Kubek Larissa Alice, Kutz Patrizia, Roll Claudia, Zernikow Boris, Wager Julia
PedScience Research Institute, 45711 Datteln, Germany.
Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, 58455 Witten, Germany.
J Clin Med. 2022 Nov 30;11(23):7107. doi: 10.3390/jcm11237107.
In children with life-limiting conditions and severe neurological impairment receiving pediatric palliative care (PPC), the degree to which actigraphy generates meaningful sleep data is uncertain. Benchmarked against the gold standard polysomnography (PSG), the applicability of actigraphy in this complex population was to be assessed. An actigraph was placed on N = 8 PPC patients during one-night polysomnography measurement in a pediatric tertiary care hospital's sleep laboratory. Patient characteristics, sleep phase data, and respiratory abnormalities are presented descriptively. Bland-Altman plots evaluated actigraphy's validity regarding sleep onset, sleep offset, wake after sleep onset (WASO), number of wake phases, total sleep time (TST) and sleep efficiency compared to PSG. PSG revealed that children spent most of their time in sleep stage 2 (46.6%) and most frequently showed central apnea (28.7%) and irregular hypopnea (14.5%). Bland-Altman plots showed that actigraphy and PSG gave similar findings for sleep onset, sleep offset, wake after sleep onset (WASO), total sleep time (TST) and sleep efficiency. Actigraphy slightly overestimated TST and sleep efficiency while underestimating all other parameters. Generally, the Actiwatch 2 low and medium sensitivity levels showed the best approximation to the PSG values. Actigraphy seems to be a promising method for detecting sleep problems in severely ill children.
在接受儿科姑息治疗（PPC）的患有危及生命疾病和严重神经功能障碍的儿童中，活动记录仪生成有意义睡眠数据的程度尚不确定。以金标准多导睡眠图（PSG）为基准，评估活动记录仪在这一复杂人群中的适用性。在一家儿科三级护理医院的睡眠实验室对8名PPC患者进行一夜多导睡眠图测量时，在他们身上放置了活动记录仪。对患者特征、睡眠阶段数据和呼吸异常进行了描述性呈现。通过Bland-Altman图评估活动记录仪在睡眠开始、睡眠结束、睡眠中觉醒（WASO）、觉醒阶段数量、总睡眠时间（TST）和睡眠效率方面相对于PSG的有效性。PSG显示，儿童大部分时间处于睡眠2期（46.6%），最常见的是中枢性呼吸暂停（28.7%）和不规则低通气（14.5%）。Bland-Altman图显示，活动记录仪和PSG在睡眠开始、睡眠结束、睡眠中觉醒（WASO）、总睡眠时间（TST）和睡眠效率方面的结果相似。活动记录仪略微高估了TST和睡眠效率，而低估了所有其他参数。总体而言，Actiwatch 2的低灵敏度和中等灵敏度水平与PSG值的近似度最佳。活动记录仪似乎是检测重症儿童睡眠问题的一种有前景的方法。
