慢性阻塞性肺疾病睡眠结局测量的活动记录仪评分
Actigraphy scoring for sleep outcome measures in chronic obstructive pulmonary disease.
作者信息
Kapella Mary C, Vispute Sachin, Zhu Bingqian, Herdegen James J
机构信息
University of Illinois at Chicago, Center for Narcolepsy, Sleep and Health Research, Department of Biobehavioral Health Science, College of Nursing, USA.
University of Illinois at Chicago, Center for Narcolepsy, Sleep and Health Research, Department of Biobehavioral Health Science, College of Nursing, USA.
出版信息
Sleep Med. 2017 Sep;37:124-129. doi: 10.1016/j.sleep.2017.06.012. Epub 2017 Jun 30.
BACKGROUND
Actigraphy is commonly used to measure sleep outcomes so that sleep can be measured conveniently at home over multiple nights. Actigraphy has been validated in people with sleep disturbances; however, the 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 (PSG) for the measurement of sleep outcomes in people with chronic obstructive pulmonary disease who have insomnia.
METHODS
Participants underwent overnight sleep assessment simultaneously by PSG and actigraphy at the University of Illinois of Chicago Sleep Science Center. Fifty participants (35 men and 15 women) with mild-to-severe chronic obstructive pulmonary disease and co-existing insomnia were included in the analysis. Sleep onset latency, total sleep time (TST), wake after sleep onset (WASO), and sleep efficiency (SE) were calculated independently from data derived from PSG and actigraphy. Actigraphy sleep outcome scores obtained at the default setting and several customized actigraphy settings were compared to the scored PSG results.
RESULTS
Although no single setting was optimal for all sleep outcomes, the combination of 10 consecutive immobile minutes for sleep onset or end and an 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.
CONCLUSION
Results support the conclusion that the default actigraphy settings may not be optimal for people with chronic obstructive pulmonary disease and co-existing insomnia.
背景
活动记录仪常用于测量睡眠结果，以便能在多个夜晚方便地在家中测量睡眠情况。活动记录仪已在睡眠障碍患者中得到验证；然而，在慢性阻塞性肺疾病等慢性疾病患者中，评分设置的有效性仍不明确。这项二次分析的目的是比较活动记录仪定制的评分设置与多导睡眠图（PSG）在测量患有失眠的慢性阻塞性肺疾病患者睡眠结果方面的差异。
方法
参与者在芝加哥伊利诺伊大学睡眠科学中心同时接受PSG和活动记录仪的夜间睡眠评估。分析纳入了50名患有轻至重度慢性阻塞性肺疾病且并存失眠的参与者（35名男性和15名女性）。分别根据PSG和活动记录仪的数据独立计算入睡潜伏期、总睡眠时间（TST）、睡眠中觉醒时间（WASO）和睡眠效率（SE）。将默认设置及几种定制的活动记录仪设置所获得的睡眠结果评分与PSG评分结果进行比较。
结果
尽管没有一种设置对所有睡眠结果都是最佳的，但入睡或结束时连续10分钟静止不动且活动阈值为10的组合效果良好。活动记录仪高估了TST和SE，低估了WASO，但使用10×10组合时，PSG和活动记录仪在TST和SE的方差上没有差异。随着平均TST和SE的增加，PSG与活动记录仪之间的一致性似乎增加，而随着平均WASO的减少，PSG与活动记录仪之间的一致性似乎增加。
结论
结果支持这样的结论，即默认的活动记录仪设置可能不适用于患有慢性阻塞性肺疾病且并存失眠的患者。
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