scholarly journals 0825 Sleep During Pregnancy Through One Year Postpartum: Correspondence Between Actigraphy and Self-Report Measures

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A314-A315
Author(s):  
C M Beverly Hery ◽  
L M Christian
Keyword(s):  
Sleep Time ◽  
Epidemiologic Studies ◽  
Self Report ◽  
Poor Sleep ◽  
Hormonal Changes ◽  
Time In Bed ◽  
Wrist Actigraphy ◽  
Pregnancy And Postpartum ◽  
One Year ◽  
In Pregnancy

Abstract Introduction Disrupted sleep and shorter sleep duration is common in pregnancy, due to hormonal changes and physical discomfort, and in postpartum due to new infants. Objective data in this population studied over more than one year are lacking. The current analysis focuses on actigraphy-based and self-reported sleep. We examined the level of correspondence between these two complementary measurement modalities. Methods Pregnant women were enrolled in the Stress and Health in Pregnancy and Postpartum (SHIPP) study. Study visits were conducted from 2016-2019 during the 3rd trimester, 4-6 weeks postpartum, and 4 months, 8 months, and 12 months postpartum. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and provided wrist-actigraphy data (Actiwatch, Philips Respironics) for one week prior to each study visit. Actigraphy-based time in bed (TIB), total sleep time (TST), sleep efficiency (SE), WASO and sleep latency (SL) were calculated. Correlations were conducted between actigraphy-based and self-reported PSQI sleep measures. Results 79 women (28.9±4.6 years) provided complete actigraphy data (≥3 valid days; 6.4±1.0 days) for at least one time point. Objective TST from the 3rd trimester to 12-months postpartum was 7.19, 6.87, 6.86, 6.89, and 6.78 hours, respectively. Actigraphy-based TIB was positively correlated with self-reported TIB at all five visits (r’s: 0.37-0.62, p’s<0.01). Actigraphy-based TST was positively correlated with self-reported TST (r’s: 0.27-0.48, p’s<0.05) at all visits. Actigraphy-based SE was negatively correlated with the PSQI Global Score at 4, 8, and 12 months postpartum (r’s: -0.29 to -0.39, p’s<0.05). Of note, actigraphy-based WASO and SL were not consistently correlated with any self-reported PSQI sleep measures. Conclusion Ensuring collection of accurate sleep data during pregnancy and postpartum is important, as poor sleep is associated with negative health outcomes for both mother and child. Self-reported data is common in large, epidemiologic studies yet actigraphy-based measures may capture different aspects of sleep than self-report. Support This study was supported by the National Institutes of Health (R01 NR01366).

scholarly journals Assessment of Sleep Duration Based on Ankle and Wrist Actigraphy in Hospitalized Older Patients

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 632-632
Author(s):  
Juliana Smichenko ◽  
Tamar Shochat ◽  
Nurit Gur-Yaish ◽  
Anna Zisberg
Keyword(s):  
Repeated Measures ◽  
Field Studies ◽  
Sleep Time ◽  
Self Report ◽  
Repeated Measure ◽  
Poor Sleep ◽  
Activity Data ◽  
Wrist Actigraphy ◽  
Sleep Assessment ◽  
Within Subjects

Abstract Poor sleep at time of hospitalization is associated with undesirable outcomes. Most studies performed in the hospital assess sleep by self-report, while only few rely on actigraphy. Although wrist actigraphy is commonly used for sleep assessment in field studies, in-hospital assessment may be challenging and cumbersome due to other more necessary monitoring devices that are often attached to patients’ upper limbs, that may in turn affect interpretation of wrist activity-data. Placement on the ankle may be a viable solution. In this pilot study, we aimed to compare total sleep time (TST) using concomitant wrist and ankle actigraphy as well as self-report. Twenty-one older adults (65+) hospitalized in medical units wore ankle and wrist actigraphy devices and subjectively estimated their TST for an average of (2.15±1.01) nights. A total of 45 nights were available for analysis. Average TST in minutes was 332.06±81.58, 427.05±97.74 and 374.28±124.96 based on wrist, ankle, and self-report, respectively. Repeated measure mixed models analysis was performed adjusting for age, gender, and sleep medications. TST was significantly lower using wrist compared to ankle actigraphy (F(2,102)=7.63, p=0.0008), and both were not different from self-report. No significant within subjects variation and no interaction between device and repeated measures were found. Despite differences between ankle and wrist assessments, all three provide consistent TST estimation within subjects. Self-report provides a stable and accessible assessment of TST, representing a good approximation of ankle and wrist actigraphy. Findings provide preliminary support for the use of ankle actigraphy for sleep assessment in hospital settings.

scholarly journals Sleep and Olfaction among Older Adults

2017 ◽  
Vol 48 (3-4) ◽  
pp. 147-154 ◽  
Author(s):  
V. Eloesa McSorley ◽  
Jayant Pinto ◽  
L. Philip Schumm ◽  
Kristen Wroblewski ◽  
David Kern ◽  
...  
Keyword(s):  
Older Adults ◽  
Sleep Quality ◽  
Structural Equation Models ◽  
Sleep Problems ◽  
Community Dwelling ◽  
Odor Identification ◽  
Self Report ◽  
Poor Sleep ◽  
Wrist Actigraphy ◽  
Odor Sensitivity

Background: Sleep and olfaction are both critical physiological processes that tend to worsen with age. Decline in olfaction can be an early indicator of neurodegenerative diseases, whereas poor sleep quality is associated with reduced physical and mental health. Given associations with aging-related health declines, we explored whether variations in sleep were associated with olfactory function among older adults. Methods: We assessed the relationship between sleep characteristics and olfaction among 354 community-dwelling older adults. Olfaction was measured using a validated field and survey research tool. Sleep characteristics were measured using wrist actigraphy and with self-report of sleep problems. We fit structural equation models of latent constructs of olfaction based on olfactory task items and let this be a function of each sleep characteristic. Results: Actigraph sleep quality measures were associated with odor identification, but not with odor sensitivity. Longer duration sleepers had worse odor sensitivity compared to medium (58 h) sleepers, but sleep duration was not associated with odor identification. Reported sleep problems and reported usual duration were not associated with olfaction. Conclusions: Diminished sleep quality was associated with reduced capacity to identify odors. Determining whether this is a causal association will require further study and longitudinal data.

scholarly journals The anxious aspects of insecure attachment styles are associated with depression either in pregnancy or in the postpartum period

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Emanuela Bianciardi ◽  
Cristina Vito ◽  
Sophia Betrò ◽  
Alberto De Stefano ◽  
Alberto Siracusano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Postpartum Period ◽  
Postnatal Depression ◽  
Attachment Styles ◽  
Perinatal Depression ◽  
Self Report ◽  
Pregnancy And Postpartum ◽  
Foreign Nationality ◽  
In Pregnancy

Abstract Background Perinatal depression (PND) is a major complication of pregnancy and many risk factors have been associated with its development both during pregnancy and postpartum. The transition to motherhood activates the attachment system. The aim of our study was to investigate the relationship between women’s attachment style (AS) and PND in pregnancy, and 1 month after childbirth, in a large cohort of women. We hypothesized that different patterns of AS were associated with either antenatal or postnatal depression. We, further, explored the role of other possible risk factors such as life-stress events. Methods A final sample of 572 women was enrolled. At the third trimester of pregnancy, clinical data sheet and self-report questionnaires (ASQ, PSS, LTE-Q, and EPDS) were administered. One month after delivery, EPDS was administered by telephone interview. Results We found 10.1% of the women with depression during pregnancy and 11.1% in the postpartum period. The first logistic regression showed that ASQ-CONF subscale (OR = 0.876, p < 0.0001), ASQ-NFA subscale (OR = 1.097, p = 0.002), foreign nationality (OR = 2.29, p = 0.040), low education levels (OR = 0.185, p = 0.012), PSS total score (OR = 1.376, p = 0.010), and recent life adversities (OR = 3.250, p = 0.012) were related to EPDS ≥ 14 during pregnancy. The second logistic regression showed that ASQ-PRE subscale (OR = 1.077, p < 0.001) and foreign nationality (OR = 2.88, p = 0.010) were related to EPDS ≥ 12 in the postpartum period. Conclusions Different dimensions of anxious insecure AS were, respectively, associated with either antenatal or postnatal depression. These findings support the literature investigating subtypes of perinatal depression. The PND may be heterogeneous in nature, and the comprehension of psychopathological trajectories may improve screening, prevention, and treatment of a disorder which has a long-lasting disabling impact on the mental health of mother and child. We provided a rationale for targeting an attachment-based intervention in this group of women.

scholarly journals Associations of Actigraphic Sleep Parameters With Fatigability in Older Adults

2020 ◽  
Vol 75 (9) ◽  
pp. e95-e102 ◽  
Author(s):  
Alfonso J Alfini ◽  
Jennifer A Schrack ◽  
Jacek K Urbanek ◽  
Amal A Wanigatunga ◽  
Sarah K Wanigatunga ◽  
...  
Keyword(s):  
Older Adults ◽  
Perceived Exertion ◽  
Sleep Onset ◽  
Later Life ◽  
Sleep Time ◽  
Community Dwelling ◽  
Rating Of Perceived Exertion ◽  
Poor Sleep ◽  
Wrist Actigraphy ◽  
Sleep Parameters

Abstract Background Poor sleep may increase the likelihood of fatigue, and both are common in later life. However, prior studies of the sleep–fatigue relationship used subjective measures or were conducted in clinical populations; thus, the nature of this association in healthier community-dwelling older adults remains unclear. We studied the association of actigraphic sleep parameters with perceived fatigability—fatigue in response to a standardized task—and with conventional fatigue symptoms of low energy or tiredness. Methods We studied 382 cognitively normal participants in the Baltimore Longitudinal Study of Aging (aged 73.1 ± 10.3 years, 53.1% women) who completed 6.7 ± 0.9 days of wrist actigraphy and a perceived fatigability assessment, including rating of perceived exertion (RPE) after a 5-minute treadmill walk or the Pittsburgh Fatigability Scale (PFS). Participants also reported non-standardized symptoms of fatigue. Results After adjustment for age, sex, race, height, weight, comorbidity index, and depressive symptoms, shorter total sleep time (TST; &lt;6.3 hours vs intermediate TST ≥6.3 to 7.2 hours) was associated with high RPE fatigability (odds ratio [OR] = 2.56, 95% confidence interval [CI] = 1.29, 5.06, p = .007), high PFS physical (OR = 1.88, 95% CI = 1.04, 3.38, p = .035), and high mental fatigability (OR = 2.15, 95% CI = 1.02, 4.50, p = .044), whereas longer TST was also associated with high mental fatigability (OR = 2.19, 95% CI = 1.02, 4.71, p = .043). Additionally, longer wake bout length was associated with high RPE fatigability (OR = 1.53, 95% CI = 1.14, 2.07, p = .005), and greater wake after sleep onset was associated with high mental fatigability (OR = 1.14, 95% CI = 1.01, 1.28, p = .036). Conclusion Among well-functioning older adults, abnormal sleep duration and sleep fragmentation are associated with greater perceived fatigability.

262 Comparing Two Methods for Scoring Wrist Actigraphy to Polysomnography for Estimating Total Sleep Time in Healthy Men

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A105-A105
Author(s):  
Emma Tussey ◽  
Corey Rynders ◽  
Christine Swanson
Keyword(s):  
Decision Tree ◽  
Total Sleep Time ◽  
Reference Method ◽  
Sleep Time ◽  
Sleep Diary ◽  
Scoring Methods ◽  
Scoring Method ◽  
Time In Bed ◽  
Wrist Actigraphy ◽  
Rest Intervals

Abstract Introduction This analysis assessed whether manually setting rest (i.e., time in bed) intervals prior to using a proprietary software package (Actiware, version 6.09) to analyze wrist actigraphy data improved estimates of total sleep time (TST) compared to polysomnography (PSG). Methods The Phillips Actiwatch 2 and PSG (reference method) were used to calculate TST on two separate nights in twelve men (age=28.3 ± 5.7). Participants had an 8-hour sleep opportunity on night one and a 5-hour sleep opportunity and on night two. Estimates of TST from actigraphy data were calculated using two scoring methods. For scoring method 1, we allowed the software to automatically choose rest intervals and then applied a proprietary algorithm to calculate TST. For scoring method 2, we manually entered rest intervals using a published decision tree that incorporates activity, light, event marker, and sleep diary data. After the rest intervals were set in method 2, the proprietary algorithm was applied to calculate TST. Mean bias and limits of agreement (LOA) from Bland-Altman plots compared TST derived from both actigraphy scoring methods to PSG estimates. Results On night 1 (n=8) TST measured by PSG was 398.4 ± 40.6 minutes, compared to 395.5 ± 70.9 minutes using actigraphy scoring method 1 and 396 ± 44.5 minutes using scoring method 2. Mean bias was similar when comparing both scoring methods to PSG, but the LOA were wider in method 1 compared to method 2 (method 1 vs. PSG: -2.9 [-110.4, 104.7]; method 2 vs. PSG: -2.4 [-66.5, 61.7]; minutes). On night 2 (n=12) TST determined by PSG was 283.3 ± 11.2 minutes, compared to 302.1 ± 84.4 minutes using actigraphy scoring method 1 and 273.1 ± 14.5 minutes using scoring method 2. Again, LOA for TST estimated by actigraphy scoring method 1 were wider compared to scoring method number 2 (method 1 vs. PSG: 18.8 [-136.9, 174.6]; method 2 vs. PSG: -10.2 [-35.1, 14.8]). Conclusion These data demonstrate that applying a decision tree to manually set time in bed intervals prior to running analyses in the software results in better agreement when estimating TST from wrist actigraphy compared to PSG. Support (if any) UL1RR025780, K23AR070275.

“I Am Pregnant; Why Can’t I Sleep?”

2017 ◽  
Author(s):  
Sandra L. Horowitz
Keyword(s):  
Sleep Apnea ◽  
Gestational Hypertension ◽  
Adverse Outcomes ◽  
Airflow Limitation ◽  
Poor Sleep ◽  
Hormonal Changes ◽  
Restless Leg Syndrome ◽  
Pregnancy And Postpartum ◽  
Induced Hypertension ◽  
The Common

This chapter reviews the common sleep disorders of pregnancy. During pregnancy and postpartum, 84% of women report poor sleep at least a few nights a week. These problems are common, disruptive to daytime and nighttime activity, and may have multiple causes. This chapter covers aspects of insomnia and restless leg syndrome. It also discusses sleep apnea in pregnancy with related hormonal changes that may increase the incidence. There is an association of sleep apnea and pregnancy-induced hypertension, with increased adverse outcomes of pregnancy, including fetal growth retardation and premature birth. It has been suggested that treating nocturnal airflow limitation may improve gestational hypertension. The recommended therapies in this chapter may also be applied to non-pregnant patients with similar complaints.

scholarly journals Concordance between self-reported and actigraphy-assessed sleep duration among African-American adults: findings from the Jackson Heart Sleep Study

SLEEP ◽  
2019 ◽  
Vol 43 (3) ◽  
Author(s):  
Chandra L Jackson ◽  
Julia B Ward ◽  
Dayna A Johnson ◽  
Mario Sims ◽  
James Wilson ◽  
...  
Keyword(s):  
African American ◽  
African Americans ◽  
Sleep Duration ◽  
Sleep Time ◽  
Epidemiological Studies ◽  
Poor Sleep ◽  
Linear Regression Models ◽  
Sleep Study ◽  
Time In Bed ◽  
Objectively Measured

Abstract Study Objectives Most epidemiological studies assess sleep duration using questionnaires. Interpreting this information requires understanding the extent to which self-reported habitual sleep reflects objectively assessed sleep duration, particularly among African Americans, who disproportionately experience poor sleep health. Methods Among African-American participants of the Jackson Heart Sleep Study, we investigated differences in questionnaire-based self-assessed average sleep duration and self-assessed wake-bed time differences compared to actigraphy-based assessments of total sleep time (TST) and average time in bed (TIB). Linear regression models provided estimates of concordance between actigraphy-based and self-reported sleep duration. Results Among 821 adults, self-assessed average sleep duration was lower than self-assessed wake-bed time differences (6.4 ± 1.4 vs. 7.5 ± 1.7 h, p &lt; 0.0001). Mean actigraphy-based TST was 6.6 ± 1.2 h, and actigraphy-based average TIB was 7.6 ± 1.2 h. Self-assessed average sleep duration and actigraphy-based TST were moderately correlated (r = 0.28, p &lt; 0.0001). Self-assessed average sleep duration underestimated actigraphy-based TST by −30.7 min (95% confidence intervals [CI]: −36.5 to −24.9). In contrast, self-assessed wake-bed time differences overestimated actigraphy-based TST by 45.1 min (95% CI: 38.6–51.5). In subgroup analyses, self-assessed average sleep duration underestimated actigraphy-based measures most strongly among participants with insomnia symptoms. Conclusions Among African Americans, self-assessed average sleep duration underestimated objectively measured sleep while self-assessed wake-bed time differences overestimated objectively measured sleep. Sleep measurement property differences should be considered when investigating disparities in sleep and evaluating their associations with health outcomes.

Elusive hypersomnolence in seasonal affective disorder: actigraphic and self-reported sleep in and out of depressive episodes

2021 ◽  
pp. 1-10
Author(s):  
Delainey L. Wescott ◽  
Peter L. Franzen ◽  
Brant P. Hasler ◽  
Megan A. Miller ◽  
Adriane M. Soehner ◽  
...  
Keyword(s):  
Affective Disorder ◽  
Seasonal Affective Disorder ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Self Report ◽  
Clinical Interviews ◽  
Sleep Diaries ◽  
Time In Bed ◽  
Research Findings ◽  
Depressive Episodes

Abstract Background Hypersomnolence has been considered a prominent feature of seasonal affective disorder (SAD) despite mixed research findings. In the largest multi-season study conducted to date, we aimed to clarify the nature and extent of hypersomnolence in SAD using multiple measurements during winter depressive episodes and summer remission. Methods Sleep measurements assessed in individuals with SAD and nonseasonal, never-depressed controls included actigraphy, daily sleep diaries, retrospective self-report questionnaires, and self-reported hypersomnia assessed via clinical interviews. To characterize hypersomnolence in SAD we (1) compared sleep between diagnostic groups and seasons, (2) examined correlates of self-reported hypersomnia in SAD, and (3) assessed agreement between commonly used measurement modalities. Results In winter compared to summer, individuals with SAD (n = 64) reported sleeping 72 min longer based on clinical interviews (p < 0.001) and 23 min longer based on actigraphy (p = 0.011). Controls (n = 80) did not differ across seasons. There were no seasonal or group differences on total sleep time when assessed by sleep diaries or retrospective self-reports (p's > 0.05). Endorsement of winter hypersomnia in SAD participants was predicted by greater fatigue, total sleep time, time in bed, naps, and later sleep midpoints (p's < 0.05). Conclusion Despite a winter increase in total sleep time and year-round elevated daytime sleepiness, the average total sleep time (7 h) suggest hypersomnolence is a poor characterization of SAD. Importantly, self-reported hypersomnia captures multiple sleep disruptions, not solely lengthened sleep duration. We recommend using a multimodal assessment of hypersomnolence in mood disorders prior to sleep intervention.

scholarly journals Association between Antidepressant Treatment during Pregnancy and Postpartum Self-Harm Ideation in Women with Psychiatric Disorders: A Cross-Sectional, Multinational Study

2020 ◽  
Vol 18 (1) ◽  
pp. 46
Author(s):  
Jennifer Vallee ◽  
Yih Wong ◽  
Eline Mannino ◽  
Hedvig Nordeng ◽  
Angela Lupattelli
Keyword(s):  
Antidepressant Treatment ◽  
Depression Scale ◽  
Antenatal Depression ◽  
Cross Sectional ◽  
Pregnancy And Postpartum ◽  
Self Harm ◽  
Antidepressant Use ◽  
Disorder Treatment ◽  
One Year ◽  
In Pregnancy

This study sought to estimate whether there is a preventative association between antidepressants during pregnancy and postpartum self-harm ideation (SHI), as this knowledge is to date unknown. Using the Multinational Medication Use in Pregnancy Study, we included a sample of mothers who were in the five weeks to one year postpartum period at the time of questionnaire completion, and reported preexisting or new onset depression and/or anxiety during pregnancy (n = 187). Frequency of postpartum SHI (‘often/sometimes’ = frequent, ‘hardly ever’ = sporadic, ‘never’) was measured via the Edinburgh Postnatal Depression Scale (EPDS) item 10, which reads “The thought of harming myself has occurred to me”. Mothers reported their antidepressant use in pregnancy retrospectively. Overall, 52.9% of women took an antidepressant during pregnancy. Frequent SHI postpartum was reported by 15.2% of non-medicated women and 22.0% of women on past antidepressant treatment in pregnancy; this proportion was higher following a single trimester treatment compared to three trimesters (36.3% versus 18.0%). There was no preventative association of antidepressant treatment in pregnancy on reporting frequent SHI postpartum (weighted RR: 1.90, 95% CI: 0.79, 4.56), relative to never/hardly ever SHI. In a population of women with antenatal depression/anxiety, there was no preventative association between past antidepressant treatment in pregnancy and reporting frequent SHI in the postpartum year. This analysis is only a first step in providing evidence to inform psychiatric disorder treatment decisions for pregnant women.

063 Differential Impact of Sleep Duration on Nocturnal Blood Pressure Dipping Between Men and Women

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A26-A26
Author(s):  
Jeremy Bigalke ◽  
Ian Greenlund ◽  
Jennifer Nicevski ◽  
Neha John-Henderson ◽  
Jason Carter
Keyword(s):  
Blood Pressure ◽  
Sleep Duration ◽  
Significant Relationship ◽  
Sleep Time ◽  
Cardiovascular Complications ◽  
Poor Sleep ◽  
Sample Population ◽  
Wrist Actigraphy ◽  
Nocturnal Blood Pressure Dipping ◽  
The Impact

Abstract Introduction There is growing evidence that poor sleep may have a greater impact on the development of cardiovascular complications in women compared to men. However, most studies that have evaluated the impact of sex on sleep insufficiencies and blood pressure (BP) have not utilized ambulatory BP, and often rely more heavily on subjective sleep diaries as opposed to objective sleep assessment. The purpose of this study was to examine the impact of sex on the relationship between objectively measured sleep and nocturnal BP dipping. We hypothesized that poor sleep would be associated with decreased nocturnal BP dipping, and that this association would be stronger in women. Methods Total sleep time (TST) and sleep efficiency (SE) were monitored in fifty adults (31 men, 19 women; 36±3 years; 26±1 kg/m2) utilizing wrist actigraphy monitoring over the course of 5–14 days (Avg: 10±0 days). On a separate occasion, participants underwent a 24-hour ambulatory BP recording session. Independent samples T-tests were used to compare characteristics between sexes. Partial correlations controlling for age and BMI were utilized to probe relationships between sleep and nocturnal BP dipping. Results TST and SE were not different between sexes. However, women exhibited reduced mean arterial pressure (MAP: 86±1 vs. 90±1 mmHg, P=0.026) compared to men. Partial correlation revealed a significant relationship between TST and the magnitude of nocturnal MAP dipping in the sample population (R = 0.460, P&lt;0.001). When stratified by sex, this significant relationship persisted in men (R = 0.610, P&lt;0.001), but not women (R = 0.108, P&gt;0.05). In contrast, no relationship was observed between SE and nocturnal MAP dipping (R = -0.052, P&gt;0.05) for the sample population. Similarly, SE did not correlate with nocturnal MAP dipping in men (R = -0.080, P&gt;0.05) or women (R = 0.045, P&gt;0.05). Conclusion Contrary to our initial hypothesis, our results demonstrate that actigraphy-based TST is associated with nocturnal BP dipping in healthy men, but not women. This suggests a relation between impaired nocturnal BP regulation and habitual sleep duration, potentially predisposing men to an increased overall risk for cardiovascular complications. Support (if any) National Institutes of Health (HL-098676 and HL-122919)

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