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Use of remote monitoring and integrated platform for the evaluation of sleep quality in adult-onset idiopathic cervical dystonia

Grace Bailey Orcid Logo, Clare Matthews, Konrad Szewczyk-krolikowski, Peter Moore, Sandra Komarzynski, Elin Haf Davies, Kathryn J. Peall Orcid Logo

Journal of Neurology, Volume: 270, Issue: 3, Pages: 1759 - 1769

Swansea University Author: Grace Bailey Orcid Logo

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Abstract

BackgroundUp to 70% of individuals diagnosed with adult-onset idiopathic focal cervical dystonia (AOIFCD) report difficulties with sleep. Larger cohort studies using wrist-worn accelerometer devices have emerged as an alternative to smaller polysomnography studies, in order to evaluate sleep archite...

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Published in: Journal of Neurology
ISSN: 0340-5354 1432-1459
Published: Springer Science and Business Media LLC 2023
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa66532
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Abstract: BackgroundUp to 70% of individuals diagnosed with adult-onset idiopathic focal cervical dystonia (AOIFCD) report difficulties with sleep. Larger cohort studies using wrist-worn accelerometer devices have emerged as an alternative to smaller polysomnography studies, in order to evaluate sleep architecture.MethodsTo measure activity during the sleep/wake cycle, individuals wore a consumer-grade wrist device (Garmin vivosmart 4) continuously over 7 days on their non-dominant wrist, while completing a daily sleep diary and standardised sleep and non-motor questionnaires via a dedicated app. Sleep measures were derived from the captured raw triaxial acceleration and heart rate values using previously published validated algorithms.ResultsData were collected from 50 individuals diagnosed with AOIFCD and 47 age- and sex-matched controls. Those with AOIFCD self-reported significantly higher levels of excessive daytime sleepiness (p = 0.04) and impaired sleep quality (p = 0.03), while accelerometer measurements found the AOIFCD cohort to have significantly longer total sleep times (p = 0.004) and time spent in NREM sleep (p = 0.009), compared to controls. Overall, there was limited agreement between wearable-derived sleep parameters, and self-reported sleep diary and visual analogue scale records.DiscussionThis study shows the potential feasibility of using consumer-grade wearable devices in estimating sleep measures at scale in dystonia cohorts. Those diagnosed with AOIFCD were observed to have altered sleep architecture, notably longer total sleep time and NREM sleep, compared to controls. These findings suggest that previously reported disruptions to brainstem circuitry and serotonin neurotransmission may contribute to both motor and sleep pathophysiology.
Keywords: Dystonia; Sleep; Non-motor; Wearable devices; Accelerometry
College: Faculty of Medicine, Health and Life Sciences
Funders: GAB is funded by a KESS2, European Social Fund and Cardiff University PhD Studentship in partnership with Aparito Limited. KJP is funded by an MRC Clinician-Scientist Fellowship (MR/P008593/1).
Issue: 3
Start Page: 1759
End Page: 1769