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      Estimating sleep parameters using an accelerometer without sleep diary

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          Abstract

          Wrist worn raw-data accelerometers are used increasingly in large-scale population research. We examined whether sleep parameters can be estimated from these data in the absence of sleep diaries. Our heuristic algorithm uses the variance in estimated z-axis angle and makes basic assumptions about sleep interruptions. Detected sleep period time window (SPT-window) was compared against sleep diary in 3752 participants (range = 60–82 years) and polysomnography in sleep clinic patients (N = 28) and in healthy good sleepers (N = 22). The SPT-window derived from the algorithm was 10.9 and 2.9 minutes longer compared with sleep diary in men and women, respectively. Mean C-statistic to detect the SPT-window compared to polysomnography was 0.86 and 0.83 in clinic-based and healthy sleepers, respectively. We demonstrated the accuracy of our algorithm to detect the SPT-window. The value of this algorithm lies in studies such as UK Biobank where a sleep diary was not used.

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          Most cited references20

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          Automatic sleep/wake identification from wrist activity.

          The purpose of this study was to develop and validate automatic scoring methods to distinguish sleep from wakefulness based on wrist activity. Forty-one subjects (18 normals and 23 with sleep or psychiatric disorders) wore a wrist actigraph during overnight polysomnography. In a randomly selected subsample of 20 subjects, candidate sleep/wake prediction algorithms were iteratively optimized against standard sleep/wake scores. The optimal algorithms obtained for various data collection epoch lengths were then prospectively tested on the remaining 21 subjects. The final algorithms correctly distinguished sleep from wakefulness approximately 88% of the time. Actigraphic sleep percentage and sleep latency estimates correlated 0.82 and 0.90, respectively, with corresponding parameters scored from the polysomnogram (p < 0.0001). Automatic scoring of wrist activity provides valuable information about sleep and wakefulness that could be useful in both clinical and research applications.
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            Chi-Square Tests for Goodness of Fit and Contingency Tables

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              Comparison between subjective and actigraphic measurement of sleep and sleep rhythms.

              Sleep is often assessed in circadian rhythm studies and long-term monitoring is required to detect any changes in sleep over time. The present study aims to investigate the ability of the two most commonly employed methods, actigraphy and sleep logs, to identify circadian sleep/wake disorders and measure changes in sleep patterns over time. In addition, the study assesses whether sleep measured by both methods shows the same relationship with an established circadian phase marker, urinary 6-sulphatoxymelatonin. A total of 49 registered blind subjects with different types of circadian rhythms were studied daily for at least four weeks. Grouped analysis of all study days for all subjects was performed for all sleep parameters (1062-1150 days data per sleep parameter). Good correlations were observed when comparing the measurement of sleep timing and duration (sleep onset, sleep offset, night sleep duration, day-time nap duration). However, the methods were poorly correlated in their assessment of transitions between sleep and wake states (sleep latency, number and duration of night awakenings, number of day-time naps). There were also large and inconsistent differences in the measurement of the absolute sleep parameters. Overall, actigraphs recorded a shorter sleep latency, advanced onset time, increased number and duration of night awakenings, delayed offset, increased night sleep duration and increased number and duration of naps compared with the subjective sleep logs. Despite this, there was good agreement between the methods for measuring changes in sleep patterns over time. In particular, the methods agreed when assessing changes in sleep in relation to a circadian phase marker (the 6-sulphatoxymelatonin (aMT6s) rhythm) in both entrained (n = 30) and free-running (n = 4) subjects.
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                Author and article information

                Contributors
                v.vanhees@esciencecenter.nl
                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                28 August 2018
                28 August 2018
                2018
                : 8
                : 12975
                Affiliations
                [1 ]GRID grid.454309.f, Netherlands eScience Center, ; Amsterdam, The Netherlands
                [2 ]INSERM U1018, Centre for Research in Epidemiology and Population Health, Université Paris-Saclay, Paris, France
                [3 ]ISNI 0000000121901201, GRID grid.83440.3b, Department of Epidemiology & Public Health, , University College London (UCL), ; London, UK
                [4 ]ISNI 0000 0004 1936 8024, GRID grid.8391.3, University of Exeter Medical School, Genetics of Complex Traits, ; Exeter, UK
                [5 ]ISNI 0000 0004 0641 3308, GRID grid.415050.5, Regional Sleep Service, Freeman Hospital, ; Newcastle-upon-Tyne, UK
                [6 ]Center for Sleep and Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
                [7 ]ISNI 0000 0004 1936 8972, GRID grid.25879.31, Department of Genetics, Perelman School of Medicine, , University of Pennsylvania School of Medicine, ; Philadelphia, Pennsylvania USA
                [8 ]ISNI 0000 0004 1936 8972, GRID grid.25879.31, Department of Psychiatry, Perelman School of Medicine, , University of Pennsylvania School of Medicine, ; Philadelphia, Pennsylvania USA
                [9 ]ISNI 0000 0001 0462 7212, GRID grid.1006.7, Movelab, Newcastle University, ; Newcastle-upon-Tyne, UK
                Author information
                http://orcid.org/0000-0003-0182-9008
                http://orcid.org/0000-0003-0153-922X
                http://orcid.org/0000-0002-4699-5627
                http://orcid.org/0000-0002-1244-5037
                Article
                31266
                10.1038/s41598-018-31266-z
                6113241
                30154500
                43f2a1a2-273c-4616-bd0b-89f86568d729
                © The Author(s) 2018

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 8 March 2018
                : 8 August 2018
                Funding
                Funded by: FundRef https://doi.org/10.13039/100000050, U.S. Department of Health &amp; Human Services | NIH | National Heart, Lung, and Blood Institute (NHLBI);
                Award ID: HL-094307 (AIP)
                Award Recipient :
                Funded by: FundRef https://doi.org/10.13039/501100000265, Medical Research Council (MRC);
                Award ID: MR/P012167/1
                Award Recipient :
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