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Polysomnography and actigraphy concordance in juvenile idiopathic arthritis, asthma and healthy children - PubMed

Comparative Study

Polysomnography and actigraphy concordance in juvenile idiopathic arthritis, asthma and healthy children

Teresa M Ward et al. J Sleep Res. 2012 Feb.

Abstract

The aims of this study were to evaluate sensitivity, specificity and accuracy with an epoch-by-epoch comparison of polysomnography (PSG) and actigraphy with activity counts scored at low, medium and high thresholds, and to compare PSG-derived total sleep time (TST), sleep efficiency (SE) and wake after sleep onset (WASO) to the same variables derived from actigraphy at low, medium and high thresholds in 9- to 11-year-old children with juvenile idiopathic arthritis (JIA), asthma and healthy control children. One night of PSG and actigraphy were recorded. Pairwise group comparisons for sensitivity showed significant differences at the low [Tukey's honest significant difference (HSD) P < 0.002], medium (P < 0.001) and high thresholds (P < 0.001) between JIA and asthma groups, and at the high threshold between JIA and controls (P < 0.009). Significant differences were found for specificity at the low (P < 0.001), medium (P < 0.001) and high thresholds (P < 0.001) between JIA and asthma groups, and between JIA and controls (low, P < 0.002: medium, P < 0.002: high, P < 0.008 threshold). PSG TST, WASO and SE were not significantly different among the groups, but significant group differences were found for actigraphy TST, WASO and SE at all three thresholds. Actigraphy showed the least overestimation or underestimation of sleep or wakefulness at the medium threshold for TST and WASO for all three groups. Compared to PSG, actigraphy was most accurate in the identification of sleep from wakefulness in 9- to 11-year-old healthy children, and less accurate in children with JIA and asthma.

Published 2011. This article is a US Government work and is in the public domain in the USA.

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Conflict of interest statement

Conflict of interests: None for all the authors.

Figures

Figure 1
Figure 1. Actigraphy Sensitivity vs. 1-specificity

Data represent low (A), medium (B), and high (C) actigraphy thresholds. JIA = ●, Asthma (AS) = □, + = controls. False positive fraction (FPF) is defined as the fraction or probability of actigraphy reporting sleep when PSG detects wake. The figures show the discrimination for each subject with respect to threshold. Each point represents the decision criterion (true positive vs. false positive) for each child at a given threshold.

Figure 2
Figure 2

Bland-Altman plots between Polysomnography and Actigraphy for Total Sleep Time (TST) (A) and Wake After Sleep Onset (WASO) (B). Data represent the mean bias ± standard deviation which provides an estimate of the degree of variation of the difference between polysomnography and actigraphy measures of the TST and WASO. JIA = ●, Asthma (AS) = □, + = controls.

Figure 2
Figure 2

Bland-Altman plots between Polysomnography and Actigraphy for Total Sleep Time (TST) (A) and Wake After Sleep Onset (WASO) (B). Data represent the mean bias ± standard deviation which provides an estimate of the degree of variation of the difference between polysomnography and actigraphy measures of the TST and WASO. JIA = ●, Asthma (AS) = □, + = controls.

Figure 2
Figure 2

Bland-Altman plots between Polysomnography and Actigraphy for Total Sleep Time (TST) (A) and Wake After Sleep Onset (WASO) (B). Data represent the mean bias ± standard deviation which provides an estimate of the degree of variation of the difference between polysomnography and actigraphy measures of the TST and WASO. JIA = ●, Asthma (AS) = □, + = controls.

Figure 2
Figure 2

Bland-Altman plots between Polysomnography and Actigraphy for Total Sleep Time (TST) (A) and Wake After Sleep Onset (WASO) (B). Data represent the mean bias ± standard deviation which provides an estimate of the degree of variation of the difference between polysomnography and actigraphy measures of the TST and WASO. JIA = ●, Asthma (AS) = □, + = controls.

Figure 2
Figure 2

Bland-Altman plots between Polysomnography and Actigraphy for Total Sleep Time (TST) (A) and Wake After Sleep Onset (WASO) (B). Data represent the mean bias ± standard deviation which provides an estimate of the degree of variation of the difference between polysomnography and actigraphy measures of the TST and WASO. JIA = ●, Asthma (AS) = □, + = controls.

Figure 2
Figure 2

Bland-Altman plots between Polysomnography and Actigraphy for Total Sleep Time (TST) (A) and Wake After Sleep Onset (WASO) (B). Data represent the mean bias ± standard deviation which provides an estimate of the degree of variation of the difference between polysomnography and actigraphy measures of the TST and WASO. JIA = ●, Asthma (AS) = □, + = controls.

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