Relationship between objective and subjective sleep measures in depressed patients and healthy controls

Armitage, Roseanne; Trivedi, Madhukar H.; Hoffmann, Robert; Rush, A. John

doi:10.1002/(sici)1520-6394(1997)5:2<97::aid-da6>3.0.co;2-2

Cited by 148 publications

(112 citation statements)

References 16 publications

(21 reference statements)

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“…It should be kept in mind that, due to its largely subjective nature, sleep quality correlates with, but is not accurately defined by, sleep laboratory measurements. A previous study comparing subjective sleep characteristics assessed by questionnaire with objective measures obtained during polysomnography showed that, although individuals are able to satisfactorily judge time in bed, total sleep time and sleep latency, correlation between sleep quality and objective sleep characteristics is less strong (40). In summary, melatonin, as used in this study, has the potential to become a useful tool for the management of sleep problems in COPD patients.…”

Section: Discussionmentioning

confidence: 73%

Effect of melatonin administration on subjective sleep quality in chronic obstructive pulmonary disease

Nunes

Mota

Machado

et al. 2008

Braz J Med Biol Res

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Disturbed sleep is common in chronic obstructive pulmonary disease (COPD). Conventional hypnotics worsen nocturnal hypoxemia and, in severe cases, can lead to respiratory failure. Exogenous melatonin has somnogenic properties in normal subjects and can improve sleep in several clinical conditions. This randomized, double-blind, placebo-controlled study was carried out to determine the effects of melatonin on sleep in COPD. Thirty consecutive patients with moderate to very severe COPD were initially recruited for the study. None of the participants had a history of disease exacerbation 4 weeks prior to the study, obstructive sleep apnea, mental disorders, current use of oral steroids, methylxanthines or hypnotic-sedative medication, nocturnal oxygen therapy, and shift work. Patients received 3 mg melatonin (N = 12) or placebo (N = 13), orally in a single dose, 1 h before bedtime for 21 consecutive days. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI) and daytime sleepiness was measured by the Epworth Sleepiness Scale. Pulmonary function and functional exercise level were assessed by spirometry and the 6-min walk test, respectively. Twenty-five patients completed the study protocol and were included in the final analysis. Melatonin treatment significantly improved global PSQI scores (P = 0.012), particularly sleep latency (P = 0.008) and sleep duration (P = 0.046). No differences in daytime sleepiness, lung function and functional exercise level were observed. We conclude that melatonin can improve sleep in COPD. Further long-term studies involving larger number of patients are needed before melatonin can be safely recommended for the management of sleep disturbances in these patients.

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Section: Discussionmentioning

confidence: 73%

Effect of melatonin administration on subjective sleep quality in chronic obstructive pulmonary disease

Nunes

Mota

Machado

et al. 2008

Braz J Med Biol Res

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“…However, these impressions of disrupted sleep were not borne out by objective sleep measures in this study or in a previous study (Haney et al, 2003), suggesting that sleep disruption may not be a symptom of marijuana withdrawal. The differences between subjective and objective measures of sleep are not uncommon, particularly in individuals with mood disorders (Armitage et al, 1997). It may be that the mood symptoms of withdrawal skewed the subjective impression of sleep.…”

Section: Discussionmentioning

confidence: 99%

Marijuana Withdrawal in Humans: Effects of Oral THC or Divalproex

Haney

Hart

Vosburg

et al. 2003

Neuropsychopharmacol

239

228

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Abstinence following daily marijuana use can produce a withdrawal syndrome characterized by negative mood (eg irritability, anxiety, misery), muscle pain, chills, and decreased food intake. Two placebo-controlled, within-subject studies investigated the effects of a cannabinoid agonist, delta-9-tetrahydrocannabinol (THC: Study 1), and a mood stabilizer, divalproex (Study 2), on symptoms of marijuana withdrawal. Participants (n ¼ 7/study), who were not seeking treatment for their marijuana use, reported smoking 6-10 marijuana cigarettes/day, 6-7 days/week. Study 1 was a 15-day in-patient, 5-day outpatient, 15-day in-patient design. During the in-patient phases, participants took oral THC capsules (0, 10 mg) five times/day, 1 h prior to smoking marijuana (0.00, 3.04% THC). Active and placebo marijuana were smoked on in-patient days 1-8, while only placebo marijuana was smoked on days 9-14, that is, marijuana abstinence. Placebo THC was administered each day, except during one of the abstinence phases (days 9-14), when active THC was given. Mood, psychomotor task performance, food intake, and sleep were measured. Oral THC administered during marijuana abstinence decreased ratings of 'anxious', 'miserable', 'trouble sleeping', 'chills', and marijuana craving, and reversed large decreases in food intake as compared to placebo, while producing no intoxication. Study 2 was a 58-day, outpatient/in-patient design. Participants were maintained on each divalproex dose (0, 1500 mg/day) for 29 days each. Each maintenance condition began with a 14-day outpatient phase for medication induction or clearance and continued with a 15-day in-patient phase. Divalproex decreased marijuana craving during abstinence, yet increased ratings of 'anxious', 'irritable', 'bad effect', and 'tired.' Divalproex worsened performance on psychomotor tasks, and increased food intake regardless of marijuana condition. Thus, oral THC decreased marijuana craving and withdrawal symptoms at a dose that was subjectively indistinguishable from placebo. Divalproex worsened mood and cognitive performance during marijuana abstinence. These data suggest that oral THC, but not divalproex, may be useful in the treatment of marijuana dependence.

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“…Equally constructive would be a head-to-head comparison of the app and subjective measures such as sleep diaries and questionnaires. Such instruments, while widely used in clinical practice despite conflicting reports of their reliability, [17][18][19][20] require active patient involvement and motivation, and are often abandoned as being burdensome and inconvenient. Sleep apps such as this one that passively collect comparable data may represent a potential substitute for sleep diaries, especially in patients with poor motivation to maintain useful logs of their sleep.…”

Section: (20%)mentioning

confidence: 99%

Is There a Clinical Role For Smartphone Sleep Apps? Comparison of Sleep Cycle Detection by a Smartphone Application to Polysomnography

Bhat

Ferraris

Gupta

et al. 2015

Journal of Clinical Sleep Medicine

113

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Study Objectives: Several inexpensive, readily available smartphone apps that claim to monitor sleep are popular among patients. However, their accuracy is unknown, which limits their widespread clinical use. We therefore conducted this study to evaluate the validity of parameters reported by one such app, the Sleep Time app (Azumio, Inc., Palo Alto, CA, USA) for iPhones. Methods: Twenty volunteers with no previously diagnosed sleep disorders underwent in-laboratory polysomnography (PSG) while simultaneously using the app. Parameters reported by the app were then compared to those obtained by PSG. In addition, an epoch-by-epoch analysis was performed by dividing the PSG and app graph into 15-min epochs. S martphones are now ubiquitous. As their technological capabilities continue to improve, both consumers and healthcare personnel are constantly fi nding new and innovative uses for smartphone apps in the fi eld of health and medicine.1 Apps have been incorporated into the practice of medical specialties as diverse as diabetology and neurosurgery, and have found a role in activities ranging from interpretation of radiology imaging to smoking cessation counseling. Sleep related concerns are commonplace as well, and given the burgeoning popularity and easy availability of inexpensive apps that purport to monitor multiple physiological parameters, it is not surprising that several apps have been designed to evaluate sleep quality.2 The inexorable permeation of smartphones into the fi eld of sleep medicine has resulted in the development of promising apps that screen for obstructive sleep apnea (OSA) 3,4 and periodic limb movements in sleep (PLMS). S C I E N T I F I C I N V E S T I G AT I O N Sinsomnia, circadian rhythm disorders, and hypersomnolence to have objective data about sleep patterns in order to make diagnoses and treatment recommendations. There are several apps that allow users to report and analyze their sleep quality and duration, 6 but such data are often intrinsically subjective. In-laboratory polysomnography (PSG) is the gold standard for BRIEF SUMMARY Current Knowledge/Study Rationale: There are several preexisting, widely available, inexpensive smartphone apps designed to monitor sleep, but it is unclear whether they have clinical utility. Our goal was to systematically compare the results obtained by using one such app, the Sleep Time app (Azumio, Inc.) to the gold standard, polysomnography (PSG). Study Impact: Our study shows that the absolute parameters and sleep staging reported by the Sleep Time app (Azumio, Inc.) for iPhones correlate poorly with PSG. Further studies comparing app sleep-wake detection to actigraphy may help elucidate its potential clinical utility.

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Relationship between objective and subjective sleep measures in depressed patients and healthy controls

Cited by 148 publications

References 16 publications

Effect of melatonin administration on subjective sleep quality in chronic obstructive pulmonary disease

Effect of melatonin administration on subjective sleep quality in chronic obstructive pulmonary disease

Marijuana Withdrawal in Humans: Effects of Oral THC or Divalproex

Is There a Clinical Role For Smartphone Sleep Apps? Comparison of Sleep Cycle Detection by a Smartphone Application to Polysomnography

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