Minimum duration of actigraphy-defined nocturnal awakenings necessary for morning recall

Background: Healthy adults awaken between each sleep cycle approximately 5 times each night but generally do not remember all of these awakenings in the morning. A rule of thumb has arisen in the sleep field that approximately 5 min of continuous wakefulness are required to form a memory for an awakening. However, few studies have examined memory for these sleep-wake transitions and none have done so in the home, while participants follow their normal routine. Methods: Self-report and actigraphy were used in the participant's home environment to determine the minimum duration of an awakening necessary for morning recall for each of the 39 healthy adults. Results: Recall thresholds ranged from 30 to 600 s with a mean of 259 s (4 min 19 s) and were negatively associated with sleep efficiency but not significantly associated with total sleep time, age, income, or education. There also was a sex by cohabitation interaction, with single men having lower thresholds than single women and cohabiting participants, which was explained by higher sleep efficiency in noncohabitating men. Large individual differences suggest that many factors may influence recall threshold. Conclusions: Our preliminary study is the first to calculate the duration of wakefulness necessary for morning recall of nocturnal awakenings and the first to use a field-based design, allowing for the study of habitual sleep patterns at the participant's home. Further study is needed to explore if recall thresholds calculated using actigraphy can be validated against polysomnography (PSG) or be used to guide potential treatments. (c) 2013 Elsevier B.V. All rights reserved.