunteers with Insomnia Disorder, cluster analysis derived at least two clusters from objective sleep parameters: Insomnia with normal objective sleep duration (I-NSD: n = 53) and Insomnia with short sleep duration (I-SSD: n = 43). At sleep onset, differences in HRV between I-NSD and I-SSD clusters suggest attenuated parasympathetic activity in I-SSD (P < 0.05). Preliminary work suggested three clusters by retaining the I-NSD and splitting the I-SSD cluster into two: I-SSD A (n = 29): defined by high WASO and I-SSD B (n = 14): a second I-SSD cluster with high SOL and medium WASO. The I-SSD B cluster performed worse than I-SSD A and I-NSD for sustained attention (P ≤ 0.05). In an exploratory analysis, q-EEG revealed reduced spectral power also in I-SSD B before (Delta, Alpha, Beta-1) and after sleep-onset (Beta-2) compared to I-SSD A and I-NSD (P ≤ 0.05). Conclusions: Two insomnia clusters derived from cluster analysis differ in sleep onset HRV. Preliminary data suggest evidence for three clusters in insomnia with differences for sustained attention and sleep-onset q-EEG. Clinical Trial Registration: Insomnia 100 sleep study: Australia New Zealand Clinical Trials Registry (ANZCTR) identification number 12612000049875. URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=347742.

AB - Study Objectives: To empirically derive and evaluate potential clusters of Insomnia Disorder through cluster analysis from polysomnography (PSG). We hypothesized that clusters would differ on neurocognitive performance, sleep-onset measures of quantitative (q)-EEG and heart rate variability (HRV). Methods: Research volunteers with Insomnia Disorder (DSM-5) completed a neurocognitive assessment and overnight PSG measures of total sleep time (TST), wake time after sleep onset (WASO), and sleep onset latency (SOL) were used to determine clusters. Results: From 96 volunteers with Insomnia Disorder, cluster analysis derived at least two clusters from objective sleep parameters: Insomnia with normal objective sleep duration (I-NSD: n = 53) and Insomnia with short sleep duration (I-SSD: n = 43). At sleep onset, differences in HRV between I-NSD and I-SSD clusters suggest attenuated parasympathetic activity in I-SSD (P < 0.05). Preliminary work suggested three clusters by retaining the I-NSD and splitting the I-SSD cluster into two: I-SSD A (n = 29): defined by high WASO and I-SSD B (n = 14): a second I-SSD cluster with high SOL and medium WASO. The I-SSD B cluster performed worse than I-SSD A and I-NSD for sustained attention (P ≤ 0.05). In an exploratory analysis, q-EEG revealed reduced spectral power also in I-SSD B before (Delta, Alpha, Beta-1) and after sleep-onset (Beta-2) compared to I-SSD A and I-NSD (P ≤ 0.05). Conclusions: Two insomnia clusters derived from cluster analysis differ in sleep onset HRV. Preliminary data suggest evidence for three clusters in insomnia with differences for sustained attention and sleep-onset q-EEG. Clinical Trial Registration: Insomnia 100 sleep study: Australia New Zealand Clinical Trials Registry (ANZCTR) identification number 12612000049875. URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=347742.

KW - And phenotyping

KW - Cluster analysis

KW - Insomnia Disorder

KW - Polysomnography

KW - Sleep

UR - http://www.scopus.com/inward/record.url?scp=84995685516&partnerID=8YFLogxK

U2 - 10.5665/sleep.6230

DO - 10.5665/sleep.6230

M3 - Article

C2 - 27568796

AN - SCOPUS:84995685516

SN - 0161-8105

VL - 39

SP - 1993

EP - 2004

JO - Sleep

JF - Sleep

IS - 11

ER -

Clusters of insomnia disorder: An exploratory cluster analysis of objective sleep parameters reveals differences in neurocognitive functioning, quantitative EEG, and heart rate variability

Abstract

Keywords

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