Glucocorticoid Replacement Is Permissive for Rapid Eye Movement Sleep and Sleep Consolidation in Patients with Adrenal Insufficiency1

There is a well described temporal relation between hormonal secretion and sleep phase, with hormones of the hypothalamic-pituitary-adrenal (HPA) axis possibly playing a role in determining entry into and duration of different sleep stages. In this study sleep features were studied in primary Addison’s patients with undetectable levels of cortisol treated in a double blind, randomized, cross-over fashion with either hydrocortisone or placebo supplementation. We found that REM latency was significantly decreased in Addison’s patients when receiving hydrocortisone at bedtime, whereas REM sleep time was increased. There was a trend toward an increase in the percentage of time in REM sleep and the number of REM sleep episodes. Waking time after sleep onset was increased, whereas no differences were observed between the two conditions when total sleep time or specific non-REM sleep parameters were evaluated. Our results suggest that in Addison’s patients, cortisol plays a positive, permissive role in REM sleep regulation and may help to consolidate sleep. These effects may be mediated either directly by the central effects of glucocorticoids and/or indirectly through CRH and/or ACTH.

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344 Daridorexant Improves Total Sleep Time (TST) in Insomnia Patients Without Altering the Proportion of Sleep Stages

SLEEP ◽

10.1093/sleep/zsab072.343 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A137-A138

Author(s):

Gary Zammit ◽

David Mayleben ◽

Ingo Fietze ◽

Scott Pain ◽

Dalma Seboek Kinter ◽

...

Keyword(s):

Sleep Stage ◽

Oral Treatment ◽

Sleep Time ◽

Sleep Stages ◽

Dependent Manner ◽

Treatment Change ◽

Pivotal Phase ◽

Double Blind ◽

Treatment Groups ◽

Sleep Parameters

Abstract Introduction Daridorexant, a new dual orexin receptor antagonist, improved sleep parameters and daytime functioning in two pivotal Phase 3 trials in patients with insomnia (Trial-1, NCT03545191; Trial-2, NCT03575104); polysomnography data were collected at multiple timepoints from >1,800 patients. We report the effects of daridorexant on TST and sleep stages from both trials. Methods Eligible patients with insomnia (according to DSM-5) were randomized (1:1:1) in Trial-1 (N=930) to daridorexant 25mg, 50mg, or placebo and in Trial-2 (N=924) to daridorexant 10mg, 25mg, or placebo. Oral treatment was administered each night during a 3-month double-blind treatment period. Assessment of TST and sleep stages (non-rapid eye movement [NREM, N]1, N2, N3, REM), measured by polysomnography in sleep laboratory, was performed on two consecutive nights during single-blind placebo run-in (baseline) and Months 1 and 3 (M1 and M3) of double-blind treatment. Change from baseline in TST and sleep stages were exploratory endpoints in both trials. Data for M3 (mean ± standard deviation) are presented as change from baseline. Results Daridorexant dose-dependently increased TST(minutes) from baseline to M3, more than placebo, in Trial-1 (25mg, 55±56; 50mg, 61±53; placebo, 40±56) and Trial-2 (10mg, 37±57; 25mg, 50±53; placebo, 35±56). In both trials, sleep stage proportions were preserved from baseline to M3, with no relevant changes in any group. Baseline time spent in each sleep stage (% of TST) was consistent across groups in both trials (range across treatment groups in both trials: N1:11–13; N2:55–57; N3:11–14; REM:19–20). In Trial-1 (25mg/50mg/placebo), the change from baseline to M3 in % of TST spent in N1(-0.3±4.7/-0.2±5/0.1±5), N2(2±8/1±7/1±7), N3(-2±6/-2±6/-2±6), and REM(1±6/1±5/1±5) was low and numerically similar across treatments. In Trial-2, the change from baseline to M3 in % of TST spent in each sleep stage was consistent with Trial-1, with no effect of dose. Mean changes from baseline (% of TST) for each sleep stage appeared to be independent from increasing TST. Data for 25mg were consistent between trials. Conclusion Daridorexant at any dose, and each more than placebo, increased TST in a dose-dependent manner without affecting the proportion of all sleep stages in patients with insomnia. Support (if any) Funded by Idorsia Pharmaceuticals Ltd.

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Regular Caffeine Intake Delays REM Sleep Promotion and Attenuates Sleep Quality in Healthy Men

Journal of Biological Rhythms ◽

10.1177/07487304211013995 ◽

2021 ◽

pp. 074873042110139

Author(s):

Janine Weibel ◽

Yu-Shiuan Lin ◽

Hans-Peter Landolt ◽

Christian Berthomier ◽

Marie Brandewinder ◽

...

Keyword(s):

Sleep Quality ◽

Rem Sleep ◽

Sleep Time ◽

Caffeine Intake ◽

Sleep Regulation ◽

Caffeine Consumption ◽

Subjective Sleep Quality ◽

Placebo Condition ◽

Double Blind ◽

Sleep Episode

Acute caffeine intake can attenuate homeostatic sleep pressure and worsen sleep quality. Caffeine intake—particularly in high doses and close to bedtime—may also affect circadian-regulated rapid eye movement (REM) sleep promotion, an important determinant of subjective sleep quality. However, it is not known whether such changes persist under chronic caffeine consumption during daytime. Twenty male caffeine consumers (26.4 ± 4 years old, habitual caffeine intake 478.1 ± 102.8 mg/day) participated in a double-blind crossover study. Each volunteer completed a caffeine (3 × 150 mg caffeine daily for 10 days), a withdrawal (3 × 150 mg caffeine for 8 days then placebo), and a placebo condition. After 10 days of controlled intake and a fixed sleep-wake cycle, we recorded electroencephalography for 8 h starting 5 h after habitual bedtime (i.e., start on average at 04:22 h which is around the peak of circadian REM sleep promotion). A 60-min evening nap preceded each sleep episode and reduced high sleep pressure levels. While total sleep time and sleep architecture did not significantly differ between the three conditions, REM sleep latency was longer after daily caffeine intake compared with both placebo and withdrawal. Moreover, the accumulation of REM sleep proportion was delayed, and volunteers reported more difficulties with awakening after sleep and feeling more tired upon wake-up in the caffeine condition compared with placebo. Our data indicate that besides acute intake, also regular daytime caffeine intake affects REM sleep regulation in men, such that it delays circadian REM sleep promotion when compared with placebo. Moreover, the observed caffeine-induced deterioration in the quality of awakening may suggest a potential motive to reinstate caffeine intake after sleep.

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Greatest changes in objective sleep architecture during COVID-19 lockdown in night-owls with increased REM sleep

SLEEP ◽

10.1093/sleep/zsab075 ◽

2021 ◽

Author(s):

Jean-Louis Pépin ◽

Sébastien Bailly ◽

Ernest Mordret ◽

Jonathan Gaucher ◽

Renaud Tamisier ◽

...

Keyword(s):

Rem Sleep ◽

Sleep Onset ◽

Eating Behaviour ◽

Depression Scale ◽

Severity Index ◽

Smartphone Application ◽

Sleep Time ◽

Sleep Architecture ◽

Physiological Data ◽

Sleep Stages

Abstract Study Objectives The Covid-19 pandemic has had dramatic effects on society and people’s daily habits. In this observational study we recorded objective data on sleep macro- and microarchitecture repeatedly over several nights before and during the Covid-19 government-imposed lockdown. The main objective was to evaluate changes in patterns of sleep duration and architecture during home confinement using the pre-confinement period as a control. Methods Participants were regular users of a sleep-monitoring headband that records, stores, and automatically analyses physiological data in real time, equivalent to polysomnography. We measured: sleep onset duration (SOD), total sleep time (TST), duration of sleep stages (N2, N3 and REM), and sleep continuity. Via the user’s smartphone application participants filled-in questionnaires on how lockdown changed working hours, eating behaviour, and daily-life at home. They also filled-in the Insomnia Severity Index, reduced Morningness-Eveningness Questionnaire and Hospital Anxiety and Depression Scale questionnaires allowing us to create selected sub-groups. Results The 599 participants were mainly men (71%) of median age 47 [IQR: 36;59]. Compared to before lockdown, during lockdown individuals slept more overall (mean +3·83 min; SD: ±1.3), had less deep sleep (N3), more light sleep (N2) and longer REM sleep (mean +3·74 min; SD: ±0.8). They exhibited less week-end specific changes, suggesting less sleep restriction during the week. Changes were most pronounced in individuals reporting eveningness preferences, suggesting relative sleep deprivation in this population and exacerbated sensitivity to societal changes. Conclusions This unique dataset should help us understand the effects of lockdown on sleep architecture and on our health.

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Regular caffeine intake attenuates REM sleep promotion and sleep quality in healthy men

10.1101/2020.09.18.291039 ◽

2020 ◽

Author(s):

Janine Weibel ◽

Yu-Shiuan Lin ◽

Hans-Peter Landolt ◽

Christian Berthomier ◽

Marie Brandewinder ◽

...

Keyword(s):

Sleep Quality ◽

Rem Sleep ◽

Sleep Time ◽

Caffeine Intake ◽

Sleep Regulation ◽

Caffeine Consumption ◽

Subjective Sleep Quality ◽

Placebo Condition ◽

Double Blind ◽

Sleep Episode

AbstractAcute caffeine intake can attenuate homeostatic sleep pressure and worsen sleep quality. Besides, caffeine intake – particularly in high doses and close to bedtime – may also affect circadian-regulated REM sleep promotion, an important determinant of subjective sleep quality. However, it is not known whether such changes persist under chronic caffeine consumption during daytime. Twenty male caffeine consumers (26.4 ± 4 years old, habitual caffeine intake 478.1 ± 102.8 mg/day) participated in a double-blind crossover study. Each volunteer completed a caffeine (3 × 150 mg caffeine daily), a withdrawal (3 × 150 mg caffeine for eight days then placebo), and a placebo condition. After ten days of controlled intake and a fixed sleep-wake cycle, we recorded 8 h of electroencephalography starting 5 h after habitual bedtime (i.e., start on average at 04:22 am which is around the peak of circadian REM sleep promotion). A 60 min evening nap preceded each sleep episode and reduced high sleep pressure levels. While total sleep time and sleep architecture did not significantly differ between the three conditions, REM latency was longer after daily caffeine intake compared to both placebo and withdrawal. Moreover, the accumulation of REM sleep proportion was slower, and volunteers reported more difficulties at awakening after sleep and feeling more tired upon wake-up in the caffeine condition compared to placebo. Our data indicate that besides acute also regular daytime caffeine intake affects REM sleep regulation in men. We have evidence that regular caffeine intake during daytime weakens circadian sleep promotion when compared to placebo. Moreover, the observed caffeine-induced deterioration in the quality of awakening may suggest a potential motive to reinstate caffeine intake after sleep.

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Variations in Elite Female Soccer Players' Sleep, and Associations With Perceived Fatigue and Soccer Games

Frontiers in Sports and Active Living ◽

10.3389/fspor.2021.694537 ◽

2021 ◽

Vol 3 ◽

Author(s):

Frode Moen ◽

Maja Olsen ◽

Gunvor Halmøy ◽

Maria Hrozanova

Keyword(s):

Respiration Rate ◽

Rem Sleep ◽

Sleep Onset ◽

Sleep Time ◽

Self Report ◽

Ultra Wideband ◽

Soccer Players ◽

Sleep Stages ◽

Sleep Onset Latency ◽

Time In Bed

The current study investigated the associations between female perceived fatigue of elite soccer players and their sleep, and the associations between the sleep of players and soccer games. The sample included 29 female elite soccer players from the Norwegian national soccer team with a mean age of ~26 years. Perceived fatigue and sleep were monitored over a period of 124 consecutive days. In this period, 12.8 ± 3.9 soccer games per player took place. Sleep was monitored with an unobtrusive impulse radio ultra-wideband Doppler radar (Somnofy). Perceived fatigue was based on a self-report mobile phone application that detected daily experienced fatigue. Multilevel analyses of day-to-day associations showed that, first, increased perceived fatigue was associated with increased time in bed (3.6 ± 1.8 min, p = 0.037) and deep sleep (1.2 ± 0.6 min, p = 0.007). Increased rapid eye movement (REM) sleep was associated with subsequently decreased perceived fatigue (−0.21 ± 0.08 arbitrary units [AU], p = 0.008), and increased respiration rate in non-REM sleep was associated with subsequently increased fatigue (0.27 ± 0.09 AU, p = 0.002). Second, game night was associated with reduced time in bed (−1.0 h ± 8.4 min, p = <0.001), total sleep time (−55.2 ± 6.6 min, p = <0.001), time in sleep stages (light: −27.0 ± 5.4 min, p = <0.001; deep: −3.6 ± 1.2 min, p = 0.001; REM: −21.0 ± 3.0 min, p = <0.001), longer sleep-onset latency (3.0 ± 1.2 min, p = 0.013), and increased respiration rate in non-REM sleep (0.32 ± 0.08 respirations per min, p = <0.001), compared to the night before the game. The present findings show that deep and REM sleep and respiration rate in non-REM sleep are the key indicators of perceived fatigue in female elite soccer players. Moreover, sleep is disrupted during game night, likely due to the high physical and mental loads experienced during soccer games. Sleep normalizes during the first and second night after soccer games, likely preventing further negative performance-related consequences.

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A study on sleep apnea in patients with abnormal sewda type of depression

Traditional Medicine and Modern Medicine ◽

10.1142/s2575900020500044 ◽

2020 ◽

pp. 1-8

Author(s):

Aman Gul ◽

Nassirhadjy Memtily ◽

Pirdun Mijit ◽

Palidan Wushuer ◽

Ainiwaer Talifu ◽

...

Keyword(s):

Rem Sleep ◽

Sleep Onset ◽

Sleep Time ◽

Sleep Efficiency ◽

Control Group ◽

Poor Sleep ◽

Sleep Structure ◽

Maintenance Rate ◽

Sleep Maintenance ◽

Insomnia Symptoms

Objective: To preliminarily investigate the clinical features and PSG in abnormal sewda-type depressive insomnia. Methods: A total of 127 abnormal sewda-type depressive insomnia patients were evaluated with overnight PSG, and 32 normal participants were compared. Results: Patients with abnormal sewda-type depressive insomnia were compared with the control group; the sleep symptoms showed a long incubation period of sleep, low sleep maintenance rate, low sleep efficiency and poor sleep quality as well as daytime dysfunction. At process and continuity of sleep: Total sleep time, sleep efficiency, sleep maintenance rate in abnormal sewda-type depressive insomnia group were shorter than the control group. Wake after sleep onset, and sleep latency were longer than the control group. At sleep structure: N1 ratio and N2 ratio in depressive insomnia group were longer than the control group, N3 ratio and REM sleep ratio shorter than the control group. At REM index: REM latency, REM cycles, and REM sleep time were shorter than the control group. Conclusion: Insomnia symptoms in abnormal sewda-type depression comorbid insomnia patients were similar to the ordinary insomnia patients. The PSG characteristics had significant changes in sleep process, sleep structure and REM indicators. The severity of the abnormal sewda-type depression was closely related to REM indicators. Change of REM sleep characteristics may be the specificity, and these could be taken as reference in diagnosis and identification of abnormal sewda-type depressive insomnia.

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347 Daridorexant is Safe and Improves Both Sleep and Daytime Functioning in Elderly Patients with Insomnia

SLEEP ◽

10.1093/sleep/zsab072.346 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A138-A139

Author(s):

Ingo Fietze ◽

Claudio Bassetti ◽

David Mayleben ◽

Alberto Gimona ◽

Scott Pain ◽

...

Keyword(s):

Sleep Onset ◽

Symptom Burden ◽

The Elderly ◽

Sleep Time ◽

Least Square ◽

Double Blind ◽

Daytime Functioning ◽

Sleep Behavior ◽

Safety Risks ◽

Benzodiazepine Withdrawal

Abstract Introduction Insomnia affects elderly more than younger adults, and comorbidities more prevalent in elderly populations can add to symptom burden and reduce therapeutic options. Drugs that improve insomnia symptoms with limited safety risks are needed to treat this patient group. We report elderly subgroup analyses from a Phase-3 registration trial with daridorexant. Methods In this multi-center, double-blind trial (NCT03545191), adult (18–64y) and elderly (≥65y) patients with insomnia were randomized (1:1:1) to receive oral daridorexant 25mg, 50mg or placebo every evening for 3 months. Month 3 endpoints were: change from baseline in polysomnography-measured wake-after-sleep-onset (WASO) and latency-to-persistent-sleep (LPS) (both primary endpoints), subjective total sleep time (sTST), and daytime functioning (Insomnia Daytime Symptoms and Impacts Questionnaire [IDSIQ] – sleepiness domain; with a lower score indicating improved daytime functioning). Safety endpoints included treatment emergent adverse events (TEAE), AEs of special interest (AESI; symptoms related to excessive daytime sleepiness or complex sleep behavior, and suicidal ideation/self-injury) and withdrawal effects upon treatment cessation (assessed by the Benzodiazepine Withdrawal Symptom Questionnaire total score and relevant AEs). Results Of the 930 patients randomized, 364 (39.1%) were ≥65y: daridorexant 25mg (n=121), 50mg (n=121) and placebo (n=122). In this subgroup, at Month 3, the placebo-corrected least-square mean of change from baseline [95%CL] for daridorexant 25mg and 50mg were: WASO -17.0[-27.0,-7.0] and -19.6[-29.5,-9.7] mins; LPS -7.8[-15.2,-0.4] and -14.9[-22.3,-7.5] mins; sTST 18.7[4.1,33.2] and 30.6[16.1,45.2] mins; IDSIQ sleepiness domain -0.6[-2.2,0.9] and -2.6[-4.1,-1.0], all respectively. TEAEs were reported in 32.2%, 35.3%, and 31.1% of patients ≥65y in the 25mg, 50mg and placebo groups, respectively. Falls (n=1,1,4 for 25mg, 50mg, placebo, respectively) and dizziness (n=4,1,1), both of particular interest in elderly, were least frequent in the 50mg group. Compared to placebo, somnolence was as frequent for 50mg daridorexant (n=6,1,1) while fatigue was more frequent in both daridorexant groups (n=4,3,1); incidence did not appear dose-related. AESI, of mild intensity, were reported in 2 patients ≥65y (one in each daridorexant group). There was no evidence of withdrawal symptoms. Conclusion Daridorexant is efficacious in the elderly population for improvements in sleep and daytime functioning. No safety concerns in this vulnerable population were identified at either dose. Support (if any) Funded by Idorsia Pharmaceuticals Ltd.

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Abstract P417: Relationship Between Blood Pressure Variability and Sleep Architecture

Circulation ◽

10.1161/circ.141.suppl_1.p417 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Xiaoyue Liu ◽

Jeongok G Logan ◽

Younghoon Kwon ◽

Jennifer Lobo ◽

Hyojung Kang ◽

...

Keyword(s):

Blood Pressure ◽

Eye Movement ◽

Rem Sleep ◽

Sleep Time ◽

Sleep Architecture ◽

Sleep Stages ◽

Apnea Hypopnea Index ◽

Rapid Eye Movement ◽

Sleep Studies ◽

The Relationship

Introduction: Blood pressure (BP) variability (BPV) is a novel marker for cardiovascular disease (CVD) independent of high BP. Sleep architecture represents the structured pattern of sleep stages consisting of rapid eye movement (REM) and non-rapid eye movement (NREM), and it is an important element in the homeostatic regulation of sleep. Currently, little is known regarding whether BPV is linked to sleep stages. Our study aimed to examine the relationship between sleep architecture and BPV. Methods: We analyzed in-lab polysomnographic studies collected from individuals who underwent diagnostic sleep studies at a university hospital from 2010 to 2017. BP measures obtained during one year prior to the sleep studies were included. BPV was computed using the coefficient of variation for all individuals who had three or more systolic and diastolic BP data. We conducted linear regression analysis to assess the relationship of systolic BPV (SBPV) and diastolic BPV (DBPV) with the sleep stage distribution (REM and NREM sleep time), respectively. Covariates that can potentially confound the relationships were adjusted in the models, including age, sex, race/ethnicity, body mass index, total sleep time, apnea-hypopnea index, mean BP, and history of medication use (antipsychotics, antidepressants, and antihypertensives) during the past two years before the sleep studies. Results: Our sample (N=3,565; male = 1,353) was racially and ethnically diverse, with a mean age 54 ± 15 years and a mean BP of 131/76 ± 13.9/8.4 mmHg. Among the sleep architecture measures examined, SBPV showed an inverse relationship with REM sleep time after controlling for all covariates ( p = .033). We subsequently categorized SBPV into four quartiles and found that the 3 rd quartile (mean SBP SD = 14.9 ± 2.1 mmHg) had 3.3 fewer minutes in REM sleep compared to the 1 st quartile ( p = .02). However, we did not observe any relationship between DBPV and sleep architecture. Conclusion: Greater SBPV was associated with lower REM sleep time. This finding suggests a possible interplay between BPV and sleep architecture. Future investigation is warranted to clarify the directionality, mechanism, and therapeutic implications.

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1059 Sleep Parameters In People With Type 2 Diabetes With And Without Insomnia Symptoms

SLEEP ◽

10.1093/sleep/zsaa056.1055 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A402-A403

Author(s):

M Alshehri ◽

A Alkathiry ◽

A Alenazi ◽

S Alothman ◽

J Rucker ◽

...

Keyword(s):

Type 2 Diabetes ◽

Total Sleep Time ◽

Sleep Onset ◽

Sleep Time ◽

Circular Data ◽

Objective Measures ◽

Subjective Measures ◽

Sleep Parameters ◽

Insomnia Symptoms

Abstract Introduction There is an increasing awareness of the high prevalence of insomnia symptoms in people with type 2 diabetes (T2D). Past studies have demonstrated the importance of measuring sleep parameters in both averages and variabilities using subjective and objective methods. Thus, we aimed to compare the averages and variability of sleep parameters in people with T2D with and without insomnia symptoms. Methods Actigraph measurements and sleep diaries were used in 59 participants to assess sleep parameters, including sleep efficiency (SE), sleep latency, total sleep time, and wake after sleep onset over seven nights. Validated instruments were used to assess the symptoms of depression, anxiety, and pain. Circular data were used to describe the distribution of bed distribution with SE as a magnitude for both groups. Mann Whitney U test was utilized to compare averages and variability of sleep parameters between the two groups. Multivariable general linear model to control for demographic and clinical variables. For the secondary aim, multiple linear regression tests were utilized to assess the association between averages and variability values for both groups. Results SE was found to be lower in average and higher in variability for participants with T2D and insomnia symptoms, than those with T2D only subjectively and objectively. SE variability was also the only sleep parameter higher in people with T2D and insomnia symptoms, with psychological symptoms potentially playing a role in this difference. We observed that people in T2D+Insomnia tend to go to bed earlier compared to the T2D only group based on objective measures, but no difference was observed between groups in subjective measures. The only significant relationship in both objective and subjective measures was between the averages and variability of SE. Conclusion Our findings suggest a discrepancy between subjective and objective measures in only average of total sleep time, as well as agreement in measures of variability in sleep parameters. Also, the relationship between averages and variabilities suggested the importance of improving SE to minimize its variability. Further research is warranted to investigate the complex relationship between sleep parameters and psychological factors in people with T2D and insomnia symptoms. Support None

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On the influence of the day of the week on objective and self-rated sleep quality of adults

Somnologie - Schlafforschung und Schlafmedizin ◽

10.1007/s11818-020-00288-z ◽

2020 ◽

Author(s):

C. Sauter ◽

H. Dorn ◽

H. Danker-Hopfe

Keyword(s):

Sleep Quality ◽

Adult Population ◽

Analysis Data ◽

Sleep Time ◽

Base Station ◽

Double Blind ◽

Sleep Parameters ◽

A Cell ◽

Day Of The Week

Abstract Background and objective The extent to which adult sleep varies depending on the day of the week has not yet been systematically investigated with electroencephalography (EEG) data. Whether such effects exist and whether they are related to age, gender, and employment status was retrospectively analyzed based on data from an experimental double-blind cross-over study in which effects of electromagnetic fields of a cell phone base station on the sleep of a general rural population had been examined. Methods The sleep of 397 adults (age 45.0 ± 14.2 years, range 18–81 years; 50.9% women) from ten different rural German villages was recorded for 12 nights with ambulatory devices. Self-reported sleep quality was recorded in morning and evening protocols. Friedman tests were used for statistical analysis of the comparison between the days, and the Kruskal–Wallis and Mann–Whitney U tests were used for pairwise comparisons of independent parameters between groups. Results For the present analysis, data from 335 participants were considered. Overall, the differences between nights were small and the quality of sleep was good. Three of the five objective and all six self-rated sleep parameters differed significantly between the days of the week. While the objective and the self-estimated total sleep time were longest on Sunday nights, the qualitatively poorest values occurred on Monday nights. People who worked fulltime had the longest sleep latencies on Sunday nights. Friday nights were rated the best. Conclusion The objective and self-rated sleep quality varied relatively little in a rural adult population over the course of the week, being worst on Monday nights and best on Friday nights.

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