Validity of an under-mattress sensor for objective sleep measurement in critically ill patients: a prospective observational study
Validity of an under-mattress sensor for objective sleep measurement in critically ill patients: a prospective observational study
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DOI：
10.1186/s40560-020-0433-x
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发表时间：
2020-02-11
影响因子：
7.1
通讯作者：
Sanui, Masamitsu
中科院分区：
文献类型：
--
作者：
Nagatomo, Kanae;Masuyama, Tomoyuki;Sanui, Masamitsu
背景考虑到重症监护环境中睡眠障碍的不良影响，准确的评估可以帮助治疗;然而，方法上的不足意味着目前没有可行的选择。最近对健康人群的研究表明，放置在床垫下的非穿戴式睡眠测量设备在重症监护环境中可能是有益的。因此，我们的目的是验证该设备与多导睡眠图（PSG）相比，并评估其与主观睡眠评估的关系。方法本观察性研究测量了危重成人患者的睡眠。主要目标是验证Nemuri SCAN（NSCAN; Paramount Bed Co.，有限公司、Tokyo，Japan）对照参考标准PSG进行24 h。次要目标是评估从NSCAN和PSG获得的客观参数与使用Richards-Campbell睡眠问卷（RCSQ）获得的夜间主观报告数据之间的相关性。结果11名参与者接受了评估。PSG总睡眠时间的中位数夜间为456.0（353.0-517.5）min，白天为305.0（186.2-542.5）min。24小时PSG显示恢复性睡眠显著减少，白天睡眠过多，但夜间睡眠量正常。与PSG相比，NSCAN的一致性、敏感性和特异性（95%置信区间）分别为68.4%（67.9-69.0%）、90.1%（89.7-90.6%）和38.7%（37.9-39.7%）。主观评价夜间睡眠时的中位RCSQ值为68.0（26.3-83.5）;这表明与NSCAN睡眠参数无关，尽管与PSG评估中N2阶段单独或与恢复性睡眠相结合的比率呈正相关。结论NSCAN在重症监护环境中具有中等一致性，高灵敏度和低特异性，这很可能是由于其无法识别危重患者中经常观察到的不动觉醒或睡眠深度。这仍然是其用于主观睡眠质量评估的障碍。
Background Considering the adverse effects of sleep disturbance in critical care settings, accurate assessment could aid therapy; however, methodological inadequacies mean that no viable option is currently available. Research in healthy population has recently shown that a non-wearable sleep measurement device placed under the mattress of the bed could be beneficial in intensive care settings. Therefore, we aimed to validate this device compared with polysomnography (PSG) and to assess how it related to subjective sleep evaluations. Methods This observational study measured the sleep of critically ill adult patients. The primary goal was to validate the Nemuri SCAN (NSCAN; Paramount Bed Co., Ltd., Tokyo, Japan) against the reference standard PSG for 24 h. The secondary goal was to evaluate the association between the objective parameters obtained from NSCAN and PSG and the subjective report data obtained using the Richards-Campbell Sleep Questionnaire (RCSQ) for the nighttime. Results Eleven participants were evaluated. The median of the total sleep time scored by PSG was 456.0 (353.0-517.5) min during the nighttime and 305.0 (186.2-542.5) min during the daytime. PSG over 24 h revealed significant decreases in restorative sleep, with excessive daytime sleep, but with a normal quantity of nighttime sleep. The agreement, sensitivity, and specificity rates (with 95% confidence intervals) for the NSCAN compared with PSG were 68.4% (67.9-69.0%), 90.1% (89.7-90.6%), and 38.7% (37.9-39.7%), respectively. The median RCSQ value when subjectively evaluating nighttime sleep was 68.0 (26.3-83.5); this showed no correlation with the NSCAN sleep parameters, despite a positive correlation with the ratio of the stage N2 isolated or combined with restorative sleep in the PSG assessment. Conclusions NSCAN had moderate agreement, high sensitivity, and poor specificity in intensive care settings, which is most likely due to its inability to identify immobile wakefulness often observed in critically ill patients or sleep depth. This remains a barrier to its use in the assessment of subjective sleep quality.