scholarly journals A direct comparison of wrist actigraphy and sleep diaries in measuring sleep in healthy adults.

2021 ◽  
Author(s):  
Zainab Alyobi ◽  
Susan M Sherman
Keyword(s):  
Sleep Time ◽  
Sleep Diary ◽  
Monitoring Tool ◽  
Sleep Study ◽  
Sleep Diaries ◽  
Wrist Actigraphy ◽  
Significant Difference ◽  
Sleep Measurement ◽  
The Mean ◽  
Day By Day

Measuring sleep and sleep quality is an important diagnostic and monitoring tool, and a number of different methods for measurement have been developed over the last half-century. Two prevalent methods include wrist actigraphy and sleep diaries. Both methods can be applied in different circumstances, but both have strengths and weaknesses. This study aimed to identify the extent to which there is congruence in the scores achieved by each method of sleep measurement. Sixty-eight respondents were asked to wear a wrist actigraphy and complete a sleep diary over the course of five days. There was a significant difference between the mean scores achieved using each measurement method, with actigraphy scores indicating lower total sleep time (TST) than diaries. However, this difference was not consistently present when the scores were compared on a day by day basis. Participant adherence is likely to fluctuate over the course of a sleep study and may undermine the accuracy of sleep diaries.

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.

346 Semi-Individualized Acupuncture for Insomnia Disorder: A Randomized Sham-Controlled Trial

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A138-A138
Author(s):  
Jerry Wing-Fai Yeung ◽  
Branda Yee-Man Yu ◽  
John Yuen ◽  
Janice Ho ◽  
Ka-Fai Chung ◽  
...  
Keyword(s):  
Total Sleep Time ◽  
Sleep Time ◽  
Sleep Diary ◽  
Linear Mixed Effect Model ◽  
Mixed Effect ◽  
Insomnia Symptom ◽  
Insomnia Disorder ◽  
Wrist Actigraphy ◽  
Significant Difference ◽  
Sleep Parameters

Abstract Introduction Acupuncture is an alternative treatment for improving sleep quality and the effectiveness is thought to be optimized with an individualized approach resembling real practice. However, existing evidence is limited by methodological shortcomings due to blinding issues, standardized measures, and diagnostic procedures. It was of the present study’s interest to examine the efficacy and safety of semi-individualized acupuncture treatment on insomnia. Methods Adults with DSM-5 insomnia disorder (n = 140) were randomized with 1:1 allocation to a 4-week intervention traditional acupuncture (TA) or validated non-invasive sham acupuncture (SA). The selection of acupoints was semi-individualized by the acupuncturist. As the primary outcome, the sleep efficiency (SE) by sleep diary was assessed at baseline, 1-week posttreatment, and 5-week posttreatment. Other sleep parameters derived from sleep diary, the wrist-actigraphy-derived sleep parameters, insomnia symptom severity, anxiety, and depressive symptoms, as well as the health-related quality of life, were also evaluated. Results Although linear mixed-effect model revealed both groups did not attain significant difference in sleep-diary-derived SE and other outcome measures (all P > 0.05), TA promising effect on improving insomnia symptom (within-group effect size, d = 1.13 & 1.30 at 1-week & 5-week posttreatment respectively) and also a higher proportion of subjects achieved SE ≥ 85% compared with SA (55.6% versus 36.4% at week 9, P = 0.03). Besides, subjects in TA group reported significantly greater improvement in both the total sleep time (TST) derived from sleep diary and actigraph than those in the SA group at 1-week posttreatment (difference in mean changes from baseline: sleep diary = 22.0 min, p = 0.01; actigraphy =18.8 min, P = 0.02) but not 5-week posttreatment. Conclusion This study is the first to evaluate the effect of the TCM-theory-based individualized acupuncture on sleep using a sham-control design. A 4-week semi-individualized acupuncture is able to significantly increase total sleep time with few adverse events. Support (if any) Research Grants Council of Hong Kong, Early Career Scheme (Project no.: 25101017)

scholarly journals 0880 A Pilot Study Evaluating the Effect of Head Elevation During Sleep on Obstructive Sleep Apnea in Pre-Pubertal Children with Down Syndrome

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A335-A335
Author(s):  
K Kaplan ◽  
D Spielberg ◽  
L Petitto ◽  
M Musso ◽  
D Glaze
Keyword(s):  
Obstructive Sleep Apnea ◽  
Down Syndrome ◽  
Sleep Apnea ◽  
Pediatric Population ◽  
Sleep Time ◽  
Sleep Study ◽  
Children With Down Syndrome ◽  
Head Elevation ◽  
Obstructive Sleep ◽  
Significant Difference

Abstract Introduction Children with down syndrome are at high risk for developing obstructive sleep apnea when compared to typically developing children. Treatment of obstructive sleep apnea is complicated as these children often struggle with traditional therapies such as positive airway pressure. In adult populations it has been shown that head elevation is successful in reducing the severity of OSA (AHI). The hypothesis of this study is that head elevation (30°) would improve OSA in a cohort of pre-pubertal children with down syndrome. Methods Children with down syndrome, aged 4-13, presenting to the sleep clinic at Texas Children’s Hospital were screened for enrollment into the study (n=21; 11 male). Subjects were randomized to begin a diagnostic polysomnogram with either the head of the bed flat (0°) or elevated (30°). Head position was alternated every 2 hours during the study. Studies were performed in an AASM pediatric sleep center by a registered PSG technologist. Studies were scored using AASM pediatric scoring rules. Data was analyzed using paired student t-tests. Each subject served as their own control. Results There was no significant difference in AHI (p=0.71), RDI (p=0.7), O2 nadir (p=0.17), total sleep time (p=0.34), sleep efficiency (p=0.28), time in REM sleep (p=0.94) or arousal index (p=0.14) when the head of the bed was flat (0°) versus elevated (30°). The study shows that head elevation is not successful in significantly reducing obstructive sleep apnea in a pre-pubertal pediatric population of children with down syndrome. Conclusion In children with down syndrome, aged 4-13, referred for a diagnostic sleep study, there is no improvement in OSA due to head elevation (30°) when compared to sleeping flat (0°). These findings were independent of if the subject started with the head of the bed flat or elevated. Other cofounders were eliminated as each subject served as their own control. Support No external funding was utilized for this study.

scholarly journals Objective measurement of sleep by smartphone application: comparison with actigraphy and relation to self-reported sleep

2021 ◽  
Author(s):  
Taylor Maynard ◽  
Erica Appleman ◽  
Alice Cronin-Golomb ◽  
Sandy Neargarder
Keyword(s):  
Smartphone Application ◽  
Sleep Time ◽  
Community Dwelling ◽  
Sleep Efficiency ◽  
Ease Of Use ◽  
Self Report ◽  
Future Research ◽  
Sleep Diaries ◽  
Significant Difference ◽  
Self Report Data

Aim: Smartphone technology is increasingly used by the public to assess sleep. Specific features of some sleep-tracking applications are comparable to actigraphy in objectively monitoring sleep. The clinical utility of smartphone apps should be investigated further to increase access to convenient means of monitoring sleep. Methods: Smartphone and subjective sleep measures were administered to 29 community-dwelling healthy adults [aged 20-67, Mean (M) = 26.8; 18 women, 11 men], and actigraphy to 19 of them. Total sleep time (TST) and sleep efficiency were measured with actigraphy and the Sleep Time app (Azumio Inc.). Sleep diaries captured subjective TST and sleep efficiency, and the Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index provided self-report data. An exit questionnaire was administered to examine app feasibility and likelihood of future use. Results: The app significantly overestimated TST when compared to actigraphy. There was no significant difference in sleep efficiency between methodologies. There was also no significant difference between TST recorded through the app and through sleep diaries. Participants’ self-reported ease of use of the smartphone app positively correlated with likelihood of future use. Conclusions: Based on the current findings, future research is needed to investigate the utility and feasibility of multiple smartphone applications in monitoring sleep in healthy and clinical populations.

scholarly journals Sleep and affect in adolescents: bi-directional daily associations over 28 days’ ecological momentary assessment

2020 ◽  
Author(s):  
Lin Shen ◽  
Joshua F. Wiley ◽  
Bei Bei
Keyword(s):  
Individual Differences ◽  
Sleep Duration ◽  
Multilevel Models ◽  
Sleep Time ◽  
Self Report ◽  
Sleep Diary ◽  
High Arousal ◽  
Low Dimensions ◽  
Sleep Measurement ◽  
Ecological Momentary

Study Objectives: To examine bi-directional, temporal associations between daily sleep and affect under naturally constrained (school) and unconstrained (vacation) sleep opportunities, while simultaneously incorporating both valence (positive versus negative) and arousal (high versus low) dimensions of affect. Methods: Sleep and affect were measured over 2 weeks of school and 2 weeks of vacation in 205 adolescents (54.1% females, Mage=16.9 years), providing 5231 days of data. Total sleep time (TST) and sleep efficiency were measured using actigraphy and sleep diary. High- and low-arousal positive and negative affect (PA, NA) were self-reported each afternoon. Between- and within-person sleep-affect associations were tested using cross-lagged, multilevel models. Lagged outcome, day of the week, study day, and sociodemographics were controlled.Results: Bi-directional associations between self-report sleep and affect were found on the between-person level: longer self-report TST associated with lower high and low arousal NA. Higher high arousal PA associated with longer actigraphy TST between-persons, but predicted shorter same-night actigraphy TST within-persons. Results did not differ between school and vacation. Significant within-person random effects demonstrate individual differences in daily sleep-affect associations. Conclusions: Associations differed based on sleep measurement and affect dimensions, highlighting the complex relationship between sleep and affect. Strong between-person associations between self-report sleep and affect suggest that improving either sleep or mood may benefit the other. Although overall high arousal PA was protective of sleep duration, on a day-to-day basis, higher-than-usual high arousal PA may reduce sleep duration on nights it is experienced. Further research needs to identify causes of individual differences in sleep-affect associations.

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.

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 0694 Positive Airway Pressure Use In The Context Of Total Sleep Time

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A264-A265
Author(s):  
B Saconi ◽  
A J Watach ◽  
A M Sawyer
Keyword(s):  
Experimental Data ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Sleep Diary ◽  
Post Hoc Analysis ◽  
Obstructive Sleep ◽  
Wrist Actigraphy ◽  
Post Hoc

Abstract Introduction Positive airway pressure (PAP) adherence definitions are independent of total sleep time (TST). When PAP efficacy is examined by biophysiologic outcomes in adults with obstructive sleep apnea (OSA), sensitivity and specificity of the measurement of PAP adherence/non-adherence is important. Methods A post-hoc analysis of experimental data: 1) investigated agreement among concurrently-measured objective PAP use, objective and subjective TST; 2) assessed untreated TST among adherers and non-adherers defined by CMS PAP adherence criterion and separately by proportion of TST on PAP criteria (≥65%, ≥75%, ≥85%). Objective TST was measured with wrist actigraphy and concurrent sleep diary on the first five days of PAP use. Objective five day PAP use (hours/night) was abstracted from full record. Analyses included descriptive and exploratory correlations. Results PAP-naïve adults (n=36; 76% male, 84% white) were middle-aged (51±10 years), with severe OSA (median AHI 31.1 events/hr), mean PAP use (371.5±85.4 min), mean objective and subjective TST (417.5±50.6 min, 439.6±58.1 min, respectively) from a single sleep center. Objective TST was correlated with concurrent objective PAP use (r=0.46) and with subjective TST (r=0.78). Eight percent (39mins) of objective TST was untreated among CMS-defined adherers, and 54.1% (216.8mins) of TST was untreated among CMS-defined non-adherers. When TST-on-treatment criteria were imposed (≥65%, ≥75%, and ≥85%, respectively), the percentage of untreated TST decreased among adherers, 5.2% (23 min), 4.3% (19 min), 0% (0 min) and among non-adherers, 42.8% (168 min), 41.2% (162 min), and 28.7% (118 min). From CMS to ≥85% of TST-on-treatment criteria, categorization as an adherer decreased from 89% (n=34) to 58% (n=22); non-adherer categorization increased from 5% (n=2) to 37% (n=14). Conclusion In the context of understanding biophysiological responses to PAP treatment, more sensitive and specific criteria for adherence and non-adherence is necessary. PAP use based on untreated TST is an opportunity to address this gap. Support The parent clinical trial was supported by NIH/NINR (R00NR011173; Sawyer PI)

scholarly journals 0395 “Doctor, I Can’t Sleep”, How Intensivist Cannot Restore Their Sleep Debt

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A151-A151
Author(s):  
V Chhor ◽  
D Leger ◽  
E Pepin ◽  
M Elbaz
Keyword(s):  
Medical Staff ◽  
Total Sleep Time ◽  
Rest Period ◽  
Sleep Time ◽  
Work Period ◽  
Whitney Test ◽  
Sleep Debt ◽  
Wrist Actigraphy ◽  
The Mean ◽  
Open Question

Abstract Introduction Since 2001, intensivist physicians working in France have been organized in 24-hour shifts (in order to provide 24/7 support), followed by a mandatory rest period of at least 24 hours between shifts.. The goal was to survey how intensivists cope with maintaining enough sleep throughout their 24-hour shifts. Methods During twelve months, the whole medical staff of our ICU, i.e. 29 individuals (11 senior physicians and 18 residents), agreed to participate in this study. They were allowed to settle into a typical work period of 7 days and 7 nights (i.e. 3 days before and 3 days following the 24-hour shift), separated by at least 5 days from any previous 24-hour shifts. A 24-hour shift typically started at 8:30am in the morning and finished 24 hours later. All physicians wore a wrist actigraphy device (MotionWatch 8) assessing total sleep time (TST) on a 24-hour period. We retained several criteria such as: The reference TST, i.e. the mean of the TST during the first three days preceding the 24-hour shift The sleep debt, through the comparison between the average of the TST during the 24-hour shift and the 24 (SD24) or 72 following hours (SD72) and the reference TST. Results Twenty nine actigraphy records from 29 individuals were analyzed. The reference TST preceding the shift was 377 min (IQR25-75: 346-396). Doctors participating in the study slept very little during a 24-hour shift: 181 min (IQR25-75: 134-260). Subsequently, we observed that intensivists were unable to completely recover their sleep debt, even after 72 hours. Average TST was significantly shorter at 72 hours compared to reference (343 min [IQR25-75: 304-367], Mann-Whitney test, p=0.015). Conclusion These findings raise the question of whether it is possible for intensivist doctors to maintain their energy and intensity in their jobs without sleeping enough. This remains an open question and we are currently unable to respond with only a simple study. Support No support

scholarly journals P121 Comparison of Actigraphy versus PSG and Perception of Sleep in Patients with Excessive Daytime Sleepiness

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A60-A61
Author(s):  
T Roebuck ◽  
E McDermott ◽  
R Cuesta ◽  
R Nguy ◽  
M Spiteri ◽  
...  
Keyword(s):  
Sleep Latency ◽  
Sleep Onset ◽  
Sleep Time ◽  
Sleep Diary ◽  
Sleep Onset Latency ◽  
Onset Latency ◽  
Activity Data ◽  
Significant Difference ◽  
Sleep Parameters ◽  
Perception Of Sleep

Abstract Actigraphy is used as a validated measure of rest and sleep, however, there are reported differences in WASO in healthy individuals (Chinoy, 2021). Methods This study compares the sleep parameters from PSG with simultaneous overnight actigraphy on patients the night prior to MSLT. We also compare the actigraphy data collected on the week prior to the PSG with the patient’s sleep diary. 22 subjects, age 38.7 ± 3.1 years, BMI 23.5 ± 1.4 kg/m2, 40.1% male, 4 participants were treated with CPAP. Results WASO was found to be under estimated by actigraphy versus PSG (y=-0.957x+18.014, R2=0.51), there is an increase in underestimation beyond 18minutes. Our data also show on overestimation of sleep onset latency by actigraphy versus PSG when sleep latency is longer than 12 minutes (y=0.27x-12.04, R2=0.08). Total sleep time was perceived to be longer on the PSG night than the PSG data shows (y=0.68x-4.65, R2=0.21). Data demonstrated participants to overestimate their sleep period in their sleep diary compared to the actigraphy data (y=-0.87x+6.58, R2=0.21). T-tests showed a significant difference between WASO (minutes) detected by PSG and the actigraphy data (67.4 ± 8.9 vs 33.3 ± 3.9 p=0.0007). There were no other significant differences in the datasets. Conclusion Actigraphy uses activity data and light detection to estimate rest and sleep periods in wearers. Our data reflects expected differences reported in the literature of actigraphy data versus PSG due to the limitation of actigraphy being able to differentiate between sleep and motionless wakefulness.

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