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Wrist actigraphy Objective sleep quality and disturbance were assessed with wrist actigraphy, an activity-based monitor to assess sleep�Cwake patterns, which has been shown to be valid in healthy and sleep-disordered populations.34�C37 Actigraphy data were collected using ActiSleep wrist-monitors that utilized ActiLife 6 data analysis software. Actigraphy-measured sleep data were collected in 1-minute epochs using the zero-crossing modes and the Cole-Kripke algorithm.9 Caregivers wore ActiSleep monitors for seven consecutive nights on non-dominant [http://www.selleckchem.com/products/nu7441.html Selleckchem NU7441] wrists. Reported actigraphy-measured parameters include total time in bed (hours), sleep latency (minutes), sleep duration (hours), sleep efficiency (%), wake after sleep onset (WASO; minutes); average awakening length (minutes), and number of awakenings. Actigraphy wrist-monitors were inspected and cleaned prior to distribution to ensure that devices were in working condition, and visual inspection of data was performed regularly. Patient Health Questionnaire Depression was assessed [http://en.wikipedia.org/wiki/ATP7A ATP7A] using the eight-item Patient Health Questionnaire (PHQ-8), which uses a self-administered module for unipolar depression that asks the participant ��Over the last 2 weeks, how often have you been bothered by the following problems?�� We did not include the ninth question from the nine-item Patient Health Questionnaire, which assesses for suicidal thoughts, because of the impracticality of timely clinical follow-up of positive responses. Also, in other studies, the modification of the nine-item Patient Health Questionnaire to the PHQ-8 depression questionnaire has been demonstrated to minimally influence overall scale performance, mean scores, or diagnostic cut points.38,39 The eight items [http://www.selleckchem.com/screening/anti-infection-compound-library.html Selleck Anti-infection Compound Library] of the PHQ-8 include feigned interest, hopelessness, trouble sleeping, lack of energy, changes in appetite, self-deprecation, trouble concentrating, and changes in physical behavior. The participant��s endorsement of each item was ranked on a scale from 0 to 3: not at all (0), several days (1), more than half of the days (2), and nearly every day (3). Response to each item was summed for a total PHQ-8 score ranging from 0 to 24. Validated cutoffs were used to categorize patients into either depressed (PHQ-8 score ��10) or non-depressed (PHQ-8 score