Effects of Sleep Loss on Waking Actigraphy

Abstract

The validity of actigraphy to make this distinction relative to polysomnography depends on several factors, including the population being studied and the time-of-day. In healthy, normal young, and middle-age adults sleeping at night, the agreement between actigrahpic and polysomnographic assessment of sleep time is generally 90% and better. 1 In contrast, in the elderly and patients with sleep disorders, the percent agreement generally is less, sometimes 80% or lower. 1 The discrepancy is in both directions with over-and under-estimations of sleep time. Some elderly and patients often lie motionless while awake producing over-estimation of sleep time, while other patients may have many body movements or leg movements during sleep producing under-estimations of sleep time.As to time-of-day, detecting sleep episodes with actigraphy in the context of normal waking activity has not been successful. In healthy young adults actigraphy differentiated sleep and wake at night, but it did not do so during daytime napping. 2 The agreement between actigraphic and polysomnographic identification of sleep was 40%. Periods of inactivity while reading or watching TV could not be differentiated from daytime nap episodes.While actigraphy may not detect daytime sleep episodes, it may differentiate increasing levels of daytime sleepiness as reflected in reduced overall activity or increased brief periods of inactivity. Reducing sleep time in healthy normals increases the level of daytime sleepiness in a linear manner as measured by the Multiple Sleep Latency Test (MSLT). 3,4 Increased daytime sleepiness then may be associated with reduced activity. We know of no previous attempts to document with actigraphy differing levels of daytime sleepiness due to reduced bedtime the previous night. Since previous studies have shown increased sleepiness and reduced performance following sedating drugs, the antihistamine diphenhydramine was used as a positive control in this study. 5,6 Thus, this study compared the effect of sleep loss, due to reduced sleep times, with the effect of diphenhydramine 50 mg on the MSLT and waking actigraphy. It was hypothesized that sleep loss the previous night would reduce activity levels during the following day. Each day the volunteers wore actigraphs from 0700-1800 hrs. Decreasing TIB was associated with decreased daily mean sleep latency on the MSLT with 4 and 0 hrs differing from 8 hrs and each other. Daytime activity also was reduced by the reduced prior TIB. Increased inactivity relative to the 8 hr TIB developed between the 4 hr and 0 hr TIBs, with 4 hrs differing from 0 hrs, but not 8 hrs. Accepted for publication June 2000Diphenhydramine 50 mg reduced mean daily sleep latency and increased percent inactive time relative to placebo. On the MSLT diphenhydramine was intermediate to 4 hr and 0 hr TIB and on actigraphy it was similar to 0 hr TIB. Conclusions:The difference in the effect of diphenhydramine on these actigraphy and MSLT may reflect the different sensitivities of the measures.

Benzodiazepine‐induced reduction in activity mirrors decrements in cognitive and psychomotor performance

“…It also confirms that the actiwatch is able to detect the effects of a hypnotic on actigraphically measured sleep. Moreover this study, following the recommendation of Roehrs and colleagues [24], adds further evidence that actigraphy can provide a reliable and sensitive indication of the time course of action of psychoactive drugs. Studies using actigraphy to measure the effects of other psychoactive compounds and drug groups in both subject and patient populations both in the laboratory and in field studies will be necessary to further validate this method as a useful tool in psychopharmacology.…”

“…Whilst some authors [22,24,29] have reported that the derived actigraph data show significant reductions in activity after dosing with various compounds, a variety of times blocks have been used ranging from 6 to 24 h. Although this has provided an indication that actigraphy may be able to detect changes in behavioural activity due to the effects of medication, the use of these large analysis time frames may not be sufficient to provide a discrete profile of the drug and of its time course of effect on activity and pharmacodynamics. A study on the effects of several antihistamines in comparison to placebo [33], however, has provided evidence that by using the AMI 32 actigraph (Ambulatory Monitoring Inc., New York, USA) it is possible to show significant changes in actigraphically measured activity up to 6 h post dose with promethazine.…”

“…Various studies [24,28,29] As psychoactive drugs have varied durations of efficacy, it is important to establish the maximum duration of impairment in order to provide safety data when prescribing. If a hypnotic taken to aid sleep has residual or hangover effects in the morning clearly this may be a safety hazard.…”

“…Previous research has assessed the effect of drugs on actigraphic sleep and daytime behaviour in small scale studies including sedatives [18,19], antidepressants [13,20,21], hypnotics [22,23], antihistamines [24][25][26] and stimulants [27]. The classes of drugs which are prescribed for inducing sleep, reducing anxiety or reducing a histaminic response have well documented side effects including reduction in activity during wake [22,23] and impairment of mental ability and alertness in the acute phase following drug administration [28,29].…”

Actigraphy in human psychopharmacology: a review

“…The results of these studies confirm that data derived from the sleep/wake detection algorithm can accurately reflect the rise and fall of daytime sedation (Alford et al, 2000;Stanley and Hindmarch, 2001). Roehrs et al (2000) used waking actigraphy to investigate the effects of reduced time in bed and the sedating effects of the first generation antihistamine diphenhydramine (50 mg). Seventeen young adult subjects (6 males, 11 females) completed the study which consisted of four treatment periods placebo-8 h TIB, placebo-4 h TIB, placebo 0 h TIB and diphenhydramine 50 mg 8 h TIB.…”