Feasibility of Continuous Actigraphy in Patients in a Medical Intensive Care Unit.
Biren B Kamdar, Daniel J Kadden, Sitaram Vangala and 4 others
PMID 28668919WHAT IT FOUND
Continuous wrist and ankle actigraphy was feasible in medical ICU patients, but the devices disagreed about sleep and activity.
Treat it as a monitoring feasibility result, not as evidence that actigraphy improves patient care.
Key findings
01Thirty-four of 35 enrolled patients completed the 48-hour actigraphy recording period.
02Wrist and ankle devices estimated different amounts of sleep and disagreed about sleep/wake and activity.
03Device comfort ratings were mixed: 20 patients rated the devices comfortable or moderately comfortable, and 6 rated them very uncomfortable.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study included only 35 enrolled patients, and all were studied in a single ICU, so the findings may not generalise to other units. Only 36% of screened patients met eligibility criteria, and 27% declined enrollment. The sleep scoring algorithm was not validated in critically ill patients, so immobile patients may have been scored as sleeping when awake. The study did not assess validity or superiority of wrist versus ankle recordings. Some patients could not rate comfort because of delirium or coma.
The easy way to misread this
Do not conclude that actigraphy is a validated clinical measure of sleep or activity in ICU patients. The study tested feasibility, and the sleep scoring algorithm was not validated in critically ill patients.