Exploring Accelerometer Versus Self-Report Sleep Assessment in Youth With Concussion

Abstract

This study examines accelerometer-based and self-report assessment of sleep disturbance from a larger prospective cohort of youth 5 to 18 years of age with postconcussive injury. Twenty-one participants with self-reported sleep disturbance were evaluated using accelerometers. Participants completed the Pittsburgh Sleep Quality Index (PSQI) every 48 hours and also measured sleep via accelerometry. Correlations were conducted matching PSQI scores to accelerometry assessment. PSQI scores were significantly correlated only with “average number of awakenings” (r = −0.21; P = .049). Accelerometer-measured mean (standard deviation) sleep efficiency was 79.9% (5.20%), with normal sleep defined as >85%. The mean (standard deviation) PSQI global score was 10.5 (3.78) out of 21, where scores of >5 indicate subjective insomnia. Results suggest the PSQI and accelerometers may be measuring different attributes of sleep. Both may be needed as actual sleep is important but so is perception of good sleep. These findings call for further validity testing of objective sleep assessment measures and commonly used self-report tools.

Association between sleep quality and time with energy metabolism in sedentary adults

“…Surprisingly, different results were observed when the association between sleep quality and energy metabolism was performed considering subjective instead of objective measures of sleep quality. It has been previously reported that PSQI and accelerometer records measure different attributes of sleep, highlighting the bias of accelerometry to register wakefulness, thus lying in bed awake but motionless is likely to be coded as sleep 63 . Therefore, it is recommended to use both methods to obtain complementary information additionally to the body movements 64 .…”

Association between Sleep Quality and Body Composition in Sedentary Middle-Aged Adults

“…Interestingly, we observed different results when the association between sleep quality and body composition was performed considering subjective sleep quality measured by a PSQI questionnaire versus objective sleep quality measured with an accelerometer. A previous study in youth observed that the PSQI and the accelerometer may measure different attributes of sleep, reporting the inadequate capacity of an accelerometry to detect wakefulness, thus lying in bed awake but motionless is likely to be coded as sleep [ 51 ]. Due to this limitation, using both complementary assessment methods (objective and subjective) to obtain detailed information beyond the limited data derived from body movements, is recommended [ 52 ].…”

Physical activity after mild traumatic brain injury: What are the relationships with fatigue and sleep quality?

“…Further research should explore the use of objective measures in addition to subjective measures when studying physical activity 7 and sleep. 57 Future research should explore other pre-and post-injury factors that can influence activities and participation in adolescents and young adults after mTBI such as deconditioning, increasing demands on participation, or psychosocial issues.…”