Use of Actigraphy for the Evaluation of Sleep Disorders and Circadian Rhythm Sleep-Wake Disorders: An American Academy of Sleep Medicine Clinical Practice Guideline

Abstract

The following recommendations are intended as a guide for clinicians using actigraphy in evaluating patients with sleep disorders and circadian rhythm sleep-wake disorders, and only apply to the use of FDA-approved devices. Each recommendation statement is assigned a strength ("Strong" or "Conditional"). A "Strong" recommendation (ie, "We recommend…") is one that clinicians should follow under most circumstances. A "Conditional" recommendation (ie, "We suggest…") reflects a lower degree of certainty regarding the outcome and appropriateness of the patient-care strategy for all patients. The ultimate judgment regarding any specific care must be made by the treating clinician and the patient, taking into consideration the individual circumstances of the patient, available treatment options, and resources. We suggest that clinicians use actigraphy to estimate sleep parameters in adult patients with insomnia disorder. (Conditional). We suggest that clinicians use actigraphy in the assessment of pediatric patients with insomnia disorder. (Conditional). We suggest that clinicians use actigraphy in the assessment of adult patients with circadian rhythm sleep-wake disorder. (Conditional). We suggest that clinicians use actigraphy in the assessment of pediatric patients with circadian rhythm sleep-wake disorder. (Conditional). We suggest that clinicians use actigraphy integrated with home sleep apnea test devices to estimate total sleep time during recording (in the absence of alternative objective measurements of total sleep time) in adult patients suspected of sleep-disordered breathing. (Conditional). We suggest that clinicians use actigraphy to monitor total sleep time prior to testing with the Multiple Sleep Latency Test in adult and pediatric patients with suspected central disorders of hypersomnolence. (Conditional). We suggest that clinicians use actigraphy to estimate total sleep time in adult patients with suspected insufficient sleep syndrome. (Conditional). We recommend that clinicians use actigraphy in place of electromyography for the diagnosis of periodic limb movement disorder in adult and pediatric patients. (Strong).

High prevalence of parent‐reported sleep problems in pediatric patients with acute lymphoblastic leukemia after induction therapy

“…Additionally, most previous studies employed only a single mode of sleep assessment, while PROs and objective sleep outcomes (such as polysomnography and actigraphy) provide complementary information . Although polysomnography is considered the gold standard, in an ambulant setting objective sleep outcomes are best measured with actigraphy . Actigraphy provides quantitative sleep parameters such as sleep duration, wake after sleep onset, and sleep efficiency.…”

“…Actigraphy provides quantitative sleep parameters such as sleep duration, wake after sleep onset, and sleep efficiency. The sleep estimates obtained with actigraphy can contribute to our understanding of clinical sleep disorders . PROs provide valuable qualitative and subjective information on sleep behaviors and consequences of impaired sleep (such as bedtime routines, sleep anxiety, and daytime sleepiness) that cannot be assessed with actigraphy.…”

“…29,30 Although polysomnography is considered the gold standard, in an ambulant setting objective sleep outcomes are best measured with actigraphy. 31 at home in between two hospital admissions ( Figure 1). Families were instructed to start the assessment directly after discharge from the hospital.…”

Subjective sleep quality as a mediator in the relationship between pain severity and sustained attention performance in patients with fibromyalgia

“…Sleep diaries are commonly used in sleep studies. Although the American Sleep Disorders Association recommended using the actigraphy and polysomnography for objectively assessing sleep in sleep research and sleep medicine (Kushida et al., ; Smith et al., ), certain sleep parameters such as sleep quality (SQ) may not be sufficiently explained by objective measures (Sadeh, ). Previous studies have shown that total sleep time (TST) and sleep efficiency (SE) measured using sleep diaries and those measured by actigraphy were not significantly different in patients with chronic musculoskeletal pain (Wilson, Watson, & Currie, ).…”

“…Sleep diaries are commonly used in sleep studies. Although the American Sleep Disorders Association recommended using the actigraphy and polysomnography for objectively assessing sleep in sleep research and sleep medicine (Kushida et al, 2005;Smith et al, 2018), certain sleep parameters such as sleep quality (SQ) may not be sufficiently explained by objective measures (Sadeh, 2011).…”