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Sleep and Breathing

, Volume 21, Issue 4, pp 837–843 | Cite as

Discordant sleep parameters among actigraphy, polysomnography, and perceived sleep in patients with sleep-disordered breathing in comparison with patients with chronic insomnia disorder

  • Su Jung Choi
  • Miri Kang
  • Min Je Sung
  • Eun Yeon JooEmail author
Sleep Breathing Physiology and Disorders • Original Article

Abstract

Purpose

Although the clinical usefulness of actigraphy (ACT) in chronic insomnia disorder (CID) is extensively investigated, the evaluation on the utility of ACT in sleep-disordered breathing (SDB) is limited and the report of comparison with perceived sleep by patients and polysomnography (PSG) is scarce.

Methods

Thirty-six patients with SDB and 30 with CID underwent PSG and ACT, and they reported perceived sleep time and latency simultaneously. Sleep parameters (total sleep time [TST], sleep onset latency [SOL], sleep efficiency, and wakefulness after sleep onset [WASO]) were compared. Agreement among parameters was assessed with intraclass correlation coefficient (ICC) and 95% confidence interval.

Results

ACT overestimated TST and underestimated SOL and WASO relative to PSG in both groups. Perceived sleep was commonly undervalued relative to PSG or ACT. In post hoc analyses, perceived sleep was significantly shorter and SOL significantly longer compared to PSG and ACT in both groups. Perception of sleep time by PSG was significantly higher than perception by ACT. In the CID group, all sleep parameters were significantly correlated between ACT and PSG (ICC = 0.627–0.813). In the SDB group, only TST was significantly correlated (ICC = 0.804).

Conclusion

ACT is useful to monitor sleep and sleep quality in patients with CID. In patients with SDB, TST by ACT is reliable. However, ACT is insufficient to assess sleep quality due to its low agreement with PSG. Significantly lower sleep perception relative to PSG and ACT should be considered in the treatment of sleep disorders.

Keywords

Actigraphy Polysomnography Sleep-disordered breathing Insomnia Total sleep time 

Notes

Compliance with ethical standards

Funding

The National Research Foundation of Korea funded by the Ministry of Science, ICT & Future Planning, Republic of Korea, provided financial support in the form of Basic Science Research Program (No. 2014 R1A1A3049510) and Samsung Biomedical Research Institute also provided grant (#SMO1162071).

The sponsor had no role in the design or conduct of this research.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study protocol was approved by the Institutional Review Board of Samsung Medical Center. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Sadeh A (2011) The role and validity of actigraphy in sleep medicine: an update. Sleep Med Rev 15:259–267. doi: 10.1016/j.smrv.2010.10.001 CrossRefPubMedGoogle Scholar
  2. 2.
    Kushida CA, Chang A, Gadkary C, Guilleminault C, Carrillo O, Dement WC (2001) Comparison of actigraphic, polysomnographic, and subjective assessment of sleep parameters in sleep-disordered patients. Sleep Med 2:389–396. doi: 10.1016/S1389-9457(00)00098-8 CrossRefPubMedGoogle Scholar
  3. 3.
    Ancoli-Israel S, Cole R, Alessi C, Chambers M, Moorcroft W, Pollak CP (2003) The role of actigraphy in the study of sleep and circadian rhythms. Sleep 26:342–392CrossRefPubMedGoogle Scholar
  4. 4.
    Morgenthaler T, Alessi C, Friedman L, Owens J, Kapur V, Boehlecke B, Brown T, Chesson A Jr, Coleman J, Lee-Chiong T, Pancer J, Swick TJ, Standards of Practice C, American Academy of Sleep M (2007) Practice parameters for the use of actigraphy in the assessment of sleep and sleep disorders: an update for 2007. Sleep 30:519–529CrossRefPubMedGoogle Scholar
  5. 5.
    American Sleep Disorders Association (1995) Practice parameters for the use of actigraphy in the clinical assessment of sleep disorders. American Sleep Disorders Association. Sleep 18:285–287CrossRefGoogle Scholar
  6. 6.
    Lichstein KL, Stone KC, Donaldson J, Nau SD, Soeffing JP, Murray D, Lester KW, Aguillard RN (2006) Actigraphy validation with insomnia. Sleep 29:232–239PubMedGoogle Scholar
  7. 7.
    Chae KY, Kripke DF, Poceta JS, Shadan F, Jamil SM, Cronin JW, Kline LE (2009) Evaluation of immobility time for sleep latency in actigraphy. Sleep Med 10:621–625. doi: 10.1016/j.sleep.2008.07.009 CrossRefPubMedGoogle Scholar
  8. 8.
    Choi SJ, Suh S, Ong J, Joo EY (2016) Sleep misperception in chronic insomnia patients with obstructive sleep apnea syndrome: implications for clinical assessment. J Clin Sleep Med 12:1517–1525. doi: 10.5664/jcsm.6280 CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Le Bon O, Hoffmann G, Tecco J, Staner L, Noseda A, Pelc I, Linkowski P (2000) Mild to moderate sleep respiratory events: one negative night may not be enough. Chest 118:353–359. doi: 10.1378/chest.118.2.353 CrossRefPubMedGoogle Scholar
  10. 10.
    McCall C, McCall WV (2012) Comparison of actigraphy with polysomnography and sleep logs in depressed insomniacs. J Sleep Res 21:122–127. doi: 10.1111/j.1365-2869.2011.00917.x CrossRefPubMedGoogle Scholar
  11. 11.
    Sadeh A, Acebo C (2002) The role of actigraphy in sleep medicine. Sleep Med Rev 6:113–124. doi: 10.1053/smrv.2001.0182 CrossRefPubMedGoogle Scholar
  12. 12.
    Sanchez-Ortuno MM, Edinger JD, Means MK, Almirall D (2010) Home is where sleep is: an ecological approach to test the validity of actigraphy for the assessment of insomnia. J Clin Sleep Med 6:21–29PubMedPubMedCentralGoogle Scholar
  13. 13.
    Sack RL, Auckley D, Auger RR, Carskadon MA, Wright KP Jr, Vitiello MV, Zhdanova IV, American Academy of Sleep M (2007) Circadian rhythm sleep disorders: part I, basic principles, shift work and jet lag disorders. An American Academy of Sleep Medicine review. Sleep 30:1460–1483CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Elbaz M, Roue GM, Lofaso F, Quera Salva MA (2002) Utility of actigraphy in the diagnosis of obstructive sleep apnea. Sleep 25:527–531PubMedGoogle Scholar
  15. 15.
    Garcia-Diaz E, Quintana-Gallego E, Ruiz A, Carmona-Bernal C, Sanchez-Armengol A, Botebol-Benhamou G, Capote F (2007) Respiratory polygraphy with actigraphy in the diagnosis of sleep apnea-hypopnea syndrome. Chest 131:725–732. doi: 10.1378/chest.06-1604 CrossRefPubMedGoogle Scholar
  16. 16.
    Sadeh A, Hauri PJ, Kripke DF, Lavie P (1995) The role of actigraphy in the evaluation of sleep disorders. Sleep 18:288–302CrossRefPubMedGoogle Scholar
  17. 17.
    American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association.Google Scholar
  18. 18.
    American Academy of Sleep Medicine (2005) The international classification of sleep disorders, 2nd ed.: diagnostic and coding manual. American Academy of Sleep Medicine, WestchesterGoogle Scholar
  19. 19.
    Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14:540–545CrossRefPubMedGoogle Scholar
  20. 20.
    Bastien CH, Vallieres A, Morin CM (2001) Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med 2:297–307. doi: 10.1016/S1389-9457(00)00065-4 CrossRefPubMedGoogle Scholar
  21. 21.
    Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 28:193–213. doi: 10.1016/0165-1781(89)90047-4 CrossRefPubMedGoogle Scholar
  22. 22.
    Sung HM, Kim JB, Park YN, Bai DS, Lee SH, Ahn HN (2008) A study on the reliability and the validity of Korean version of the Beck Depression Inventory-II (BDI-II). J Korean Soc Biol Ther Psychiatry 14:2001–2012Google Scholar
  23. 23.
    Beck AT, Steer RA, Brown GK (1996) Manual for the BDI-II. The psychological corporation, San AntonioGoogle Scholar
  24. 24.
    De Vet H (1999) Observer reliability and agreement. Wiley, ChichesterGoogle Scholar
  25. 25.
    Webster JB, Kripke DF, Messin S, Mullaney DJ, Wyborney G (1982) An activity-based sleep monitor system for ambulatory use. Sleep 5:389–399CrossRefPubMedGoogle Scholar
  26. 26.
    Newell J, Mairesse O, Verbanck P, Neu D (2012) Is a one-night stay in the lab really enough to conclude? First-night effect and night-to-night variability in polysomnographic recordings among different clinical population samples. Psychiatry Res 200:795–801. doi: 10.1016/j.psychres.2012.07.045 CrossRefPubMedGoogle Scholar
  27. 27.
    Drinnan MJ, Murray A, White JE, Smithson AJ, Gibson GJ, Griffiths CJ (1996) Evaluation of activity-based techniques to identify transient arousal in respiratory sleep disorders. J Sleep Res 5:173–180. doi: 10.1046/j.1365-2869.1996.d01-71.x CrossRefPubMedGoogle Scholar
  28. 28.
    Gagnadoux F, Nguyen XL, Rakotonanahary D, Vidal S, Fleury B (2004) Wrist-actigraphic estimation of sleep time under nCPAP treatment in sleep apnoea patients. Eur Respir J 23:891–895. doi: 10.1183/09031936.04.00089604 CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Su Jung Choi
    • 1
    • 2
  • Miri Kang
    • 3
  • Min Je Sung
    • 2
  • Eun Yeon Joo
    • 2
    • 4
    Email author
  1. 1.Department of Nursing, Department of Clinical Nursing Science, Graduate School of Clinical Nursing Science, Samsung Medical CenterSungkyunkwan UniversitySeoulSouth Korea
  2. 2.Department of Neurology, Neuroscience Center, Samsung Biomedical Research Institute, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  3. 3.Department of Neurology, Busan Paik HospitalInje University College of MedicineBusanSouth Korea
  4. 4.Department of Health Sciences and Technology, SAIHSTSungkyunkwan UniversitySeoulSouth Korea

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