Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands.
Departments of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU University, Amsterdam, The Netherlands.
J Sleep Res. 2023 Feb;32(1):e13750. doi: 10.1111/jsr.13750. Epub 2022 Oct 11.
In the past decades, actigraphy has emerged as a promising, cost-effective, and easy-to-use tool for ambulatory sleep recording. Polysomnography (PSG) validation studies showed that actigraphic sleep estimates fare relatively well in healthy sleepers. Additionally, round-the-clock actigraphy recording has been used to study circadian rhythms in various populations. To this date, however, there is little evidence that the diagnosis, monitoring, or treatment of insomnia can significantly benefit from actigraphy recordings. Using a case-control design, we therefore critically examined whether mean or within-subject variability of actigraphy sleep estimates or circadian patterns add to the understanding of sleep complaints in insomnia. We acquired actigraphy recordings and sleep diaries of 37 controls and 167 patients with varying degrees of insomnia severity for up to 9 consecutive days in their home environment. Additionally, the participants spent one night in the laboratory, where actigraphy was recorded alongside PSG to check whether sleep, in principle, is well estimated. Despite moderate to strong agreement between actigraphy and PSG sleep scoring in the laboratory, ambulatory actigraphic estimates of average sleep and circadian rhythm variables failed to successfully differentiate patients with insomnia from controls in the home environment. Only total sleep time differed between the groups. Additionally, within-subject variability of sleep efficiency and wake after sleep onset was higher in patients. Insomnia research may therefore benefit from shifting attention from average sleep variables to day-to-day variability or from the development of non-motor home-assessed indicators of sleep quality.
在过去的几十年中,活动记录仪已成为一种有前途、经济高效且易于使用的工具,可用于进行动态睡眠记录。多导睡眠图(PSG)验证研究表明,活动记录仪的睡眠估计在健康的睡眠者中表现相对较好。此外,24 小时活动记录仪记录已被用于研究各种人群的昼夜节律。但是,到目前为止,几乎没有证据表明活动记录仪记录可以显著改善失眠的诊断、监测或治疗。因此,我们采用病例对照设计,批判性地检查了活动记录仪睡眠估计或昼夜节律模式的平均值或个体内变异性是否可以帮助我们更好地理解失眠的睡眠主诉。我们在家中环境中为 37 名对照者和 167 名不同严重程度失眠症患者连续采集了长达 9 天的活动记录仪记录和睡眠日记。此外,参与者还在实验室中度过了一个晚上,在此期间,除了进行 PSG 记录以检查睡眠是否可以得到很好地估计外,还进行了活动记录仪记录。尽管在实验室中,活动记录仪和 PSG 睡眠评分之间存在中度到高度一致性,但在家庭环境中,活动记录仪对平均睡眠和昼夜节律变量的估计无法成功区分失眠患者和对照组。仅总睡眠时间在两组之间存在差异。此外,患者的睡眠效率和睡眠后觉醒内的个体内变异性更高。因此,失眠症研究可能受益于将注意力从平均睡眠变量转移到日常变异性,或者从开发非运动性家庭评估的睡眠质量指标转移。