Abstract
Sleep actigraphy in brain injured patients with chronic low functioning upper limb hemiparesis K. HERRON1, D. DIJK2, J. ELLIS3, J. SANDERS1 and A. STERR1 1Department of Psychology, University of Surrey, Guildford, United Kingdom, 2Surrey Sleep Research Centre, University of Surrey, Guildford, United Kingdom and 3Section of Psychological Medicine, University of Glasgow, Glasgow, United Kingdom Introduction: Few studies have used actigraphy to examine sleep behaviour in brain injured patients with chronic hemiparesis. This is possibly due to suggestions that actigraphy recordings in those with motor difficulties are likely to produce inaccurate sleep/wake detection (Sadeh and Acebo, 2002). However, actigraphy provides a favourable alternative to PSG when observing long term sleep behaviour. Therefore, we aimed to further validate the use of actigraphy in low functioning hemiparetic patients by comparing subjective sleep diaries (SD) with actigraphy recordings to examine: 1) concordance between SD and actigraphy, and 2) the relationship between motor deficits and activity. Method: Twelve patients with chronic upper limb hemiparesis (412 months) completed SDs and wore an actiwatch (Cambridge Neurotechnology Ltd.) on the non-affected wrist for two weeks. Residual motor ability was assessed through a series of neurobehavioural motor tests. Results: Comparison of SD and actigraphy revealed significant dissociations between final wake time, sleep efficiency, number and duration of night awakenings. Good concordance between SD and actigraphy was found for retiring time, get up time, time in bed, total sleep time and sleep onset latency. Mean activity counts, during the day or night, were not associated with residual motor ability. Discussion and Conclusion: Actigraphy of the non-affected wrist, in conjunction with SDs, are a valid apparatus for assessing long term sleep behaviour in patients with hemiparesis. The results are in line with previous studies in healthy persons without motor difficulties whereby SDs and actigraphy correlate well, apart from parameters which rely on subjective night time awakenings (Lockley et al. 1999). The latter can only be determined by PSG studies.