Skip to main content
SpringerLink
Log in

Energy expenditure in obstructive sleep apnea: validation of a multiple physiological sensor for determination of sleep and wake

  • Original Article
  • Published:
Sleep and Breathing Aims and scope Submit manuscript

Abstract

Purpose

Obstructive sleep apnea (OSA) may be associated with increased energy expenditure (EE) during sleep. As actigraphy is inaccurate at estimating EE from body movement counts alone, we aimed to compare a multiple physiological sensor with polysomnography for determination of sleep and wake, and to test the hypothesis that OSA is associated with increased EE during sleep.

Methods

We studied 50 adults referred for routine overnight polysomnography. In addition to polysomnography, the SenseWear Pro3 ArmbandTM (Bodymedia Inc.) was placed on the upper right arm. Epoch-by-epoch agreement rate between the measures of sleep versus wake was calculated. Linear regression analyses were performed for EE against apnea–hypopnea index (AHI), 3% oxygen desaturation index (ODI), body mass index (BMI), waist–hip ratio (WHR), gender, age, and average heart rate during sleep.

Results

The epoch-by-epoch agreement rate was high (79.9 ± 1.6%) and the ability of the SenseWear to estimate sleep was very good (sensitivity, 88.7 ± 1.5%). However, it was less accurate in determining wake (specificity 49.9 ± 3.6%). Sleep EE was associated with AHI, 3% ODI, BMI, WHR, and male gender (p < 0.001 for all). Stepwise multiple linear regression however revealed that BMI, male gender, age, and average heart rate during sleep were independent predictors of EE (Model R 2 = 0.78).

Conclusions

The SenseWear armband provides a reasonable estimation of sleep but a poor estimation of wake. Furthermore, in a selected population of OSA patients, increasing OSA severity is associated with increased EE during sleep, although primarily through an association with increased BMI. However, as our data are not adjusted for fat-free mass and the SenseWear has yet to be validated for EE in OSA patients, these data should be interpreted with caution.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Peppard P, Young T, Palta M, Dempsey J, Skatrud J (2000) Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA 284(23):3015–21

    Article  PubMed  CAS  Google Scholar 

  2. Newman A, Foster G, Givelber R, Nieto F, Redline S, Young T (2005) Progression and regression of sleep-disordered breathing with changes in weight: the Sleep Heart Health Study. Arch Intern Med 165(20):2408–13

    Article  PubMed  Google Scholar 

  3. Stenlof K, Grunstein R, Hedner J, Sjostrom L (1996) Energy expenditure in obstructive sleep apnea: effects of treatment with continuous positive airway pressure. Am J Physiol 271(6 Pt 1):E1036–43

    PubMed  CAS  Google Scholar 

  4. Lin C, Chang K, Lee K (2002) Effects of treatment by laser-assisted uvuloplasty on sleep energy expenditure in obstructive sleep apnea patients. Metabolism 51(5):622–7

    Article  PubMed  CAS  Google Scholar 

  5. Ryan C, Love L, Buckley P (1995) Energy expenditure in obstructive sleep apnea. Sleep 18(3):180–7

    PubMed  CAS  Google Scholar 

  6. Leenders N, Sherman W, Nagaraja H (2006) Energy expenditure estimated by accelerometry and doubly labeled water: do they agree? Med Sci Sports Exerc 38(12):2165–72

    Article  PubMed  Google Scholar 

  7. Fruin M, Rankin J (2004) Validity of a multi-sensor armband in estimating rest and exercise energy expenditure. Med Sci Sports Exerc 36(6):1063–9

    Article  PubMed  Google Scholar 

  8. Jakicic J, Marcus M, Gallagher K, Randall C, Thomas E, Goss F, Robertson R (2004) Evaluation of the SenseWear Pro Armband to assess energy expenditure during exercise. Med Sci Sports Exerc 36(5):897–904

    PubMed  Google Scholar 

  9. St-Onge M, Mignault D, Allison D, Rabasa-Lhoret R (2007) Evaluation of a portable device to measure daily energy expenditure in free-living adults. Am J Clin Nutr 85(3):742–9

    PubMed  CAS  Google Scholar 

  10. Iber C, Ancoli-Israel S, Chesson A, Quan S (2007) The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications, 1st edn. American Academy of Sleep Medicine, Westchester

    Google Scholar 

  11. Weiss A, Johnson N, Berger N, Redline S (2010) Validity of activity-based devices to estimate sleep. J Clin Sleep Med 6(4):336–42

    PubMed  Google Scholar 

  12. Ancoli-Israel S, Cole R, Alessi C, Chambers M, Moorcroft W, Pollak C (2003) The role of actigraphy in the study of sleep and circadian rhythms. Sleep 26(3):342–92

    PubMed  Google Scholar 

  13. Sadeh A, Sharkey K, Carskadon M (1994) Activity-based sleep-wake identification: an empirical test of methodological issues. Sleep 17(3):201–7

    PubMed  CAS  Google Scholar 

  14. Sadeh A, Hauri P, Kripke D, Lavie P (1995) The role of actigraphy in the evaluation of sleep disorders. Sleep 18(4):288–302

    PubMed  CAS  Google Scholar 

  15. de Souza L, Benedito-Silva A, Pires M, Poyares D, Tufik S, Calil H (2003) Further validation of actigraphy for sleep studies. Sleep 26(1):81–5

    PubMed  CAS  Google Scholar 

  16. Montgomery-Downs HE, Insana SP, Bond JA (2011) Movement toward a novel activity monitoring device. Sleep Breath. doi:10.1007/s11325-011-0585-y

  17. Kellner O, Bastuji H, Adeleine P (1997) Actimetry in sleep medicine. Sleep Breath 2(1):33–39

    PubMed  Google Scholar 

  18. Hyde M, O’Driscoll D, Binette S, Galang C, Tan S, Verginis N, Davey M, Horne R (2007) Validation of actigraphy for determining sleep and wake in children with sleep disordered breathing. J Sleep Res 16(2):213–6

    Article  PubMed  Google Scholar 

  19. Kushida C, Chang A, Gadkary C, Guilleminault C, Carrillo O, Dement W (2001) Comparison of actigraphic, polysomnographic, and subjective assessment of sleep parameters in sleep-disordered patients. Sleep Med 2(5):389–96

    Article  PubMed  CAS  Google Scholar 

  20. Hamilton G, Solin P, Naughton M (2004) Obstructive sleep apnoea and cardiovascular disease. Intern Med J 34(7):420–6

    Article  PubMed  CAS  Google Scholar 

  21. Kezirian E, Kirisoglu C, Riley R, Chang E, Guilleminault C, Powell N (2008) Resting energy expenditure in adults with sleep disordered breathing. Arch Otolaryngol Head Neck Surg 134(12):1270–5

    Article  PubMed  Google Scholar 

  22. Patel S, Benzo R, Slivka W, Sciurba F (2007) Activity monitoring and energy expenditure in COPD patients: a validation study. COPD 4(2):107–12

    Article  PubMed  Google Scholar 

  23. O’Driscoll D, Horne R, Davey M, Hope S, Anderson V, Trinder J, Walker A, Nixon G (2011) Increased sympathetic activity in children with obstructive sleep apnea: cardiovascular implications. Sleep Med 12(5):483–8

    Article  PubMed  Google Scholar 

  24. Haba-Rubio J, Darbellay G, Herrmann FR, Frey JG, Fernandes A, Vesin JM, Thiran JP, Tschopp JM (2005) Obstructive sleep apnea syndrome: effect of respiratory events and arousal on pulse wave amplitude measured by photoplethysmography in NREM sleep. Sleep Breath 9(2):73–81

    Article  PubMed  Google Scholar 

  25. Bonnet M, Berry R, Arand D (1991) Metabolism during normal, fragmented, and recovery sleep. J Appl Physiol 71(3):1112–8

    PubMed  CAS  Google Scholar 

  26. Mannix E, Manfredi F, Farber M (1999) Elevated O2 cost of ventilation contributes to tissue wasting in COPD. Chest 115(3):708–13

    Article  PubMed  CAS  Google Scholar 

  27. Gershan W, Forster H, Lowry T, Korducki M, Forster A, Forster M, Ohtake P, Aaron E, Garber A (1994) Effect of metabolic rate on ventilatory roll-off during hypoxia. J Appl Physiol 76(6):2310–4

    PubMed  CAS  Google Scholar 

  28. Solin P, Kaye DM, Little PJ, Bergin P, Richardson M, Naughton MT (2003) Impact of sleep apnea on sympathetic nervous system activity in heart failure. Chest 123(4):1119–26

    Article  PubMed  Google Scholar 

  29. Maquet P, Dive D, Salmon E, Sadzot B, Franco G, Poirrier R, von Frenckell R, Franck G (1990) Cerebral glucose utilization during sleep-wake cycle in man determined by positron emission tomography and [18 F]2-fluoro-2-deoxy-D-glucose method. Brain Res 513(1):136–43

    Article  PubMed  CAS  Google Scholar 

  30. Franzini C (1992) Brain metabolism and blood flow during sleep. J Sleep Res 1(1):3–16

    Article  Google Scholar 

  31. Katayose Y, Tasaki M, Ogata H, Nakata Y, Tokuyama K, Satoh M (2009) Metabolic rate and fuel utilization during sleep assessed by whole-body indirect calorimetry. Metabolism 58(7):920–6

    Article  PubMed  CAS  Google Scholar 

  32. White D, Weil J, Zwillich C (1985) Metabolic rate and breathing during sleep. J Appl Physiol 59(2):384–91

    PubMed  CAS  Google Scholar 

  33. Jung C, Melanson E, Frydendall E, Perreault L, Eckel R, Wright K (2011) Energy expenditure during sleep, sleep deprivation and sleep following sleep deprivation in adult humans. J Physiol 589(Pt 1):235–44

    Article  PubMed  CAS  Google Scholar 

  34. Geer E, Shen W (2009) Gender differences in insulin resistance, body composition, and energy balance. Gend Med 6(Suppl 1):60–75

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank all the staff of the Department of Respiratory and Sleep Medicine at Monash Medical Centre and all the participants in this study.

Financial support

This project was supported by a National Health and Medical Research Council of Australia Equipment Grant.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Respiratory and Sleep Medicine, Monash Medical Centre, 246 Clayton Rd, Clayton, Victoria, 3168, Australia

    Denise M. O’Driscoll, Anthony R. Turton, Janet M. Copland & Garun S. Hamilton

  2. Department of Medicine, Southern Clinical School, Monash University, Melbourne, Victoria, Australia

    Denise M. O’Driscoll & Boyd J. Strauss

  3. The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, Victoria, Australia

    Garun S. Hamilton

Authors
  1. Denise M. O’Driscoll
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anthony R. Turton
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Janet M. Copland
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Boyd J. Strauss
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Garun S. Hamilton
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Denise M. O’Driscoll.

Rights and permissions

Reprints and permissions

About this article

Cite this article

O’Driscoll, D.M., Turton, A.R., Copland, J.M. et al. Energy expenditure in obstructive sleep apnea: validation of a multiple physiological sensor for determination of sleep and wake. Sleep Breath 17, 139–146 (2013). https://doi.org/10.1007/s11325-012-0662-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11325-012-0662-x

Keywords

Search

Navigation