How accurately does wrist actigraphy identify the states of sleep and wakefulness?
How accurately does wrist actigraphy identify the states of sleep and wakefulness?
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DOI：
10.1093/sleep/24.8.957
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发表时间：
2001-12-15
期刊：
影响因子：
5.6
通讯作者：
Dzwonczyk, R
中科院分区：
文献类型：
--
作者：
Pollak, CP;Tryon, WW;Dzwonczyk, R
研究目的：由于睡眠和清醒的身体运动量不同，有研究称，通过腕部活动描记可以准确区分这两种状态。我们的目标是在包括昼夜成分的长时间多导睡眠图(PSG)和活动图(ACT)样本中验证这一说法。设计：14名健康的年轻(21-35岁)和老年(70-72岁)的男性和女性在没有时间线索的实验室里生活了7天。每个受试者都连续佩戴睡眠记录电极和两个手腕运动记录器。ACT测量值通过简单阈值和多元回归方法转换为睡眠和清醒的预测。PSG作为计算预测值(PV，根据PSG标准预测正确的概率)的金标准。设置：N/A参与者：N/A干预：N/AM测量和结果：7天的动作记录显示出清晰的高活动和低活动的昼夜周期，分别对应于受试者醒着的主观日和睡着的主观夜晚。较低的ACT水平对应于PSG睡眠的较深状态。对ACT的20分钟移动平均值进行Logistic回归得到的总体PV最高。然而，在完整的昼夜样本中，平均睡眠PV(PVS)仅为62.2%。夜间标本中PVS占86.6%。ACT成功地预测了主观夜晚的觉醒(PVW=89.6)，并准确地测量了昼夜节律长度和睡眠-觉醒巩固的程度，但它高估了睡眠率和睡眠效率。ACT在入睡前呈系统性下降，在觉醒前呈上升趋势，但PSG/ACT联合状态之间的可靠转换(马尔可夫-1特性)尚未得到证实。结论：目前低PV和高估睡眠使ACT不能作为准确的睡眠-觉醒指标。然而，活动记录仪可能有助于测量昼夜节律和睡眠-觉醒巩固，并具有表面有效性，作为休息/活动的衡量标准。
Study Objectives: Because sleep and wakefulness differ from each other by the amount of body movement, it has been claimed that the two states can be accurately distinguished by wrist actigraphy. Our objective was to test this claim in lengthy polysomnographic (psg) and actigraphic (act) samples that included night and day components.Design: Fourteen healthy young (21-35 years) and old (70-72 years) men and women lived in a laboratory without temporal cues for 7 days. Each subject continuously wore sleep-recording electrodes as well as 2 wrist-movement recorders. Act measurements were converted to predictions of sleep and wakefulness by simple-threshold and multiple-regression methods. Psg served as the gold standard for calculation of predictive values (PV, the probability that an act prediction is correct by psg criteria).Setting: N/AParticipants: N/AInterventions: N/AMeasurements and Results: The 7-day act recordings showed clear circadian cycles of high and low activity that respectively corresponded to subjective days, when subjects were wakeful, and subjective nights when they slept. Lower act levels corresponded to deeper states of psg sleep. Logistic regression on a 20-minute moving average of act gave the highest overall PV's. Nevertheless, the mean PV for sleep (PVS) was only 62.2% in complete, day + night samples. PVS was 86.6% in night samples. Act successfully predicted wakefulness during subjective nights (PVW = 89.6) and accurately measured circadian period length and the extent of sleep-wake consolidation, but it overestimated sleep rate and sleep efficiency. Act systematically decreased before sleep onset and increased before awakening, but reliable transitions among joint psg/act states (the Markov-1 property) were not demonstrated.Conclusions: Low PV's and overestimation of sleep currently disqualify actigraphy as an accurate sleep-wake indicator. Actigraphy may, however, by useful for measuring circadian period and sleep-wake consolidation and has face validity as a measure of rest/activity.