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10 protocols using action w2

1

Objective Sleep Assessment via Actigraphy

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The participants were asked to wear a wrist actigraph (Mini Motionlogger Actigraphy, Ambulatory Monitoring, Ardsley, NY, USA) for 7 consecutive days before taking a nap in the laboratory to gain an objective measure of nocturnal sleep. They also kept a sleep diary for a week to record their bedtimes and rise times, which were used to analyze the actigraph data. The participants’ daily activities were recorded in the zero-crossing method mode and analyzed using Action W2 (Ambulatory Monitoring). The outcome data used in this study included the mean total sleep time (TST), sleep onset latency (SOL), and wake time after sleep onset (WASO).
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2

Actigraphic Sleep Assessment Protocol

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To evaluate sleep features, actigraphic data were analysed using Action W-2 (version 2.7) software (Ambulatory Monitoring, Inc., Ardsley, NY). This software identified each epoch as sleep or wakefulness using the mathematical model validated by Cole and co-authors29 (link). According to such model, sleep onset was defined as the first epoch of the first block of 20 min of persistent sleep, while sleep offset as the end of the last sleep episode within the interval of the time spent in bed. In order to examine the actigraphic sleep profile, we considered the following measures: the time the participants went to bed and switched off the light (bedtime) and the time the participants last woke up in the morning (wake-up time); total sleep time (TST) (sum, in minutes, of all sleep epochs between sleep onset and sleep end); sleep efficiency percentage (SE%) (the ratio of total sleep time to time in bed multiplied by 100). For each participant, the mean values were calculated over the three nights.
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3

Actigraph Monitoring in Neurological Care

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Wrist actigraphs (Micro Motionlogger, Ambulatory Monitoring, Inc., Ardsley, NY) were placed on both wrists for each patient and left in place for the duration of their stay in the NCCU or SU. Actigraphs were otherwise only purposefully removed in anticipation of magnetic resonance imaging scans as a safety precaution and were then replaced thereafter.
Each actigraph was configured to collect activity data in 1-min epochs. These data were then aggregated by proprietary algorithms from the Action4 software package (Ambulatory Monitoring, Inc.) into two distinct measurements: Zero Crossing Mode (ZCM), which measures the frequency of movement by counting the number of times per epoch that the signal crosses a threshold set near zero; and Proportional Integration Mode (PIM), which calculates the area under the curve for the acceleration signal during each epoch, and therefore discriminates between different intensities of motion. Data were subsequently downloaded using the Action W-2 software package (Ambulatory Monitoring, Inc.). A sample of a patient's actigraph data is provided in Supplementary material 1.
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4

Actigraphic Monitoring of Physical Activity

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The actigraph model Micro Motionlogger Watch (Ambulatory Monitoring, Inc., Ardsley, NY, USA) was used in the current study. The device was equipped with a triaxial accelerometer with a sensitivity of 0.01 g, while the filters and sampling frequency were set at 2–3 Hz and 32 Hz, respectively. Actigraphs were initialized through the Motionlogger Watchware software (Ambulatory Monitoring, Inc., Ardsley, NY, USA) in zero crossing mode to collect data in 1 min epochs, while actigraphic records were analyzed through the software Action W2 (Ambulatory Monitoring, Inc., Ardsley, NY, USA) using the algorithms validated by Cole and Kripke [19 ] and Cole et al. [20 (link)].
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5

Actigraphy Assessment of Sleep Patterns

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Sleep was examined with Octagonal Basic Motionlogger actigraphs (Ambulatory Monitoring), and was scored using the Sadeh algorithm (Sadeh et al., 1994 (link)) in Action W2 (Ambulatory Monitoring). Three parameters were derived and assessed; both duration and quality of sleep and their definitions are consistent with the manual that accompanied the software. Minutes comprises the total number of minutes slept. Sleep efficiency represents the percentage of epochs scored as sleep during the total sleep period from actigraphically determined sleep onset until wake. Long-wake episodes (LWE) are a count of the number of wake episodes ≥ 5 min. Following common principles, actigraphy data were included in analyses for participants who had at least 5 nights of data after exclusion of nights they took medication. Data were treated as missing for participants with fewer than 5 nights (14.8% of sample); children with missing actigraphy data were not removed from the analytic sample, and missing data were handled statistically. Sleep minutes, efficiency and LWE were stable across nights (α = 0.78; 0.89; 0.87, respectively); the mean across nights for each variable was used in analyses.
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6

Actigraphy and Biomarker Assessment

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Participants completed questionnaires providing information on sociodemographics, chronic diseases, smoking status, perceived sleep quality and sleepiness, and medication use. Participants were asked to wear actigraphs on the non-dominant wrist for a minimum of 5 consecutive 24-hour periods; devices were removed only for bathing or during water sports. ActionW-2 software (Ambulatory Monitoring, Inc., Ardsley, NY) was used to score actigraphy data, and details of the scoring algorithms used have been published elsewhere (34 (link)). Inter-scorer reliability for the scoring of these data has been previously found to be high in our sample (intraclass coefficient = 0.95) (34 (link)). Blood was collected during morning clinic visits, after an overnight fast, and serum samples were frozen at −80°C until assays were performed. The institutional review boards at each clinic site approved the study, and written informed consent was obtained from all participants.
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7

Actigraphy-Derived Sleep Parameters Analysis

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ActionW-2 software (Ambulatory Monitoring, Inc., Ardsley, NY) was used to score the actigraphy data; for scoring algorithms details see (Jean-Louis, Kripke et al., 2001 (link); Blackwell, Ancoli-Israel et al., 2005 (link)). This method produces reliable estimate of sleep-wake patterns (Pollak, Tryon et al., 2001 (link); Ancoli-Israel, Cole et al., 2003 (link)). Participants were also asked to keep a sleep log which was used to edit the actigraphy data. Inter-scorer reliability has been previously found to be high in sleep studies performed by the MrOS Sleep Study team (intra-class coefficient=0.95) (Blackwell, Ancoli-Israel et al., 2005 (link)).
Actigraphy derived sleep parameters (covariates) were: total sleep time (TST; hours per night spent sleeping in bed after “lights off”), sleep latency (SL; amount of time until onset of sleep defined when participant achieved sleep for 20 continuous minutes in bed) and wake after sleep onset (WASO; minutes scored awake during the interval after sleep onset). Actigraphy measured sleep parameters were dichotomized to represent clinically significant disturbances: (1) short sleep <5 and long sleep >8 hours (contrasted in a single variable with 5–8 hour sleepers); (3) SL≥60 minutes, and (4) WASO≥90 minutes.
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8

Actigraphy-based Sleep Assessment

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Sleep characteristics were measured using an actigraphy watch, the Octagonal Motionlogger Sleep Watch-L (Ambulatory Monitoring Inc, Ardsley, New York), for 2 consecutive nights during the time that salivary specimens were collected. It was worn on the participants’ nondominant wrist to derive movement-based estimates of sleep-wake characteristics. The actigraph unit was set to 1-minute epoch and zero-crossing mode. We used the Action W-2 software and the Cole-Kripke algorithm (Ambulatory Monitoring Inc, Ardsley, New York) to analyze the sleep data. A previous study has shown good reliability and validity with a reasonable sensitivity higher than 0.60 in polysomnography-actigraphy comparison.18 (link)
For sleep characteristics, time in bed, sleep efficiency (SE), wake after sleep onset (WASO), and mean wake episode during sleep (MWE) were obtained indicating total minutes in bed for nocturnal sleep, percentage of actual sleep at night, total wake minutes during nocturnal sleep, and mean duration of wakes during sleep, respectively. Average values of the 2 nights were used for all the sleep characteristics.
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9

Wearable Actigraphy for Sleep Assessment

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Participants wore wrist accelerometers (Motionlogger Micro watch, Ambulatory Monitory Inc, Tokyo, Japan) on their nondominant wrist for 9 days and nights, except for activities involving water. Data were collected in the zero‐crossing mode (ZCM) and saved in 1‐min epochs. The University of California San Diego algorithm, which is validated to produce accurate and reliable sleep estimates relative to polysomnography (Jean‐Louis et al., 2001 (link)), along with Action W‐2 software (Ambulatory Monitoring, Inc., Ardsley, NY) were used to score the data. Data were acceptable if the accelerometer was worn for at least 7 out of the 9 days (Ancoli‐Israel et al., 2015 (link)). Participants also completed the Pittsburgh Sleep Quality Index (PSQI), on the last day of each intervention.
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10

Actigraphy-Aided Sleep Assessment Protocol

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All participants wore an actigraph on the non-dominant wrist (AMI MicroMini Motionlogger; Ambulatory Monitoring, Ardsley, NY, USA) during the five days before the conditions (RS, TSD). Additionally, in the RS condition, the night preceding the Testing phase was controlled through actigraphy. Actigraphs were initialized by ACT Millennium software (Ambulatory Monitoring, Ardsley, NY, USA) in zero crossing mode to collect data in 1-min epochs. Collected data have been analyzed through Action W-2 software (Ambulatory Monitoring, Ardsley, NY, USA). Moreover, each morning all the participants completed a sleep diary to report their subjective sleep duration and sleep quality. Three variables, total sleep time (TST), sleep efficiency (EFF%), and wake after sleep onset (WASO), were obtained by the actigraphic data. In the RS condition, the mean actigraphic variables (± SE) calculated for the sleep night preceding the Testing phase were: TST = 443.79 minutes (± 7.73), EFF% = 94.58% (± 0.82), WASO = 19.03 minutes (± 3.60).
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