Supplementary Material for: Measuring objective and subjective sleep during lisdexamfetamine treatment of acute methamphetamine withdrawal: A feasibility study

Abstract

Background: Sleep disturbance is common during methamphetamine (MA) use and withdrawal, however the feasibility of combined subjective-objective measurement of sleep-wake has not been shown in this population. Actigraphy is a well-established, non-invasive measure of sleep-wake cycles with good concordance with polysomnography. Objective: To investigate the feasibility and utility of using actigraphy and sleep diaries to investigate sleep during MA withdrawal. Method: We conducted a feasibility and utility study of actigraphy and sleep diaries during a clinical trial of lisdexamfetamine for MA withdrawal. Participants were inpatients for 7-days, wore an actigraph (Philips Actiwatch 2) and completed a modified Consensus Sleep Diary each morning. Participants were interviewed between days 3-5. Results: 10 participants (mean age 37 years, 90% male) were enrolled. No participant removed the device prematurely. Participants interviewed (n=8) reported that the actigraph was not difficult or distracting to wear or completion of daily sleep diary onerous. Actigraphic average daily sleep duration over 7 days was 568 minutes, sleep onset latency 22.4 minutes, wake after sleep onset (WASO) 75.2 minutes and sleep efficiency 83.6%. Sleep diaries underreported daily sleep compared with actigraphy (sleep duration was 56 minutes (p=0.008) and WASO 47 minutes (p<0.001) less). Overall sleep quality was 4.4 on a nine-point Likert-scale within the diary. Conclusions: Continuous actigraphy is feasible to measure sleep-wake in people withdrawing from MA, with low participant burden. We found important differences in self-reported and actigraphic sleep, which needs to be explored in more detail

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