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PSG: Detecting Sleep Disorders

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PSG is able to detect sleep disorders through monitoring cycles and stages of sleep to identify disruption in sleep patterns (6). PSG studies are considered to be the “gold standard” to quantify sleep quality (7). Several outcomes are measured in the sleep laboratory sessions including: sleep efficiency, frequency of arousals, abnormal electroencephalogram (EEG) readings, periodic leg movements (PLMs) and other sleep-related disorders. Three parameters are observed during PSG: electroencephalography (EEG), electrooculography (EOG), and electromyography of the submentalis (EMGsub). Though the EEG is the main variable that is analyzed, eye movements and muscle tone are also important in PSG studies (8). In addition to analyzing sleep stages …show more content…

This is because it provides clinicians with the ability to diagnose sleep disorders and monitor an individual’s sleep stages and cycles, which help to form treatment plans (6). Though there are numerous benefits for PSG, it is also accompanied by disadvantages. For instance, a high participant burden is associated with PSG because the participants are required to stay overnight in a sleep laboratory. There is also a high financial cost that is associated with PSG studies. In addition to these financial and personal burdens, PSG does not provide information a person’s sleep habits at home, which may skew the results. Finally, PSG may be associated with the “first night effect” (FNE) phenomenon (5). According to Tamaki et al., FNE is a complex phenomenon with many speculations made as to the cause of it, including: a change in sleeping environment, discomfort due to being observed, and discomfort from the number of electrodes attached to the patient (10, 11, 12). Agnew et al. found statistical significance of a difference in sleep stages in night one compared to two, three and four but not between nights two, three, and four, suggesting a FNE. The authors concluded that during the first night, the subject is more aroused than in subsequent nights (11). This can affect the results of PSG studies, which may lead to inaccurate …show more content…

To determine internal homogeneity, the researchers found Cronbach’s alpha to be 0.83, which demonstrates a high degree of internal consistency. They analyzed both individual items and the seven component scores, each of which demonstrated strong correlations with one another. To determine test-retest reliability, the researchers used paired t-tests to analyze the global PSQI score and the seven individual component scores. The results demonstrated no differences between the t-test values. Each of the scores were significantly correlated, demonstrating stability in the questionnaire. Validation of the PSQI was determined by looking at the significance of the global PSQI scores via ANCOVA with respect to age and sex as covariates. Age was found to be a significant covariate in the daytime dysfunction component, while sex was found to be a significant covariate in the sleeping medications and habitual sleep efficiency component. The sensitivity of the questionnaire as found to be 89.6% and the specificity was found to be 86.5%. To further validate the PSQI, researchers compared it to variables of sleep obtained via PSG. The PSQI and PSG showed similar scores for sleep latency; however the PSQI overestimates the past month’s sleep duration and efficiency. Overall, the PSQI is a valid measurement tool that demonstrated: (1) subjects and patients can easily use it;

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