Mindfulness and Behaviour Therapy for Insomnia: An Assessment of Treatment Effect in a Sleep Disorders Clinic Population with Insomnia

2020 ◽  
pp. 1-15
Author(s):  
Allie Peters ◽  
John Reece ◽  
Hailey Meaklim ◽  
Moira Junge ◽  
David Cunnington ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Treatment Effect ◽  
Sleep Onset ◽  
Sleep Efficiency ◽  
Health Concern ◽  
Sleep Diary ◽  
Sleep Onset Latency ◽  
Subjective Sleep ◽  
Sleep Parameters

Abstract Insomnia is a common major health concern, which causes significant distress and disruption in a person's life. The objective of this paper was to evaluate a 6-week version of Mindfulness-Based Therapy for Insomnia (MBTI) in a sample of people attending a sleep disorders clinic with insomnia, including those with comorbidities. Thirty participants who met the DSM-IV-TR diagnosis of insomnia participated in a 6-week group intervention. Outcome measures were a daily sleep diary and actigraphy during pre-treatment and follow-up, along with subjective sleep outcomes collected at baseline, end-of-treatment, and 3-month follow-up. Trend analyses showed that MBTI was associated with a large decrease in insomnia severity (p < .001), with indications of maintenance of treatment effect. There were significant improvements in objective sleep parameters, including sleep onset latency (p = .005), sleep efficiency (p = .033), and wake after sleep onset (p = .018). Significant improvements in subjective sleep parameters were also observed for sleep efficiency (p = .005) and wake after sleep onset (p < .001). Overall, this study indicated that MBTI can be successfully delivered in a sleep disorders clinic environment, with evidence of treatment effect for both objective and subjective measures of sleep.

scholarly journals 0480 Efficacy and Safety of Lemborexant in Female Subjects of Perimenopausal Age with Insomnia Disorder

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A184-A184
Author(s):  
J Cheng ◽  
J Yardley ◽  
K Pinner ◽  
M Moline
Keyword(s):  
Sleep Onset ◽  
Safety Data ◽  
Sleep Diary ◽  
Sleep Onset Latency ◽  
Efficacy And Safety ◽  
Subjective Sleep ◽  
Perimenopausal Women ◽  
Sleep Parameters ◽  
Age Range ◽  
Female Subjects

Abstract Introduction Insomnia is common in women in the perimenopausal age range. We present 12-month efficacy and safety data for the subgroup of female subjects in the age range associated with perimenopause (age 40-58y) from SUNRISE-2 (NCT02952820; E2006-G000-303). Methods SUNRISE-2 was a 12-month, randomized, double-blind, placebo (PBO)-controlled (first 6mo [Period 1]), global phase 3 study. During Period 1, subjects received PBO or lemborexant (LEM: 5mg, [LEM5]; 10mg, [LEM10]). During Period 2 (second 6mo), LEM subjects continued their assigned dose. PBO subjects were rerandomized to LEM5 or LEM10 (not reported here). Changes from baseline in subjective sleep parameters: subjective sleep onset latency (sSOL), sleep efficiency (sSE), wake after sleep onset (sWASO) were assessed from sleep diary data. Results The perimenopausal subgroup comprised 280 subjects (Period 1: PBO, n=90; LEM5, n=82; LEM10, n=108). Baseline median sSOL (min) was 57.5, 51.1, and 54.0 for PBO, LEM5, and LEM10. Greater median decreases from baseline in sSOL (min) occurred at 6mo with LEM vs PBO (PBO, −17.9; LEM5, −20.7; LEM10, −30.4); improvements persisted at 12mo (LEM 5, −27.7; LEM10, −33.9). Baseline mean[SD] sSE was 59.9%[16.6%], 60.7%[20.0%], and 61.2%[17.5%] for PBO, LEM5, and LEM10. Greater mean[SD] increases from baseline in sSE (%) occurred at 6mo with LEM vs PBO (PBO, 12.5%[15.0%]; LEM5, 15.9%[17.0%]; LEM10, 17.2%[14.7%]); improvement persisted at 12mo (LEM5,17.6%[18.2%]; LEM10, 19.1%[14.8%]). Baseline mean[SD] sWASO (min) was 134.9[70.8], 142.4[86.5], and 136.5[84.4]. Greater mean[SD] decreases from baseline in sWASO (min) occurred at 6mo with LEM vs PBO (PBO, −37.0[59.6]; LEM5, −50.1[74.5]; LEM10 −54.5[65.4]); improvement persisted at 12mo (LEM5, −59.1[76.7]; LEM10, −66.2[64.9]). Most treatment emergent adverse events (TEAEs) were mild/moderate. Conclusion Consistent with previously reported data from the total population, subjective sleep parameters improved, and improvement was sustained over time in perimenopausal women. LEM was well tolerated, supporting LEM as a potential treatment option for perimenopausal women with insomnia. Support Eisai Inc.

Sleep misestimation among older adults suffering from insomnia with short and normal objective sleep duration and the effects of cognitive behavior therapy

SLEEP ◽  
2020 ◽  
Author(s):  
Nicole Lovato ◽  
Gorica Micic ◽  
Leon Lack
Keyword(s):  
Older Adults ◽  
Sleep Duration ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Sleep Onset ◽  
Sleep Diary ◽  
Cognitive Behavior ◽  
Sleep Onset Latency ◽  
Normal Sleep

Abstract Study Objectives Compare the degree of sleep misestimation in older adults with insomnia presenting with objectively short relative to normal sleep duration, and investigate the differential therapeutic response on sleep misestimation between the proposed sleep duration phenotypes to cognitive-behavior therapy for insomnia (CBTi). Methods Ninety-one adults (male = 43, mean age = 63.34, SD = 6.41) with sleep maintenance insomnia were classified as short sleepers (SS; &lt;6 h total sleep time [TST]) or normal sleepers (NS; ≥6 h TST) based on one night of home-based polysomnography. Participants were randomly allocated to CBTi (N = 30 SS, N = 33 NS) or to a wait-list control condition (N = 9 SS, N = 19 NS). Sleep misestimation was calculated as the difference scores of subjective (sleep diary reported) and objective (derived from actigraphy) sleep onset latency (SOL), wake after sleep onset (WASO), and TST at pre- and post-treatment, and 3-month follow-up. Results Prior to treatment, perception of SOL, WASO, and TST did not differ between patients with objectively short sleep duration relative to those with objectively normal sleep duration. Patients’ perception of WASO and TST, improved immediately following treatment and at 3-month follow-up relative to the waitlist group. These improvements did not differ significantly between those with short or normal objective sleep duration prior to treatment. Conclusions The degree of sleep misestimation is similar for older adults suffering from chronic insomnia with short or normal objective sleep duration. Irrespective of objective sleep duration prior to treatment, CBTi produces significant improvements in sleep perception. Clinical Trial Registration Number ACTRN12620000883910

Links between sleep and body mass index in bipolar disorders: An exploratory study

2015 ◽  
Vol 30 (1) ◽  
pp. 89-93 ◽  
Author(s):  
C. Boudebesse ◽  
P.-A. Geoffroy ◽  
C. Henry ◽  
A. Germain ◽  
J. Scott ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Sleep Disturbances ◽  
Sleep Onset ◽  
Bipolar Disorders ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Sleep Onset Latency ◽  
Cross Sectional ◽  
Sleep Parameters

AbstractStudy objectives:Obesity and excess bodyweight are highly prevalent in individuals with bipolar disorders (BD) and are associated with adverse consequences. Multiple factors may explain increased bodyweight in BD including side effects of psychotropic medications, and reduced physical activity. Research in the general population demonstrates that sleep disturbances may also contribute to metabolic burden. We present a cross-sectional study of the associations between body mass index (BMI) and sleep parameters in patients with BD as compared with healthy controls (HC).Methods:Twenty-six French outpatients with remitted BD and 29 HC with a similar BMI completed a 21-day study of sleep parameters using objective (actigraphy) and subjective (PSQI: Pittsburgh Sleep Quality Index) assessments.Results:In BD cases, but not in HC, higher BMI was significantly correlated with lower sleep efficiency (P = 0.009) and with several other sleep parameters: shorter total sleep time (P = 0.01), longer sleep onset latency (P = 0.05), higher fragmentation index (P = 0.008), higher inter-day variability (P = 0.05) and higher PSQI total score (P = 0.004).Conclusions:The findings suggest a link between a high BMI and several sleep disturbances in BD, including lower sleep efficiency. Physiological mechanisms in BD cases may include an exaggeration of phenomena observed in non-clinical populations. However, larger scale studies are required to clarify the links between metabolic and sleep-wake cycle disturbances in BD.

Impact of Digital Monitoring, Assessment and Cognitive Behavioral Therapy on Subjective Sleep Quality, Workplace Productivity and Health Related Quality of Life: Observational Study (Preprint)

2018 ◽  
Author(s):  
Yuval Altman ◽  
Shuli Eyal ◽  
Anda Baharav ◽  
Kyle Niejadlik
Keyword(s):  
Sleep Problems ◽  
Behavioral Therapy ◽  
Sleep Onset ◽  
Work Productivity ◽  
Average Amount ◽  
Subjective Sleep ◽  
Sleep Parameters ◽  
Smart Mobile

BACKGROUND Sleep difficulties negatively impact health, performance and quality of life, as about a third of the general population suffers from at least one insomnia symptom. Recent studies link insomnia with reduced work productivity, resulting in extensive losses for employees, employers and insurers. Cognitive behavioral therapy for insomnia (CBTi) is recommended as first-line treatment for insomnia and the ubiquity of smart mobile devices allows for promising approaches to overcome some of the limitations surrounding it. OBJECTIVE Our aim was to propose a comprehensive sleep solution for smart mobile devices, and to characterize the effects of this solution, while using adequate sample sizes. METHODS Employees of a Fortune-50 company were randomly selected, all with a Pittsburgh Sleep Quality Index (PSQI) larger than 8. Subjects were randomly assigned to either an intervention group (IG, n=247) or a control group (CG, n=249), and were asked to fill several questionnaires, in addition to the PSQI. Questionnaires were completed pre-treatment, post-treatment at six weeks and a follow-up after two months. People in the IG were provided with a sleep assessment and therapy service via a mobile app (SleepRate). De-identified objective and subjective sleep data were acquired on a nightly basis, along with a digital sleep diary. Sleep parameters included sleep onset (SO), wake after sleep onset (WASO), sleep efficiency (SE) and sleep satisfaction (SS). Sleep problems, such as symptoms of insomnia, were detected based on the sleep data and several questionnaires. Subjects in the IG were then offered treatment to address the detected sleep problems. For subjects with symptoms of insomnia, average sleep parameters during the assessment week (AW) were compared to those during the last week in treatment (LW). RESULTS Post-treatment average PSQI was lower for the IG (8.5), compared to that of the CG (10.9, p=.005), as were absenteeism (IG: 0.39%, CG: 1.0%, p=.06) and presenteeism (IG: 15.6%, CG: 21.4%, p=.02). The average amount of healthy days was significantly higher for the IG (22.5 days) compared to that of the CG (18.6 days, p=.005). At follow-up, average PSQI of the IG was significantly lower (7.1) than that of the CG (10.4, p=.005), as well as absenteeism (IG: 0.15%, CG: 0.84%, p=.03) and presenteeism (IG: 11.9%, CG: 23.5%, p=.005), while the average amount of healthy days was significantly higher (IG: 23.8, CG: 19.0, p=.005). For subjects in the IG, subjective SE was significantly higher at LW (89.1±12.3%, mean±SD) compared to that at the AW (87.5±9.8%, p=.025), WASO significantly shortened (AW: 25.7±27minutes, LW: 19.8±18.4minutes, p=.011), as SS increased significantly (AW: 49.2±11.5, LW: 53±15.4, p=.003). CONCLUSIONS The use of a mobile sleep solution improved the subjective sleep perception in the IG and facilitated a substantial increase in work productivity.

scholarly journals 0524 Web-Delivered CBT for Insomnia Intervention Improves Sleep Among Adults with Insomnia and Depressive Symptoms

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A200-A201
Author(s):  
P J Batterham ◽  
H Christensen ◽  
F P Thorndike ◽  
L M Ritterband ◽  
R Gerwien ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Sleep Quality ◽  
Large Scale ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Sleep Onset ◽  
Sleep Diary ◽  
Sleep Onset Latency ◽  
Sleep Diaries

Abstract Introduction Cognitive behavioral therapy for insomnia (CBT-I) is the first line recommended treatment for adults with chronic insomnia. In a prior randomized controlled trial (RCT), data showed web-delivered CBT-I (SHUTi) reduced insomnia severity as well as symptoms of depression, among adults with insomnia and elevated depressive symptoms. The present study aimed to further evaluate the effectiveness of web CBT-I to improve sleep outcomes as measured by prospectively entered sleep diaries in this same sample. Methods A large-scale RCT (N=1149) of Australian adults with insomnia and depressive symptoms compared a 9-week, web CBT-I therapeutic with an attention-matched web program at baseline, posttest and 6-, 12-, and 18-month follow-ups. Although depression outcomes have been presented previously, the online sleep-diary derived variables have not yet been presented, including sleep-onset latency (SOL), wake after sleep onset (WASO), sleep efficiency (SE), number of awakenings, sleep quality, and total sleep time (TST). Sleep diaries were entered online for 10 days at each assessment period. Results Data showed web CBT-I participants demonstrated greater reductions from baseline to posttest compared with control for the following sleep variables: SOL (LS mean difference [95% CI]=-22.3 min [-29.2, -15.3]; p&lt;.0001), WASO (-17.8 min [-23.4, -12.3]; p&lt;.0001), and number of awakenings (-0.38 [-0.68, -0.09]; p=.0113). Web CBT-I also showed greater improvements in SE (9.18% [7.25%, 11.10%]; p&lt;.0001) and sleep quality (0.41 [0.30, 0.53]; p&lt;.0001) from baseline to posttest compared with control. TST was not significantly different between groups at posttest or 6-month follow-up, although it improved over baseline at 12 (18.73 min [7.39, 30.07]; p=.0013) and 18 months (23.76 min [9.15, 38.36]; p=.0015) relative to control. All other significant sleep treatment effects were maintained in the treatment arm at 6, 12, and 18-month follow-up. Conclusion Data showed web CBT-I produced lasting improvements in sleep outcomes among adults with insomnia and elevated depressive symptoms. Support Clinical trial ACTRN12611000121965 was funded by the Australian National Health and Medical Research Council. The statistical analysis described here was funded by Pear Therapeutics, Inc and conducted by Provonix.

scholarly journals Self-administered electroencephalography-based sleep assessment: compliance and perceived feasibility in children and adults

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Jesper Pedersen ◽  
Martin Gillies Banke Rasmussen ◽  
Line Grønholt Olesen ◽  
Peter Lund Kristensen ◽  
Anders Grøntved
Keyword(s):  
A Priori ◽  
Pilot Trial ◽  
Sleep Onset ◽  
Sleep Time ◽  
Secondary Outcome ◽  
Sleep Onset Latency ◽  
Assessment Protocol ◽  
Sleep Assessment ◽  
Sleep Parameters

Abstract Background Sleep is a crucial part of our lives and insufficient sleep has been linked to several health disorders in both children and adults. However, most studies are based on single night laboratory polysomnography, actigraphy, or sleep diaries. The primary aim of this study was to evaluate compliance to and perceived feasibility of the Zmachine insight+ for assessment of habitual sleep parameters in a sample of children and adults for six nights. The secondary aim was to report sleep parameters derived from the Zmachine. Methods We analyzed data from 12 families who participated in the SCREENS pilot trial (2018–2019). Children (n=14) and adults (n=19) had to undergo three nights of EEG-based sleep assessment at baseline and follow-up. We assessed compliance to the sleep assessment protocol and summarized perceived feasibility in children and adults. Summary estimates were computed for total sleep time, sleep onset latency, wake after sleep onset, light sleep, deep sleep, and rapid eye movement sleep. Results Compliance to the sleep assessment protocol was high with 92.9 and 89.4% of children and adults meeting the a priori specified compliance goal of at least two out of three nights of complete sleep data at both baseline and follow-up. In general, the protocol was perceived as feasible, with low prevalence of sleep disruption and only minor issues, e.g. difficulties with removing sensors. Results on sleep parameters indicate large within group variation. Conclusions Our findings support the use of a self-administered EEG-based habitual sleep assessment protocol, including multiple days of measurement, in children and adults. Trial registration Cilinicaltrials.gov: NCT03788525 [Secondary outcome measures; Retrospectively registered; 27th December, 2018].

Sleep Quality Associated With Different Work Schedules: A Longitudinal Study of Nursing Staff

2017 ◽  
Vol 19 (4) ◽  
pp. 375-381 ◽  
Author(s):  
Shu-Fen Niu ◽  
Nae-Fang Miao ◽  
Yuan-Mei Liao ◽  
Mei-Ju Chi ◽  
Min-Huey Chung ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Night Shift ◽  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Diary ◽  
Sleep Onset Latency ◽  
Shift Group ◽  
Parallel Group ◽  
Sleep Parameters ◽  
Work Shifts

Purpose: To explore the differences in sleep parameters between nurses working a slow, forward rotating shift and those working a fixed day shift. Method: A longitudinal parallel-group comparison design was used in this prospective study. Participants (female) were randomly assigned to a rotating shift or a fixed day shift group. Participants in the rotating shift group worked day shift for the first 4 weeks, followed by evening shift for the second and night shift the third. Those in the day shift group worked day shift for all 12 weeks. Each kept a sleep diary and wore an actigraph (actigraph data were used to calculate total sleep time [TST], sleep onset latency [SOL], wake after sleep onset [WASO], and sleep efficiency [SE]) for 12 days, from Workday 1–4 in each of Weeks 4, 8, and 12. Results: TST in nurses working evening rotating shift was higher than that for those working the day or night rotating shift and fixed day shift. WASO was significantly longer on Day 2 for rotating shift participants working evening versus day shift. SOL and SE were significantly shorter and lower in rotating shift nurses working night versus both day and evening shifts. Conclusions: A comprehensive understanding of the sleep patterns and quality of nurses with different work shifts may lead to better management of work shifts that reduces the influence of shift work on sleep quality.

scholarly journals 0178 The Cycle of Daily Stress and Sleep: Sleep Measurement Matters

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A70-A71
Author(s):  
D C Slavish ◽  
J Asbee ◽  
K Veeramachaneni ◽  
B Messman ◽  
B Scott ◽  
...  
Keyword(s):  
Sleep Disturbances ◽  
Multilevel Models ◽  
Single Channel ◽  
Sleep Onset ◽  
Sleep Diary ◽  
Sleep Onset Latency ◽  
Daily Stress ◽  
Sleep Diaries ◽  
Sleep Parameters ◽  
Sleep Measurement

Abstract Introduction Disturbed sleep can be both a cause and a consequence of increased stress. Yet intensive longitudinal studies have demonstrated that sleep assessed via sleep diaries and actigraphy is inconsistently associated with daily stress. We expanded this research by examining daily associations between sleep and stress using a three-fold approach to assess sleep: sleep diaries, actigraphy, and ambulatory single-channel electroencephalography [EEG]. Methods Participants were 80 adults (M age = 32.65 years, 63% female) who completed 7 days of sleep and perceived stress assessments in a naturalistic setting (resulting in 560 possible measurement occasions). Multilevel models were used to examine bidirectional associations between daily stressor occurrence (0 = stressor did not occur, 1 = stressor occurred) and stressor severity (0 = not at all severe to 3 = very severe) and sleep parameters assessed via diary, actigraphy, and EEG (e.g. total sleep time [TST], sleep efficiency [SE], and sleep onset latency [SOL], wake after sleep onset [WASO]). Results Participants reported at least one stressor on 37% of days. Compared to days without a stressor experienced, days with a stressor were associated with a 14.4-minute reduction in actigraphy-determined TST the subsequent night (β = -0.24, p = 0.030). Nights with greater sleep-diary determined WASO were associated with greater next-day stressor severity (β = 0.01, p = .026). No EEG-determined sleep parameters were associated with next-day stressor occurrence or severity, or vice versa. Conclusion Daily stress and sleep disturbances occurred in a bidirectional fashion, though specific results varied by sleep measurement technique and sleep parameter. Together, our results highlight that type of sleep measurement matters for examining associations with daily stress. We urge future researchers to treat sleep diaries, actigraphy, and EEG as complementary — not redundant — sleep measurement approaches. Support Funding for this study included NIH/NIAID R01AI128359-01; DoD-VA 1I01CU000144-01; the Foundation for Rehabilitation Psychology; and General Sleep Corporation.

scholarly journals Subjective Happiness Is Associated with Objectively Evaluated Sleep Efficiency and Heart Rate during Sleep: An Exploratory Study Using Non-Contact Sheet Sensors

2020 ◽  
Vol 12 (11) ◽  
pp. 4630
Author(s):  
Hisayoshi Okamura ◽  
Kengo Mihara ◽  
Akira Tsuda ◽  
Toshihiro Morisaki ◽  
Yoshiyuki Tanaka ◽  
...  
Keyword(s):  
Heart Rate ◽  
Sleep Onset ◽  
Sleep Efficiency ◽  
Sleep Onset Latency ◽  
Subjective Happiness ◽  
Onset Latency ◽  
Lower Heart Rate ◽  
Subjective Sleep ◽  
Subjective Happiness Scale ◽  
The Relationship

The objective of this study was to explore the relationship between subjective happiness and subjective and objective sleep. The participants were 24 healthy university students (11 males, 13 females; mean age 22.4 ± 2.1). Their subjective happiness was measured by the Japanese Subjective Happiness Scale (JSHS). Furthermore, their subjective and objective sleep evaluation was measured by Ogri-Shirakawa-Azumi sleep inventory MA version (OSA-MA) and a non-contact sheet sensor (SS). The results indicated that participants with higher subjective happiness had objectively shorter sleep onset latency, higher sleep efficiency, and lower heart rate during sleep. On the other hand, no such correlations were found between subjective sleep evaluation with OSA and subjective happiness. These results suggest that subjective happiness is related with the ability to more easily fall asleep and better sleep efficiency.

scholarly journals Comparison of single-channel EEG, actigraphy, and sleep diary in cognitively normal and mildly impaired older adults

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Chris A Chou ◽  
Cristina D Toedebusch ◽  
Tiara Redrick ◽  
David Freund ◽  
Jennifer S McLeland ◽  
...  
Keyword(s):  
Older Adults ◽  
Sleep Disturbances ◽  
Single Channel ◽  
Sleep Onset ◽  
Amyloid Β ◽  
Sleep Diary ◽  
Sleep Onset Latency ◽  
Cognitively Normal ◽  
Sleep Diaries ◽  
Sleep Parameters

Abstract Study Objectives Multiple methods for monitoring sleep-wake activity have identified sleep disturbances as risk factors for Alzheimer disease (AD). In order to identify the level of agreement between different methods, we compared sleep parameters derived from single-channel EEG (scEEG), actigraphy, and sleep diaries in cognitively normal and mildly impaired older adults. Methods Two hundred ninety-three participants were monitored at home for up to six nights with scEEG, actigraphy, and sleep diaries. Total sleep time (TST), sleep efficiency (SE), sleep onset latency (SOL), and wake after sleep onset (WASO) were calculated using each of these methods. In 109 of the 293 participants, the ratio of cerebrospinal fluid concentrations of phosphorylated tau (p-tau) and amyloid-β-42 (Aβ42) was used as a biomarker for AD pathology. Results Agreement was highest for TST across instruments, especially in cognitively normal older adults. Overall, scEEG and actigraphy appeared to have greater agreement for multiple sleep parameters than for scEEG and diary or actigraphy and diary. Levels of agreement between scEEG and actigraphy overall decreased in mildly impaired participants and those with biomarker evidence of AD pathology, especially for measurements of TST. Conclusions Caution should be exercised when comparing scEEG and actigraphy in individuals with mild cognitive impairment or with AD pathology. Sleep diaries may capture different aspects of sleep compared to scEEG and actigraphy. Additional studies comparing different methods of measuring sleep-wake activity in older adults are necessary to allow for comparison between studies using different methods.

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