Assessing Sleep Disturbance in Low Back Pain: The Validity of Portable Instruments
Assessing Sleep Disturbance in Low Back Pain: The Validity of Portable Instruments
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DOI：
10.1371/journal.pone.0095824
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发表时间：
2014-04-24
期刊：
影响因子：
3.7
通讯作者：
Maher, Chris G.
中科院分区：
文献类型：
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作者：
Alsaadi, Saad M.;McAuley, James H.;Maher, Chris G.
尽管便携式仪器已用于评估腰痛 (LBP) 患者的睡眠障碍，但该仪器检测该人群睡眠/觉醒发作的准确性尚不清楚。本研究调查了两种便携式仪器（Armband 和 Actiwatch）用于评估 LBP 患者睡眠障碍的标准有效性。 50 名 LBP 患者在大学睡眠实验室同时进行夜间睡眠记录。所有 50 名参与者均接受了多导睡眠图 (PSG) 和臂带评估，其中 33 名参与者佩戴了 Actiwatch。通过计算每个仪器和 PSG 之间睡眠与觉醒的逐个时期的一致性、敏感性、特异性和患病率以及偏差调整 kappa (PABAK) 来确定标准有效性。使用组内相关系数 (ICC 2, 1) 评估 PSG 和两种工具之间的关系。研究参与者表现出阈下失眠症状（平均 ISI = 13.2，95% CI = 6.36）和睡眠质量差（平均 PSQI = 9.20，95% CI = 4.27）。观察到的 Armband 和 Actiwatch 与 PSG 的一致性分别为 85% 和 88%。两种仪器的灵敏度均为 0.90，Armband 和 Actiwatch 的特异性分别为 0.54 和 0.67，PABAK 分别为 0.69 和 0.77。总睡眠时间的 ICC (95% CI) 为 0.76（0.61 至 0.86）和 0.80（0.46 至 0.92），睡眠效率为 0.52（0.29 至 0.70）和 0.55（0.14 至 0.77），睡眠效率为 0.64（0.45 至 0.78）和 0.52（0.23）对于 Armband 和 Actiwatch，入睡后唤醒时间分别为 0.13（-0.15 至 0.39）和 0.33（-0.05 至 0.63）。研究结果表明，这两种仪器在睡眠参数上具有不同的标准有效性，从总睡眠时间测量的出色有效性、睡眠效率和发作后觉醒的良好有效性到入睡潜伏期的较差有效性。
Although portable instruments have been used in the assessment of sleep disturbance for patients with low back pain (LBP), the accuracy of the instruments in detecting sleep/wake episodes for this population is unknown. This study investigated the criterion validity of two portable instruments (Armband and Actiwatch) for assessing sleep disturbance in patients with LBP. 50 patients with LBP performed simultaneous overnight sleep recordings in a university sleep laboratory. All 50 participants were assessed by Polysomnography (PSG) and the Armband and a subgroup of 33 participants wore an Actiwatch. Criterion validity was determined by calculating epoch-by-epoch agreement, sensitivity, specificity and prevalence and bias-adjusted kappa (PABAK) for sleep versus wake between each instrument and PSG. The relationship between PSG and the two instruments was assessed using intraclass correlation coefficients (ICC 2, 1). The study participants showed symptoms of sub-threshold insomnia (mean ISI = 13.2, 95% CI = 6.36) and poor sleep quality (mean PSQI = 9.20, 95% CI = 4.27). Observed agreement with PSG was 85% and 88% for the Armband and Actiwatch. Sensitivity was 0.90 for both instruments and specificity was 0.54 and 0.67 and PABAK of 0.69 and 0.77 for the Armband and Actiwatch respectively. The ICC (95% CI) was 0.76 (0.61 to 0.86) and 0.80 (0.46 to 0.92) for total sleep time, 0.52 (0.29 to 0.70) and 0.55 (0.14 to 0.77) for sleep efficiency, 0.64 (0.45 to 0.78) and 0.52 (0.23 to 0.73) for wake after sleep onset and 0.13 (-0.15 to 0.39) and 0.33 (-0.05 to 0.63) for sleep onset latency, for the Armband and Actiwatch, respectively. The findings showed that both instruments have varied criterion validity across the sleep parameters from excellent validity for measures of total sleep time, good validity for measures of sleep efficiency and wake after onset to poor validity for sleep onset latency.