Lehrer H Matthew, Yao Zhigang, Krafty Robert T, Evans Marissa A, Buysse Daniel J, Kravitz Howard M, Matthews Karen A, Gold Ellen B, Harlow Sioban D, Samuelsson Laura B, Hall Martica H
Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Statistics and Applied Probability, National University of Singapore, Singapore, Singapore.
Sleep Adv. 2022 Feb 19;3(1):zpac001. doi: 10.1093/sleepadvances/zpac001. eCollection 2022.
Polysomnography (PSG) is considered the "gold standard" for assessing sleep, but cost and burden limit its use. Although wrist actigraphy and self-report diaries are feasible alternatives to PSG, few studies have compared all three modalities concurrently across multiple nights in the home to assess their relative validity across multiple sleep outcomes. This study compared sleep duration and continuity measured by PSG, actigraphy, and sleep diaries and examined moderation by race/ethnicity.
Participants from the Study of Women's Health Across the Nation (SWAN) Sleep Study included 323 White ( = 147), African American ( = 120), and Chinese ( = 56) middle-aged community-dwelling women (mean age: 51 years, range: 48-57). PSG, wrist actigraphy (AW-64; Philips Respironics, McMurray, PA), and sleep diaries were collected concurrently in participants' homes over three consecutive nights. Multivariable repeated-measures linear models compared time in bed (TIB), total sleep time (TST), sleep efficiency (SE), sleep latency (SL), and wake after sleep onset (WASO) across modalities.
Actigraphy and PSG produced similar estimates of sleep duration and efficiency. Diaries yielded higher estimates of TIB, TST, and SE versus PSG and actigraphy, and lower estimates of SL and WASO versus PSG. Diary SL was shorter than PSG SL only among White women, and diary WASO was lower than PSG and actigraphy WASO among African American versus White women.
Given concordance with PSG, actigraphy may be preferred as an alternative to PSG for measuring sleep in the home. Future research should consider racial/ethnic differences in diary-reported sleep continuity.
多导睡眠图（PSG）被认为是评估睡眠的“金标准”，但成本和负担限制了其应用。尽管手腕活动记录仪和自我报告日记是PSG可行的替代方法，但很少有研究在家庭环境中多个夜晚同时比较这三种方式，以评估它们在多种睡眠结果方面的相对有效性。本研究比较了PSG、活动记录仪和睡眠日记所测量的睡眠时间和连续性，并研究了种族/族裔的调节作用。
来自全国妇女健康研究（SWAN）睡眠研究的参与者包括323名白人（n = 147）、非裔美国人（n = 120）和华裔（n = 56）中年社区居住女性（平均年龄：51岁，范围：48 - 57岁）。PSG、手腕活动记录仪（AW - 64；飞利浦伟康公司，麦克默里，宾夕法尼亚州）和睡眠日记在参与者家中连续三个晚上同时收集。多变量重复测量线性模型比较了不同方式下的卧床时间（TIB）、总睡眠时间（TST）、睡眠效率（SE）、睡眠潜伏期（SL）和睡眠中觉醒时间（WASO）。
活动记录仪和PSG对睡眠时间和效率的估计相似。日记对TIB、TST和SE的估计高于PSG和活动记录仪，而对SL和WASO的估计低于PSG。仅在白人女性中，日记记录的SL短于PSG记录的SL，在非裔美国女性与白人女性相比中，日记记录的WASO低于PSG和活动记录仪记录的WASO。
鉴于与PSG的一致性，活动记录仪可能是在家中测量睡眠时PSG的首选替代方法。未来的研究应考虑日记报告的睡眠连续性中的种族/族裔差异。
