Sensors, Vol. 20, Pages 549: Characterizing Behavioral Activity Rhythms in Older Adults Using Actigraphy
Sensors, Vol. 20, Pages 549: Characterizing Behavioral Activity Rhythms in Older Adults Using Actigraphy Sensors doi: 10.3390/s20020549 Authors: Ariel B. Neikrug Ivy Y. Chen Jake R. Palmer Susan M. McCurry Michael Von Korff Michael Perlis Michael V. Vitiello Wrist actigraphy has been used to assess sleep in older adult populations for nearly half a century. Over the years, the continuous raw activity data derived from actigraphy has been used for the characterization of factors beyond sleep/wake such as physical activity patterns and circadian rhythms. Behavioral activity rhythms (BAR) are useful to describe individual daily behavioral patterns beyond sleep and wake, which represent important and meaningful clinical outcomes. This paper reviews common rhythmometric approaches and summarizes the available data from the use of these different approaches in older adult populations. We further consider a new approach developed in our laboratory designed to provide graphical characterization of BAR for the observed behavioral phenomenon of activity patterns across time. We illustrate the application of this new approach using actigraphy data collected from a well-characterized sample of older adults (age 60+) with osteoarthritis (OA) pain and insomnia. Generalized additive models (GAM) were implemented to fit smoothed nonlinear curves to log-transformed aggregated actigraphy-derived activity measurements. This approach demonstrated an overall strong model fit (...
The OsteoArthritis and Therapy for Sleep (OATS) study is a population-based randomized controlled trial of cognitive behavioral therapy for insomnia (CBTI) with four innovative methodological aims. These are to: (1) Enroll representative participants across Washington state, including those from medically underserved communities; (2) Enroll persons with persistent insomnia and chronic osteoarthritis (OA) pain; (3) Test a scalable CBT-I intervention; and (4) Evaluate patient-reported outcomes (insomnia, pain severity, fatigue, depression) and cost-effectiveness over one year.
Poor sleep quality, pain and fatigue are commonly experienced by older adults with osteoarthritis (OA).1,40,48,65,66 Cross-sectional studies have demonstrated significant associations between poor sleep quality and higher OA-related pain intensity and/or fatigue24,46 and sleep improvements following Cognitive Behavioral Therapy for Insomnia (CBT-I) have been associated with downstream and sustained reductions in pain and fatigue.61,62 In older age adults with hip or knee OA, weekly fluctuations in sleep interference and OA-related pain have been shown to track with each other.
ConclusionHip pain patients with radiographs demonstrating minimal to no hip arthritis with and without hip deformity experience significant cofounding yet modifiable disorders of sleep and anxiety. If recognized early in presentation, treatment of insomnia and anxiety ultimately will improve outcomes for hip patients treated either conservatively or surgically for their hip disorder.Level of EvidenceII
Conclusion Hip pain patients with radiographs demonstrating minimal to no hip arthritis with and without hip deformity experience significant cofounding yet modifiable disorders of sleep and anxiety. If recognized early in presentation, treatment of insomnia and anxiety ultimately will improve outcomes for hip patients treated conservatively or surgically for their hip disorder.
This study examined if interventions targeting sleep found to be effective in improving sleep in KOA also reduce pain catastrophizing measured as a trait through the pain catastrophizing scale and measured as a daytime and nocturnal state through daily diaries. Secondary analyses were conducted on data collected as part of a randomized controlled trial assessing the effectiveness of cognitive behavioral therapy for insomnia in patients with KOA at 5 different time points: pretreatment, midtreatment and posttreatment and at 3- and 6-month follow-up. One hundred patients diagnosed with KOA and insomnia were randomized to rec...
Patients with knee osteoarthritis and insomnia may be less troubled by joint pain after they get treatment to help them sleep better, a recent study suggests.Reuters Health Information
Patients with knee osteoarthritis and insomnia may be less troubled by joint pain after they get treatment to help them sleep better, a recent study suggests.
This study compared predictors of nighttime sleep complaints and daytime sleep-related consequences as measured by the Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) in older adults with comorbid OA pain and insomnia.
Condition: Insomnia Related to Osteoarthritis Pain Interventions: Behavioral: Cognitive Behavior Therapy for Insomnia; Behavioral: Education Only Control Sponsors: University of Washington; Group Health Cooperative Recruiting - verified October 2016