Objective: Uncoupled sleep is a phenomenon characterized by a discrepancy between sleep patterns and sleep complaints. This study aimed to evaluate the effect of sleep report feedback utilizing information and communication technology combined with health guidance on improving subjective and objective sleep outcomes in community-dwelling older people with and without uncoupled sleep.

Methods: This study was conducted in Sakai City, Japan. The Athens Insomnia Scale (AIS) was employed to evaluate subjective sleep outcomes. Participants were categorized as complaining sleepers if they reported their overall sleep quality as markedly or very unsatisfactory, in addition to having a total AIS score ≥10. Non-wearable actigraphy devices were placed under participants’ bedding to continuously measure their objective sleep outcomes. Sleep latency (SL), wake after sleep onset (WASO), and sleep efficiency (SE) parameters were recorded. Participants were classified as poor sleepers if their actigraphy-measured SL was ≥31 min or SE was＜85%, or WASO was ≥31 min. All measurements were taken prior to and following a 3- month intervention program.

Statistical analysis was conducted using SPSS Version 26. This study received approval from the Institutional Review Board of Osaka University.

Results: A total of 105 participants completed the study, with 65 females (62%). Among them, 8 were complaining good sleepers, 12 were complaining poor sleepers, 42 were non-complaining good sleepers, and 43 were non- complaining poor sleepers. Improvements in subjective sleep quality were observed across all sleeper classifications (P < 0.05). Specifically, subjective SL (P = 0.009) and WASO (P = 0.023) improved in complaining poor sleepers without uncoupled sleep. Objective and self-reported changes in sleep parameters were demonstrated in non- complaining poor sleepers with uncoupled sleep, specifically manifested as improvements in objective WASO (P < 0.001), SE (P < 0.001), andsubjective sleep quality (P = 0.038). However, there were no significant changes in objective sleep outcomes among complaining good sleepers, non-complaining good sleepers, and complaining poor sleepers (P > 0.05).

Conclusion: The implementation of sleep report feedback and health guidance intervention for community- dwelling older people has demonstrated improvement in subjective sleep quality across all sleeper classifications. Furthermore, it shows promising effects on non-complaining poor sleepers with uncoupled sleep, as evidenced by both objective and subjective sleep measures.