Discordant sleep parameters among actigraphy, polysomnography, and perceived sleep in patients with sleep-disordered breathing in comparison with patients with chronic insomnia disorder
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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.
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.
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).
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.
KeywordsActigraphy Polysomnography Sleep-disordered breathing Insomnia Total sleep time
Compliance with ethical standards
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.
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 was obtained from all individual participants included in the study.
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