Actigraphic assessment of sleep disorders in children with chronic fatigue syndrome

Department of Pediatrics, Asahikawa Medical College, Japan.
Brain and Development (Impact Factor: 1.88). 06/2008; 30(5):329-33. DOI: 10.1016/j.braindev.2007.10.004
Source: PubMed


Children with chronic fatigue syndrome (CFS) often suffer from sleep disorders, which cause many physiological and psychological problems. Understanding sleep characteristics in children with CFS is important for establishing a therapeutic strategy. We conducted an actigraphic study to clarify the problems in sleep/wake rhythm and physical activity in children with CFS.
Actigraphic recordings were performed for 1-2 weeks in 12 CFS children. The obtained data were compared with those of healthy age-matched children used as the control.
Sleep patterns were divided into two groups based on subjects' sleep logs: irregular sleep type and delayed sleep phase type. Compared to the control group, total sleep time was longer and physical activity was lower in both groups of CFS. Continuous sleep for more than 10h was not uncommon in CFS. In the irregular sleep type, impaired daily sleep/wake rhythms and disrupted sleep were observed.
Using actigraphy, we could identify several characteristics of the sleep patterns in CFS children. Actigraphic analysis proved to be useful in detecting sleep/wake problems in children with CFS.

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    • "The pressing need for non-obtrusive and clinically practical tools to monitor sleep-wake patterns in the context of evaluating children with specific conditions has yielded relatively promising results (Owens et al., 2009, Goldman et al., 2009, Kothare and Kaleyias, 2008, Ohinata et al., 2008, Aronen et al., 2002, Marshall et al., 2008). However, caution should be applied when generalizing the applicability of such reports to other clinical situations, especially when considering some of the potential methodological shortcomings, such as small sample sizes, lack of established validity of the device, limited report of ACT recording and analysis details (Acebo and LeBourgeois, 2006, Morgenthaler et al., 2007) and a decreased psychometric quality of ACT in cases with disrupted or disordered sleep (Gale et al., 2005, Sadeh and Acebo, 2002, Littner et al., 2003). "
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    ABSTRACT: Actigraphic (ACT) recordings are used widely in schoolchildren as a less intrusive and more extended approach to evaluation of sleep problems. However, critical assessment of the validity and reliability of ACT against overnight polysomnography (NPSG) are unavailable. Thus, we explored the degree of concordance between NPSG and ACT in school-aged children to delineate potential ACT boundaries when interpreting pediatric sleep. Non-dominant wrist ACT was recorded simultaneously with NPSG in 149 healthy school-aged children (aged 4.1-8.8 years, 41.7% boys, 80.4% Caucasian) recruited from the community. Analyses were limited to the Actiware (MiniMitter-64) calculated parameters originating from 1-min epoch sampling and medium sensitivity threshold value of 40; i.e. sleep period time (SPT), total sleep time (TST) and wake after sleep onset (WASO). SPT was not significantly different between ACT and NPSG. However, ACT underestimated TST significantly by 32.2±33.4 min and overestimated WASO by 26.3±34.4 min. The decreased precision of ACT was also evident from moderate to small concordance correlation coefficients (0.47 for TST and 0.09 for WASO). ACT in school-aged children provides reliable assessment of sleep quantity, but is relatively inaccurate during determination of sleep quality. Thus, caution is advocated in drawing definitive conclusions from ACT during evaluation of the sleep-disturbed child.
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    • "To detect the disturbance of the biological rhythms, actigraphic recordings [114] as well as the diurnal measuring of body temperature, corticosteroids and melatonin must be useful. Takimoto et al. monitored human clock genes in whole blood cells to evaluate internal synchronization [115]. "
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