Hughes Jaime M, Song Yeonsu, Fung Constance H, Dzierzewski Joseph M, Mitchell Michael N, Jouldjian Stella, Josephson Karen R, Alessi Cathy A, Martin Jennifer L
a Center for Health Services Research in Primary Care , Durham VA Medical Center , Durham , North Carolina , USA.
b Geriatric Research, Education, and Clinical Center , VA Greater Los Angeles Healthcare System , Los Angeles , California , USA.
Clin Gerontol. 2018 Mar-Apr;41(2):145-157. doi: 10.1080/07317115.2017.1408734. Epub 2017 Dec 28.
This study compared subjective (questionnaire) and objective (actigraphy) sleep assessments, and examined agreement between these methods, in vulnerable older adults participating in a Veterans Administration Adult Day Health Care (ADHC) program.
59 ADHC participants (95% male, mean age = 78 years) completed sleep questionnaires and 72 continuous hours of wrist actigraphy. Linear regression was used to examine agreement between methods and explore discrepancies in subjective/objective measures.
Disturbed sleep was common, yet there was no agreement between subjective and objective sleep assessment methods. Compared with objective measures, one-half of participants reported worse sleep efficiency (SE) on questionnaires while one-quarter over-estimated SE. Participants reporting worse pain had a greater discrepancy between subjective and objective SE.
Vulnerable older adults demonstrated unique patterns of reporting sleep quality when comparing subjective and objective methods. Additional research is needed to better understand how vulnerable older adults evaluate sleep problems.
Objective and subjective sleep measures may represent unique and equally important constructs in this population. Clinicians should consider utilizing both objective and subjective sleep measures to identify individuals who may benefit from behavioral sleep treatments, and future research is needed to develop and validate appropriate sleep assessments for vulnerable older adults.
本研究比较了参与退伍军人事务部成人日间保健（ADHC）项目的脆弱老年人的主观（问卷调查）和客观（活动记录仪）睡眠评估，并检验了这些方法之间的一致性。
59名ADHC参与者（95%为男性，平均年龄 = 78岁）完成了睡眠问卷，并进行了72小时的连续腕部活动记录。采用线性回归来检验方法之间的一致性，并探讨主观/客观测量中的差异。
睡眠障碍很常见，但主观和客观睡眠评估方法之间没有一致性。与客观测量相比，一半的参与者在问卷中报告睡眠效率（SE）较差，而四分之一的参与者高估了SE。报告疼痛较重的参与者在主观和客观SE之间的差异更大。
在比较主观和客观方法时，脆弱老年人表现出独特的睡眠质量报告模式。需要进一步研究以更好地了解脆弱老年人如何评估睡眠问题。
客观和主观睡眠测量可能代表了该人群中独特且同样重要的结构。临床医生应考虑同时使用客观和主观睡眠测量来识别可能从行为睡眠治疗中受益的个体，并且需要未来的研究来开发和验证适用于脆弱老年人的睡眠评估方法。
