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Journal of Clinical Sleep Medicine :... Jul 2018The purpose of this guideline is to establish clinical practice recommendations for the use of actigraphy in adult and pediatric patients with suspected or diagnosed...
INTRODUCTION
The purpose of this guideline is to establish clinical practice recommendations for the use of actigraphy in adult and pediatric patients with suspected or diagnosed sleep disorders or circadian rhythm sleep-wake disorders.
METHODS
The American Academy of Sleep Medicine (AASM) commissioned a task force of experts in sleep medicine to develop recommendations and assigned strengths based on a systematic review of the literature and an assessment of the evidence using the GRADE process. The task force provided a summary of the relevant literature and the quality of evidence, the balance of benefits and harms, patient values and preferences, and resource use considerations that support the recommendations. The AASM Board of Directors approved the final recommendations.
RECOMMENDATIONS
The following recommendations are intended as a guide for clinicians using actigraphy in evaluating patients with sleep disorders and circadian rhythm sleep-wake disorders, and only apply to the use of FDA-approved devices. Each recommendation statement is assigned a strength ("Strong" or "Conditional"). A "Strong" recommendation (ie, "We recommend…") is one that clinicians should follow under most circumstances. A "Conditional" recommendation (ie, "We suggest…") reflects a lower degree of certainty regarding the outcome and appropriateness of the patient-care strategy for all patients. The ultimate judgment regarding any specific care must be made by the treating clinician and the patient, taking into consideration the individual circumstances of the patient, available treatment options, and resources. We suggest that clinicians use actigraphy to estimate sleep parameters in adult patients with insomnia disorder. (Conditional). We suggest that clinicians use actigraphy in the assessment of pediatric patients with insomnia disorder. (Conditional). We suggest that clinicians use actigraphy in the assessment of adult patients with circadian rhythm sleep-wake disorder. (Conditional). We suggest that clinicians use actigraphy in the assessment of pediatric patients with circadian rhythm sleep-wake disorder. (Conditional). We suggest that clinicians use actigraphy integrated with home sleep apnea test devices to estimate total sleep time during recording (in the absence of alternative objective measurements of total sleep time) in adult patients suspected of sleep-disordered breathing. (Conditional). We suggest that clinicians use actigraphy to monitor total sleep time prior to testing with the Multiple Sleep Latency Test in adult and pediatric patients with suspected central disorders of hypersomnolence. (Conditional). We suggest that clinicians use actigraphy to estimate total sleep time in adult patients with suspected insufficient sleep syndrome. (Conditional). We recommend that clinicians use actigraphy in place of electromyography for the diagnosis of periodic limb movement disorder in adult and pediatric patients. (Strong).
Topics: Academies and Institutes; Actigraphy; Humans; Sleep Disorders, Circadian Rhythm; Sleep Medicine Specialty; Sleep Wake Disorders; United States
PubMed: 29991437
DOI: 10.5664/jcsm.7230 -
JMIR MHealth and UHealth Nov 2020Assessment of sleep quality is essential to address poor sleep quality and understand changes. Owing to the advances in the Internet of Things and wearable technologies,...
BACKGROUND
Assessment of sleep quality is essential to address poor sleep quality and understand changes. Owing to the advances in the Internet of Things and wearable technologies, sleep monitoring under free-living conditions has become feasible and practicable. Smart rings and smartwatches can be employed to perform mid- or long-term home-based sleep monitoring. However, the validity of such wearables should be investigated in terms of sleep parameters. Sleep validation studies are mostly limited to short-term laboratory tests; there is a need for a study to assess the sleep attributes of wearables in everyday settings, where users engage in their daily routines.
OBJECTIVE
This study aims to evaluate the sleep parameters of the Oura ring along with the Samsung Gear Sport watch in comparison with a medically approved actigraphy device in a midterm everyday setting, where users engage in their daily routines.
METHODS
We conducted home-based sleep monitoring in which the sleep parameters of 45 healthy individuals (23 women and 22 men) were tracked for 7 days. Total sleep time (TST), sleep efficiency (SE), and wake after sleep onset (WASO) of the ring and watch were assessed using paired t tests, Bland-Altman plots, and Pearson correlation. The parameters were also investigated considering the gender of the participants as a dependent variable.
RESULTS
We found significant correlations between the ring's and actigraphy's TST (r=0.86; P<.001), WASO (r=0.41; P<.001), and SE (r=0.47; P<.001). Comparing the watch with actigraphy showed a significant correlation in TST (r=0.59; P<.001). The mean differences in TST, WASO, and SE of the ring and actigraphy were within satisfactory ranges, although there were significant differences between the parameters (P<.001); TST and SE mean differences were also within satisfactory ranges for the watch, and the WASO was slightly higher than the range (31.27, SD 35.15). However, the mean differences of the parameters between the watch and actigraphy were considerably higher than those of the ring. The watch also showed a significant difference in TST (P<.001) between female and male groups.
CONCLUSIONS
In a sample population of healthy adults, the sleep parameters of both the Oura ring and Samsung watch have acceptable mean differences and indicate significant correlations with actigraphy, but the ring outperforms the watch in terms of the nonstaging sleep parameters.
Topics: Actigraphy; Adult; Female; Humans; Male; Polysomnography; Sleep; Sleep Initiation and Maintenance Disorders; Wearable Electronic Devices
PubMed: 33038869
DOI: 10.2196/20465 -
Behavioral Sleep Medicine 2019: To evaluate the performance of a multisensor sleep-tracker (ŌURA ring) against polysomnography (PSG) in measuring sleep and sleep stages. : Forty-one healthy...
: To evaluate the performance of a multisensor sleep-tracker (ŌURA ring) against polysomnography (PSG) in measuring sleep and sleep stages. : Forty-one healthy adolescents and young adults (13 females; Age: 17.2 ± 2.4 years). : Sleep data were recorded using the ŌURA ring and standard PSG on a single laboratory overnight. Metrics were compared using Bland-Altman plots and epoch-by-epoch (EBE) analysis. : Summary variables for sleep onset latency (SOL), total sleep time (TST), and wake after sleep onset (WASO) were not different between ŌURA ring and PSG. PSG-ŌURA discrepancies for WASO were greater in participants with more PSG-defined WASO ( < .001). Compared with PSG, ŌURA ring underestimated PSG N3 (~20 min) and overestimated PSG REM (~17 min; < .05). PSG-ŌURA differences for TST and WASO lay within the ≤ 30 min a-priori-set clinically satisfactory ranges for 87.8% and 85.4% of the sample, respectively. From EBE analysis, ŌURA ring had a 96% sensitivity to detect sleep, and agreement of 65%, 51%, and 61%, in detecting "light sleep" (N1), "deep sleep" (N2 + N3), and REM sleep, respectively. Specificity in detecting wake was 48%. Similarly to PSG-N3 ( < .001), "deep sleep" detected with the ŌURA ring was negatively correlated with advancing age ( = .001). ŌURA ring correctly categorized 90.9%, 81.3%, and 92.9% into PSG-defined TST ranges of < 6 hr, 6-7 hr, > 7 hr, respectively. : Multisensor sleep trackers, such as the ŌURA ring have the potential for detecting outcomes beyond binary sleep-wake using sources of information in addition to motion. While these first results could be viewed as promising, future development and validation are needed.
Topics: Actigraphy; Adolescent; Adult; Female; Humans; Male; Polysomnography; Reproducibility of Results; Sleep; Young Adult
PubMed: 28323455
DOI: 10.1080/15402002.2017.1300587 -
Journal of Medical Internet Research Nov 2019Wearable sleep monitors are of high interest to consumers and researchers because of their ability to provide estimation of sleep patterns in free-living conditions in a... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Wearable sleep monitors are of high interest to consumers and researchers because of their ability to provide estimation of sleep patterns in free-living conditions in a cost-efficient way.
OBJECTIVE
We conducted a systematic review of publications reporting on the performance of wristband Fitbit models in assessing sleep parameters and stages.
METHODS
In adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we comprehensively searched the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane, Embase, MEDLINE, PubMed, PsycINFO, and Web of Science databases using the keyword Fitbit to identify relevant publications meeting predefined inclusion and exclusion criteria.
RESULTS
The search yielded 3085 candidate articles. After eliminating duplicates and in compliance with inclusion and exclusion criteria, 22 articles qualified for systematic review, with 8 providing quantitative data for meta-analysis. In reference to polysomnography (PSG), nonsleep-staging Fitbit models tended to overestimate total sleep time (TST; range from approximately 7 to 67 mins; effect size=-0.51, P<.001; heterogenicity: I=8.8%, P=.36) and sleep efficiency (SE; range from approximately 2% to 15%; effect size=-0.74, P<.001; heterogenicity: I=24.0%, P=.25), and underestimate wake after sleep onset (WASO; range from approximately 6 to 44 mins; effect size=0.60, P<.001; heterogenicity: I=0%, P=.92) and there was no significant difference in sleep onset latency (SOL; P=.37; heterogenicity: I=0%, P=.92). In reference to PSG, nonsleep-staging Fitbit models correctly identified sleep epochs with accuracy values between 0.81 and 0.91, sensitivity values between 0.87 and 0.99, and specificity values between 0.10 and 0.52. Recent-generation Fitbit models that collectively utilize heart rate variability and body movement to assess sleep stages performed better than early-generation nonsleep-staging ones that utilize only body movement. Sleep-staging Fitbit models, in comparison to PSG, showed no significant difference in measured values of WASO (P=.25; heterogenicity: I=0%, P=.92), TST (P=.29; heterogenicity: I=0%, P=.98), and SE (P=.19) but they underestimated SOL (P=.03; heterogenicity: I=0%, P=.66). Sleep-staging Fitbit models showed higher sensitivity (0.95-0.96) and specificity (0.58-0.69) values in detecting sleep epochs than nonsleep-staging models and those reported in the literature for regular wrist actigraphy.
CONCLUSIONS
Sleep-staging Fitbit models showed promising performance, especially in differentiating wake from sleep. However, although these models are a convenient and economical means for consumers to obtain gross estimates of sleep parameters and time spent in sleep stages, they are of limited specificity and are not a substitute for PSG.
Topics: Actigraphy; Female; Humans; Male; Sleep; Wrist
PubMed: 31778122
DOI: 10.2196/16273 -
ELife Dec 2023A large observational study has found that irregular sleep-wake patterns are associated with a higher risk of overall mortality, and also mortality from cancers and... (Observational Study)
Observational Study
A large observational study has found that irregular sleep-wake patterns are associated with a higher risk of overall mortality, and also mortality from cancers and cardiovascular disease.
Topics: Humans; Circadian Rhythm; Actigraphy; Sleep; Cardiovascular Diseases
PubMed: 38038345
DOI: 10.7554/eLife.94131 -
Child Development Mar 2022Reciprocal relations between sleep and adjustment were investigated. Participants included 246 adolescents (M = 15.80 years; 67.5% White, 32.5% Black/African...
Reciprocal relations between sleep and adjustment were investigated. Participants included 246 adolescents (M = 15.80 years; 67.5% White, 32.5% Black/African American; 53% female, 47% male) at Time 1 (data collected 2012-2013), 227 at Time 2 (M = 16.78 years) and 215 at Time 3 (M = 17.70 years). Sleep-wake variables were measured with self-reports (sleepiness) and actigraphy (average sleep minutes and efficiency, variability in sleep minutes and efficiency). Adolescents reported on depression and anxiety symptoms, and parents reported on externalizing problems. Greater variability in sleep duration and efficiency as well as sleepiness predicted adjustment problems (range of R : 36%-60%). Reciprocal relations were supported mostly for sleepiness (range of R : 16%-32%). Results help understand bidirectional relations between sleep and adjustment.
Topics: Actigraphy; Adolescent; Anxiety; Female; Humans; Male; Self Report; Sleep; Sleep Wake Disorders; Sleepiness
PubMed: 34757645
DOI: 10.1111/cdev.13703 -
Nutricion Hospitalaria Jun 2016The present study aims to compare the vertical counts registered by GT1M, GT3X and ActiTrainer. (Comparative Study)
Comparative Study
OBJECTIVE
The present study aims to compare the vertical counts registered by GT1M, GT3X and ActiTrainer.
METHODS
Treadmill activities, repeated sit-stands and rest were completed by 31 young, 31 adults and 35 older adults while wearing the accelerometers (GT1M, GT3X and ActiTrainer) on their right hips. Independent sample t-test analyses were performed to determine differences between counts in each age group and activities along with the Bland & Altman analysis to determine the degree of agreement. In order to determine the correction factor for the ActiTrainer counts, the linear regression forward analysis was used to minimize differences with the GT3X and the GT1M counts.
RESULTS
Differences among ActiTrainer, GT1M, and GT3X were revealed in all activities except in rest. The counts for ActiTrainer were significantly lower than those of GT3X and GT1M. The correction factor for ActiTrainer with GT1M (GT1M counts = 3185.564 + 649.647; *ActiTrainer counts - 36.163; *weight [kg] - 7.545 *age [years] r = 0.864; r2 = 0.746; r2 corrected = 0.745; SEE = 1451) and GT3X (GT3X counts = 3501.977 + 705.662 *ActiTrainer counts - 40.523 *weight [kg] - 11.864 *age [years] r = 0.901; r2 = 0.812; r2 corrected = 0.811; SEE = 310.160) reduced these differences.
CONCLUSION
The GT1M and GT3X vertical counts may be compared. However, a correction factor to decrease differences to compare ActiTrainer counts with those of GT1M or GT3X counts must be applied.
Topics: Actigraphy; Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Child; Exercise; Female; Humans; Male; Middle Aged; Motor Activity; Reproducibility of Results; Young Adult
PubMed: 27513507
DOI: 10.20960/nh.280 -
Critical Care Nursing Clinics of North... Jun 2021Sleep affects physiologic and psychological recovery throughout critical illness. Patients often describe poor sleep as a major source of distress while hospitalized in... (Review)
Review
Sleep affects physiologic and psychological recovery throughout critical illness. Patients often describe poor sleep as a major source of distress while hospitalized in an intensive care unit. The intensive care unit environment poses unique challenges for sleep assessment and monitoring. The purpose of this literature review is to discuss methods of assessment and monitoring of sleep within the intensive care unit setting. The advantages and disadvantages of physiologic monitoring of sleep (eg, polysomnography, bispectral index, and actigraphy) are compared with those of subjective measures of sleep quality (eg, validated patient-oriented sleep questionnaires, and informal nursing assessments).
Topics: Actigraphy; Critical Illness; Humans; Intensive Care Units; Polysomnography; Sleep; Sleep Wake Disorders
PubMed: 34023079
DOI: 10.1016/j.cnc.2021.01.008 -
Psychological Medicine May 2022Psychomotor slowing is a key feature of depressive disorders. Despite its great clinical importance, the pathophysiology and prevalence across different diagnoses and... (Meta-Analysis)
Meta-Analysis Review
Psychomotor slowing is a key feature of depressive disorders. Despite its great clinical importance, the pathophysiology and prevalence across different diagnoses and mood states are still poorly understood. Actigraphy allows unbiased, objective, and naturalistic assessment of physical activity as a marker of psychomotor slowing. Yet, the true effect-sizes remain unclear as recent, large systematic reviews are missing. We conducted a novel meta-analysis on actigraphically measured slowing in depression with strict inclusion and exclusion criteria for diagnosis ascertainment and sample duplications. Medline/PubMed and Web-of-Science were searched with terms combining mood-keywords and actigraphy-keywords until September 2021. Original research measuring actigraphy for ⩾24 h in at least two groups of depressed, remitted, or healthy participants and applying operationalized diagnosis was included. Studies in somatically ill patients, N < 10 participants/group, and studies using consumer-devices were excluded. Activity-levels between groups were compared using random-effects models with standardized-mean-differences and several moderators were examined. In total, 34 studies (n = 1804 patients) were included. Patients had lower activity than controls [standardized mean difference (s.m.d.) = -0.78, 95% confidence interval (CI) -0.99 to -0.57]. Compared to controls, patients with unipolar and bipolar disorder had lower activity than controls whether in depressed (unipolar: s.m.d. = -0.82, 95% CI -1.07 to -0.56; bipolar: s.m.d. = -0.94, 95% CI -1.41 to -0.46), or remitted/euthymic mood (unipolar: s.m.d. = -0.28, 95% CI -0.56 to 0.0; bipolar: s.m.d. = -0.92, 95% CI -1.36 to -0.47). None of the examined moderators had any significant effect. To date, this is the largest meta-analysis on actigraphically measured slowing in mood disorders. They are associated with lower activity, even in the remitted/euthymic mood-state. Studying objective motor behavior via actigraphy holds promise for informing screening and staging of affective disorders.
Topics: Actigraphy; Bipolar Disorder; Depression; Humans; Mood Disorders
PubMed: 35550677
DOI: 10.1017/S0033291722000903 -
Journal of Clinical Sleep Medicine :... Apr 2013Patients undergoing surgery have severe sleep and sleep-wake rhythm disturbances resulting in increased morbidity. Actigraphy is a tool that can be used to quantify... (Review)
Review
STUDY OBJECTIVES
Patients undergoing surgery have severe sleep and sleep-wake rhythm disturbances resulting in increased morbidity. Actigraphy is a tool that can be used to quantify these disturbances. The aim of this manuscript was to present the literature where actigraphy has been used to measure sleep and sleep-wake rhythms in relation to surgery.
METHODS
A systematic review was performed in 3 databases (Medline, Embase, and Psycinfo), including all literature until July 2012.
RESULTS
Thirty-two studies were included in the review. Actigraphy could demonstrate that total sleep time and sleep efficiency was reduced after surgery and number of awakenings was increased in patients undergoing major surgery. Disturbances were less severe in patients undergoing minor surgery. Actigraphy could be used to differentiate between delirious and non-delirious patients after major surgery. Actigraphy measurements could determine a differential effect of surgery based on the patient's age. The effect of pharmacological interventions (chronobiotics and hypnotics) in surgical patients could also be demonstrated by actigraphy.
CONCLUSION
Actigraphy can be used to measure sleep and sleep-wake rhythms in patients undergoing surgery.
Topics: Actigraphy; Female; Humans; Male; Sleep Disorders, Circadian Rhythm; Surgical Procedures, Operative
PubMed: 23585756
DOI: 10.5664/jcsm.2598