The accuracy of simple, feasible alternatives to polysomnography for assessing sleep in intensive care: An observational study

Article

Delaney, Lori J., Litton, Edward, Carol, H-C Carol, Lopez, Violeta and van Haren, Frank MP.. 2025. "The accuracy of simple, feasible alternatives to polysomnography for assessing sleep in intensive care: An observational study." Australian Critical Care. 36 (3), pp. 361-369. https://doi.org/10.1016/j.aucc.2022.02.004
Article Title

The accuracy of simple, feasible alternatives to polysomnography for assessing sleep in intensive care: An observational study

ERA Journal ID14054
Article CategoryArticle
AuthorsDelaney, Lori J., Litton, Edward, Carol, H-C Carol, Lopez, Violeta and van Haren, Frank MP.
Journal TitleAustralian Critical Care
Journal Citation36 (3), pp. 361-369
Number of Pages9
Year2025
PublisherElsevier
Place of PublicationUnited States
ISSN1036-7314
1878-1721
Digital Object Identifier (DOI)https://doi.org/10.1016/j.aucc.2022.02.004
Web Address (URL)https://www.australiancriticalcare.com/article/S1036-7314(22)00030-3/
Abstract

Background
Sleep disturbance is common in intensive care patients. Understanding the accuracy of simple, feasible sleep measurement techniques is essential to informing their possible role in usual clinical care.
Objective
The aim of the study was to investigate whether sleep monitoring techniques such as actigraphy (ACTG), behavioural assessments, and patient surveys are comparable with polysomnography (PSG) in accurately reporting sleep quantity and quality among conscious, intensive care patients.
Methods
An observational study was conducted in 20 patients admitted to the intensive care unit (ICU) for a minimum duration of 24 h, who underwent concurrent sleep monitoring via PSG, ACTG, nursing-based observations, and self-reported assessment using the Richards–Campbell Sleep Questionnaire.
Results
The reported total sleep time (TST) for the 20 participants measured by PSG was 328.2 min (±106 min) compared with ACTG (362.4 min [±62.1 min]; mean difference = 34.22 min [±129 min]). Bland–Altman analysis indicated that PSG and ACTG demonstrated clinical agreement and did not perform differently across a number of sleep variables including TST, awakening, sleep-onset latency, and sleep efficiency. Nursing observations overestimated sleep duration compared to PSG TST (mean difference = 9.95 ± 136.3 min, p > 0.05), and patient-reported TST was underestimated compared to PSG TST (mean difference = −51.81 ± 144.1 7, p > 0.05).
Conclusions
Amongst conscious patients treated in the ICU, sleep characteristics measured by ACTG were similar to those measured by PSG. ACTG may provide a clinically feasible and acceptable proxy approach to sleep monitoring in conscious ICU patients.

KeywordsSleep; Patient experience; Intensive care; Sleep disturbance; Actigraphy; Sleep monitoring; Richards-Campbell sleep questionnaire; Clinical environment; Noise
Contains Sensitive ContentDoes not contain sensitive content
ANZSRC Field of Research 2020420501. Acute care
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Byline AffiliationsQueensland University of Technology
Australian National University
Fiona Stanley Hospital, Australia
St John of God Health Care, Australia
Canberra Hospital, Australia
Canberra Health Services, Australia
Central Queensland University
St George Hospital, Australia
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