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Total sleep time obtained from actigraphy versus sleep logs in an academic sleep center and impact on further sleep testing.

Auger RR, Varghese R, Silber MH, Slocumb NL - Nat Sci Sleep (2013)

Bottom Line: Among the subset with both available in complete form, significant mean TST differences were observed on weekends (7.06 ± 2.18 hours versus 8.30 ± 1.93 hours, P = 0.009), but not on weekdays (7.38 ± 1.97 hours versus 7.72 ± 1.62 hours, P = 0.450) for actigraphy and logs, respectively.Determination of insufficient sleep time was cited as the primary reason for cancellation (64%).Actigraphy was completed more reliably than logs.

View Article: PubMed Central - PubMed

Affiliation: Center for Sleep Medicine, Rochester, MN, USA ; Department of Psychiatry and Psychology, Rochester, MN, USA.

ABSTRACT

Background: While actigraphy has been deemed ideal for the longitudinal assessment of total sleep time (TST) by select groups, endorsement has not been universal and reimbursement is lacking, preventing its widespread use in clinical practice. This study compares longitudinal TST data obtained by actigraphy and logs preceding a clinical evaluation, and secondarily ascertains whether longitudinal TST impacts clinicians' decisions to proceed with further sleep testing.

Methods: This was a retrospective, consecutive chart review spanning about 4 months in an academic sleep center. Eighty-four patients wore actigraphs in anticipation of clinical evaluations. Concomitant completion of sleep logs is routinely requested in this setting. Longitudinal TST data available in complete form was reviewed in a blinded fashion among a subset of these patients. A review of text from clinical notes of an expanded cohort with complete actigraphy data (regardless of the degree of completion of logs) enabled determination of the frequency and rationale for cancellation of prescheduled sleep testing.

Results: Of 84 actigraphy recordings, 90% produced complete data, and 30% produced fully completed logs. Among the subset with both available in complete form, significant mean TST differences were observed on weekends (7.06 ± 2.18 hours versus 8.30 ± 1.93 hours, P = 0.009), but not on weekdays (7.38 ± 1.97 hours versus 7.72 ± 1.62 hours, P = 0.450) for actigraphy and logs, respectively. Further analyses revealed poor agreement between the two measures, with predominantly increased TST estimation with logs. Among those with complete actigraphy data (±logs), testing was cancelled in 11 (15%), eight of whom (73%) presented with hypersomnia and three of whom (27%) presented with insomnia. Determination of insufficient sleep time was cited as the primary reason for cancellation (64%).

Conclusion: Actigraphy and sleep logs provided discrepant mean TST data on weekends only, and the latter predominantly estimated increased TST. Actigraphy was completed more reliably than logs. Longitudinal TST information influenced clinicians' decisions to proceed with further testing, particularly among patients presenting with hypersomnia.

No MeSH data available.


Related in: MedlinePlus

Plot depicting agreement between TST in hours assessed by sleep logs versus ACTI on weekdays.Abbreviations: TST, total sleep time; ACTI, actigraphy.
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f1-nss-5-125: Plot depicting agreement between TST in hours assessed by sleep logs versus ACTI on weekdays.Abbreviations: TST, total sleep time; ACTI, actigraphy.

Mentions: Of the 84 patients initially identified actigraphy data were noninterpretable (eg, due to device malfunction) among eight (10%), and 23 (27%) did not complete sleep logs to any degree. Complete sleep log and actigraphy data for both weekend and weekdays were available for 25 subjects (60% female, mean age 32.5 ± 17.3 years), with mean durations of observation of 14.4 ± 4.8 and 14.1 ± 4.7 days (actigraphy and logs, respectively). This subsample comprised the comparison cohort. Significant mean differences in TST were observed on weekends (actigraphy 7.06 ± 2.18 hours versus logs 8.30 ± 1.93 hours, P = 0.009), but not on weekdays (actigraphy 7.38 ± 1.97 hours versus logs 7.72 ± 1.62 hours, P = 0.450). For the agreement analyses, Lin’s concordance correlation coefficient was 0.257 (95% confidence interval, −0.1296 to 0.5761) for weekdays and 0.364 (95% confidence interval 0.03737–0.6203) for weekends. In the majority of instances, logs overestimated TST (60% and 68% for weekdays and weekends, respectively; Figures 1 and 2).


Total sleep time obtained from actigraphy versus sleep logs in an academic sleep center and impact on further sleep testing.

Auger RR, Varghese R, Silber MH, Slocumb NL - Nat Sci Sleep (2013)

Plot depicting agreement between TST in hours assessed by sleep logs versus ACTI on weekdays.Abbreviations: TST, total sleep time; ACTI, actigraphy.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3794964&req=5

f1-nss-5-125: Plot depicting agreement between TST in hours assessed by sleep logs versus ACTI on weekdays.Abbreviations: TST, total sleep time; ACTI, actigraphy.
Mentions: Of the 84 patients initially identified actigraphy data were noninterpretable (eg, due to device malfunction) among eight (10%), and 23 (27%) did not complete sleep logs to any degree. Complete sleep log and actigraphy data for both weekend and weekdays were available for 25 subjects (60% female, mean age 32.5 ± 17.3 years), with mean durations of observation of 14.4 ± 4.8 and 14.1 ± 4.7 days (actigraphy and logs, respectively). This subsample comprised the comparison cohort. Significant mean differences in TST were observed on weekends (actigraphy 7.06 ± 2.18 hours versus logs 8.30 ± 1.93 hours, P = 0.009), but not on weekdays (actigraphy 7.38 ± 1.97 hours versus logs 7.72 ± 1.62 hours, P = 0.450). For the agreement analyses, Lin’s concordance correlation coefficient was 0.257 (95% confidence interval, −0.1296 to 0.5761) for weekdays and 0.364 (95% confidence interval 0.03737–0.6203) for weekends. In the majority of instances, logs overestimated TST (60% and 68% for weekdays and weekends, respectively; Figures 1 and 2).

Bottom Line: Among the subset with both available in complete form, significant mean TST differences were observed on weekends (7.06 ± 2.18 hours versus 8.30 ± 1.93 hours, P = 0.009), but not on weekdays (7.38 ± 1.97 hours versus 7.72 ± 1.62 hours, P = 0.450) for actigraphy and logs, respectively.Determination of insufficient sleep time was cited as the primary reason for cancellation (64%).Actigraphy was completed more reliably than logs.

View Article: PubMed Central - PubMed

Affiliation: Center for Sleep Medicine, Rochester, MN, USA ; Department of Psychiatry and Psychology, Rochester, MN, USA.

ABSTRACT

Background: While actigraphy has been deemed ideal for the longitudinal assessment of total sleep time (TST) by select groups, endorsement has not been universal and reimbursement is lacking, preventing its widespread use in clinical practice. This study compares longitudinal TST data obtained by actigraphy and logs preceding a clinical evaluation, and secondarily ascertains whether longitudinal TST impacts clinicians' decisions to proceed with further sleep testing.

Methods: This was a retrospective, consecutive chart review spanning about 4 months in an academic sleep center. Eighty-four patients wore actigraphs in anticipation of clinical evaluations. Concomitant completion of sleep logs is routinely requested in this setting. Longitudinal TST data available in complete form was reviewed in a blinded fashion among a subset of these patients. A review of text from clinical notes of an expanded cohort with complete actigraphy data (regardless of the degree of completion of logs) enabled determination of the frequency and rationale for cancellation of prescheduled sleep testing.

Results: Of 84 actigraphy recordings, 90% produced complete data, and 30% produced fully completed logs. Among the subset with both available in complete form, significant mean TST differences were observed on weekends (7.06 ± 2.18 hours versus 8.30 ± 1.93 hours, P = 0.009), but not on weekdays (7.38 ± 1.97 hours versus 7.72 ± 1.62 hours, P = 0.450) for actigraphy and logs, respectively. Further analyses revealed poor agreement between the two measures, with predominantly increased TST estimation with logs. Among those with complete actigraphy data (±logs), testing was cancelled in 11 (15%), eight of whom (73%) presented with hypersomnia and three of whom (27%) presented with insomnia. Determination of insufficient sleep time was cited as the primary reason for cancellation (64%).

Conclusion: Actigraphy and sleep logs provided discrepant mean TST data on weekends only, and the latter predominantly estimated increased TST. Actigraphy was completed more reliably than logs. Longitudinal TST information influenced clinicians' decisions to proceed with further testing, particularly among patients presenting with hypersomnia.

No MeSH data available.


Related in: MedlinePlus