scholarly journals Sleep disturbances in patients with Addison's disease

2003 ◽  
Vol 148 (4) ◽  
pp. 449-456 ◽  
Author(s):  
K Lovas ◽  
ES Husebye ◽  
F Holsten ◽  
B Bjorvatn
Keyword(s):  
Sleep Disturbances ◽  
Sleep Onset ◽  
Addison’S Disease ◽  
Early Morning ◽  
Addison's Disease ◽  
Sleep Onset Latency ◽  
Onset Latency ◽  
Sleep Diaries ◽  
Falling Asleep ◽  
Pituitary Adrenal Axis

OBJECTIVE: The standard replacement therapy in Addison's disease does not restore normal nocturnal levels of the hormones of the hypothalamic-pituitary-adrenal axis. The aim of the study was to describe the prevalence and characteristics of sleep disturbances in patients with Addison's disease. METHODS: Sixty patients completed a self-administered sleep questionnaire and the Epworth Sleepiness Scale (ESS) questionnaire. Activity-based monitoring (actigraph recordings) and sleep diaries were obtained from eight patients. RESULTS: Thirty-four percent reported weekly sleep disturbances (difficulties falling asleep in 13%; repeated awakenings in 14%; early morning awakenings in 20%). The sleep need was 8.21 h (s.d. 1.34; range 6-14 h), and sleep onset latency was 29 min (s.d. 29, range 2-150 min). Forty percent of the patients were tired during daily activities more than once a week, but the scores of the ESS were 6.0 (s.d. 3.5), which is not higher than normal. The actigraph recordings showed higher sleep efficiency than the subjective recordings. CONCLUSION: We did not identify specific sleep disturbances which were characteristic for patients with Addison's disease. Patients with Addison's disease have increased daytime fatigue, but no more daytime sleepiness than normal.

scholarly journals 0916 The Use of Immersive Virtual Reality and Slow Breathing to Enhance Relaxation and Sleep in Adolescents

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A348-A348
Author(s):  
D Yüksel ◽  
A Goldstone ◽  
D Prouty ◽  
M Forouzanfar ◽  
S Claudatos ◽  
...  
Keyword(s):  
Heart Rate ◽  
Virtual Reality ◽  
Sleep Disturbances ◽  
Sleep Onset ◽  
Apparent Difference ◽  
Sleep Onset Latency ◽  
Onset Latency ◽  
Post Intervention ◽  
Falling Asleep ◽  
Slow Breathing

Abstract Introduction Sleep disturbances frequently emerge during adolescence amongst profound, normative, sleep maturation and biopsychosocial changes. Factors like stress, worry or rumination may make falling asleep and maintaining sleep more difficult. Here, we evaluate the efficacy of a novel intervention based on virtual reality (VR) and slow breathing to promote bedtime relaxation and facilitate sleep in high-school adolescents. Methods Twenty-nine 16-18 year-old adolescents with (N=9, 6 girls) and without (N=20, 11 girls) sleep difficulties underwent two counterbalanced in-lab relaxation and baseline polysomnography (PSG) nights. For the relaxation condition, immediately preceding bedtime, participants were engaged in slow diaphragmatic breathing (to promote physiological downregulation) whilst passively experiencing a relaxation immersive VR environment, designed to promote cognitive relaxation/distraction (20min). On the baseline night, participants engaged in quiet activities (e.g., reading a book) before bedtime (20min). Results The VR intervention resulted in a significant immediate increase in perceived relaxation and reduced worry (p<0.05). Also, heart rate dropped (~5bpm) in the pre-to-post intervention (p<0.05), while no significant change in heart rate was evident before and after the time spent in quiet activities on the baseline night. PSG-defined sleep onset latency was shorter (~6min reduction) and sleep efficiency was greater (~3% increase) on the VR relaxation night compared to the baseline night (p<0.05). In addition, baseline sleep onset latency was related to the magnitude of the baseline-to-relaxation reduction in sleep onset latency in participants (R2=0.70; p<0.01). There was no apparent difference in responses to the VR intervention between adolescents with or without insomnia. Conclusion Our data highlight the potential for combining cognitive relaxation/distraction strategies, using immersive VR technology and physiological downregulation, to promote bedtime relaxation and improve overall sleep quality in adolescents. Further research is needed to evaluate the feasibility and effectiveness of such interventions over time. Support National Heart, Lung and Blood Institute (NHLBI) R01HL139652 (to MdZ)

scholarly journals 1253 Multiple sleep onset REM episodes in middle age woman with excessive daytime sleepiness – Is this automatically assumed narcolepsy?

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A477-A477
Author(s):  
Kamal Patel ◽  
Bianca J Lang
Keyword(s):  
Daytime Sleepiness ◽  
Sleep Latency ◽  
Sleep Onset ◽  
Sleep Time ◽  
Multiple Sleep Latency Test ◽  
Sleep Onset Latency ◽  
Onset Latency ◽  
Obstructive Sleep ◽  
Falling Asleep ◽  
Multiple Sleep Latency

Abstract Introduction Presence of sleep onset REM episodes often raises concerns of narcolepsy. However other conditions have shown to have presence of sleep on REM episodes which include but not limited to obstructive sleep apnea, sleep wake schedule disturbance, alcoholism, neurodegenerative disorders, depression and anxiety Report of Case Here we present a case of 30 year old female with history of asthma, patent foraman ovale, migraine headache, and anxiety who presented with daytime sleepiness, falling asleep while at work, occasional scheduled naps, non-restorative sleep, sleep paralysis, and hypnopompic hallucination. Pertinent physical exam included; mallampati score of 4/4, retrognathia, high arched hard palate, crowded posterior oropharynx. She had a score of 16 on Epworth sleepiness scale. Patient previously had multiple sleep latency test at outside facility which revealed 4/5 SOREM, with mean sleep onset latency of 11.5 minutes. She however was diagnosed with narcolepsy and tried on modafinil which she failed to tolerate. She was tried on sertraline as well which was discontinued due to lack of benefit. She had repeat multiple sleep latency test work up which revealed 2/5 SOREM, with mean sleep onset latency was 13.1 minutes. Her overnight polysomnogram prior to repeat MSLT showed SOREM with sleep onset latency of 10 minutes. Actigraphy showed consistent sleep pattern overall with sufficient sleep time but was taking hydroxyzine and herbal medication. Patient did not meet criteria for hypersomnolence disorder and sleep disordered breathing. Conclusion There is possibility her medication may have played pivotal role with her daytime symptoms. We also emphasize SOREMs can be present in other disorders such as anxiety in this case and not solely in narcolepsy

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

2020 ◽  
Author(s):  
Danica C Slavish ◽  
Justin Asbee ◽  
Kirti Veeramachaneni ◽  
Brett A Messman ◽  
Bella Scott ◽  
...  
Keyword(s):  
Sleep Disturbances ◽  
Multilevel Models ◽  
Single Channel ◽  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Diary ◽  
Sleep Onset Latency ◽  
Daily Stress ◽  
Sleep Diaries ◽  
Sleep Measurement

Abstract Background Disturbed sleep can be a cause and a consequence of elevated stress. Yet intensive longitudinal studies have revealed that sleep assessed via diaries and actigraphy is inconsistently associated with daily stress. Purpose We expanded this research by examining daily associations between sleep and stress using a threefold approach to assess sleep: sleep diaries, actigraphy, and ambulatory single-channel electroencephalography (EEG). Methods Participants were 80 adults (mean age = 32.65 years, 63% female) who completed 7 days of stressor and sleep assessments. Multilevel models were used to examine bidirectional associations between occurrence and severity of daily stress with diary-, actigraphy-, and EEG-determined sleep parameters (e.g., total sleep time [TST], sleep efficiency, and sleep onset latency, and wake after sleep onset [WASO]). Results Participants reported at least one stressor 37% of days. Days with a stressor were associated with a 14.4-min reduction in actigraphy-determined TST (β = −0.24, p = 0.030), but not with other actigraphy, diary, or EEG sleep measures. Nights with greater sleep diary-determined WASO were associated with greater next-day stressor severity (β = 0.01, p = 0.026); no other diary, actigraphy, or EEG sleep measures were associated with next-day stressor occurrence or severity. Conclusions 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 the 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.

Abstract P359: Difficulty Falling Asleep is Predictive of Metabolic Syndrome

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Megan E Petrov ◽  
Alex J Zautra ◽  
Nicole Hoffmann ◽  
Mary C Davis
Keyword(s):  
Metabolic Syndrome ◽  
Healthy Aging ◽  
Smoking Status ◽  
Sleep Onset ◽  
Community Dwelling ◽  
Moderate Physical Activity ◽  
Sleep Onset Latency ◽  
Onset Latency ◽  
Falling Asleep ◽  
Insomnia Symptoms

Introduction: Insomnia symptoms are associated with cardiovascular disease and multiple metabolic syndrome components, yet few studies have investigated their association with metabolic syndrome. Hypothesis: Insomnia symptoms will be significantly associated with prevalent metabolic syndrome. Methods: Middle-aged, community-dwelling adults, ages 40-65 yrs, were recruited to participate in a study on healthy aging. All participants completed questionnaires on demographics, medical history, and sleep patterns in the past month including estimated sleep-onset latency, frequency of difficulty falling asleep, and severity of difficulty falling asleep, difficulty maintaining sleep, and early morning awakenings. Measurements for metabolic syndrome were collected at a home health visit. All metabolic syndrome criteria consisting of waist circumference, triglyceride level, HDL cholesterol level, blood pressure, and fasting glucose were identified using the American Heart Association definitions. Participants with three or more positive criteria were considered to have metabolic syndrome. Of a total sample of 770 individuals, 557 participants who did not have a history of cardiovascular events (n = 62), and had complete sleep and metabolic syndrome data were included in the analysis. We conducted logistic regression models predicting presence of metabolic syndrome from the sleep measures adjusting for age, sex, race, education level, smoking status, alcohol consumption, moderate physical activity minutes per week, and current major depression diagnosis. Results: Metabolic syndrome was prevalent in 24.2% of the sample (n = 135). Sleep onset latency of greater than 30 minutes and difficulty falling asleep three or more nights per week were significantly related to metabolic syndrome, but no other insomnia symptoms were related (see Table). Conclusions: Difficulty falling asleep, a marker of physiological and emotional hyperarousal, may be a modifiable risk factor for metabolic syndrome.

scholarly journals 0007 Daytime Sleep in Night Shift Workers: Quantifying the Role of Circadian Misalignment

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A3-A3
Author(s):  
E Mann ◽  
C Sagong ◽  
A Cuamatzi Castelan ◽  
M Singh ◽  
T Roth ◽  
...  
Keyword(s):  
Sleep Duration ◽  
Sleep Disturbances ◽  
Night Shift ◽  
Sleep Onset ◽  
Sleep Onset Latency ◽  
Shift Workers ◽  
Circadian Misalignment ◽  
Daytime Sleep ◽  
Falling Asleep ◽  
Dim Light

Abstract Introduction Circadian misalignment is commonly cited as a culprit of daytime sleep disturbances in night shift workers; however, the specific impact and magnitude that circadian misalignment has on daytime sleep has not been well-characterized in larger samples of night shift workers. Methods Participants included fixed-night shift workers (n=52, ages 18–50) who completed an 8-hour daytime polysomnography (PSG) in the lab following a night shift. Measures of sleep disturbances included: difficulty falling asleep (sleep onset latency [SOL], latency to persistent sleep [LPS]), difficulty staying asleep (sleep efficiency [SE], wake after sleep onset [WASO]), and sleep duration (total sleep time [TST]). Melatonin samples were collected hourly for 24 hours under dim light (<10 lux) and used to determine dim light melatonin offset (DLMOff). Circadian misalignment (CM) was calculated as the time difference between bedtime and DLMOff (higher values represented sleeping after DLMOff), and correlated with PSG sleep variables. Results CM was significantly associated with difficulty staying asleep (WASO: r=0.48, p<0.001; SE: r=-0.45, p<0.001), and sleep duration (TST: r=-0.38, p<0.01). Specifically, every 3 hours of CM on average added 19.2 minutes of WASO and reduced TST by 15 minutes. In contrast, CM was not significantly correlated with sleep onset difficulties (SOL: r=-0.27; LPS: r=-0.02). Conclusion These data suggest that circadian misalignment in shift workers may be a better predictor of difficulties staying asleep and sleep duration during the day relative to difficulties falling asleep. Because longer work hours (10–12 hours) are common in night shift worker, it may be that sleep initiation difficulties associated with circadian misalignment is masked by elevated fatigue or an increased homeostatic drive from prolonged wakefulness. These results may help guide decisions about the magnitude of phase shifts required (e.g., with light therapy) for the desired improvement in daytime sleep. Support Support for this study was provided to PC by the NHLBI (K23HL138166)

scholarly journals Yesterday’s Work–Home Conflict and Actigraphically Recorded Sleep-Onset Latency as Predictors of Today’s Cognitive Failure

2021 ◽  
Author(s):  
Maria Undine Kottwitz ◽  
Wilken Wehrt ◽  
Christin Gerhardt ◽  
Diana Augusto Coelho ◽  
Damian Schmutz ◽  
...  
Keyword(s):  
Cognitive Functioning ◽  
Occupational Safety ◽  
Sleep Onset ◽  
Sleep Onset Latency ◽  
Onset Latency ◽  
Saturday Morning ◽  
Sleep Quantity ◽  
Cognitive Failures ◽  
Falling Asleep ◽  
Working Day

AbstractCognitive failures are errors in routine action regulation that increase with higher mental demands. In particular, in occupations where guidance such as teaching or supervision is essential, cognitive failures harm one’s performance and also negatively impact knowledge transfer. The aim of this study is to investigate yesterday’s work–home conflict (WHC) and objectively assessed sleep-onset latency as antecedents of a next-day increase in cognitive failures. Fifty-three teachers were assessed during a working week, in the morning, after work, and in the evening on each working day, as well as on Saturday morning. Sleep-onset latency was assessed with ambulatory actimetry. The multi-level analyses showed both WHC and sleep-onset latency predict cognitive failures the next working day (controlling for cognitive failures from the previous day, sleep quantity, and leisure time rumination until falling asleep). However, there was no association between yesterday’s WHCs and the nightly sleep-onset latency. Thus, nightly sleep-onset latency did not mediate the effects of yesterday’s WHCs on today’s cognitive failures. Our results highlight the importance of sleep and a good work–life balance for daily cognitive functioning. In order to promote the cognitive functioning of employees as well as occupational safety, good working conditions and recovery should both be considered.

579 Child Sleep Onset Latency Mediates Parental Depression and Non-Compliance in Children with Autism Spectrum Disorder

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A228-A228
Author(s):  
Melanie Stearns ◽  
Braden Hayse ◽  
Neetu Nair ◽  
Micah Mazurek ◽  
Ashley Curtis ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Sleep Onset ◽  
Children With Autism ◽  
Parental Depression ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Sleep Onset Latency ◽  
Onset Latency ◽  
Child Sleep ◽  
Falling Asleep

Abstract Introduction Parents who have been diagnosed with depression often report that their children are not compliant and have difficulty falling asleep. Parents with depression are less likely to be consistent or enforce bedtimes resulting in the child having less bedtime rules and getting less sleep. Overtime this may mean the child develops poor sleep habits and difficulty falling asleep. Although these relationships have yet to be studied in children with Autism Spectrum Disorder (ASD), it is an important area given the high prevalence of children with ASD who have sleep difficulties. The current study examined whether parent-reported child sleep onset latency mediated the relationship between parental depression and child non-compliance. Methods The sample (N=50) consisted of parents (81% female) reporting on their children aged 6–12 (M=8.63, SD = 2.00; 76% male). All children were diagnosed with ASD and had parent reported sleep complaints. Children and their parents were recruited because they expressed interest in a behavioral treatment sleep study and these data come from the baseline data collection associated with that study. Measures included sleep onset latency on the Child Sleep Health Questionnaire (CSHQ), an item on the Pediatric Symptom Checklist (PSC) which asked if a child follows rules, and a question asking if the parent had been diagnosed with depression. Results Analyses were conducting using AMOS 27.0. Slightly less than half (45%) of parents reported having been diagnosed with depression. Parent-reported child sleep onset latency significantly mediated (β =.13) the relation between parental depression and non-compliance. Parents who had been diagnosed with depression were associated with greater child sleep onset latency (β =.32, p = .04) and greater child sleep onset latency was associated with greater non-compliance (β =.40, p = .01). The direct effect between parental depression and non-compliance was not significant. Conclusion These results suggest that difficulty falling asleep may help to explain why children of parents who have depression are not compliant. Future research should utilize longitudinal and experimental methodology to determine the causality of these relationships. Support (if any) University of Missouri Research Board Grant (McCrae, PI); United States Department of Defense USAMRAA Autism Research Program (McCrae, PI; CTA AR190047).

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 1071 Subjective Measures Of Hyperarousal Predict Subjective Longitudinal And Retrospective Measures Of Sleep Quality In Individuals Exposed To Trauma

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A408-A408
Author(s):  
A Kram Mendelsohn ◽  
C Daffre ◽  
K I Oliver ◽  
J Seo ◽  
N B Lasko ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Sleep Disturbances ◽  
Traumatic Event ◽  
Behavioral Therapy ◽  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Onset Latency ◽  
Wake Time ◽  
Sleep Diaries ◽  
Dsm 5

Abstract Introduction Hyperarousal and disturbed sleep are intrinsic symptoms of posttraumatic stress disorder (PTSD). We explored whether self-reported indices of hyperarousal predict longitudinally measured objective, subjective, and retrospective evaluations of sleep quality in trauma-exposed individuals. Methods Individuals exposed to a DSM-5 PTSD Criterion-A traumatic event within the past two years (N=130, 91 females), aged 18-40 (mean 24.43, SD 5.30), 51.54% of whom met DSM-5 criteria for PTSD, completed 14 days of actigraphy and sleep diaries. Participants also completed the PTSD Checklist for DSM-5 (PCL-5), the Clinician-Administered PTSD Scale (CAPS-5), published Hyperarousal (HAS) and Hypervigilance (HVQ) scales, and the Pittsburgh Sleep Quality Index (PSQI) (N=108-125 for different scales). Mean total sleep time (TST), sleep onset latency (SOL), sleep efficiency (SE) and sleep midpoint were calculated from actigraphy and subjective SOL, SE, number of awakenings, and time spent awake from diaries. Simple regressions were used to predict associations of the PCL-5, HAS, and HVQ scores with measures of sleep quality. Results Hyperarousal indices predicted diary but not actigraphy measures of sleep quality. Longer diary-reported SOL was predicted by higher scores for: PCL-5 total score (R=0.290, p=0.001), PCL-5 hyperarousal items without the sleep item (R=0.261, p=0.004), and HAS without sleep items (R=0.220, p=0.016). Diary-reported number of awakenings and wake time after sleep onset were predicted by higher HAS scores without the sleep question: (R=0.373, p<0.001; r=0.352, p<0.001). Similarly, all hyperarousal indices significantly predicted PSQI global score (PCL-5: R=0.482, p<0.001; PCL-5 hyperarousal: R=0.389, p<0.001; HVQ: R=0.214, p=0.017; HAS without sleep question: R=0.415, p<0.001). Conclusion Self-reported hyperarousal measures predict subjective longitudinal (especially SOL) and retrospective measures, but not objective measurements of sleep quality. Similar discrepancies between self-reported and objective measures of sleep quality have been reported in patients with insomnia disorder. Cognitive-behavioral therapy for insomnia may be especially effective in treating post-traumatic sleep disturbances. Support R01MH109638

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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