Comparison of sleep diary and actigraphy to evaluate total sleep time in hypersomnia patients

Abstract

A sleep diary is often employed for diagnosing and treating hypersomnia. However, its reliability needs to be evaluated because overlooked chronic sleep insufficiency could be misdiagnosed as narcolepsy. In this study, we compared simultaneous sleep measurements using a sleep diary and by actigraphy in patients visiting our sleep clinic for the first time with complaints of excessive daytime sleepiness. Of the 28 patients enrolled, 24 complied with both these requirements. In this population, the results obtained using a sleep diary tended to estimate a statistically significant earlier sleep onset time and longer total sleep time than those via actigraphy. For total sleep time, this tendency was more prominent in patients with a higher Epworth Sleepiness Scale score. In 5 of the 24 (20.8%) patients, the sleep diary records indicated >6 h of total sleep time while the actigraphy records indicated <6 h of total sleep time, with a discrepancy of >1 h. These results suggested that sleep insufficiency in hypersomnia patients may be overlooked when their sleep time is assessed using only a sleep diary in the initial phase of the diagnostic procedure, and the simultaneous use of actigraphy may be preferable in this assessment.

Comparison between self-reported sleep duration and actigraphy among adolescents: gender differences

“…Similarly to previous reports 15,[19][20][21]29 , this study found a discrepancy of about one hour on average (with SD of around two hours) between the informed sleep duration and the one measured objectively through ACT. While Lauderdale et al 19 studied young adults and Tomita et al 15 did the same with restless adults, the other three studies 20,21,29 involved children and adolescents with ages ranging from 11 to 18 years, and all of them ascertained overestimation of subjective measures of sleep time when compared to the ACT. Tremaine, Dorrian and Blunden 20 observed a difference of about one hour (66 minutes among adolescents and 72 minutes among children) in a group of 66 boys and girls ranging from 11 to 17 years, without gender-based differences, when comparing the sleep diaries with ACT.…”

“…Actigraphs are regarded as a more natural, noninvasive and practical alternative compared to PSG 14 , with also lower costs. They must be complemented by sleep diaries 10,15 filled by parents, guardians or investigated individuals, and are more accurate than reports of interviews and/or questionnaires, if the latter are used alone 10,11,16 . RESUMO: Introdução: Existem poucos estudos de concordância entre as medidas subjetivas de sono e a actigrafia entre adolescentes.…”

Sleep Problems in Chronic Inflammatory Diseases: Prevalence, Treatment, and New Perspectives: A Narrative Review

“…Sleep diaries, in contrast to questionnaires, are less prone to be biased by flawed recall: patients are meant to log sleep data daily; however, nocturnal awakenings might not be remembered. Some researchers report that sleep diaries might overestimate total sleep time, as well as sleep onset latency [ 93 , 94 ].…”