Su Jung Choi1,2, Miri Kang3, Min Je Sung2, Eun Yeon Joo4,5. 1. Department of Nursing, Department of Clinical Nursing Science, Graduate School of Clinical Nursing Science, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea. 2. Department of Neurology, Neuroscience Center, Samsung Biomedical Research Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Samsung Medical Center, Annex 3rd F, #7, Gangnam-gu, Seoul, 06351, South Korea. 3. Department of Neurology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea. 4. Department of Neurology, Neuroscience Center, Samsung Biomedical Research Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Samsung Medical Center, Annex 3rd F, #7, Gangnam-gu, Seoul, 06351, South Korea. ejoo@skku.edu. 5. Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea. ejoo@skku.edu.
Abstract
PURPOSE: Although the clinical usefulness of actigraphy (ACT) in chronic insomnia disorder (CID) is extensively investigated, the evaluation on the utility of ACT in sleep-disordered breathing (SDB) is limited and the report of comparison with perceived sleep by patients and polysomnography (PSG) is scarce. METHODS: Thirty-six patients with SDB and 30 with CID underwent PSG and ACT, and they reported perceived sleep time and latency simultaneously. Sleep parameters (total sleep time [TST], sleep onset latency [SOL], sleep efficiency, and wakefulness after sleep onset [WASO]) were compared. Agreement among parameters was assessed with intraclass correlation coefficient (ICC) and 95% confidence interval. RESULTS: ACT overestimated TST and underestimated SOL and WASO relative to PSG in both groups. Perceived sleep was commonly undervalued relative to PSG or ACT. In post hoc analyses, perceived sleep was significantly shorter and SOL significantly longer compared to PSG and ACT in both groups. Perception of sleep time by PSG was significantly higher than perception by ACT. In the CID group, all sleep parameters were significantly correlated between ACT and PSG (ICC = 0.627-0.813). In the SDB group, only TST was significantly correlated (ICC = 0.804). CONCLUSION: ACT is useful to monitor sleep and sleep quality in patients with CID. In patients with SDB, TST by ACT is reliable. However, ACT is insufficient to assess sleep quality due to its low agreement with PSG. Significantly lower sleep perception relative to PSG and ACT should be considered in the treatment of sleep disorders.
PURPOSE: Although the clinical usefulness of actigraphy (ACT) in chronic insomnia disorder (CID) is extensively investigated, the evaluation on the utility of ACT in sleep-disordered breathing (SDB) is limited and the report of comparison with perceived sleep by patients and polysomnography (PSG) is scarce. METHODS: Thirty-six patients with SDB and 30 with CID underwent PSG and ACT, and they reported perceived sleep time and latency simultaneously. Sleep parameters (total sleep time [TST], sleep onset latency [SOL], sleep efficiency, and wakefulness after sleep onset [WASO]) were compared. Agreement among parameters was assessed with intraclass correlation coefficient (ICC) and 95% confidence interval. RESULTS: ACT overestimated TST and underestimated SOL and WASO relative to PSG in both groups. Perceived sleep was commonly undervalued relative to PSG or ACT. In post hoc analyses, perceived sleep was significantly shorter and SOL significantly longer compared to PSG and ACT in both groups. Perception of sleep time by PSG was significantly higher than perception by ACT. In the CID group, all sleep parameters were significantly correlated between ACT and PSG (ICC = 0.627-0.813). In the SDB group, only TST was significantly correlated (ICC = 0.804). CONCLUSION: ACT is useful to monitor sleep and sleep quality in patients with CID. In patients with SDB, TST by ACT is reliable. However, ACT is insufficient to assess sleep quality due to its low agreement with PSG. Significantly lower sleep perception relative to PSG and ACT should be considered in the treatment of sleep disorders.
Entities:
Keywords:
Actigraphy; Insomnia; Polysomnography; Sleep-disordered breathing; Total sleep time
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