Intraindividual variability in sleep and comorbid medical and mental health conditions

Sleep. 2019 Jun 11;42(6):zsz052. doi: 10.1093/sleep/zsz052.


Study objectives: Intraindividual variability (IIV) in sleep may be a risk factor for disease above the influence of mean sleep. Associations between IIV in sleep and risk for a comprehensive set of common medical and mental health conditions have not been assessed in a representative sample.

Methods: This study examined mean and IIV in total sleep time (TST), sleep quality (SQ), sleep efficiency (SE), and circadian midpoint (CM) in 771 adults recruited for an epidemiological study. Participants completed 14 days of sleep diaries to assess TST, SQ, SE, and CM, after which they reported on medical conditions and mental health symptoms. Data were analyzed using logistic regression, and models controlled for gender, body mass index, age, and race.

Results: Lower mean TST, SQ, and SE were related to increased odds of having gastrointestinal problems, depression, and anxiety. IIV in TST was related to increased odds of having neurological, breathing, and gastrointestinal problems, as well as pain and depression; all results held controlling for mean sleep and adjusting for false discovery rate. IIV in SQ and SE was not associated with odds of having any medical or mental health conditions after adjusting for false discovery rate, nor was IIV in CM or mean CM.

Conclusions: Confirming previous research, mean TST, SQ, and SE are related to risk for gastrointestinal problems, depression, and anxiety. IIV in TST may be a unique facet of disturbed sleep that is associated with increased risk for a diverse cluster of medical and mental health conditions.

Keywords: epidemiology; intraindividual variability; medical conditions; public health; sleep diaries; total sleep time.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Anxiety / psychology*
  • Circadian Rhythm / physiology*
  • Comorbidity
  • Depression / psychology*
  • Female
  • Gastrointestinal Diseases / physiopathology*
  • Humans
  • Logistic Models
  • Male
  • Mental Health
  • Middle Aged
  • Polysomnography
  • Sleep / physiology*
  • Sleep Wake Disorders / physiopathology