腕表式睡眠监测仪与多导睡眠监测的睡眠参数比较和相关性分析

doi:10.19723/j.issn.1671-167X.2021.05.022

摘要/Abstract

摘要：

目的: 随着睡眠医学的飞速发展,检测睡眠疾病的方法多种多样,各具优势。本研究以“金标准”多导睡眠监测(polysomnography,PSG)的结果为标准,探索在中国人群中使用小巧轻便的腕表式睡眠监测仪(Actiwatch)获得相关指标的可靠性,以期为Actiwatch的临床应用提供依据。方法: 选取北京大学人民医院睡眠中心2018年8月至2019年12月的121例受试者,受试者进行PSG的同时佩戴Actiwatch,并于第2天清晨填写睡眠日志。收集监测获得的指标进行线性相关分析,并用配对t检验比较两者的差异。结果: Actiwatch在低灵敏度条件下,PSG和Actiwatch总睡眠时间(total sleep time,TST)的相关系数为0.53(P<0.05), 配对t检验表明PSG和Actiwatch的TST差异无统计学意义(t=-0.890,P=0.36)。按年龄分层发现,年龄越小,两者的TST相关性越强,系数最高可达0.92(P<0.05), 配对t检验表明两者TST的差异无统计学意义(t=-1.057,P=0.35)。按诊断分层发现,PSG正常组中两者的TST相关系数可高达0.79(P<0.05), 配对t检验表明PSG正常组中两者TST的差异无统计学意义(t=-0.784,P=0.44)。结论: 作为一种可穿戴的居家体动记录仪,腕表式睡眠监测仪Actiwatch的分析参数设定为低灵敏度时,PSG和Actiwatch的TST相关性最高;年龄越小,PSG与Actiwatch的TST相关性越强;PSG正常的受试者PSG和Actiwatch的TST相关性更高。

关键词: 睡眠, 腕表式睡眠监测仪, 体动描记术, 多导睡眠监测

Abstract:

Objective: With the rapid development of sleep medicine, there are various methods for detecting sleep diseases. This study compared the correlation between the lightweight watch-type sleep monitor (Actiwatch) and the “gold standard” polysomnography (PSG) in the Chinese population, in order to provide a basis for clinical application. Methods: From August 2018 to December 2019, 121 subjects who simultaneously performed sleep breathing monitoring (PSG) and wearing a watch-type sleep monitor (Actiwatch) in the Sleep Center of Peking University People’s Hospital were enrolled. All subjects received PSG and Actiwatch at the same time, and filled out the sleep diary next morning. Monitoring indicators were collected for linear correlation analysis and paired t test to compare the differences. Results: Under low sensitivity conditions, the correlation coefficient of total sleep time (TST) between PSG and Actiwatch was 0.53 (P<0.05). Paired t test analysis showed that there was no significant difference between the TSTs of Actiwatch and PSG (t=-0.890, P=0.36). According to age stratification, the smaller the age, the stronger the correlation between the TSTs of Actiwatch and PSG, and the coefficient could be up to 0.92 (P<0.05). Paired t test showed that there was no significant difference between them (t=-1.057, P=0.35). According to the stratification by diagnosis, the correlation coefficient between the TSTs of Actiwatch and PSG in normal PSG group could be as high as 0.79 (P<0.05), the results of paired t test showed that there was no significant difference between the TSTs of Actiwatch and PSG in normal PSG group (t=-0.784, P=0.44). Conclusion: As a wearable home recorder, when the analysis parameters of Actiwatch were set as low sensitivity, PSG and Actiwatch had the highest TST correlation. The younger the age, the stronger correlation between the TSTs of Actiwatch and PSG. The PSG and Actiwatch subjects with normal PSG presentation had a higher TST correlation.

Key words: Sleep, Watch-type sleep monitor, Actigraphy, Polysomnography

中图分类号:

R338.63

霍阳,周兵,何红彦,赵龙,张雪丽,李静,左玉花,郑宇,任正洪,韩芳,张俊. 腕表式睡眠监测仪与多导睡眠监测的睡眠参数比较和相关性分析[J]. 北京大学学报（医学版）, 2021, 53(5): 942-945.

Yang HUO,Bing ZHOU,Hong-yan HE,Long ZHAO,Xue-li ZHANG,Jing LI,Yu-hua ZUO,Yu ZHENG,Zheng-hong REN,Fang HAN,Jun ZHANG. Comparison and correlation analysis of sleep parameters between watch-type sleep monitor (Actiwatch) and polysomnography[J]. Journal of Peking University (Health Sciences), 2021, 53(5): 942-945.

图/表 3

表1

PSG与不同灵敏度条件下Actiwatch的相关睡眠参数比较"

Group	TRT/min
Group	$x ?$ ±s	r	$x ?$ ±s	r	$x ?$ ±s	r
PSG	486.88±35.54		394.48±64.00		81.22±12.94
Actiwatch (low)	517.42±48.47^*	0.47	399.59±66.67^*	0.53	77.40±12.17^*	0.46
Actiwatch (medium)	517.42±48.47^*	0.47	420.75±62.55^*	0.51	81.48±11.12^*	0.45
Actiwatch (high)	517.42±48.47^*	0.47	440.94±62.63^*	0.47	85.37±10.90^*	0.42

表1

表2

年龄分组后PSG与低灵敏度条件下Actiwatch的相关睡眠参数比较"

Age group/years	Monitoring		TRT/min				TST/min				SE/%
Age group/years	Monitoring		$x ?$ ±s		r		$x ?$ ±s		r		$x ?$ ±s	r
≤18	PSG	519.28±45.61				442.30±61.74				85.81±14.36
≤18	Actiwatch	551.80±61.53		0.20		356.40±76.96^*		0.92		65.54±7.10		0.77
19-40	PSG	448.12±39.68				396.54±68.21				81.37±13.50
19-40	Actiwatch	517.27±45.56^*		0.55		400.71±67.57^*		0.67		77.53±12.07^*		0.60
41-65	PSG	481.35±29.93				390.96±61.04				81.48±12.91
41-65	Actiwatch	514.69±50.21		0.46		400.73±64.02^*		0.47		78.02±11.54^*		0.38
≥66	PSG	500.71±36.00				381.94±61.72				76.09±9.62
≥66	Actiwatch	517.89±43.65		0.17		410.11±77.74		0.45		78.99±12.76		0.48

表2

表3

按诊断分组后PSG与低灵敏度条件下Actiwatch的相关睡眠参数比较"

Group	Monitoring		TRT/min				TST/min				SE/%
Group	Monitoring		$x ?$ ±s		r		$x ?$ ±s		r		$x ?$ ±s	r
Narcolepsy	PSG	488.28±39.36				416.23±55.72				85.58±10.41
Narcolepsy	Actiwatch	518.80±69.54^*		0.71		373.20±77.05		0.45		72.06±12.93		0.38
Normal PSG	PSG	482.40±24.38				388.29±70.50				80.40±14.00
Normal PSG	Actiwatch	497.30±41.61^*		0.51		394.90±72.94^*		0.79		79.46±13.92^*		0.72
OSAS	PSG	488.37±36.41				392.63±62.76				80.68±12.95
OSAS	Actiwatch	525.09±44.32^*		0.37		406.64±61.22^*		0.47		77.63±11.10^*		0.40

表3

参考文献 13

[1]	Rundo JV, Downey R, 3rd. Polysomnography [J]. Handb Clin Neurol, 2019, 160:381-392.
[2]	Morgenthaler T, Alessi C, Friedman L, et al. Practice parameters for the use of actigraphy in the assessment of sleep and sleep disorders: An update for 2007 [J]. Sleep, 2007, 30(4):519-529. pmid: 17520797
[3]	Smith MT, McCrae CS, Cheung J, et al. Use of actigraphy for the evaluation of sleep disorders and circadian rhythm sleep-wake disorders: An American Academy of Sleep Medicine clinical practice guideline [J]. J Clin Sleep Med, 2018, 14(7):1231-1237. doi: 10.5664/jcsm.7230
[4]	Park KS, Choi SH. Smart technologies toward sleep monitoring at home [J]. Biomed Eng Lett, 2019, 9(1):73-85. doi: 10.1007/s13534-018-0091-2
[5]	Haghayegh S, Khoshnevis S, Smolensky MH, et al. Performance comparison of different interpretative algorithms utilized to derive sleep parameters from wrist actigraphy data [J]. Chronobiol Int, 2019, 36(12):1752-1760. doi: 10.1080/07420528.2019.1679826 pmid: 31658822
[6]	Conley S, Knies A, Batten J, et al. Agreement between actigra-phic and polysomnographic measures of sleep in adults with and without chronic conditions: A systematic review and meta-analysis [J]. Sleep Med Rev, 2019, 46(1):151-160. doi: 10.1016/j.smrv.2019.05.001
[7]	Tonetti L, Pasquini F, Fabbri M, et al. Comparison of two diffe-rent actigraphs with polysomnography in healthy young subjects [J]. Chronobiol Int, 2008, 25(1):145-153. doi: 10.1080/07420520801897228
[8]	Lee PH, Suen LK. The convergent validity of Actiwatch 2 and ActiGraph Link accelerometers in measuring total sleeping period, wake after sleep onset, and sleep efficiency in free-living condition [J]. Sleep Breath, 2017, 21(1):209-215. doi: 10.1007/s11325-016-1406-0
[9]	van de Wouw E, Evenhuis HM, Echteld MA. Comparison of two types of Actiwatch with polysomnography in older adults with intellectual disability: a pilot study [J]. J Intellect Dev Disabil, 2013, 38(3):265-273. doi: 10.3109/13668250.2013.816274
[10]	Meltzer LJ, Walsh CM, Traylor J, et al. Direct comparison of two new actigraphs and polysomnography in children and adolescents [J]. Sleep, 2012, 35(1):159-166. doi: 10.5665/sleep.1608 pmid: 22215930
[11]	Martin JL, Hakim AD. Wrist actigraphy [J]. Chest, 2011, 139(6):1514-1527. doi: 10.1378/chest.10-1872
[12]	Baron KG, Duffecy J, Berendsen MA, et al. Feeling validated yet? A scoping review of the use of consumer-targeted wearable and mobiletechnology to measure and improve sleep [J]. Sleep Med Rev, 2018, 40(1):151-159. doi: 10.1016/j.smrv.2017.12.002
[13]	李清华, 王碧瑛, 董霄松, 等. 腕动仪结合血氧监测仪在诊断睡眠呼吸暂停低通气综合征中的价值 [J]. 中华医学杂志, 2015, 95(42):3411-3415.

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