Characterisation of ICU sleep by a commercially available activity tracker and its agreement with patient-perceived sleep quality

Background A low-cost, quantitative method to evaluate sleep in the intensive care unit (ICU) that is both feasible for routine clinical practice and reliable does not yet exist. We characterised nocturnal ICU sleep using a commercially available activity tracker and evaluated agreement between trac...

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Main Authors: John W Devlin, Xavier Torres, Yuan Du, Patricia R Louzon, Jessica L Andrews, Eric C Pyles, Mahmood H Ali
Format: Article
Language:English
Published: BMJ Publishing Group 2020-09-01
Series:BMJ Open Respiratory Research
Online Access:https://bmjopenrespres.bmj.com/content/7/1/e000572.full
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author John W Devlin
Xavier Torres
Yuan Du
Patricia R Louzon
Jessica L Andrews
Eric C Pyles
Mahmood H Ali
author_facet John W Devlin
Xavier Torres
Yuan Du
Patricia R Louzon
Jessica L Andrews
Eric C Pyles
Mahmood H Ali
author_sort John W Devlin
collection DOAJ
description Background A low-cost, quantitative method to evaluate sleep in the intensive care unit (ICU) that is both feasible for routine clinical practice and reliable does not yet exist. We characterised nocturnal ICU sleep using a commercially available activity tracker and evaluated agreement between tracker-derived sleep data and patient-perceived sleep quality.Patients and methods A prospective cohort study was performed in a 40-bed ICU at a community teaching hospital. An activity tracker (Fitbit Charge 2) was applied for up to 7 ICU days in English-speaking adults with an anticipated ICU stay ≥2 days and without mechanical ventilation, sleep apnoea, delirium, continuous sedation, contact isolation or recent anaesthesia. The Richards-Campbell Sleep Questionnaire (RCSQ) was administered each morning by a trained investigator.Results Available activity tracker-derived data for each ICU study night (20:00–09:00) (total sleep time (TST), number of awakenings (#AW), and time spent light sleep, deep sleep and rapid eye movement (REM) sleep) were downloaded and analysed. Across the 232 evaluated nights (76 patients), TST and RCSQ data were available for 232 (100%), #AW data for 180 (78%) and sleep stage data for 73 (31%). Agreement between TST (349±168 min) and RCSQ Score was moderate and significant (r=0.34; 95% CI 0.18 to 0.48). Agreement between #AW (median (IQR), 4 (2–9)) and RCSQ Score was negative and non-significant (r=−0.01; 95% CI −0.19 to 0.14). Agreement between time (min) spent in light (259 (182 to 328)), deep (43±29), and REM (47 (28–72)) sleep and RCSQ Score was moderate but non-significant (light (r=0.44, 95% CI −0.05 to 0.36); deep sleep (r=0.44, 95% CI −0.11 to 0.15) and REM sleep (r=0.44; 95% CI −0.21 to 0.21)).Conclusions A Fitbit Charge 2 when applied to non-intubated adults in an ICU consistently collects TST data but not #AW or sleep stage data at night. The TST moderately correlates with patient-perceived sleep quality; a correlation between either #AW or sleep stages and sleep quality was not found.
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spelling doaj-art-c5559d79914244d697a43a18049a29932024-11-24T09:55:08ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392020-09-017110.1136/bmjresp-2020-000572Characterisation of ICU sleep by a commercially available activity tracker and its agreement with patient-perceived sleep qualityJohn W Devlin0Xavier Torres1Yuan Du2Patricia R Louzon3Jessica L Andrews4Eric C Pyles5Mahmood H Ali6Northeastern University Bouvé College of Health Sciences School of Pharmacy, Boston, Massachusetts, USADepartment of Pharmacy, University of Chicago Medical Center, Chicago, Illinois, USAResearch Institute, AdventHealth Orlando, Orlando, Florida, USADepartment of Pharmacy, AdventHealth Orlando, Orlando, Florida, USADepartment of Pharmacy, Baptist Health, Jacksonville, Florida, USADepartment of Pharmacy, AdventHealth Orlando, Orlando, Florida, USAPulmonology, Central Florida Pulmonary Group PA, Orlando, Florida, USABackground A low-cost, quantitative method to evaluate sleep in the intensive care unit (ICU) that is both feasible for routine clinical practice and reliable does not yet exist. We characterised nocturnal ICU sleep using a commercially available activity tracker and evaluated agreement between tracker-derived sleep data and patient-perceived sleep quality.Patients and methods A prospective cohort study was performed in a 40-bed ICU at a community teaching hospital. An activity tracker (Fitbit Charge 2) was applied for up to 7 ICU days in English-speaking adults with an anticipated ICU stay ≥2 days and without mechanical ventilation, sleep apnoea, delirium, continuous sedation, contact isolation or recent anaesthesia. The Richards-Campbell Sleep Questionnaire (RCSQ) was administered each morning by a trained investigator.Results Available activity tracker-derived data for each ICU study night (20:00–09:00) (total sleep time (TST), number of awakenings (#AW), and time spent light sleep, deep sleep and rapid eye movement (REM) sleep) were downloaded and analysed. Across the 232 evaluated nights (76 patients), TST and RCSQ data were available for 232 (100%), #AW data for 180 (78%) and sleep stage data for 73 (31%). Agreement between TST (349±168 min) and RCSQ Score was moderate and significant (r=0.34; 95% CI 0.18 to 0.48). Agreement between #AW (median (IQR), 4 (2–9)) and RCSQ Score was negative and non-significant (r=−0.01; 95% CI −0.19 to 0.14). Agreement between time (min) spent in light (259 (182 to 328)), deep (43±29), and REM (47 (28–72)) sleep and RCSQ Score was moderate but non-significant (light (r=0.44, 95% CI −0.05 to 0.36); deep sleep (r=0.44, 95% CI −0.11 to 0.15) and REM sleep (r=0.44; 95% CI −0.21 to 0.21)).Conclusions A Fitbit Charge 2 when applied to non-intubated adults in an ICU consistently collects TST data but not #AW or sleep stage data at night. The TST moderately correlates with patient-perceived sleep quality; a correlation between either #AW or sleep stages and sleep quality was not found.https://bmjopenrespres.bmj.com/content/7/1/e000572.full
spellingShingle John W Devlin
Xavier Torres
Yuan Du
Patricia R Louzon
Jessica L Andrews
Eric C Pyles
Mahmood H Ali
Characterisation of ICU sleep by a commercially available activity tracker and its agreement with patient-perceived sleep quality
BMJ Open Respiratory Research
title Characterisation of ICU sleep by a commercially available activity tracker and its agreement with patient-perceived sleep quality
title_full Characterisation of ICU sleep by a commercially available activity tracker and its agreement with patient-perceived sleep quality
title_fullStr Characterisation of ICU sleep by a commercially available activity tracker and its agreement with patient-perceived sleep quality
title_full_unstemmed Characterisation of ICU sleep by a commercially available activity tracker and its agreement with patient-perceived sleep quality
title_short Characterisation of ICU sleep by a commercially available activity tracker and its agreement with patient-perceived sleep quality
title_sort characterisation of icu sleep by a commercially available activity tracker and its agreement with patient perceived sleep quality
url https://bmjopenrespres.bmj.com/content/7/1/e000572.full
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