Abstract
BackgroundSince adequate sleep is essential for optimal inpatient rehabilitation, there is an increased interest in sleep assessment. Unobtrusive, contactless, portable bed sensors show great potential for objective sleep analysis.ObjectiveThe aim of this study was to investigate the feasibility of a bed sensor for continuous sleep monitoring overnight in a clinical rehabilitation center.MethodsPatients with incomplete spinal cord injury (iSCI) or stroke were monitored overnight for a 1-week period during their in-hospital rehabilitation using the Emfit QS bed sensor. Feasibility was examined based on missing measurement nights, coverage percentages, and missing periods of heart rate (HR) and respiratory rate (RR). Furthermore, descriptive data of sleep-related parameters (nocturnal HR, RR, movement activity, and bed exits) were reported.ResultsIn total, 24 participants (12 iSCI, 12 stroke) were measured. Of the 132 nights, 5 (3.8%) missed sensor data due to Wi-Fi (2), slipping away (1), or unknown (2) errors. Coverage percentages of HR and RR were 97% and 93% for iSCI and 99% and 97% for stroke participants. Two-thirds of the missing HR and RR periods had a short duration of ≤120 seconds. Patients with an iSCI had an average nocturnal HR of 72 (SD 13) beats per minute (bpm), RR of 16 (SD 3) cycles per minute (cpm), and movement activity of 239 (SD 116) activity points, and had 86 reported and 84 recorded bed exits. Patients with a stroke had an average nocturnal HR of 61 (SD 8) bpm, RR of 15 (SD 1) cpm, and movement activity of 136 (SD 49) activity points, and 42 reported and 57 recorded bed exits. Patients with an iSCI had significantly higher nocturnal HR (t18=−2.1, P=.04) and movement activity (t18=−1.2, P=.02) compared to stroke patients. Furthermore, there was a difference between self-reported and recorded bed exits per night in 26% and 38% of the nights for iSCI and stroke patients, respectively.ConclusionsIt is feasible to implement the bed sensor for continuous sleep monitoring in the clinical rehabilitation setting. This study provides a good foundation for further bed sensor development addressing sleep types and sleep disorders to optimize care for rehabilitants.
Highlights
An important aim of rehabilitation therapy for patients with neurological disorders such as stroke or spinal cord injury (SCI; including incomplete SCI [incomplete spinal cord injury (iSCI)]) is to develop skills needed for independent living
No statistical differences in sex, age, premorbid sleep problems, or the use of sleep medication were found between the iSCI and stroke groups (Table 1)
The aim of this study was to investigate the feasibility of an unobtrusive, contactless, portable bed sensor for continuous sleep monitoring overnight in a clinical rehabilitation SCI and stroke ward
Summary
An important aim of rehabilitation therapy for patients with neurological disorders such as stroke or spinal cord injury (SCI; including incomplete SCI [iSCI]) is to develop skills needed for independent living. Up to 60% of patients with stroke or SCI suffer from sleep disorders [1,2], which is high compared to the 24% of people with sleep problems in the general European population [4] Those sleep disturbances may interfere with their long-term rehabilitation process for a variety of reasons in terms of lowering motivation, energy, and concentration, which are needed to fully participate in the rehabilitation process [3,5]. Patients with an iSCI had an average nocturnal HR of 72 (SD 13) beats per minute (bpm), RR of 16 (SD 3) cycles per minute (cpm), and movement activity of 239 (SD 116) activity points, and had 86 reported and 84 recorded bed exits. This study provides a good foundation for further bed sensor development addressing sleep types and sleep disorders to optimize care for rehabilitants
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