Abstract

Objectives

Previous studies on the interrelationship between sleep and agitation relied on group-aggregates and so results may not be applicable to individuals. This proof-of-concept study presents the single-subject study design with time series analysis as a method to evaluate the association between sleep and agitation in individual nursing home residents using actigraphy.

Method

To record activity, three women and two men (aged 78–89 years) wore the MotionWatch 8© (MW8) for 9 consecutive weeks. Total sleep time and agitation were derived from the MW8 data. We performed time series analysis for each individual separately. To gain insight into the experiences with the actigraphy measurements, care staff filled out an investigator-developed questionnaire on their and participants’ MW8 experiences.

Results

A statistically significant temporal association between sleep and agitation was present in three out of five participants. More agitation was followed by more sleep for participant 1, and by less sleep for participant 4. As for participants 3 and 4, more sleep was followed by more agitation. Two-thirds of the care staff members (16/24) were positive about the use of the MW8. Acceptability of the MW8 was mixed: two residents refused to wear the MW8 thus did not participate, one participant initially experienced the MW8 as somewhat unpleasant, while four participants seemed to experience no substantial problems.

Conclusion

A single-subject approach with time series analysis can be a valuable tool to gain insight into the temporal relationship between sleep and agitation in individual nursing home residents with dementia experiencing sleep disturbance and agitation.

中文翻译：

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睡眠与激动之间时间关系的个体差异：一项针对患有睡眠障碍和激动的老年痴呆症的疗养院居民的单受试者研究

摘要

目标

以前关于睡眠和激动之间相互关系的研究依赖于群体聚合，因此结果可能不适用于个人。这项概念验证研究提出了带有时间序列分析的单受试者研究设计，作为一种使用活动记录仪评估个体疗养院居民睡眠与躁动之间关联的方法。

方法

为了记录活动，三名女性和两名男性（78-89 岁）连续 9 周佩戴 MotionWatch 8© (MW8)。总睡眠时间和激动来自 MW8 数据。我们分别对每个人进行时间序列分析。为了深入了解活动记录仪测量的经验，护理人员填写了一份调查员开发的关于他们和参与者的 MW8 经历的问卷。

结果

在五分之三的参与者中，睡眠和激动之间存在统计学上显着的时间关联。参与者 1 更多的激动之后是更多的睡眠，而参与者 4 的睡眠更少。对于参与者 3 和 4，更多的睡眠之后是更多的激动。三分之二的护理人员 (16/24) 对 MW8 的使用持积极态度。MW8 的接受程度参差不齐：两名居民拒绝佩戴 MW8，因此没有参加，一名参与者最初觉得 MW8 有点不愉快，而四名参与者似乎没有遇到实质性问题。

结论

具有时间序列分析的单受试者方法可能是一种有价值的工具，可以深入了解患有睡眠障碍和躁动的痴呆症患者的睡眠和躁动之间的时间关系。