Validation of actigraphy for determining sleep and wake in children with sleep disordered breathing

Area of Science:

• Pediatric Sleep Medicine
• Biomedical Engineering
• Clinical Validation Studies

Background:

• Limited validation studies exist for actigraphy in pediatric sleep-wake determination.
• Actigraphy is a non-invasive method for sleep monitoring.
• Polysomnography (PSG) is the gold standard for sleep assessment.

Purpose of the Study:

• To validate wrist actigraphy against polysomnography (PSG) for sleep and wake determination in children.
• To compare the accuracy of different activity threshold settings on actigraphy devices.
• To assess the reliability of actigraphy in a pediatric population.

Main Methods:

• 45 children (aged 1-12 years) underwent concurrent wrist actigraphy and overnight PSG.
• Actigraphic data were analyzed using four activity threshold settings: low, medium, high, and auto.
• Epoch-by-epoch comparison of actigraphy and PSG data was performed.

Main Results:

• Sleep time estimation was comparable between actigraphy (low/auto thresholds) and PSG.
• Wake time was underestimated by actigraphy (low/auto thresholds) but accurately estimated by medium/high thresholds.
• High agreement rates (85.1-88.6%) and sensitivity (90.1-97.7%) were observed for sleep detection.
• Predictive value for wake and specificity were generally low across thresholds.

Conclusions:

• Wrist actigraphy is a reliable method for determining sleep in children when validated against PSG.
• Actigraphy demonstrates potential as a useful tool in pediatric sleep clinics and research.
• Optimal threshold settings may be necessary for accurate wake detection in pediatric actigraphy.