Subjective and Objective Measures of Daytime Activity and Sleep Disturbance in Retinitis Pigmentosa. 2018

Ava Katherine Bittner, and Jennifer A Haythornthwaite, and Chandni Patel, and Michael T Smith
College of Optometry, Nova Southeastern University, Ft. Lauderdale, Florida.

Objectively measured limitations in daytime activity levels appear to be inextricably linked with sleep disturbances in retinitis pigmentosa (RP) patients, as well as associated with unemployment status and central vision loss. Innovative interventional strategies should be developed to help improve these issues and overall quality of life for RP patients. Novel sensor devices are emerging as valuable tools to objectively assess behavior. We used validated measures of wrist accelerometry to determine relationships between sleep, vision, and physical activity in RP subjects. For one week, 33 RP adults wore a wrist Actiwatch to detect movement during the day (average total activity counts) and disturbed sleep at night. They completed Early Treatment Diabetic Retinopathy Study visual acuity testing, Pelli-Robson contrast sensitivity, Goldmann V4e visual fields, and sleep diaries and validated questionnaires to assess their sleep and general health. Greater wake after sleep onset time measured with actigraphy (i.e., sleep disruption) (P = .01), loss of visual acuity (P = .009), and nonemployment/student status (P = .002) were all significant predictors of reduced daytime average total activity counts in a multiple linear regression model, after adjusting for contrast sensitivity as a cooperative suppressor variable (P = .01) (R = 0.54). Fragmentation measured with actigraphy (i.e., restlessness during sleep) (P = .07) and decreased sleep quality ratings reported upon awakening by the participants in a sleep diary (P = .06) were each marginally associated with reduced daytime average total activity counts, whereas nonemployment/student status, reduced visual acuity, and contrast sensitivity were still significant predictors. Objective and subjective measures of sleep or daytime activity were not statistically significantly correlated (P > .05). We find nonemployment/student status and sleep disturbances appear to be related to reduced daytime activity levels in adults with central vision loss due to RP. These findings underscore the importance of developing and evaluating interventions to help RP patients maintain engagement in productive activities and improve their disturbed sleep.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011788 Quality of Life A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral, social environment as well as health and disease. HRQOL,Health-Related Quality Of Life,Life Quality,Health Related Quality Of Life
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000203 Activities of Daily Living The performance of the basic activities of self care, such as dressing, ambulation, or eating. ADL,Chronic Limitation of Activity,Limitation of Activity, Chronic,Activities, Daily Living,Activity, Daily Living,Daily Living Activities,Daily Living Activity,Living Activities, Daily,Living Activity, Daily
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D012174 Retinitis Pigmentosa Hereditary, progressive degeneration of the retina due to death of ROD PHOTORECEPTORS initially and subsequent death of CONE PHOTORECEPTORS. It is characterized by deposition of pigment in the retina. Pigmentary Retinopathy,Tapetoretinal Degeneration,Pigmentary Retinopathies,Retinopathies, Pigmentary,Retinopathy, Pigmentary,Tapetoretinal Degenerations

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