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Jerks are useful: extracting pulse rate from wrist-placed accelerometry jerk during sleep in children

R Glenn Weaver1, M V S Chandrashekhar1, Bridget Armstrong1

  • 1Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.

Sleep
|May 3, 2024
PubMed

Insights

Wrist-worn accelerometers can estimate children's sleep heart rate. The Apple Watch Series 7 showed moderate accuracy, while the ActiGraph GT9X performed poorly, indicating potential for non-invasive pediatric sleep monitoring.

Area of Science:

  • Biomedical Engineering
  • Sleep Medicine
  • Wearable Technology

Background:

  • Accurate heart rate monitoring during sleep is crucial for assessing pediatric sleep health.
  • Electrocardiogram (ECG) is the gold standard but is invasive and impractical for long-term monitoring.
  • Wrist-worn accelerometers offer a non-invasive alternative for continuous physiological data collection.

Purpose of the Study:

  • To evaluate the accuracy of heart rate estimation using wrist-worn accelerometers compared to ECG in children during sleep.
  • To compare the performance of the Apple Watch Series 7 (AWS7) and ActiGraph GT9X devices in predicting heart rate from accelerometry data.

Main Methods:

  • Eighty-two children underwent polysomnography while wearing an AWS7 and ActiGraph GT9X.
  • Heart rate was derived from accelerometry (jerk analysis) and ECG (R-R intervals).
  • Agreement was assessed using Lin's concordance correlation coefficient (CCC), mean absolute error (MAE), and mean absolute percent error (MAPE).

Main Results:

  • The AWS7 demonstrated moderate agreement (CCC=0.61) with ECG heart rate, with lower MAE (6.4 bpm) and MAPE (7.3%).
  • The ActiGraph GT9X showed poor agreement (CCC=-0.11) with high MAE (16.8 bpm) and MAPE (20.4%).
  • AWS7 accuracy was better during deeper sleep stages (N2, N3, REM) and with higher signal quality.

Conclusions:

  • Raw accelerometry data from the AWS7 can be utilized to estimate heart rate in sleeping children.
  • The ActiGraph GT9X's accelerometry data was not suitable for accurate heart rate estimation in this population.
  • Further investigation is required to understand the limitations of the GT9X's performance.
Abstract

Keywords:
actigraphyambulatory sleep monitoringchildrenheart rate variabilityopen sourcepediatrics – behaviorsleep trackingvalidation

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