Estimating Sleep Patterns with Activity Monitoring in Children and Adolescents: How Many Nights Are Necessary for Reliable Measures?

Acebo, Christine; Sadeh, Avi; Seifer, Ronald; Tzischinsky, Orna; Wolfson, Amy R.; Hafer, Abigail; Carskadon, Mary A.

doi:10.1093/sleep/22.1.95

Cited by 627 publications

(518 citation statements)

References 31 publications

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“…Finally, data were collected for only one night in the sleep laboratory. An early study has shown that five or more nights are needed to ensure reliability of actigraphy assessments of sleep in children and adolescents, 31 and first night effects of laboratory PSG can influence sleep outcomes. 32 As such, this study cannot make inferences to a particular device's ability to assess sleep and wake over long periods of time or in more natural environments.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Commercial Wrist-Based and Smartphone Accelerometers, Actigraphy, and PSG in a Clinical Cohort of Children and Adolescents

Toon

Davey

Hollis

et al. 2016

Journal of Clinical Sleep Medicine

121

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Study Objectives: To compare two commercial sleep devices, an accelerometer worn as a wristband (UP by Jawbone) and a smartphone application (MotionX 24/7), against polysomnography (PSG) and actigraphy (Actiwatch2) in a clinical pediatric sample. Methods: Children and adolescents (n = 78, 65% male, mean age 8.4 ± 4.0 y) with suspected sleep disordered breathing (SDB), simultaneously wore an actiwatch, a commercial wrist-based device and had a smartphone with a sleep application activated placed near their right shoulder, during their diagnostic PSG. Outcome variables were sleep onset latency (SOL), total sleep time (TST), wake after sleep onset (WASO), and sleep efficiency (SE). Paired comparisons were made between PSG, actigraphy, UP, and MotionX 24/7. Epoch-by-epoch comparisons determined sensitivity, specificity, and accuracy between PSG, actigraphy, and UP. Bland-Altman plots determined level of agreement. Differences in bias between SDB severity and developmental age were assessed. Results: No differences in mean TST, WASO, or SE between PSG and actigraphy or PSG and UP were found. Actigraphy overestimated SOL (21 min). MotionX 24/7 underestimated SOL (12 min) and WASO (63 min), and overestimated TST (106 min) and SE (17%). UP showed good sensitivity (0.92) and accuracy (0.86) but poor specificity (0.66) when compared to PSG. Bland-Altman plots showed similar levels of bias in both actigraphy and UP. Bias did not differ by SDB severity, however was affected by age. Conclusions: When compared to PSG, UP was analogous to Actiwatch2 and may have some clinical utility in children with sleep disordered breathing. MotionX 24/7 did not accurately reflect sleep or wake and should be used with caution. I NTRO DUCTI O NShort sleep duration or sleep disruption during childhood, either due to a physiological sleep disorder or psychosocial basis, have adverse effects on brain development, cognitive performance, behavioral functioning, and psychological well-being.1-7 Appropriate treatment of sleep problems in children and adolescents depends on accurate assessment. The current gold standard for assessing sleep and diagnosing sleep disorders in children is polysomnography (PSG). 8,9 This technique, which uses sophisticated technology to assess brain, cardiovascular and respiratory activity during sleep usually in a laboratory environment, is expensive and labor-intensive and typically only provides one or two nights of information, which may not be reflective of sleep in the home. 10Actigraphy, which use accelerometer technology to provide estimates of sleep and wake based on the level of activity, is used to provide objective assessments of sleep-wake patterns over long periods of time 11,12 and assist in diagnosis and treatment monitoring of sleep disorders such as delayed sleep phase syndrome and behavioral insomnia.13 Validation studies in infants, children and adolescents have shown that actigraphy is sensitive in assessing actual sleep, however over-or

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Section: Discussionmentioning

confidence: 99%

Comparison of Commercial Wrist-Based and Smartphone Accelerometers, Actigraphy, and PSG in a Clinical Cohort of Children and Adolescents

Toon

Davey

Hollis

et al. 2016

Journal of Clinical Sleep Medicine

121

View full text Add to dashboard Cite

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“…The most common is wrist actigraphy. Worn on the non-dominant wrist, the watch-like computer detects omni-directional movement and has algorithms to infer sleep vs. wake states (Sadeh, Gruber, & Raviv, 2002;Acebo et al, 1999;Sadeh, Sharkey, & Carskadon, 1994;Hoffmann, 2004;Kushida et al, 2001). Wrist actigraphy has been used in research with children having asthma (Sadeh, Horowitz, Wolach-Benodis, & Wolach, 1998) and those not having asthma (Acebo et al, 2005;El-Sheikh, Buckhalt, Keller, Cummings, & Acebo, 2007;Sadeh, Raviv, & Gruber, 2000) for the past decade.…”

Section: Discussionmentioning

confidence: 99%

Parent-Child Agreement in Report of Nighttime Respiratory Symptoms and Sleep Disruptions and Quality

Kieckhefer

Lentz²,

Tsai³

et al. 2009

Journal of Pediatric Health Care

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Introduction-Asthma control requires assessment of nighttime symptoms and sleep disruption. Cognitive and emotional development enables most school age children to report nocturnal problems but providers often rely only on parental report potentially limiting the comprehensiveness of their assessments and their ability to support the child's emerging efforts at shared management of their illness. This study investigated parent-child concordance in report of nighttime respiratory symptoms, sleep disruption and quality of sleep in a sample of 9-11 year old children with asthma. Secondarily, similar concordance patterns in an equal number of dyads where the child was asthma free were examined, to illustrate the potential influence of asthma.

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“…Actigraphy has been shown to be a reliable measure of sleep patterns when at least five nights are recorded (Acebo et al, 1999). One participant with less than five recorded nights was thus excluded.…”

Section: Methodsmentioning

confidence: 99%

Sleep, Attention, and Executive Functioning in Children with Attention-Deficit/Hyperactivity Disorder

Moreau

Rouleau

Morin

2013

Archives of Clinical Neuropsychology

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Estimating Sleep Patterns with Activity Monitoring in Children and Adolescents: How Many Nights Are Necessary for Reliable Measures?

Abstract: Five or more nights of usable recordings are required to obtain reliable actigraph measures of sleep for children and adolescents.

Cited by 627 publications

References 31 publications

Comparison of Commercial Wrist-Based and Smartphone Accelerometers, Actigraphy, and PSG in a Clinical Cohort of Children and Adolescents

Comparison of Commercial Wrist-Based and Smartphone Accelerometers, Actigraphy, and PSG in a Clinical Cohort of Children and Adolescents

Parent-Child Agreement in Report of Nighttime Respiratory Symptoms and Sleep Disruptions and Quality

Sleep, Attention, and Executive Functioning in Children with Attention-Deficit/Hyperactivity Disorder

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