Source:Sleep Medicine
Author(s): Mary C. Kapella, Sachin Vispute, Bingqian Zhu, James J. Herdegen
BackgroundActigraphy is commonly used to measure sleep outcomes so sleep can be measured conveniently at home over multiple nights. Validity of actigraphy has been demonstrated in people with sleep disturbances; however, validity of scoring settings in people with chronic medical illnesses such as chronic obstructive pulmonary disease remains unclear. The purpose of this secondary analysis was to compare actigraphy customized scoring settings with polysomnography for measurement of sleep outcomes in people with chronic obstructive pulmonary disease who have insomnia.MethodsParticipants underwent overnight sleep assessment simultaneously by polysomnography and actigraphy at the University of Illinois of Chicago Sleep Science Center. Fifty participants (35 men, 15 women) with mild to severe chronic obstructive pulmonary disease and insomnia were included in the analysis. Sleep onset latency, total sleep time, wake after sleep onset, and sleep efficiency were calculated independently from data derived from polysomnography and from actigraphy. Actigraphy sleep outcome scores obtained at the default setting and several customized actigraphy settings were compared to the scored polysomnography results.ResultsAlthough no single setting was optimal for all sleep outcomes, the combination of 10 consecutive immobile minutes for sleep onset or end and activity threshold of 10 worked well. Actigraphy overestimated TST and SE and underestimated WASO but there was no difference in variance between PSG and actigraphy in TST and SE when the 10*10 combination was used. As the average TST and SE increased, the agreement between PSG and actigraphy appeared to increase and as the average WASO decreased, the agreement between PSG and actigraphy appeared to increase.ConclusionResults support the conclusion that the default actigraphy settings may not be optimal for people with chronic obstructive pulmonary disease and insomnia.
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