GA3-71
Comparison of the Fitbit® Charge and polysomnography for measuring sleep quality after adenotonsillectomy in children.
1Hakim M, 2Tumin D, 3Hakim M, 2Jatana K, 4Tobias J, 4Raman V
1Nationwide Childrens Hospital, columbus, Ohio, Unites states of america; 2Nationwide children's Hospital, Columbus, Ohio, United states of america; 3Montefiore medical Centre, Bronx, New york, Unites states of america; 4Nationwide Children's Hospital, Columbus, Ohio, United states of america
Introduction: Polysomnography (PSG) remains the gold standard for the diagnosis of obstructive sleep apnea (OSA). However, PSG is time-consuming and expensive. The primary objective of the current study was to assess sleep quality using the Fitbit® Charge and compare it to PSG.
Methods: Patients 3-18 years were included in this prospective study. The Fitbit® Charge was placed and time-synchronized with sleep laboratory devices that were worn during overnight PSG.
Results: The study cohort included 10 patients who had undergone adenotonsillectomy(AT) to treat OSA. One patient was eliminated due to technical issues with data acquisition resulting in a final cohort of 9 patients. Based on clinical history, ongoing sleep disordered breathing (SDB) symptoms were noted in all 9 patients. On PSG, 2 of the 9 patients met the cutoff for OSA. Total sleep time (TST) was 393 ± 35 minutes on PSG and 400 ± 34 minutes on Fitbit® Charge with no statistically significant difference between the two measurements. Total wake time (TWT) was 50 ± 25 minutes by PSG and 44 ± 18 minutes by Fitbit® Charge. Concordance between PSG and Fitbit® Charge was statistically significant for TST, whereas it failed to reach statistical significance for TWT and number of awakenings.
Discussion: In our study, we evaluated agreement between PSG and one model of the Fitbit® commercial accelerometers. The Fitbit® Charge provides an inexpensive, user-friendly, compatible alternative to PSG, potentially enabling wider clinical use of sleep quality monitoring especially in children with vague or inconclusive symptoms. Prior studies have cautioned that actigraphy devices (such as the Fitbit® Charge) may underestimate TST in preschoolers and school-aged children while over-estimating TST in adolescents when compared to PSG. These same studies reported that epoch-by-epoch agreement between actigraphy and PSG was poor. Despite shortcomings of actigraphy illustrated in these studies, our preliminary data showed a good agreement of TST measurements between Fitbit® Charge and PSG in the specific application of monitoring sleep quality after AT. Although the agreement of other study measures (TWT, number of awakenings) was less, there was no evidence that Fitbit® data systematically overestimated or underestimated study measures, when compared to PSG findings.
Therefore, these preliminary data suggest that the Fitbit® Charge may offer an attractive option for monitoring sleep quality in patients with recurring or persistent OSA/SDB symptoms after AT, Fitbit® Charge measurements of sleep time, wake time, and number of awakenings were unbiased relative to PSG. The Fitbit® Charge achieved good concordance with PSG on TST. Fitbit® Charge may be a useful tool to cost effectively measure improvement in those with persistence of clinical signs and symptoms of OSA or SDB after adenotonsillectomy.
Conclusion: Our preliminary data suggests that the Fitbit® Charge offers an option for monitoring sleep quality in patients with ongoing OSA/SDB symptoms after adenotonsillectomy.
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