Sleep Assessment by Actigraphy in Obstructive Sleep Apnea Patients after Positive Airway Pressure Therapy
Narumol Luekitinun¹,³, Kanlaya Panjapornpon¹,³, Pattharaphong Plurksathaporn¹, Rungaroon Tangsrikertikul¹, Siwaporn Pawaphutanon na Mahasarakam²,³, Rungridee Singpeam²,³, Sunsanee Pungtaway²,³, Pairaya Pinthong³
Affiliation : ¹ Department of Respiratory Medicine, Central Chest Institute of Thailand, Nonthaburi, Thailand; ² Department of Nursing, Central Chest Institute of Thailand, Nonthaburi, Thailand; ³ CCIT Sleep Disorders Center, Central Chest Institute of Thailand, Nonthaburi, Thailand
Background: The initial phase of positive airway pressure (PAP) therapy in patients with obstructive sleep apnea (OSA) can significantly influence sleep and treatment compliance.
Objective: To assess clinical sleep parameters using actigraphy, the Epworth Sleepiness Scale (ESS), and the Pittsburgh Sleep Quality Index (PSQI) in OSA patients comparing before and after a one-week PAP therapy period.
Materials and Methods: The present study was a prospective observational study conducted at the Central Chest Institute of Thailand (CCIT). Adult OSA patients diagnosed using standard criteria following the International Classification of Sleep Disorders, third ed., text revision (ICSD-3-TR) and achieving optimal PAP titration from split-night polysomnography (PSG) were recruited. Participants wore actigraphy devices for one week before and after PAP therapy. Clinical sleep parameters, including time in bed (TIB), total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO), the number of wake bouts (NWB), sleep latency (SL), ESS, and PSQI were collected and analyzed.
Results: Twenty OSA patients participated in the present study. The majority were male at 55%, and 45% had comorbidities, including hypertension and dyslipidemia. The median age, body mass index (BMI), ESS, PSQI, apnea-hypopnea index (AHI), and nadir SpO₂ were 42.5 years, 27.9 kg/m², 10.5, 8, 37.8 events/hour, and 86%, respectively. Sleep assessment by actigraphy comparing before and after one week of PAP treatment revealed a significant reduction in NWB at 45.4 versus 37.6 events (p=0.002) and SL of 29.6 versus 19.4 minutes (p=0.017) after PAP therapy. Additionally, ESS was at 10.5 versus 7.5 (p=0.003) and PSQI at 8 versus 4 (p=0.001) scores improved significantly, days used PAP for four hours or more was 100% and achieving good PAP compliance in 80%.
Conclusion: Short-term use of PAP therapy in newly treated severe OSA patients resulted in meaningful improvement in sleep continuity, daytime sleepiness, and sleep quality, within one week, with good PAP adherence.
Received 18 March 2025 | Revised 13 June 2025 | Accepted 13 June 2025
DOI: 10.35755/jmedassocthai.2025.7.565-573-02853
Keywords : Obstructive sleep apnea (OSA); Positive airway pressure (PAP); Actigraphy
