University of South Florida College of Medicine, Tampa, FL, USA
Hurricane Sally Update
The ActiGraph office is open, and we have resumed normal operations as of Monday, September 21st. Shipping delays are still possible as our community recovers from the storm. If you need immediate assistance, please contact us by email at email@example.com and we will respond as quickly as possible. Thank you for your continued support.
0944 A Comparison Of Medical-grade Actigraphy Devices With Polysomnography During Inpatient Rehabilitation For Traumatic Brain Injury (TBI)
- Published on April 12, 2019
Sleep disturbances in TBI population can have negative consequences on physical, psychological and cognitive recovery. While polysomnography (PSG) is the gold standard for evaluating sleep disorders, actigraphy has been widely used to screen for sleep-wake disorders, especially ones that change longitudinally. In a small sample of TBI patients (n=50, single center sample of convenience) during inpatient rehabilitation, we have previously found two models (Philips Actiwatch2/Actiwatch Spectrum) to be feasible and valid for collecting sleep data. Herein, we extend this validation to a prospective study of more than 200 TBI patients and include both the Actigraph Core wGT3X-BT (ACT-Core) and Philips Actiwatch Spectrum Plus (PASP).
This is a secondary analysis from a six-center, prospective, observational cohort study from the TBI Model System Lifetimes Study where overnight, fully attended polysomnography with concomitant actigraphy were conducted on moderate to severe TBI subjects during acute inpatient rehabilitation as part of an ongoing PCORI-funded clinical trial. Actigraphy variables of total sleep time (TST), sleep efficiency (SE), sleep latency (SL), wake after sleep onset (WASO) were compared between actigraphy devices and with Level 1, fully attended PSG (Phillips Sleepware-G3) to evaluate their concordance (Pearson). PASP-derived sleep was determined with Actiware (sensitivity=Automatic), while ACT-Core-derived sleep was determined with ActiLife (Cole-Kripke algorithm).
Simultaneous collection of PSG and PASP (n=230) and ACT-Core (n=179) were examined. Correlations (p>.01) with PSG were found for both PASP and ACT-Core for TST (r=.70, .69), SE (r=.33, .31), and WASO (r=-.19, -.24) respectively. Comparison of actigraphy devices to one another revealed correlations (p>.01) for TST (r=.80), SE (r=.58), WASO (r=.68), and SL (r=.23).
This larger, prospective study across six-centers supports the use of actigraphy as a proxy measure of sleep quantity (TST, SE) in acute neurorehabilitation admissions with moderate to severe TBI. No relationship was found for SL with mixed findings for WASO. Sensitivity analyses with subsets of TBI survivors with comorbidities (sleep apnea, spasticity, muscle strength) may affect agreement and warrant further study.
- Giselle Y Guerrero 1
- Daniel Schwartz, MD 2
- Marc Y Silva, MHBS 2
- Jamie Marc Zeitzer 3
- Kimberley Monden 4
- Lara Wittine, MD 1
- Jennifer Bogner 5
- Tea Reljic 1
- Risa Nakase-Richardson 2
James A. Haley Veterans Affairs Medical Center, Tampa, FL, USA
Psychiatry and Behavioral Sciences, Stanford University, VA Palo Alto Health Care System, Palo Alto, CA, USA
Craig Hospital, Englewood, CO, USA
PMRS, Ohio State University, Columbus, OH, USA