Comparison of sleep parameters obtained from actigraphy and polysomnography during the rehabilitative phase after...

The evaluation of sleep is an important aspect of holistic care. Polysomnographic assessment is not always possible or justified. Actigraphy has gained popularity as an alternative sleep/wake monitor. The purpose of this study was to determine whether actigraphy has reasonable validity within the special population of rehabilitating burn patients. Total sleep time, sleep efficiency, number of arousals, wake time after sleep onset, and latency of sleep onset as assessed by actigraphy (proportional integration mode [PIM] and zero crossing mode [ZCM]) were compared with polysomnography in 36 children an average of 10.5 years after burn injury during an overnight hospital stay. The subjects' mean age at the time of study was 14.4 years; original burn injuries involved 63% TBSA, 41% of that full thickness. Polysomnographic data demonstrated the mean total sleep time to be only 5.25 hours of sleep per night. This study reaffirms previous findings of significantly increased wake time and N1 sleep with a reduction in rapid eye movement compared to normal. Although both the ZCM and PIM did not accurately derive total sleep time using polysomnography results as the benchmark, PIM was more precise in the estimation of the number of sleep arousals and ZCM more accurately characterized sleep latency. In conclusion, actigraphy provides a fairly good indication of sleep for the rehabilitating burn patient as long as clinicians and researchers remain mindful of its limitations. Additional field testing is warranted to determine its application in adult and critically ill populations after injury and the usefulness of actigraphy in the home setting.