The feasibility of sleep assessment by actigraph in patients with tetraplegia

Spivak, E; Oksenberg, Arie; Catz, Amiram

doi:10.1038/sj.sc.3102040

Cited by 20 publications

(18 citation statements)

References 21 publications

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“…While wrist actigraphy has been validated for sleep assessment in patients with C5 to C7 tetraplegia [23], these patients are nevertheless capable of small but purposeful wrist movements. Patients in the VS, however, are by definition unable to produce purposeful movements, although spontaneous movements are common.…”

Section: Discussionmentioning

confidence: 99%

“…This method is known to correlate well with polysomnographic measurements of sleep and wakefulness in healthy individuals, as well as non-ambulatory patients, such as those with C5 to C7 tetraplegia [21-23]. A number of algorithms have been developed in order to produce minute-to-minute estimations of sleeping/waking from short-term variations in actigraphy data in healthy individuals.…”

Section: Introductionmentioning

confidence: 99%

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Actigraphy assessments of circadian sleep-wake cycles in the Vegetative and Minimally Conscious States

Cruse

Thibaut

Demertzi

et al. 2013

BMC Med

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BackgroundThe Vegetative and Minimally Conscious States (VS; MCS) are characterized by absent or highly disordered signs of awareness alongside preserved sleep-wake cycles. According to international diagnostic guidelines, sleep-wake cycles are assessed by means of observations of variable periods of eye-opening and eye-closure. However, there is little empirical evidence for true circadian sleep-wake cycling in these patients, and there have been no large-scale investigations of the validity of this diagnostic criterion.MethodsWe measured the circadian sleep-wake rhythms of 55 VS and MCS patients by means of wrist actigraphy, an indirect method that is highly correlated with polysomnographic estimates of sleeping/waking.ResultsContrary to the diagnostic guidelines, a significant proportion of patients did not exhibit statistically reliable sleep-wake cycles. The circadian rhythms of VS patients were significantly more impaired than those of MCS patients, as were the circadian rhythms of patients with non-traumatic injuries relative to those with traumatic injuries. The reliability of the circadian rhythms were significantly predicted by the patients' levels of visual and motor functioning, consistent with the putative biological generators of these rhythms.ConclusionsThe high variability across diagnoses and etiologies highlights the need for improved guidelines for the assessment of sleep-wake cycles in VS and MCS, and advocates the use of actigraphy as an inexpensive and non-invasive alternative.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Actigraphy assessments of circadian sleep-wake cycles in the Vegetative and Minimally Conscious States

Cruse

Thibaut

Demertzi

et al. 2013

BMC Med

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“…Inexpensive multipurpose devices providing a favorable cost–benefit balance in the clinical setting are, however, necessary to realize these new potential applications. There have been a few previous studies that assessed sleep/wake activity using an actigraphy placed on the trunk 8,9 and the head 10 because the current mainstream wrist‐worn actigraphy unit cannot be readily used in individuals with upper dystaxia, individuals with involuntary movement such as finger tremors, and children and dementia patients who may inadvertently interfere with the device. Most are also not waterproof and cannot thus readily be used in individuals whose work involves handling of water.…”

Section: Introductionmentioning

confidence: 99%

Newly developed waist actigraphy and its sleep/wake scoring algorithm

Enomoto

Endo

Suenaga³

et al. 2009

Sleep and Biological Rhythms

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The purpose of this study was to formulate an algorithm for assessing sleep/waking from activity intensities measured with a waist-worn actigraphy, the Lifecorder PLUS (LC; Suzuken Co. Ltd., Nagoya, Japan), and to test the validity of the algorithm. The study consisted of 31 healthy subjects (M/F = 20/11, mean age 31.7 years) who underwent one night of simultaneous measurement of activity intensity by LC and polysomnography (PSG). A sleep(S)/wake(W) scoring algorithm based on a linear model was determined through discriminant analysis of activity intensities measured by LC over a total of 235 h and 56 min and the corresponding PSG-based S/W data. The formulated S/W scoring algorithm was then used to score S/W during the monitoring epochs (2 min each, 7078 epochs in total) for each subject. The mean agreement rate with the corresponding PSG-based S/W data was 86.9%, with a mean sensitivity (sleep detection) of 89.4% and mean specificity (wakefulness detection) of 58.2%. The agreement rates for the individual stages of sleep were 60.6% for Stage 1, 89.3% for Stage 2, 99.2% for Stage 3 + 4, and 90.1% for Stage REM. These results demonstrate that sleep/wake activity in young to middle-aged healthy subjects can be assessed with a reliability comparable to that of conventional actigraphy through LC waist actigraphy and the optimal S/W scoring algorithm.

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“…At-home sleep was monitored using participant-completed sleep logs and wrist actigraphy (Actiwatch-L, Minimitter, Bend, OR, USA), a useful proxy for monitoring sleep--wake patterns in individuals who do not have damage to their spinal cord, 37 as well as in those with lower cervical SCI. 38,39 The sleep log was completed every morning and consisted of questions regarding the prior night of sleep. It also included a question regarding subjective sleep quality (rated on a scale of 1-9 with 9 being best) and current subjective alertness (Stanford Sleepiness Scale, 40 Likert-like scale of 1-7 with descriptors indicating 1 being most alert).…”

Section: Methodsmentioning

confidence: 99%