The gold standard assessment for sleep quality is polysomnography (PSG). However, actigraphy has gained popularity as an ambulatory monitor. We aimed to assess the value of actigraphy in measuring sleep fragmentation in children.
130 children aged 2-18 years referred for assessment for sleep disordered breathing (SDB) were recruited. The arousal index (AI) scored from PSG was compared to the actigraphic fragmentation index (FI) and number of wake bouts/h.
The ability of actigraphic measures to correctly classify a child as having an AI>10 events/h rated as fair for the FI and poor for wake bouts/h (area under the receiver operator characteristic curve, 0.73 and 0.67, respectively).
Actigraphy provides only a fair indication of the level of arousal from sleep in children. While the limitations of actigraphy prevent it from being a diagnostic tool for SDB, it still has a role in evaluating sleep/wake schedules in children.
[Show abstract][Hide abstract] ABSTRACT: A single-nucleotide polymorphism (SNP) near the IL28B gene (rs12979860) strongly predicts sustained virological response to pegylated interferon plus ribavirin (pegIFN-RBV) treatment for chronic hepatitis C virus (HCV) infection. Given that therapy is poorly tolerated and rates of response are lower in patients coinfected with HCV and human immunodeficiency virus (HIV), the recognition of predictors of response is a high priority in this population.
A baseline noninvasive index was derived on the basis of the probability of achieving sustained virological response in a group of 159 HIV-HCV-coinfected patients treated at one clinic in Spain. The index was then validated using data from a separate cohort of 86 coinfected individuals. Only individuals who had completed a course of pegIFN-RBV therapy and had validated outcomes were considered.
The final score included 4 variables: 2 host-related variables (IL28B SNP rs12979860 and liver stiffness) and 2 HCV-related variables (genotype and viral load). The area under the receiver operating characteristic curve was 0.89 in the derivation group and 0.85 in the validation group.
The probability of achieving sustained virological response with pegIFN-RBV therapy in HIV-HCV-coinfected patients can be reliably estimated prior to initiation of therapy using an index that includes 4 noninvasive parameters.
[Show abstract][Hide abstract] ABSTRACT: The use of actigraphs, or ambulatory devices that estimate sleep-wake patterns from activity levels, has become common in pediatric research. Actigraphy provides a more objective measure than parent-report, and has gained popularity due to its ability to measure sleep-wake patterns for extended periods of time in the child's natural environment. The purpose of this review is: 1) to provide comprehensive information on the historic and current uses of actigraphy in pediatric sleep research; 2) to review how actigraphy has been validated among pediatric populations; and 3) offer recommendations for methodological areas that should be included in all studies that utilize actigraphy, including the definition and scoring of variables commonly reported. The poor specificity to detect wake after sleep onset was consistently noted across devices and age groups, thus raising concerns about what is an "acceptable" level of specificity for actigraphy. Other notable findings from this review include the lack of standard scoring rules or variable definitions. Suggestions for the use and reporting of actigraphy in pediatric research are provided.
Sleep Medicine Reviews 03/2012; 16(5):463-75. DOI:10.1016/j.smrv.2011.10.002 · 8.51 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background:
A correlation has been observed between obstructive sleep events and sleep quality. The aim of the study was to assess if there is also a correlation between nocturnal hypoxemia and hypercapnia and sleep efficiency and sleep fragmentation in children.
Nocturnal pulse oximetry (S(pO(2))) and transcutaneous carbon dioxide (P(tcCO(2))) recordings with simultaneous actigraphy were performed in 38 children with nocturnal hypoxemia and hypercapnia during spontaneous breathing (nocturnal hypoventilation [NH] group), 25 children with partially corrected nocturnal hypoventilation (PC-NH group), and 11 subjects with normal nocturnal gas exchange (no-NH group).
Sleep efficiency and sleep fragmentation on actigraphy correlated with minimal S(pO(2)) (r(2) = 0.21, P = .004, and r(2) = -0.10, P = .050, respectively) and the percentage of night time with S(pO(2)) < 90% (r(2) = -0.33, P < .001, and r(2) = 0.13, P = .028, respectively) in the NH group. Sleep efficiency and sleep fragmentation also correlated with pulse rate standard deviation (r(2) = -0.42, P < .001, and r(2) = 0.37, P < .001, respectively). No correlation was observed between sleep efficiency and sleep fragmentation and P(tcCO(2)). No correlation was observed between sleep efficiency and sleep fragmentation and S(pO(2)), P(tcCO(2)), and pulse rate in the PC-NH group. Sleep efficiency, sleep fragmentation, and nocturnal S(pO(2)), and P(tcCO(2)) were all normal and not correlated in the no-NH group.
In children with nocturnal hypoventilation, nocturnal hypoxemia but not hypercapnia correlates with sleep efficiency and sleep fragmentation on actigraphy.
Respiratory care 06/2012; 57(11). DOI:10.4187/respcare.01771 · 1.84 Impact Factor
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