title: A novel approach using actigraphy to quantify the level of disruption of sleep by in-home polysomnography: the MrOS Sleep Study: Sleep disruption by polysomnography.
abstract: BACKGROUND
  The "first-night effect" of polysomnography (PSG) has been previously studied; however, the ability to quantify the sleep disruption level has been confounded with the use of PSG on all nights. We used actigraphy to quantify disruption level and examined characteristics associated with disruption.
  
  
  METHODS
  Totally, 778 older men (76.2 ± 5.4 years) from a population-based study at six US centers underwent one night of in-home PSG. Actigraphy was performed on the PSG night and three subsequent nights. Actigraphically measured total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO), and sleep onset latency (SOL) from the PSG night and subsequent nights were compared. Linear regression models were used to examine the association of characteristics and sleep disruption.
  
  
  RESULTS
  On average, sleep on the PSG night was worse than the following night (p < 0.05, TST 21 ± 85 min less, SE 2.3 ± 11.3% less, WASO 4.9 ± 51.8 min more, SOL 6.6 ± 56.2 min more). Sleep on the PSG night was significantly worse than that two and three nights later. Characteristics associated with greater sleep disruption on the PSG night included older age, higher apnea-hypopnea index, worse neuromuscular function, and more depressive symptoms. Minorities and men with excessive daytime sleepiness slept somewhat better on the PSG night.
  
  
  CONCLUSIONS
  Among older men, there was sleep disruption on the PSG night, which may lead to sleep time underestimation. The increase of sleep on the night after the PSG suggests that data from the second monitoring may overestimate sleep.
authors.affiliation: California Pacific Medical Center Research Institute, San Francisco, CA, United States. Electronic address: tblackwell@sfcc-cpmc.net.
authors.forename: Terri
authors.initials: T
authors.lastname: Blackwell
authors.affiliation: Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN, United States.
authors.forename: Misti
authors.initials: M
authors.lastname: Paudel
authors.affiliation: Department of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.
authors.forename: Susan
authors.initials: S
authors.lastname: Redline
authors.affiliation: Department of Psychiatry and Medicine, University of California, San Diego, La Jolla, CA, United States.
authors.forename: Sonia
authors.initials: S
authors.lastname: Ancoli-Israel
authors.affiliation: California Pacific Medical Center Research Institute, San Francisco, CA, United States.
authors.forename: Katie L
authors.initials: KL
authors.lastname: Stone
mesh_terms: D056044:Actigraphy / Q000295:instrumentation / Q000379:methods*; D000368:Aged; D000072936:Fitness Trackers; D006801:Humans; D008297:Male; D017286:Polysomnography / Q000009:adverse effects*; D012890:Sleep; D012893:Sleep Wake Disorders / Q000175:diagnosis*
keywords: Actigraphy; First-night effect; Polysomnography; Reverse first-night effect