Objective measurement of activity of daily living and sleep in subjects with COPD

Decreased Activity of Daily Living (ADL) and sleep disorders are associated with high morbidity that impacts quality of life in patients with chronic obstructive pulmonary disease (COPD). There is no good data to assess the ADL and sleep of COPD subjects in their home environment. Wrist based actigraphy (Actiwatch-Spectrum) was used to evaluate activity in COPD subjects to address the hypothesis that actigraphy is a good method of evaluating ADL and sleep and demonstrate subject compliance. Twelve COPD subjects and twelve age and gender matched controls wore the Actiwatch for fourteen (14) days continuously and the activity data was analyzed for ADL and sleep. Compliance was measured by the built in “off wrist “detector. Total activity counts/day were significantly less (p≤0.01) in the COPD subjects than Controls; 237,494±22,946 vs. 557,842±36,006, respectively. Average activity counts/min and maximum activity counts were significantly less (p≤0.001) in the COPD subjects; 219±28 vs. 630±58 and 1,560±269 vs. 3,163±862, (p≤0.01), respectively. Total sleep time in the COPD subjects was significantly reduced (p≤0.01); 343±15 minutes vs. 451±19 minutes. Sleep efficiency was decreased in the COPD subjects vs. Controls; 72±3 vs. 88±4 respectively (p≤0.05). The minutes of wake after sleep onset was significantly (p≤0.01) increased in the COPD subjects from 105±14 minutes to 39±23. Compliance,% time wearing the Actiwatch, was the same in COPD and Controls; 99.6±0.2% Activity of daily living and sleep were significantly decreased in the COPD subjects as compared to controls and compliance was extremely high for both groups indicating that wrist actigraphy may be a useful measure in COPD.