Actigraphy prior to Multiple Sleep Latency Test: nighttime total sleep time predicts sleep-onset latency - PubMed (original) (raw)

Actigraphy prior to Multiple Sleep Latency Test: nighttime total sleep time predicts sleep-onset latency

Monica R Kelly et al. J Clin Sleep Med. 2022.

Abstract

Study objectives: To evaluate the clinical utility of actigraphy as compared with sleep questionnaires prior to the Multiple Sleep Latency Test (MSLT) in a sleep disorders clinic population.

Methods: Twenty-eight clinically referred participants (mean age: 42.3 ± 18.8 years) completed the study protocol. On day 1, participants completed the following questionnaires: Epworth Sleepiness Scale (ESS), Insomnia Severity Index, Pittsburgh Sleep Quality Index (PSQI), Visual Analog Scale (affect, vigor), Patient Health Questionnaire, and Multidimensional Fatigue Symptom Inventory-Short Form. On days 1-8, participants wore an actigraph and completed a sleep diary to assess mean nighttime and mean daytime total sleep time and sleep efficiency or sleep percentage. On day 9, participants repeated the ESS and completed an MSLT. Correlations assessed mean MSLT sleep-onset latency (MSLT-SOL) vs actigraphy, sleep diary, and questionnaires. Chi-square analyses assessed abnormal MSLT-SOL (≤ 8 minutes) or daytime sleepiness (ESS ≥ 10) and referral question (ie, sleep-disordered breathing vs hypersomnolence disorder).

Results: Mean MSLT-SOL was correlated with nighttime total sleep time assessed via both actigraphy and diary, but not with questionnaires. Significant correlations emerged for ESS score on day 1 vs 9, actigraphy vs sleep diary mean nighttime total sleep time, and PSQI vs mean sleep diary sleep efficiency. There was no significant relationship between mean MSLT-SOL and referral question.

Conclusions: Our finding that total sleep time measured by actigraphy was associated with MSLT-SOL suggests it is useful in informing the interpretation of MSLT findings; however, it does not appear to be a viable substitute for MSLT for the measurement of objective sleepiness in clinical settings.

Citation: Kelly MR, Zeidler MR, DeCruz S, et al. Actigraphy prior to Multiple Sleep Latency Test: nighttime total sleep time predicts sleep-onset latency. J Clin Sleep Med. 2022;18(1):161-170.

Keywords: Epworth Sleepiness Scale; Multiple Sleep Latency Test; actigraphy; hypersomnolence.

© 2022 American Academy of Sleep Medicine.

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Conflict of interest statement

All authors have seen and approved the manuscript and have agreed to be accountable for all aspects of the work. Work for this study was performed at VA Sepulveda Ambulatory Care Center, North Hills, California. This study was funded by the American Academy of Sleep Medicine Foundation Strategic Research Award #107-SR-13 (principal investigator: Martin); Dr. Martin was supported by a VA Health Services Research and Development Service (HSR&D) Service Research Career Scientist Award (#RCS 20-191) and the National Institutes of Health/National Heart, Lung, and Blood Institute with a research mentoring award (K24 HL143055). Dr. Kelly was supported by the VA Office of Academic Affiliations through the Advanced Fellowship Program in Advanced Geriatrics. This was not an industry-supported study. The views expressed are those of the authors and do not represent the views of the Department of Veterans Affairs or the US government. The authors report no conflicts of interest.

Figures

Figure 1

Figure 1. Scatterplots of mean MSLT-SOL and TST via actigraphy, sleep diary, and PSQI.

Mean MSLT-SOL (_y_-axis) with (A) mean actigraphy nighttime TST, (B) mean sleep diary nighttime TST, and (C) PSQI nighttime TST (_x_-axes). Blue circles represent patients with no SDB (AHI < 5 events/h), red triangles represent patients with mild SDB (AHI 5–14 events/h), and green squares represent patients with moderate to severe SDB (AHI ≥ 15 events/h). *MSLT-SOL vs PSQI was not significant when excluding the potential outlier: r(27) = .13, P = .521. AHI = apnea-hypopnea index, MSLT = Multiple Sleep Latency Test, PSQI = Pittsburgh Sleep Quality Index, SDB = sleep-disordered breathing, SOL = sleep-onset latency, TST = total sleep time.

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