Sleep monitoring challenges in patients with neurocognitive disorders: A cross‐sectional analysis of missing data from activity trackers

Abstract

Background and Aims: Activity monitors, such as Fitbits ® , are being used increasingly for research purposes and data have been validated in healthy community-dwelling older adults. Given the lack of research in older adults with neurocognitive disorders, we investigated the consistency of sleep data recorded from a wrist-worn activity monitor in this population. Methods: Fitbit ® activity monitors were worn by hospitalized older adults as part of a parent study investigating sleep and step count in patients recovering from hip fracture surgery in a tertiary care academic hospital in Hamilton, Canada between March 2018 and June 2019. In this secondary analysis, we compared the proportion of missing sleep data between participants with and without a neurocognitive disorder and used a multivariable model to assess the association between neurocognitive disorder and missing sleep data.Results: Of 67 participants included in the analysis, 22 had a neurocognitive disorder (median age: 86.5 years). Sleep data were missing for 47% of the neurocognitive disorder group and 23% of the non-neurocognitive disorder group. The presence of a neurocognitive disorder was associated with an increased likelihood of missing sleep data using the Fitbit ® activity monitors (adjusted odds ratio: 3.41; 95% confidence interval: 1.06-11.73, p = 0.04). Conclusion:The inconsistent nature of sleep data tracking in hospitalized older adults with neurocognitive disorders highlights the challenges of using interventions in patient populations who are often excluded from validation studies. As opportunities expand for activity monitoring in persons with neurocognitive disorders, novel technologies not previously studied in this group should be used with caution.

Feasibility of wearable activity tracking devices to measure physical activity and sleep change among adolescents with chronic pain—a pilot nonrandomized treatment study

“…Secondly, Baroni and colleagues expressed similar concerns with missing data, noting up to 70% of college student participants had missing sleep data and 35% had no data at all ( 54 ). Similar missing sleep data findings for adults were reported by Ahuja and colleagues ( 55 ). If sleep is to be a focal point of any future studies with youth participating in an IIPT, either a significant increase in adherence coaching will need to occur before and during programming or another device with more sensitive sleep informatics would need to be utilized to obtain valid and reliable data.…”