Actigraphy assessment of sleep quality among patients with acute myeloid leukaemia during induction chemotherapy

Objectives: Patients receiving induction chemotherapy for acute myeloid leukaemia (AML) anecdotally describe poor sleep, but sleep disturbances have not been well-characterised in this population. We aimed to test the feasibility of measuring sleep quality in AML inpatients using a wearable actigraphy device.

Methods: Using the ActiGraph GT3X ‘watch’, we assessed the total sleep time, sleep onset latency, wake after sleep onset, number of awakenings after sleep onset and sleep efficiency for inpatients with AML receiving induction chemotherapy. We assessed patient self-reported sleep quality using the Pittsburgh Sleep Quality Index (PSQI).

Results: Of the 12 patients enrolled, 11 completed all actigraphy and PSQI assessments, demonstrating feasibility. Patients wore the ActiGraph device for a mean (SD) of 15.92 (8.3) days, and actigraphy measures suggested poor sleep. Patients had a median average awakening length of 6.92 min, a median number of awakenings after sleep onset of 4 and a median sleep onset latency of 10.8 min. Actual median sleep efficiency (0.91) was high, suggesting that patients’ poor sleep was not due to insomnia but perhaps due to interruptions, such as administration of medications, lab draws and vital sign measurements.

Conclusions: Collection of sleep quality data among inpatients with AML via a wearable actigraphy device is feasible. AML inpatients appear to have poor sleep quality and quantity, suggesting that sleep issues represent an area of unmet supportive care needs in AML. Further research in this areas is needed to inform the development of interventions to improve sleep duration and quality in hospitalised patients with AML.