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The feasibility and reliability of actigraphy to monitor sleep in intensive care patients: An observational study

journal contribution
posted on 16.02.2022, 00:15 by LJ Delaney, E Litton, KL Melehan, H-CC Huang, Violeta LopezVioleta Lopez, F Van Haren
Background: Sleep amongst intensive care patients is reduced and highly fragmented which may adversely impact on recovery. The current challenge for Intensive Care clinicians is identifying feasible and accurate assessments of sleep that can be widely implemented. The objective of this study was to investigate the feasibility and reliability of a minimally invasive sleep monitoring technique compared to the gold standard, polysomnography, for sleep monitoring. Methods: Prospective observational study employing a within subject design in adult patients admitted to an Intensive Care Unit. Sleep monitoring was undertaken amongst minimally sedated patients via concurrent polysomnography and actigraphy monitoring over a 24-h duration to assess agreement between the two methods; total sleep time and wake time. Results: We recruited 80 patients who were mechanically ventilated (24%) and non-ventilated (76%) within the intensive care unit. Sleep was found to be highly fragmented, composed of numerous sleep bouts and characterized by abnormal sleep architecture. Actigraphy was found to have a moderate level of overall agreement in identifying sleep and wake states with polysomnography (69.4%; K = 0.386, p < 0.05) in an epoch by epoch analysis, with a moderate level of sensitivity (65.5%) and specificity (76.1%). Monitoring accuracy via actigraphy was improved amongst non-ventilated patients (specificity 83.7%; sensitivity 56.7%). Actigraphy was found to have a moderate correlation with polysomnography reported total sleep time (r = 0.359, p < 0.05) and wakefulness (r = 0.371, p < 0.05). Bland–Altman plots indicated that sleep was underestimated by actigraphy, with wakeful states overestimated. Conclusions: Actigraphy was easy and safe to use, provided moderate level of agreement with polysomnography in distinguishing between sleep and wakeful states, and may be a reasonable alternative to measure sleep in intensive care patients.

Funding

Category 2 - Other Public Sector Grants Category

History

Volume

25

Issue

1

Start Page

1

End Page

12

Number of Pages

12

eISSN

1364-8535

Publisher

Springer

Additional Rights

CC BY 4.0

Language

en

Peer Reviewed

Yes

Open Access

Yes

Acceptance Date

18/12/2020

External Author Affiliations

Royal Prince Alfred Hospital, Sydney, NSW; Australian National University; Queensland University of Technology; Fiona Stanley Hospital, Perth, WA

Era Eligible

Yes

Journal

Critical Care

Article Number

42