Related Experiment Video
Updated: Aug 17, 2026
Measuring Neural Mechanisms Underlying Sleep-Dependent Memory Consolidation During Naps in Early Childhood
Published on: October 2, 2019
Actigraphic recordings in quantification of periodic leg movements during sleep in children
Hawley E Montgomery-Downs1, Valerie M Crabtree, David Gozal
1Division of Pediatric Sleep Medicine, Department of Pediatrics, University of Louisville, 571 South Floyd Street, Suite 439, Louisville, KY 40202, USA.
Insights
Actigraphy software shows low accuracy for diagnosing periodic limb movement disorder (PLMD) in children. Further research is needed to refine this cost-effective diagnostic alternative to polysomnography.
Area of Science:
- Pediatric Sleep Medicine
- Biomedical Engineering
- Movement Disorders
Background:
- Periodic limb movement disorder (PLMD) is an underdiagnosed condition in children, causing sleep disruption and impacting learning and behavior.
- Accurate diagnosis of pediatric PLMD is challenging due to the limitations of current diagnostic methods.
- There is a need for cost-effective and accessible diagnostic tools for pediatric PLMD.
Purpose of the Study:
- To evaluate the reliability of a new actigraphy software for identifying periodic leg movements in children.
- To compare actigraphy-based leg movement detection with polysomnography (PSG) using electromyography (EMG).
Main Methods:
- 99 children (ages 4-12) wore bilateral actigraphs on their feet during overnight PSG.
- Simultaneous bilateral anterior tibial electromyogram (EMG) was recorded.
- Leg movements were scored independently by actigraphy and EMG for comparison.
Main Results:
- Initial agreement between actigraphy and EMG for leg movement detection was low, with actigraphy overestimating movement indices.
- Applying a correction factor based on EMG-measured movements during arousals improved agreement.
- The necessary correction factor varied significantly between children diagnosed with PLMD and those without.
Conclusions:
- The actigraphy approach, effective in adults, is not sufficiently accurate for reliable PLM event detection in children.
- Current actigraphy software requires significant refinement for accurate pediatric PLMD diagnosis.
- Actigraphy is not yet a reliable substitute for PSG in diagnosing PLMD in pediatric populations.
Background:
Periodic limb movement disorder (PLMD) has recently emerged as a relatively frequent and markedly underdiagnosed condition in children that induces arousals and sleep fragmentation and leads to poor learning and behavioral problems. Because a cost-effective and widely available alternative to pediatric polysomnography is needed for diagnosis of limb movement disorders, this study sought to examine whether periodic leg movements in children could be reliably identified using recently developed actigraphy software.
Methods:
Bilateral actigraphs were worn around the feet by 99 children ages 4-12 years during standard clinical overnight polysomnography, which included bilateral anterior tibial electromyogram (EMG). Left and right leg movements were scored independently for comparison purposes.
Results:
Agreement between tibial EMG and actigraphy-derived events were initially low, with movement indices being overestimated by actigraphy. This agreement was improved when a correction factor based on the average number of movements during arousals as measured by EMG was applied. However, the correction factor itself was found to differ substantially for patients who were diagnosed with PLMD compared to other patients.
Conclusions:
A novel actigraphic approach currently used for detection of PLM events during sleep in adults is insufficiently accurate to permit reliable estimates in children.
