SLEEP 2011 Abstract Supplement

B. Clinical Sleep Science XIV. Instrumentation and Methodology
0967
THE ROLE OF ACTIGRAPHY AND A SLEEP DIARY IN CPAP
ADHERENCE
Muehlbach MJ, Powell ED, Poeppel EL, Ojile JM
Clayton Sleep Institute, St. Louis, MO, USA
Introduction: The topic of CPAP adherence is of continual clinical relevance.
Various studies have tried to assess variables that may predict
or influence adherence with CPAP therapy. Actigraphy and sleep diaries
are common tools used to gather ambulatory sleep patterns, but limited
data have been presented on the benefits of these tools in reporting adherence
patterns. The goal of the present study was to assess the relationship
between CPAP usage patterns and actigraphy/sleep diary data.
Methods: Data was used from a prior study assessing adherence with
various treatment modalities. As part of that study, actigraphy, sleep diary,
and treatment adherence was measured daily. Each day with matching
and complete variables was used as a data point for analysis.
Results: A total of 333 days with complete data sets were used for analysis.
CPAP adherence significantly correlated with actigraphy variables
of TIB (p< .001), TST (p< .001), WASO (p< .05), and Fragmentation Index
(p< .001). However, only the Fragmentation Index was significantly
correlated to diary estimates of CPAP use (p< .001). Using actigraphy
and diary variables as predictors for CPAP adherence, the variables of
diary TST and actigraphy TST entered the predictive model and accounted
for 12% of the variance (F= 20.691, p< .001). Comparing compliant
vs. non-compliant CPAP users (> 240 min/nt), the non-compliant
users drastically overestimate usage (diary: 305.2 min vs. actual 87.1
min) whereas the compliant users more accurately estimate their usage
(diary: 374.1 min vs. actual 375.1 min). Actigraphy may also be a beneficial
tool for assessing treatment adherence, as non-compliant users
had a significantly higher WASO and Fragmentation Index and lower
TST than the compliant users (all p< .05).
Conclusion: There are a variety of factors involved in CPAP adherence,
and it can be challenging to clinicians to fully assess and understand adherence
patterns. Actigraphy and sleep diary collection while on CPAP
may be a beneficial tool to understanding this process. Specifically, the
fragmentation index may give insight to either non-use or unresolved
sleep disruptions that may be factors tied to treatment use.
0968
DIRECT ACTIVITY MEASURES ARE USEFUL ACTIGRAPHY
ENDPOINTS FOR DETECTING DIFFERENCES IN SLEEP
AND DAYTIME ACTIVITY AMONG DIFFERENT PATIENT
POPULATIONS
Peterson BT 1 , Resnick M 2 , Chen C 1 , Amin N 1 , Brosnan M 1 , Badura L 1 ,
Pickering EH 1
1
Pfizer Global Research and Development, Groton, CT, USA, 2 Pfizer
Primary Care Business Unit, New York, NY, USA
Introduction: Actigraphy helps diagnose sleep problems in patients,
but clinical studies require objective endpoints that quantify sleep and
daytime activity. An algorithm is typically used to identify “sleep” vs.
“awake” periods allowing endpoints such as total sleep time (aTST) and
sleep efficiency (aEff) to be derived. Alternatively, activity counts can
be used to calculate direct activity endpoints. This study assessed direct
activity and derived endpoints in different populations.
Methods: A Bodymedia Armband was worn day and night (3-21 days)
by 38 healthy volunteers (HV), 66 fibromyalgia (FM) patients, and 15
obese subjects. 24 patients with Restless Leg Syndrome (RLS) wore the
armband for 2-5 nights. All patient data are from the placebo-arm of
clinical trials. A program calculated derived (aTST [mins], aEff [%])
and direct activity endpoints (mean, 75th, 90th percentiles during sleep,
and mean, 10th, 25th percentiles during daytime). Percentiles were
based on patient’s distribution of recorded activity (counts/min). Data
are mean±s.e.
Results: Compared with HV (415.0±10.4), aTST (mins) was unchanged
in FM (419.2±10.3), increased in obese (477.0±17.9;P