Caffeine Therapy for Apnea of Prematurity: Long-Term Effect on Sleep by Actigraphy and Polysomnography

摘要

Marcus and colleagues checked the long-term effects of caffeine therapy for apnea of prematurity by using actigraphy, polysomnography, and parental sleep questionnaire. Although the authors concluded that therapeutic neonatal caffeine administration had no long-term effects on sleep duration or sleep apnea during childhood, there was a discrepancy in sleep duration between results from actigraphy and polysomnography. Melzer and colleagues mentioned that actigraphy showed poorer specificity (to detect wake), and each researcher should adjust the scoring algorithm/ sensitivity depending on age and the level of sleep disturbance. I suppose that the authors understand the limitation of actigraphy for sleep evaluation, but there was no precise description on the adjustment of actigraphy in the text or the online supplement. Meltzer and colleagues reported that actigraphy should be used with caution to keep specificity and sensitivity by adjusting the scoring threshold of sensitivity of Actiwatch 2 (Philips Respironics, Bend, OR), which could be done by the setting through software. As Marcus and colleagues conducted the validation study with an epoch-by-epoch comparison of actigraphy and simultaneous ambulatory polysomnography in a random sample of 20 subjects, I want to know the level of sensitivity for Actiwatch 2.