Analyzing sensor based human activity data using time series segmentation to determine sleep duration

Sleep is the most important thing to rest our brain and body. A lack of sleep has adverse effects on overall personal health and may lead to a variety of health disorders. According to Data from the Center for disease control and prevention in the United States of America, there is a formidable increase in the number of people suffering from sleep disorders like insomnia, sleep apnea, hypersomnia and many more. Sleep disorders can be avoided by assessing an individual\u27s activity over a period of time to determine the sleep pattern and duration. The sleep pattern and duration can be determined for an individual with the help of commercially available fitness devices such as Fitbit, Nike, Apple, and many others, which are activity trackers with accelerometer sensors. But these devices determine sleep duration from a \u27Proprietary Algorithm\u27, which processes the movement sensor data. Due to the proprietary nature, in a long-term study, the developer of the algorithm could update and make changes to the algorithm without revealing the details of the update to the user. This affects the measures reported by the algorithm. Hence to determine correct and reliable sleep duration, an Algorithm is developed by directly analyzing the actigraphy signals using time series segmentation. The study was done on a group of 20 healthy Undergraduate students from Missouri University of Science and Technology, whose daily physical activities were recorded using the GENEActiv accelerometer wristwatch worn on the non-dominant wrist. In this thesis, an open source algorithm has been developed using the daily physical activity data to estimate the sleep duration for any individual --Abstract, page iii

Transient Effects of Sleep on Next-Day Pain and Fatigue in Older Adults With Symptomatic Osteoarthritis

Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.Peer reviewedPublisher PD

Hidden Markov models for monitoring circadian rhythmicity in telemetric activity data

Wearable computing devices allow collection of densely sampled real-time information on movement enabling researchers and medical experts to obtain objective and non-obtrusive records of actual activity of a subject in the real world over many days. Our interest here is motivated by the use of activity data for evaluating and monitoring the circadian rhythmicity of subjects for research in chronobiology and chronotherapeutic healthcare. In order to translate the information from such high-volume data arising we propose the use of a Markov modelling approach which (i) naturally captures the notable square wave form observed in activity data along with heterogeneous ultradian variances over the circadian cycle of human activity, (ii) thresholds activity into different states in a probabilistic way while respecting time dependence and (iii) gives rise to circadian rhythm parameter estimates, based on probabilities of transitions between rest and activity, that are interpretable and of interest to circadian research

야간 근무자의 수면 장애에 대한 비약물적 중재의 효과: 체계적 문헌고찰 및 메타분석

학위논문(박사)--서울대학교 대학원 :간호대학 간호학과,2019. 8. 최스미.야간 근무자는 일주기 불균형으로 인하여 일반 낮 근무자에 비해 수면 장애가 심한 것으로 보고되었으며, 이는 심혈관 질환, 비만, 암, 우울증 및 비만과 같은 신체적, 정신적 건강 문제와 연관성이 있는 것으로 알려져 있다. 2007년 국제 암 연구 기관 (International Agency for Cancer)이 야간 근무를 포함하는 교대 근무가 발암 가능성이 있는 것으로 분류 한 이후, 많은 연구자들은 야간 근무자들을 대상으로 비약물적 수면 중재 효과를 조사하기 위한 임상 실험을 실시했다. 여러 비약물적 수면 중재 효과를 평가한 연구는 많음에도 불구하고 이러한 중재를 종합적으로 검토하고 효과의 크기를 분석한 연구가 부족한 실정이다. 따라서 본 연구는 체계적 문헌고찰 및 메타분석을 통해 그 동안 축적된 야간 근무자를 대상으로 수면 장애를 해결하기 위한 비약물적 중재를 실시한 연구를 평가, 종합, 분석하여 과학적인 근거를 제시하고자 시도되었다. 본 연구의 설계, 수행, 보고의 전 단계는 중재연구에서의 메타분석 가이드라인인 PRISMA를 적용하여 확인하는 과정을 거쳤으며, 계획 단계에서 연구의 주요 질문 및 선택 기준은 PICOTS-SD를 기반으로 선정하였다. PICOTS-SD의 각 구성 요소를 나타내는 주요 개념어는 중심 주제어와 자연어를 사용하여 MEDLINE, EMBASE, CINAHL, PsychINFO 검색엔진, 수면 관련 국제 저널 및 회색 문헌을 검색하였다. 본 연구에서 문헌의 질과 잠재적 비뚤림 평가는 Cochrane Risk of Bias 도구를 활용하여 시행하였다. 선택배제 기분에 따라 총 28편의 문헌이 추출되었으며, 그 중 20 편의 문헌이 메타분석에 포함되었다. 랜덤효과모형을 이용하여 전반적인 수면 장애에 대한 비약물적 중재의 효과 크기, 수면 장애 종류에 따른 비약물적 중재의 효과 크기, 비약물적 중재 방법에 따른 효과 크기 및 직업 종류에 따른 효과 크기를 산출하였다. 메타분석 결과, 야간 근무자의 수면 장애에 대한 비약물적 중재의 효과 크기는 Hedges g -1.43 (95%CI: -2.34, -0.53)로 통계적으로 유의한 것으로 나타났다. 수면 장애 종류별로 분석한 결과, 근무 중 졸림 (Hedges g= -2.83, 95% CI: -4.55, -1.10), 수면의 양 (Hedges g= 0.76, 95% CI: 0.15, 1.37), 수면의 질 shift (Hedges g= -0.57, 95% CI: -0.81, -0.34)로 통계적으로 유의한 효과 크기를 나타냈다. 비약물적 중재 방법 중 빛 요법 (Hedges g= -1.62, 95% CI: -2.81, -0.43)은 통계적으로 유의한 효과 크기를 나타냈으나, 근무 중 낮잠과 행동 중재 프로그램은 통계적으로 유의한 효과를 나타내지 않았다. 직업 종류에 따른 분석 결과, 의료계에 종사하는 야근 근무자와 산업 및 제조업에 종사하는 야간 근무자에게서 비약물적 중재는 유의한 효과를 나타냈다. 본 연구의 결과는 야간 근무자의 수면 장애 완화에 비약물적 중재가 유의한 효과가 있음을 시사한다. 또한, 수면 장애 완화 효과는 의료계, 산업 및 제조업에 종사하는 야간 근무자에게 빛 요법을 적용했을 때 가장 큰 것으로 보인다. 본 연구 결과는 야간 근로자의 수면 장애 예방 및 완화에 다양한 비약물적 중재가 효과적임을 확인함으로써, 실무에서 야간 근로자를 위한 중재를 선택하고 실행하는 데 객관적은 증거를 제공할 수 있을 것이다.Sleep disturbances are notorious among night workers and remain as a popular target of research. Various adverse physiological and psychological problems in night workers are associated with sleep disturbances caused by chronic exposure to circadian misalignment. In 2007, the International Agency for Research on Cancer classified shift work including night work as a probable human carcinogen. Since then, researchers have conducted trials to investigate effects of various interventions in mitigating sleep problems. Although many have evaluated different sleep-mediating methods, there is a lack of study that summarizes currently existing interventions applicable to night workers and provides a pooled effect size of the interventions. Therefore, the primary objective of this systematic review and meta-analysis was to critically review and synthesize exiting literature on the impact of non-pharmacological interventions implemented among night workers in mitigating and decreasing sleep disturbances. A systematic review was performed following the PRISMA reporting guideline. The leading study question and the selection criteria were developed using PICOTS-SD framework. MeSH terms, EMTREE terms, CINAHL headings and keywords representing each component of PICOTS-SD were selected to conduct a rigorous literature search using MEDLINE, EMBASE, CINAHL Plus with Full Text, PsycINFO databases, internationally renowned journals and grey literature. Cochrane Risk of Bias tool was used to evaluate study quality and to identify potential risk of biases. Of the 3,093 retrieved articles, 28 met our inclusion and exclusion criteria. Of these, 20 were included in the meta-analysis. We identified 6 non-pharmacological interventional methods: controlled light exposure, short-wavelength light protection, strategic naps, shift schedule modification, behavioral training and aromatherapy. Overall, non-pharmacological interventions had a significantly therapeutic effect on sleep disturbances in night workers compared to the control group who did not receive any treatment (Hedges g= -1.43, 95% CI: -2.34, -0.53). The interventions showed significant effects on reducing sleepiness on-shift (Hedges g= -2.83, 95% CI: -4.55, -1.10), increasing sleep length off-shift (Hedges g= 0.76, 95% CI: 0.15, 1.37) and sleep quality off-shift (Hedges g= -0.57, 95% CI: -0.81, -0.34) with medium to large effect sizes. Subgroup analysis based on the intervention types showed controlled light exposure to have a significant effect on reducing sleep disturbances (Hedges g= -1.62, 95% CI: -2.81, -0.43). However, the effects of strategic naps and behavioral training were not significant. Non-pharmacological interventions showed a significant effect in night workers engaged in healthcare industries (Hedges g= -1.28; 95% CI -2.48 to -0.07) and industrial or manufacturing industries (Hedges g= -2.74; 95% CI -4.65 to -0.83). The findings of the current study suggest non-pharmacological interventions to be favorable in mitigating sleep disturbances in night workers, with greatest impact apparent for sleepiness on-shift. The effect seems to be greatest when using the controlled light exposure intervention on night workers engaged in healthcare, industrial and manufacturing occupations. Our findings provide an objective and supporting evidence to incorporate various non-pharmacological interventions in improving sleep health among night workers. We also suggest further research to identify potential modifying factors and to establish optimal combination of strategies best suitable for real-world night work setting.ABSTRACT i CHAPTER I. INTRODUCTION 1 1. Background 1 2. Purpose 5 3. Terminology 6 CHAPTER II. LITERATURE REVIEW 9 1. Night work and sleep physiology 9 2. Night work and health 10 3. Night work adaptation 12 CHAPTER III. CONCEPTUAL FRAMEWORK 14 CHAPTER IV. METHODOLOGY 15 1. Study design 15 2. Study question and selection criteria 15 3. Search sources and strategy 20 4. Study selection 22 5. Data extraction 23 6. Assessment of risk of bias 24 7. Statistical analysis 25 8. Ethical consideration 30 CHAPTER V. RESULTS 31 1. Study selection 31 2. General description of included studies 33 3. Non-pharmacological interventions 34 4. Risk of bias within the included studies 47 5. Quantitative synthesis results 49 CHAPTER VI. DISCUSSION 70 1. Effect of non-pharmacological interventions on sleep disturbances 71 2. Effect of controlled light exposure on sleep disturbances 72 3. Effect of strategic naps on sleep disturbances 73 4. Effect of behavioral training on sleep disturbances 75 5. Effect of non-pharmacological on occupation types 77 6. Limitations 78 7. Significance of research 79 CHAPTER VII. CONCLUSIONS & RECOMMENDATIONS 81 REFERENCES 82 APPENDIXES 109 국문 초록 209Docto

Oscillatory Positive Expiratory Pressure (OPEP) therapy in COPD

People with chronic obstructive pulmonary disease (COPD) commonly have a productive cough due to mucus hypersecretion. Clearing mucus from the chest can be difficult, as lung hyperinflation, respiratory muscle dysfunction and premature airway collapse impede the ability to generate an effective cough. Airway Clearance Techniques (ACTs) with the use of oscillating positive expiratory pressure (OPEP) devices can be added to the usual care for sputum clearance. However, assessment of the effect of OPEP devices is so far based on short-term studies with low-grade evidence and there is a lack of information regarding their long-term impact and effectiveness. In this thesis, I have four results chapters to discuss this gap. First, using accepted systematic review methodology to rigorously examine the current evidence on the use of OPEP devices for the treatment of cough and sputum clearance in patients with COPD who frequently produce sputum. Second, conduct a randomised clinical trial (acronym: O-COPD) to evaluate the impact of an OPEP device (the Acapella) on the health-related quality of life in patients with COPD over three-months. Third, study cough characteristics and its relationship to overnight sleep disturbances. Fourth, evaluate the impact of an OPEP device (the Acapella) on cough frequency and sleep actigraphy in a subset of the O-COPD group. In summary, results from the O-COPD trial, coupled with the systematic review, can address the concerns raised regarding the long-term effectiveness of OPEP devices in treating sputum aspects in stable COPD patients. COPD patients with sputum production who received OPEP treatment for three months, compared to the usual care, demonstrated better disease management and improvement in general and cough-related quality of life (LCQ). The findings suggest that adding the OPEP device is effective in optimising the usual care and, perhaps, can be the new mode of usual care in managing cough and sputum production in COPD patients. Larger and longer clinical trials are required to guide the long-term use of OPEP and patient selection.Open Acces

Problematic gaming and sleep: A systematic review and meta-analysis

Postponed access: the file will be accessible after 2021-06-16Problematisk bruk av dataspill kan defineres som et mønster av spillatferd som kan negativt påvirke fysisk og mental helse og/eller forstyrre daglige aktiviteter og gjøremål. Et stigende antall studier har pekt på at problematisk bruk av dataspill er negativt knyttet til søvn. Grunnet de pågående debattene om konseptualiseringen av problemspilling, samt en økning i empirisk data de siste årene, er det behov for en oppdatert forening av kunnskapen om helseutfallene assosiert med problematisk bruk av dataspill. I lys av dette, ble det i denne studien gjennomført en systematisk litteraturgjennomgang og metaanalyse i tråd med PRISMA-retningslinjene, for å samle den tilgjengelige kunnskapen om søvnkarakteristikkene hos problemspillere og for å kvantifisere styrken i det potensielle forholdet mellom problematisk bruk av dataspill og søvnproblemer. Primærsøket ble gjennomført i januar 2020 i databasene Medline, Embase, Web of Science, PsycINFO, and Google Scholar, og resulterte i 21 studier som møtte inklusjonskritteriene. Samlet sett viser resultatene fra litteraturgjennomgangen og meta-analysene at problematisk bruk av dataspill er negativt assosiert med søvnlengde og søvnkvalitet, og at problemspillere har økt sannsynlighet til å rapportere søvnproblemer. Resultatene er diskutert i lys av deres begrensninger og deres implikasjoner for videre forskning.Masteroppgave i psykologiMAPSYK360INTL-MNINTL-SVINTL-MEDMAPS-PSYKINTL-KMDINTL-PSYKINTL-JUSINTL-H

SLEEP AND CIRCADIAN PHENOTYPES IN SEASONAL DEPRESSION

Background: Sleep and circadian rhythm disruptions have long been considered important symptoms and theorized underlying mechanisms in seasonal depression. However, discrepant observational findings and mixed treatment responses suggest heterogenous sleep and circadian disruptions in this population. This study aimed to elucidate distinct sleep and circadian profiles in seasonal depression to 1) clarify mixed findings of prior work and 2) identify modifiable treatment targets for future interventions. Methods: Biobehavioral, prospective self-report, and retrospective self-report measures of sleep and circadian rhythms were assessed during the winter in individuals meeting diagnostic criteria for Seasonal Affective Disorder (SAD), subsyndromal-SAD (S-SAD), or nonseasonal, never depressed controls (N=196). Sleep and circadian measures included: circadian phase/chronotype, sleep timing, total sleep time, sleep efficiency, regularity, and daytime sleepiness. Three k-means cluster analyses were conducted for each measurement modality. Resulting cluster solutions were compared on demographics, depression severity, and sleep and circadian dimensions. Results: There were two consistent sleep and circadian profiles across all three cluster analyses, an ‘Insomnia’ cluster, characterized by short total sleep times ( 7.5 hours). A smaller cluster, ‘Nappers with long sleep’ cluster, was also identified in the biobehavioral cluster. Clusters did not differ on depression severity or stratify by diagnostic group. Despite marked differences between clusters, there were few sleep and circadian differences between diagnostic groups (controls, SAD, S-SAD). Retrospective clusters did not differ on chronotype or sleep timing. Conclusion: The heterogeneity in seasonal depression is characterized by three sleep and circadian profiles with similar depression severity. Rather than assuming a homogenous sleep and circadian profile in seasonal depression, assessing sleep and circadian rhythms prior to treatment may reduce treatment failures. More broadly, this work highlights the utility of a precision medicine approach to treat sleep and circadian disruptions in individuals with dysregulated mood

NASA - easyJet Collaboration on the Human Factors Monitoring Program (HFMP) Study

This is the first annual report jointly prepared by NASA and easyJet on the work performed under the agreement to collaborate on a study of the many factors entailed in flight - and cabin-crew fatigue and documenting the decreases in performance associated with fatigue. The objective of this Agreement is to generate reliable, automated procedures that improve understanding of the levels and characteristics of flight - and cabin-crew fatigue factors, both latent and proximate, whose confluence will likely result in unacceptable flight crew performance. This study entails the analyses of numerical and textual data collected during operational flights. NASA and easyJet are both interested in assessing and testing NASA s automated capabilities for extracting operationally significant information from very large, diverse (textual and numerical) databases, much larger than can be handled practically by human experts

The effect of bright light on sleep in nursing home patients with dementia

Background: Up to 70% of nursing home patients with dementia suffer from disrupted sleep, often characterized by multiple awakenings at night and excessive daytime sleep. Sleep disruption may have negative effects on the cognition, mood, behaviour, and well-being of nursing home patients, while also representing a challenge for nursing home staff. However, few sleep scales are developed and validated specifically for the nursing home setting. Sleep problems among nursing home patients are frequently treated by medications, which are associated with severe side effects, including daytime sleepiness, and an increased risk of falls. Thus, there is a need for non-pharmacological interventions to improve sleep in this population. Bright light treatment (BLT) may represent such an intervention, providing increased light exposure aiming to impact sleep, circadian rhythmicity, mood, and/or behaviour. Light is the most important zeitgeber to the circadian system, and consequently has a significant impact on sleep-wake behaviour. Unfortunately, studies have reported low indoor light levels in nursing homes, which in combination with dementia-related neuropathology and age-related reductions in light sensitivity, are likely to contribute to sleep problems in this population. The aim of this thesis was to investigate whether increasing daytime light exposure, by means of BLT, can improve sleep in nursing home patients with dementia, and also to address methodological challenges in this field of research. Methods: Paper 1 is a systematic review of the literature, focusing on the methodological features of the included studies, in addition to their findings. Paper 2 and 3 are based on data from the DEM.LIGHT trial; a cluster-randomized placebo-controlled trial conducted in Norwegian nursing homes, including 69 patients. The intervention comprised a diurnal cycle of ambient light with a maximum of 1,000 lux and 6,000 Kelvin (K) from 10:00-15:00, administered using light emitting diode (LED) light. Before and after this interval, the light levels gradually increased/decreased in lux and K. In the placebo condition, standard light levels were maintained at 150-300 lux and approximately 3,000 K throughout the day. The intervention and placebo lights were installed in the common rooms of the included nursing home units. Outcomes were measured at baseline and at follow-up at week 8, 16, and 24. Paper 2 was a validation study of a proxy-rated sleep scale, using the baseline data from the DEM. LIGHT trial. Actigraphy was used as the reference standard. Paper 3 reported on the sleep outcomes of the trial, which were the primary outcomes. Results: Paper 1 found that there are promising, though inconsistent, results regarding the effect of BLT on sleep and circadian rhythmicity in dementia. Large heterogeneity in terms of interventions, study designs, population characteristics, and outcome measurement tools may explain some of the inconsistencies of results across studies. Paper 2 showed that the proxy-rated Sleep Disorder Inventory (SDI) had satisfactory internal consistency and convergent validity. Using actigraphy as the reference standard, the SDI was termed clinically useful, and we suggested a cut-off score of five or more as defining disrupted sleep in nursing home patients with dementia. These results should be interpreted keeping in mind that actigraphy have some important weaknesses, such as underestimating wake time. Paper 3 evaluated the effects of the BLT on sleep and found an improvement in sleep according to the SDI scores in the intervention group, as compared to the control group, from baseline to week 16 and baseline to week 24. There was no effect in terms of sleep measured by actigraphy. Conclusion: In summary, this thesis found that the evidence for an effect of BLT on sleep in nursing home patients with dementia is promising, but equivocal. Importantly, the research field faces some important methodological challenges, such as accurately measuring sleep. The SDI may represent a valid tool to measure sleep in the nursing home setting, which may be used both by researchers and by practitioners. Although the results of this thesis are not conclusive regarding the effect of BLT on sleep in nursing home patients with dementia, it may represent a step forward in understanding the potential value of BLT in this population, and may lay the ground for further investigation. The lack of an improvement on the SDI at week 8 indicates that the effect of BLT may take a long time to manifest in this population.Doktorgradsavhandlin

Sleep across the psychosis continuum and its relationship to paranoid thinking

Background: The present thesis sought to explore the relationship between sleep and paranoia, and investigate what factors mediate this relationship. The research was conducted at different levels, and in different groups including healthy members of the general population, people with a diagnosis of psychosis and clinicians. Method: in chapter 3, a cross-sectional study was conducted online to examine the relationships between sleep and paranoia in a non-clinical sample. Following this, chapter 4 outlines a systematic review that aimed to further understand how sleep has been investigated in clinical samples of people with psychosis. Next, chapter 5 examined the relationship between sleep disturbance and paranoia in a clinical sample using novel experience sampling methodologies. Finally, chapter 6 explored clinician perceptions of sleep problems in people with psychosis. Results: chapter 3 found evidence for a mediation model whereby sleep predicted paranoia, and this relationship was mediated by negative emotions, alexithymia and perceptual anomalies. Chapter 4 revealed that there is a range of methodologies used to assess and measure sleep and identified areas of bias. Chapter 5 found no relationship between sleep and paranoia in a clinical sample of people with psychosis. Finally, chapter 6 found that clinicians are fully aware of the range and types of sleep problems in people with psychosis but lack the training and skills to treat sleep problems. Discussion: Overall, the relationship between sleep and paranoia is inconsistent. Sleep disturbances are common and should be treated in people with psychosis. More work is required to develop effective intervention strategies to address the range and type of sleep disturbances found in people with psychosis