Actigraphy-based Sleep Parameters and Rest-activity Circadian Rhythm in a Young Scoliotic Patient Treated with Rigid Bracing: A Case Study.

Jun 29, 2019The Yale journal of biology and medicine

Sleep patterns and daily activity rhythms in a young scoliosis patient wearing a rigid brace

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Abstract

A significant rest-activity circadian rhythm (p < 0.001) was observed in a 14-year-old male patient with severe idiopathic scoliosis treated with a rigid brace 23 hours per day.

The percentage of rhythm was 23.4%, indicating a measurable pattern in activity levels.
The mean activity level, measured in Activity Counts, was 84.6.
The amplitude of activity exhibited a mean value of 74.4 Activity Counts.
The acrophase, or peak activity time, occurred at 17:56 h.
Total sleep time averaged 450.7 ± 20.1 minutes with a sleep efficiency of 83.3 ± 7.2%.
Both rest-activity rhythms and sleep behavior appeared normal in this patient.

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The correct expression of circadian rhythmicity, together with a good sleep behavior, are key factors for the body homeostasis. Rest-activity circadian rhythms (RARs) are involved in the control of the sleep-wake cycle and altered RARs could lead to a compromised health status. Therefore, we aimed to investigate the existence of RAR and to study actigraphy-based sleep behavior in a 14-year-old male patient affected by severe idiopathic scoliosis and treated with a rigid brace 23 hours per day. RAR and sleep parameters were studied through actigraphy for seven consecutive days in July 2018. The mean cosinor analysis revealed the presence of a significant RAR (p < 0.001), specifically: the percentage of rhythm was 23.4%, the mean MESOR was 84.6 Activity Count (AC), the amplitude registered a mean value of 74.4 AC's, and the acrophase occurred at 17:56 h. The subject reached a good sleep quantity: 507.9 ± 30.2 minutes of Time in Bed with a mean Total Sleep Time of 450.7 ± 20.1 minutes; Similarly, Sleep Efficiency was equal to 83.3 ± 7.2% and the Fragmentation Index was 27.3 ± 12.8%. We observed that both RAR and sleep behavior had normal trends in a 14-year-old patient treated with a rigid brace for a severe adolescent idiopathic scoliosis (AIS). Improved assessment of sleep in routine clinical practice can help to identify and manage health-related problems that could potentially affect some clinical outcomes, such as pain, mood state, and recovery process.

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Actigraphy-based Sleep Parameters and Rest-activity Circadian Rhythm in a Young Scoliotic Patient Treated with Rigid Bracing: A Case Study.

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