Elsevier

Sleep Medicine Reviews

Volume 28, August 2016, Pages 108-124
Sleep Medicine Reviews

Clinical review
Beyond the mean: A systematic review on the correlates of daily intraindividual variability of sleep/wake patterns

https://doi.org/10.1016/j.smrv.2015.06.003Get rights and content
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open access

Summary

Features of an individual's sleep/wake patterns across multiple days are governed by two dimensions, the mean and the intraindividual variability (IIV). The existing literature focuses on the means, while the nature and correlates of sleep/wake IIV are not well understood. A systematic search of records in five major databases from inception to November 2014 identified 53 peer-reviewed empirical publications that examined correlates of sleep/wake IIV in adults. Overall, this literature appeared unsystematic and post hoc, with under-developed theoretical frameworks and inconsistent methodologies. Correlates most consistently associated with greater IIV in one or more aspects of sleep/wake patterns were: younger age, non-White race/ethnicity, living alone, physical health conditions, higher body mass index, weight gain, bipolar and unipolar depression symptomatology, stress, and evening chronotype; symptoms of insomnia and poor sleep were associated with higher sleep/wake IIV, which was reduced following sleep interventions. The effects of experimentally reduced sleep/wake IIV on daytime functioning were inconclusive. In extending current understanding of sleep/wake patterns beyond the mean values, IIV should be incorporated as an additional dimension when sleep is examined across multiple days. Theoretical and methodological shortcomings in the existing literature, and opportunities for future research are discussed.

Keywords

Day-to-day
Fluctuation
Health
Intraindividual
Mental health
Night-to-night
Sleep
Systematic review
Variability
Variation

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