Abstract
Although portable instruments have been used in the assessment of sleep disturbance for patients with low back pain (LBP), the accuracy of the instruments in detecting sleep/wake episodes for this population is unknown. This study investigated the criterion validity of two portable instruments (Armband and Actiwatch) for assessing sleep disturbance in patients with LBP. 50 patients with LBP performed simultaneous overnight sleep recordings in a university sleep laboratory. All 50 participants were assessed by Polysomnography (PSG) and the Armband and a subgroup of 33 participants wore an Actiwatch. Criterion validity was determined by calculating epoch-by-epoch agreement, sensitivity, specificity and prevalence and bias- adjusted kappa (PABAK) for sleep versus wake between each instrument and PSG. The relationship between PSG and the two instruments was assessed using intraclass correlation coefficients (ICC 2, 1). The study participants showed symptoms of sub-threshold insomnia (mean ISI = 13.2, 95% CI = 6.36) and poor sleep quality (mean PSQI = 9.20, 95% CI = 4.27). Observed agreement with PSG was 85% and 88% for the Armband and Actiwatch. Sensitivity was 0.90 for both instruments and specificity was 0.54 and 0.67 and PABAK of 0.69 and 0.77 for the Armband and Actiwatch respectively. The ICC (95%CI) was 0.76 (0.61 to 0.86) and 0.80 (0.46 to 0.92) for total sleep time, 0.52 (0.29 to 0.70) and 0.55 (0.14 to 0.77) for sleep efficiency, 0.64 (0.45 to 0.78) and 0.52 (0.23 to 0.73) for wake after sleep onset and 0.13 (−0.15 to 0.39) and 0.33 (−0.05 to 0.63) for sleep onset latency, for the Armband and Actiwatch, respectively. The findings showed that both instruments have varied criterion validity across the sleep parameters from excellent validity for measures of total sleep time, good validity for measures of sleep efficiency and wake after onset to poor validity for sleep onset latency.
Highlights
IntroductionLow back pain (LBP) is a common health condition; it has a lifetime prevalence of 40%, and a point prevalence (at any point in time) of 20% [1]
Low back pain (LBP) is a common health condition; it has a lifetime prevalence of 40%, and a point prevalence of 20% [1]
As the Armband does not appear to have superior criterion validity to the actigraph we conclude that the parameters sampled by the Armband do not provide additional accuracy in identifying sleep/wake epochs in the way that they are measured by this device
Summary
Low back pain (LBP) is a common health condition; it has a lifetime prevalence of 40%, and a point prevalence (at any point in time) of 20% [1]. Studies have found that between 50–60% of patients with LBP report sleep disturbance [3,4]. Sleep disturbance in patients with LBP is associated with psychological distress, physical disability [6], fatigue and day-time sleepiness [7]. The consequences of sleep disturbance can hinder treatment effectiveness. Exercise therapy, used to reduce pain, improve function and enhance return to work [10], is a critical component of LBP management. The effects of sleep disturbance such as fatigue are likely to hinder exercise performance and lead to poorer treatment outcomes. For these reasons the assessment of sleep disturbance in patients with LBP is an important clinical and research question
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
