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Validation of Actigraphy in Middle Childhood - PubMed

  • ️Fri Jan 01 2016

Validation of Actigraphy in Middle Childhood

Lisa J Meltzer et al. Sleep. 2016.

Abstract

Study objectives: Few studies have examined the validity of actigraphy in school-aged children. The objective of this study was to examine the validity of a commonly used actigraph compared to polysomnography (PSG) in a sample of children age 5 to 12 y born prematurely, sleeping in their natural home environment.

Methods: 148 children born preterm (85 boys and 63 girls), ages 5-12 y (mean = 9.3 y, standard deviation = 2.0) wore the Philips Respironics Actiwatch-2 for 1 night concurrently with comprehensive, ambulatory PSG in the child's home. Sleep outcome variables were sleep onset latency, total sleep time (TST), and sleep efficiency. Epoch-by-epoch comparisons were used to determine sensitivity, specificity, and accuracy. Secondary analyses examined differences between children with no sleep issues, obstructive sleep apnea syndrome, and periodic limb movements in sleep (PLMS).

Results: Actigraphy significantly underestimated TST (30 min) and sleep efficiency (5%). Actigraphy underestimated or overestimated sleep onset latency by at least 10 min for a third of the children. Sensitivity and accuracy were good at 0.88 and 0.84, respectively, whereas specificity was lower at 0.46. Differences between actigraphy and PSG for TST and sleep efficiency were greatest for children with PLMS.

Conclusions: This study adds to the small existing literature demonstrating the validity of actigraphy in middle childhood. Although actigraphy shows good sensitivity (ability to detect sleep), specificity (ability to detect wake) is poor in this age group. Further, the results highlight the importance of considering whether a child has PLMS when interpreting actigraphic data, as well as the difficulties in accurately capturing sleep onset latency with actigraphy.

Keywords: accelerometer; actigraphy; children; polysomnography; sensitivity; specificity; validation.

© 2016 Associated Professional Sleep Societies, LLC.

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Figures

Figure 1
Figure 1

Scatterplots comparing actigraphy vs. polysomnography for (A) total sleep time, (B) sleep onset latency, and (C) sleep efficiency. An identity line highlights perfect agreement between the two measures. Blue dots are participants with OSAS, red dots are participants with PLMS, and white dots are participants with no sleep disorder. Dots under the line show where actigraphy has underestimated the sleep variable, while dots above the line show where actigraphy has overestimated the sleep variable.

Figure 2
Figure 2

Boxplot graphs showing the difference between actigraphy and polysomnography for the three sleep groups (no sleep disorder, OSAS, and PLMS) for (A) total sleep time, (B) sleep onset latency, and (C) sleep efficiency. The horizontal line shows perfect agreement (difference of 0), with boxplots under the line showing where actigraphy has underestimated the sleep variable, while boxplot above the line showing where actigraphy has overestimated the sleep variable.

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