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Published on: October 2, 2019
Use of actigraphy for assessment in pediatric sleep research
Lisa J Meltzer1, Hawley E Montgomery-Downs, Salvatore P Insana
1National Jewish Health, 1400 Jackson Street, G311, Denver, CO 80206, USA. meltzerL@njhealth.org
Insights
Actigraphy devices objectively measure pediatric sleep-wake patterns. This review highlights inconsistent specificity and a lack of standard rules, recommending improved methods for actigraphy use in child sleep studies.
Area of Science:
- Pediatric Sleep Medicine
- Biomedical Engineering
- Research Methodology
Background:
- Actigraphy devices are increasingly used in pediatric research for objective sleep-wake pattern assessment.
- These ambulatory monitors offer a more objective alternative to parent reports, capturing data in naturalistic settings over extended periods.
Purpose of the Study:
- To comprehensively review the historical and current applications of actigraphy in pediatric sleep research.
- To evaluate the validation of actigraphy methods within pediatric populations.
- To provide recommendations for standardized methodological approaches in pediatric actigraphy studies.
Main Methods:
- Systematic literature review of studies utilizing actigraphy in pediatric populations.
- Analysis of validation studies comparing actigraphy with objective sleep measures.
- Evaluation of reporting standards and variable definitions in published pediatric actigraphy research.
Main Results:
- Consistent findings indicate poor specificity of actigraphy devices in detecting wake after sleep onset across various pediatric age groups.
- A significant lack of standardized scoring rules and variable definitions was identified across studies.
- Variability in device performance and reporting practices complicates interpretation of pediatric sleep data.
Conclusions:
- The current use of actigraphy in pediatric sleep research is hampered by issues of specificity and a lack of standardization.
- Recommendations are provided for enhancing the methodological rigor and reporting consistency of actigraphy in pediatric studies.
- Further research is needed to establish acceptable performance benchmarks and standardized protocols for pediatric actigraphy.
Abstract:
The use of actigraphs, or ambulatory devices that estimate sleep-wake patterns from activity levels, has become common in pediatric research. Actigraphy provides a more objective measure than parent-report, and has gained popularity due to its ability to measure sleep-wake patterns for extended periods of time in the child's natural environment. The purpose of this review is: 1) to provide comprehensive information on the historic and current uses of actigraphy in pediatric sleep research; 2) to review how actigraphy has been validated among pediatric populations; and 3) offer recommendations for methodological areas that should be included in all studies that utilize actigraphy, including the definition and scoring of variables commonly reported. The poor specificity to detect wake after sleep onset was consistently noted across devices and age groups, thus raising concerns about what is an "acceptable" level of specificity for actigraphy. Other notable findings from this review include the lack of standard scoring rules or variable definitions. Suggestions for the use and reporting of actigraphy in pediatric research are provided.
