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Validation of actigraphy for sleep measurement in children with cerebral palsy
Bing Xue1, Amy Licis2, Jill Boyd3
1School of Engineering, Washington University, Saint Louis, MO, USA.
Insights
Actigraphy is a validated method for assessing sleep in children with cerebral palsy (CP). Children with CP experience poorer sleep efficiency and shorter sleep duration compared to their peers without CP.
Area of Science:
- Pediatric Sleep Medicine
- Neurology
- Biomedical Engineering
Background:
- Sleep disturbances are prevalent in children with cerebral palsy (CP).
- Objective sleep assessment in this population is challenging.
- Actigraphy, a movement-based sleep quantification tool, has unproven accuracy in children with CP.
Purpose of the Study:
- To validate actigraphy for sleep assessment in children with CP.
- To investigate sleep patterns in a cohort of children with and without CP.
Main Methods:
- Recruited 26 children (aged 2-17 years), 13 with CP and 13 without.
- Collected concurrent wrist/forehead actigraphy and polysomnography data for one night.
- Collected home wrist actigraphy data for one week.
- Developed and evaluated novel actigraphy algorithms for accuracy, sensitivity, and specificity.
Main Results:
- Developed actigraphy algorithms demonstrated 72-80% accuracy, 87-91% sensitivity, and 60-71% specificity in children with CP.
- These algorithms showed improved accuracy and specificity over existing methods.
- Children with CP exhibited significantly lower sleep efficiency and duration compared to controls.
Conclusions:
- Actigraphy is a valid and reliable tool for objective sleep assessment in children with cerebral palsy.
- Children with CP demonstrate impaired sleep efficiency and duration, highlighting the need for targeted interventions.
Objectives:
Sleep issues are common in children with cerebral palsy (CP), although there are challenges in obtaining objective data about their sleep patterns. Actigraphs measure movement to quantify sleep but their accuracy in children with CP is unknown. Our goals were to validate actigraphy for sleep assessment in children with CP and to study their sleep patterns in a cross-sectional cohort study.
Methods:
We recruited children with (N = 13) and without (N = 13) CP aged 2-17 years (mean age 9 y 11mo [SD 4 y 10mo] range 4-17 y; 17 males, 9 females; 54% spastic quadriplegic, 23% spastic diplegic, 15% spastic hemiplegic, 8% unclassified CP). We obtained wrist and forehead actigraphy with concurrent polysomnography for one night, and home wrist actigraphy for one week. We developed actigraphy algorithms and evaluated their accuracy (agreement with polysomnography-determined sleep versus wake staging), sensitivity (sleep detection), and specificity (wake detection).
Results:
Our actigraphy algorithms had median 72-80% accuracy, 87-91% sensitivity, and 60-71% specificity in children with CP and 86-89% accuracy, 88-92% sensitivity, and 70-75% specificity in children without CP, with similar accuracies in wrist and forehead locations. Our algorithms had increased specificity and accuracy compared to existing algorithms, facilitating detection of sleep disruption. Children with CP showed lower sleep efficiency and duration than children without CP.
Conclusions:
Actigraphy is a valid tool for sleep assessment in children with CP. Children with CP have worse sleep efficiency and duration.
