251 Agreement and reliability of a new polysomnography sleep staging algorithm against multiple human scorers

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A101-A101
Author(s):  
Ulysses Magalang ◽  
Brendan Keenan ◽  
Bethany Staley ◽  
Peter Anderer ◽  
Marco Ross ◽  
...  
Keyword(s):  
Total Sleep Time ◽  
High Reliability ◽  
Sleep Stage ◽  
Intraclass Correlation ◽  
Sleep Time ◽  
Sleep Staging ◽  
Original Dataset ◽  
Scoring Algorithm ◽  
Scoring Algorithms ◽  
Good Agreement

Abstract Introduction Scoring algorithms have the potential to increase polysomnography (PSG) scoring efficiency while also ensuring consistency and reproducibility. We sought to validate an updated sleep staging algorithm (Somnolyzer; Philips, Monroeville PA USA) against manual sleep staging, by analyzing a dataset we have previously used to report sleep staging variability across nine center-members of the Sleep Apnea Global Interdisciplinary Consortium (SAGIC). Methods Fifteen PSGs collected at a single sleep clinic were scored independently by technologists at nine SAGIC centers located in six countries, and auto-scored with the algorithm. Each 30-second epoch was staged manually according to American Academy of Sleep Medicine criteria. We calculated the intraclass correlation coefficient (ICC) and performed a Bland-Altman analysis comparing the average manual- and auto-scored total sleep time (TST) and time in each sleep stage (N1, N2, N3, rapid eye movement [REM]). We hypothesized that the values from auto-scoring would show good agreement and reliability when compared to the average across manual scorers. Results The participants contributing to the original dataset had a mean (SD) age of 47 (12) years and 80% were male. Auto-scoring showed substantial (ICC=0.60-0.80) or almost perfect (ICC=0.80-1.00) reliability compared to manual-scoring average, with ICCs (95% confidence interval) of 0.976 (0.931, 0.992) for TST, 0.681 (0.291, 0.879) for time in N1, 0.685 (0.299, 0.881) for time in N2, 0.922 (0.791, 0.973) for time in N3, and 0.930 (0.811, 0.976) for time in REM. Similarly, Bland-Altman analyses showed good agreement between methods, with a mean difference (limits of agreement) of only 1.2 (-19.7, 22.0) minutes for TST, 13.0 (-18.2, 44.1) minutes for N1, -13.8 (-65.7, 38.1) minutes for N2, -0.33 (-26.1, 25.5) minutes for N3, and -1.2 (-25.9, 23.5) minutes for REM. Conclusion Results support high reliability and good agreement between the auto-scoring algorithm and average human scoring for measurements of sleep durations. Auto-scoring slightly overestimated N1 and underestimated N2, but results for TST, N3 and REM were nearly identical on average. Thus, the auto-scoring algorithm is acceptable for sleep staging when compared against human scorers. Support (if any) Philips.

SLEEP PATTERNS IN PRE-ADOLESCENT CHILDREN: AN EEG-EOG STUDY

PEDIATRICS ◽  
1968 ◽  
Vol 42 (2) ◽  
pp. 324-335 ◽  
Author(s):  
John J. Ross ◽  
Harman W. Agnew ◽  
Robert L. Williams ◽  
Wilse B. Webb
Keyword(s):  
Total Sleep Time ◽  
Sleep Stage ◽  
Sleep Time ◽  
Sleep Pattern ◽  
Adolescent Male ◽  
Sleep Stages ◽  
Night Sleep ◽  
Sleep Patterns ◽  
Unequal Distribution ◽  
Older Subjects

The typical all-night sleep pattern of the pre-adolescent male was determined by analyzing the simultaneous EEG-EOG tracings of 18 healthy schoolboys (range 8 to 11 years). The sleep patterns of these boys resembled that of older subjects by the occurrence of a more or less orderly sequence of sleep stages which spontaneously shifted from one stage to another. Stability of the pattern for a given boy was observed in the consistent amount of time spent in each sleep stage and in the number of sleep stage changes night after night. When compared with the adult sleep patterns, pre-adolescent total sleep time was 2½ hours longer with unequal distribution of the added time to each of the sleep stages. Sleep stages in children are longer in duration than in adults, and the sleep patterns are as stable as that of the adult.

Extreme sleep fragmentation for 11 consecutive days and nights does not significantly alter total sleep time, and sleep stage distribution, during the continuous alpine downhill skiing world record

2021 ◽  
Vol 17 (4) ◽  
pp. 18-24
Author(s):  
Mirco Gindulis ◽  
Nikolaus C.r Netze ◽  
Martin Burtscher ◽  
Hannes Gatterer ◽  
Christian K.M. Schmidt ◽  
...  
Keyword(s):  
Sleep Deprivation ◽  
Cognitive Skills ◽  
Total Sleep Time ◽  
Sleep Stage ◽  
Initial Period ◽  
Sleep Time ◽  
Sleep Fragmentation ◽  
World Record ◽  
Stage Distribution ◽  
Downhill Skiing

Introduction: Extreme levels of sleep deprivation, fragmentation and management, are major problems in many sportive disciplines, ultramarathons, polar or extreme altitude expeditions, and in space operations. Material and methods: Polysomnographic (PSG) data was continuously recorded (total sleep time and sleep stage distribution) in a 34-year-old male whilst performing the new world record in long-term downhill skiing. He napped only during the short ski lift rides for 11 days and nights. Results: After an initial period of complete sleep deprivation for 24 hours, total sleep time and the total times of non-REM and REM achieved during the lift rides returned to standard values on the second day. PSG data revealed an average sleep time per 24 hours of 6 hours and 6 minutes. During daylight sleep was rarely registered. The subject experienced only two minor falls without injury and immediately resumed skiing. Conclusion: In a healthy, trained, elite male athlete, sleep fragmentation over 11 consecutive days did not significantly impair the sleep, motor or cognitive skills required to perform a continuous downhill skiing world record after an initial adaptation phase.

scholarly journals 1197 Utility of Fitbit Charge 2 for Sleep Monitoring in Patients With Obstructive Sleep Apnea

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A458-A458
Author(s):  
D Kim ◽  
W Shin ◽  
J Byun
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Total Sleep Time ◽  
Sleep Stage ◽  
Sleep Time ◽  
Wearable Devices ◽  
Sleep Stages ◽  
Sleep Monitoring ◽  
Obstructive Sleep ◽  
Single Center Observational Study

Abstract Introduction The wearable device may be useful in monitoring sleep. Many studies reported reliable data in detecting sleep-wake states and sleep stage proportion in healthy adults, However, only a few validation studies were performed evaluating sleep using the wearable devices in patients with obstructive sleep apnea(OSA), which showed insufficient accuracy. We aimed to evaluate the reliability of multi-sensory wristband (Fitbit Charge 2) in patients with OSA. Methods This was a preliminary analysis of a prospective single-center observational study. Consecutive patients underwent standard Polysomnography (PSG) for evaluation of OSA with Fitbit Charge 2. Sleep data from PSG and Fitbit charge 2 were compared using paired t-tests and Bland-Altman plots. Results A total of eighty-six patients were analyzed. Four of them had poor data quality, 18 of them did not show sleep stages. Compared with the PSG, Fitbit Charge 2 showed higher total sleep time (419.1±194.0 vs 269.8±22.6, p<0.001) and sleep efficiency (95.8±2.5 vs 84.6±7.1, p<0.001). Those with sleep stage data showed higher sleep efficacy (87.7±5.5 vs 82.37.5, p=0.024) and a lower proportion of N1 sleep (33.7±19.9 vs 65.3±38.8, p=0.01). Conclusion Fitbit Charge 2 showed limited utility in monitoring sleep in patients with obstructive sleep apnea. Support none

Sleep-Related Deglutition in Children

2007 ◽  
Vol 116 (10) ◽  
pp. 747-753 ◽  
Author(s):  
Kiminori Sato ◽  
Tadashi Nakashima
Keyword(s):  
Rem Sleep ◽  
Total Sleep Time ◽  
Sleep Stage ◽  
Sleep Time ◽  
Vital Function ◽  
Stage 4 ◽  
Stage 2 Sleep ◽  
Normal Human ◽  
The Mean ◽  
Stage 1

Objectives: Clearance of the pharynx by deglutition is important in protecting the airway. The pattern of deglutition during sleep was investigated in children. Methods: Ten normal human children (8.6 ± 2.9 years) were examined via time-matched recordings of polysomnography and of surface electromyography (EMG) of the thyrohyoid and suprahyoid muscles. Results: During sleep, deglutition was episodic, and it was absent for long periods. The mean number of swallows per hour (±SD) during the total sleep time was 2.8 ± 1.7 per hour. The mean period of the longest absence of deglutition was 59.7 ± 20.3 minutes. Most deglutition occurred in association with spontaneous electroencephalographic arousal in rapid eye movement (REM) and non-REM sleep. Deglutition was related to sleep stage. The mean number of swallows per hour was 27.4 ± 27.4 during stage 1 sleep, 3.1 ± 3.5 during stage 2 sleep, 2.8 ± 3.3 during stage 3 sleep, and 0.9 ± 0.8 during stage 4 sleep. The deeper the sleep stage became, the lower the mean deglutition frequency became. The mean number of swallows per hour was 2.2 ± 2.1 during REM sleep. The EMG amplitude dropped to the lowest level of recording during REM sleep. Conclusions: Deglutition, a vital function, is infrequent during sleep in children.

398 Agreement and reliability of a new respiratory event and arousal detection algorithm against multiple human scorers

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A158-A158
Author(s):  
Ulysses Magalang ◽  
Brendan Keenan ◽  
Bethany Staley ◽  
Marco Ross ◽  
Peter Anderer ◽  
...  
Keyword(s):  
Event Detection ◽  
Intraclass Correlation ◽  
Detection Algorithm ◽  
Apnea Hypopnea Index ◽  
Limits Of Agreement ◽  
Arousal Index ◽  
Original Dataset ◽  
Respiratory Event ◽  
Central Apneas ◽  
Good Agreement

Abstract Introduction Scoring algorithms have the potential to increase polysomnography (PSG) scoring efficiency while also ensuring consistency and reproducibility. We sought to validate an updated event detection algorithm (Somnolyzer; Philips, Monroeville PA USA) against manual scoring, by analyzing a dataset we have previously used to report scoring variability across nine center-members of the Sleep Apnea Global Interdisciplinary Consortium (SAGIC). Methods Fifteen PSGs collected at a single sleep clinic were scored independently by technologists at nine SAGIC centers located in six countries, and auto-scored with the algorithm. Arousals, apneas, and hypopneas were identified according to the American Academy of Sleep Medicine recommended criteria. We calculated the intraclass correlation coefficient (ICC) and performed a Bland-Altman analysis comparing the average manual- and auto-scored apnea-hypopnea index (AHI), arousal index (ArI), apneas, obstructive apneas, central apneas, mixed apneas, and hypopneas. We hypothesized that the values from auto-scoring would show good agreement and reliability when compared to the average across manual scorers. Results Participants contributing to the original dataset had a mean (SD) age of 47 (12) years, AHI of 24.7 (18.2) events/hour, and 80% were male. The ICCs (95% confidence interval) between average manual- and auto-scoring were almost perfect (ICC=0.80–1.00) for AHI [0.989 (0.968, 0.996)], ArI [0.897 (0.729, 0.964)], hypopneas [0.992 (0.978, 0.997)], total apneas [0.973 (0.924, 0.991)], and obstructive apneas [0.919 (0.781, 0.972)], and moderately reliable (ICC=0.40–0.60] for central [0.537 (0.069, 0.815)] and mixed [0.502 (0.021, 0.798)] apneas. Similarly, Bland-Altman analyses supported good agreement for event detection between techniques, with a mean difference (limits of agreement) of only 1.45 (-3.22, 6.12) events/hour for AHI, total apneas 5.2 (-23.9, 34.3), obstructive apneas 1.8 (-45.9, 49.5), central apneas 1.8 (-9.7, 13.4), mixed apneas 1.6 (-14.8, 17.9), and hypopneas 4.3 (-12.4, 20.9). Conclusion Results support almost perfect reliability between auto-scoring and manual scoring of AHI, ArI, hypopneas, total apneas, and obstructive apneas, as well as moderate reliability for central and mixed apneas. There was good agreement between methods, with small mean differences; wider limits of agreement for specific type of apneas did not affect accuracy of the overall AHI. Thus, the auto-scoring algorithm appears reliable for event detection. Support (if any) Philips

scholarly journals Evaluating Sleep Characteristics in Intensive Care Unit and Non-Intensive Care Unit Physicians

2011 ◽  
Vol 39 (6) ◽  
pp. 1071-1075 ◽  
Author(s):  
G. Ok ◽  
H. Yilmaz ◽  
D. Tok ◽  
K. Erbüyün ◽  
S. Çoban ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Shift Work ◽  
Pittsburgh Sleep Quality Index ◽  
Sleep Latency ◽  
Total Sleep Time ◽  
Total Activity ◽  
Sleep Time ◽  
Sleep Parameters ◽  
Icu Physicians

Healthcare workers’ cognitive performances and alertness are highly vulnerable to sleep loss and circadian rhythms. The purpose of this study was to investigate the changes in sleep characteristics of intensive care unit (ICU) and non-ICU physicians. Actigraphic sleep parameters, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Hamilton Depression Rating Scale were evaluated for ICU and non-ICU physicians on the day before shift-work and on three consecutive days after shift-work. Total sleep time, sleep latency, wakefulness after sleep onset, total activity score, movement fragmentation index, sleep efficiency, daytime naps and total nap duration were also calculated by actigraph. In the ICU physicians, the mean Pittsburgh Sleep Quality Index score was significantly higher than the non-ICU physicians (P=0.001), however mean Epworth Sleepiness Scale scores were not found significantly different between the two groups. None of the scores for objective sleep parameters were statistically different between the groups when evaluated before and after shift-work (P >0.05). However in both ICU and non-ICU physicians, sleep latency was observed to be decreased within the three consecutive-day period after shift-work with respect to basal values (P <0.001). Total sleep time, total activity score and sleep efficiency scores prior to shift-work were significantly different from shift-work and the three consecutive-days after shift-work, in both groups. Working in the ICU does not have an impact on objective sleep characteristics of physicians in this study. Large cohort studies are required to determine long-term health concerns of shift-working physicians.

scholarly journals Tasimelteon safely and effectively improves sleep in Smith–Magenis syndrome: a double-blind randomized trial followed by an open-label extension

2021 ◽  
Author(s):  
Christos M. Polymeropoulos ◽  
Justin Brooks ◽  
Emily L. Czeisler ◽  
Michaela A. Fisher ◽  
Mary M. Gibson ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Crossover Study ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Open Label ◽  
Double Blind ◽  
Open Label Study ◽  
Label Study ◽  
Sleep Complaints ◽  
Open Label Extension

Abstract Purpose To assess the efficacy of tasimelteon to improve sleep in Smith–Magenis syndrome (SMS). Methods A 9-week, double-blind, randomized, two-period crossover study was conducted at four US clinical centers. Genetically confirmed patients with SMS, aged 3 to 39, with sleep complaints participated in the study. Patients were assigned to treatment with tasimelteon or placebo in a 4-week crossover study with a 1-week washout between treatments. Eligible patients participated in an open-label study and were followed for >3 months. Results Improvement of sleep quality (DDSQ50) and total sleep time (DDTST50) on the worst 50% of nights were primary endpoints. Secondary measures included actigraphy and behavioral parameters. Over three years, 52 patients were screened, and 25 patients completed the randomized portion of the study. DDSQ50 significantly improved over placebo (0.4, p = 0.0139), and DDTST50 also improved (18.5 minutes, p = 0.0556). Average sleep quality (0.3, p = 0.0155) and actigraphy-based total sleep time (21.1 minutes, p = 0.0134) improved significantly, consistent with the primary outcomes. Patients treated for ≥90 days in the open-label study showed persistent efficacy. Adverse events were similar between placebo and tasimelteon. Conclusion Tasimelteon safely and effectively improved sleep in SMS.

scholarly journals Is there a relationship between the overhead press and split jerk maximum performance? Influence of sex

2021 ◽  
pp. 174795412110204
Author(s):  
Marcos A Soriano ◽  
G Gregory Haff ◽  
Paul Comfort ◽  
Francisco J Amaro-Gahete ◽  
Antonio Torres-González ◽  
...  
Keyword(s):  
Confidence Intervals ◽  
Body Mass ◽  
Upper Limb ◽  
High Reliability ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Training Experience ◽  
Maximum Performance ◽  
Repetition Maximum ◽  
Intraclass Correlation Coefficients

The aims of this study were to (I) determine the differences and relationship between the overhead press and split jerk performance in athletes involved in weightlifting training, and (II) explore the magnitude of these differences in one-repetition maximum (1RM) performances between sexes. Sixty-one men (age: 30.4 ± 6.7 years; height: 1.8 ± 0.5 m; body mass 82.5 ± 8.5 kg; weightlifting training experience: 3.7 ± 3.5 yrs) and 21 women (age: 29.5 ± 5.2 yrs; height: 1.7 ± 0.5 m; body mass: 62.6 ± 5.7 kg; weightlifting training experience: 3.0 ± 1.5 yrs) participated. The 1RM performance of the overhead press and split jerk were assessed for all participants, with the overhead press assessed on two occasions to determine between-session reliability. The intraclass correlation coefficients (ICC) and 95% confidence intervals showed a high reliability for the overhead press ICC = 0.98 (0.97 – 0.99). A very strong correlation and significant differences were found between the overhead press and split jerk 1RM performances for all participants (r = 0.90 [0.93 – 0.85], 60.2 ± 18.3 kg, 95.7 ± 29.3 kg, p ≤ 0.001). Men demonstrated stronger correlations between the overhead press and split jerk 1RM performances (r = 0.83 [0.73-0.90], p ≤ 0.001) compared with women (r = 0.56 [0.17-0.80], p = 0.008). These results provide evidence that 1RM performance of the overhead press and split jerk performance are highly related, highlighting the importance of upper-limb strength in the split jerk maximum performance.

scholarly journals Gender differences in BaYaka forager sleep-wake patterns in forest and village contexts

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Erica Kilius ◽  
David R. Samson ◽  
Sheina Lew-Levy ◽  
Mallika S. Sarma ◽  
Ujas A. Patel ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Small Scale ◽  
Cultural Variation ◽  
Sleep Patterns ◽  
Economic Activities ◽  
Mixed Effect ◽  
Wake Patterns ◽  
The Republic

AbstractSleep studies in small-scale subsistence societies have broadened our understanding of cross-cultural sleep patterns, revealing the flexibility of human sleep. We examined sleep biology among BaYaka foragers from the Republic of Congo who move between environmentally similar but socio-ecologically distinct locations to access seasonal resources. We analyzed the sleep–wake patterns of 51 individuals as they resided in a village location (n = 39) and a forest camp (n = 23) (362 nights total). Overall, BaYaka exhibited high sleep fragmentation (50.5) and short total sleep time (5.94 h), suggestive of segmented sleep patterns. Sleep duration did not differ between locations, although poorer sleep quality was exhibited in the village. Linear mixed effect models demonstrated that women’s sleep differed significantly from men’s in the forest, with longer total sleep time (β ± SE =  − 0.22 ± 0.09, confidence interval (CI) = [− 0.4, − 0.03]), and higher sleep quality (efficiency; β ± SE =  − 0.24 ± 0.09, CI = [− 0.42, − 0.05]). These findings may be due to gender-specific social and economic activities. Circadian rhythms were consistent between locations, with women exhibiting stronger circadian stability. We highlight the importance of considering intra-cultural variation in sleep–wake patterns when taking sleep research into the field.

scholarly journals The feasibility and reliability of actigraphy to monitor sleep in intensive care patients: an observational study

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
L. J. Delaney ◽  
E. Litton ◽  
K. L. Melehan ◽  
H.-C. C. Huang ◽  
V. Lopez ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Moderate Level ◽  
Sleep Monitoring ◽  
Clinical Trial Registration ◽  
Wake Time ◽  
Intensive Care Patients

Abstract Background Sleep amongst intensive care patients is reduced and highly fragmented which may adversely impact on recovery. The current challenge for Intensive Care clinicians is identifying feasible and accurate assessments of sleep that can be widely implemented. The objective of this study was to investigate the feasibility and reliability of a minimally invasive sleep monitoring technique compared to the gold standard, polysomnography, for sleep monitoring. Methods Prospective observational study employing a within subject design in adult patients admitted to an Intensive Care Unit. Sleep monitoring was undertaken amongst minimally sedated patients via concurrent polysomnography and actigraphy monitoring over a 24-h duration to assess agreement between the two methods; total sleep time and wake time. Results We recruited 80 patients who were mechanically ventilated (24%) and non-ventilated (76%) within the intensive care unit. Sleep was found to be highly fragmented, composed of numerous sleep bouts and characterized by abnormal sleep architecture. Actigraphy was found to have a moderate level of overall agreement in identifying sleep and wake states with polysomnography (69.4%; K = 0.386, p < 0.05) in an epoch by epoch analysis, with a moderate level of sensitivity (65.5%) and specificity (76.1%). Monitoring accuracy via actigraphy was improved amongst non-ventilated patients (specificity 83.7%; sensitivity 56.7%). Actigraphy was found to have a moderate correlation with polysomnography reported total sleep time (r = 0.359, p < 0.05) and wakefulness (r = 0.371, p < 0.05). Bland–Altman plots indicated that sleep was underestimated by actigraphy, with wakeful states overestimated. Conclusions Actigraphy was easy and safe to use, provided moderate level of agreement with polysomnography in distinguishing between sleep and wakeful states, and may be a reasonable alternative to measure sleep in intensive care patients. Clinical Trial Registration number ACTRN12615000945527 (Registered 9/9/2015).

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