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

Abstract

BackgroundWhile 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.MethodsThis 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.ResultsOf 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%).ConclusionActigraphy 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.

Individual differences in compliance and agreement for sleep logs and wrist actigraphy: A longitudinal study of naturalistic sleep in healthy adults

“…We first assessed the level of agreement between actigraphy and sleep logs for estimating variables related to sleep and wake states, expecting some level of consistency between the two methods [ 29 , 36 ], but also hypothesizing potential individual differences [ 38 ] across the different types of sleep metrics [ 39 ]. Second, we examined task compliance in terms of submitting sleep logs daily according to experimental instructions, expecting that compliance would tend to worsen over time [ 40 , 41 ], but also hypothesizing individual differences in the ability of participants to sustain motivation and achieve strict compliance for four consecutive months. Last we examined the relationship between compliance and agreement, evaluating whether individuals showing higher compliance also tended to produce higher fidelity subjective estimates of their sleep with reference to objective actigraph measurements.…”

Sleep in women undergoing in vitro fertilization: a pilot study

“…Actigraphy was used as a validated method to collect sleep data in the ambulatory environment to provide a more precise estimate of sleep duration than self-report. 28, 29 Additionally, we conducted an exploratory analysis to determine the impact of habitual sleep duration on the number of oocytes retrieved, an important clinical outcome in IVF and a measure associated with the ultimate goal of live birth. 30 …”

0250 The Day-to-Day Associations Between Sleep Characteristics, Affect, and Affect Reactivity

“…The correlations between selfreported sleep characteristics and those from actigraphy are uniformly higher than with respect to PSG, albeit not strong. Several studies on adult participants have shown moderate correlations between an individual's self-reported and actigraphy-derived measure of sleep duration, with most participants tending to overestimate their own sleep duration in comparison to actigraphy (r's =.34-.57; Auger, Varghese, Silber, & Slocumb, 2013;Lauderdale, Knutson, Yan, Liu, & Rathouz, 2008;Lockley, Skene, & Arendt, 1999;McCall & McCall, 2012;Tomita et al, 2013). One study estimated that among healthy adults, 34% of participants reported sleep durations that deviated ±1 hour from actigraphy-derived duration, with most of self-report durations being longer than the actigraphy measure (Van Den Berg et al, 2008).…”