背景:睡眠障碍是精神疾病的核心症状。尽管已经开发了各种睡眠措施来评估睡眠模式和睡眠质量,这些措施在精神疾病患者中的一致性仍然相对难以捉摸。
目的:本研究旨在检查3种睡眠记录方法之间的一致程度以及主观和客观睡眠测量之间的一致性,特别关注最近在患有精神疾病的人群中开发的设备。
方法:我们分析了这项横断面研究的62名参与者,都有多导睡眠图(PSG)的数据,Zmachine,Fitbit,和睡眠日志。参与者完成了关于他们的症状的问卷调查,并在过夜睡眠评估后的早晨估计了睡眠时间。计算类间相关系数(ICC)以评估从每种仪器获得的睡眠参数之间的一致性。此外,Bland-Altman地块用于直观地显示PSG测量的睡眠参数的差异和一致性限制,Zmachine,Fitbit,和睡眠日志。
结果:研究结果表明,PSG和Zmachine数据在总睡眠时间方面具有适度的一致性(ICC=0.46;P<.001),睡眠开始后醒来(ICC=0.39;P=0.002),和睡眠效率(ICC=0.40;P=.006)。相比之下,Fitbit与PSG表现出明显的分歧(总睡眠时间:ICC=0.08;睡眠开始后醒来:ICC=0.18;睡眠效率:ICC=0.10),并且与睡眠日志表现出特别大的差异(总睡眠时间:ICC=-0.01;睡眠开始后醒来:ICC=0.05;睡眠效率:ICC=-0.02)。此外,PSG之间的主观和客观一致性,Zmachine,睡眠日志似乎受到抑郁症状和阻塞性睡眠呼吸暂停的严重程度的影响,而Fitbit和其他睡眠仪器之间没有观察到这些关联。
结论:我们的研究结果表明,在存在合并症临床症状的情况下,Fitbit的准确性会降低。虽然用户友好,Fitbit在评估精神疾病患者的睡眠时应考虑其局限性。
Sleep
disturbances are core symptoms of psychiatric disorders. Although various sleep measures have been developed to assess sleep patterns and quality of sleep, the concordance of these measures in patients with psychiatric disorders remains relatively elusive.
This study aims to examine the degree of agreement among 3 sleep recording methods and the consistency between subjective and objective sleep measures, with a specific focus on recently developed devices in a population of individuals with psychiatric disorders.
We analyzed 62 participants for this cross-sectional study, all having data for polysomnography (PSG), Zmachine, Fitbit, and sleep logs. Participants completed questionnaires on their symptoms and estimated sleep duration the morning after the overnight sleep assessment. The interclass correlation coefficients (ICCs) were calculated to evaluate the consistency between sleep parameters obtained from each instrument. Additionally, Bland-Altman plots were used to visually show differences and limits of agreement for sleep parameters measured by PSG, Zmachine, Fitbit, and sleep logs.
The findings indicated a moderate agreement between PSG and Zmachine data for total sleep time (ICC=0.46; P<.001), wake after sleep onset (ICC=0.39; P=.002), and sleep efficiency (ICC=0.40; P=.006). In contrast, Fitbit demonstrated notable disagreement with PSG (total sleep time: ICC=0.08; wake after sleep onset: ICC=0.18; sleep efficiency: ICC=0.10) and exhibited particularly large discrepancies from the sleep logs (total sleep time: ICC=-0.01; wake after sleep onset: ICC=0.05; sleep efficiency: ICC=-0.02). Furthermore, subjective and objective concordance among PSG, Zmachine, and sleep logs appeared to be influenced by the severity of the depressive symptoms and obstructive sleep apnea, while these associations were not observed between the Fitbit and other sleep instruments.
Our study results suggest that Fitbit accuracy is reduced in the presence of comorbid clinical symptoms. Although user-friendly, Fitbit has limitations that should be considered when assessing sleep in patients with psychiatric disorders.