Validation of Actiwatch for Assessment of Sleep-wake States in Preterm Infants

Abstract

Keywords: behavior instruments movement preterm infants sleep s u m m a r y Purpose: The purpose of this study was to validate the Actiwatch with behaviorally determined sleepe wake state in preterm infants and to explore the influence of postmenstrual age on the accuracy of Actiwatch. Methods: A prospective and comparative research design was used. Twenty-four preterm infants with postmenstrual age ranging from 28e38 weeks were studied. The infants were studied for 2 hours between two feedings. Infant's sleep and wake state was measured every 30 seconds using Actiwatch and the Anderson Behavioral State Scale simultaneously. Results: Actiwatch demonstrated high agreement, sensitivity, and predictivity of sleep state, when validated with the Anderson Behavioral State Scale at the setting of high and automatic activity thresholds, and was not influenced by the infant's postmenstrual age. However, lower specificity and predictivity were found in the wake state, and influenced by postmenstrual age. Conclusion: Results of this study suggest that high activity thresholds are the most accurate for determining sleep state in preterm infants, and health care professionals must take the limitations into consideration while using the Actiwatch to assess wake states.

A novel machine learning unsupervised algorithm for sleep/wake identification using actigraphy

“…For example, in pediatric sleep studies, PSG data are hard to obtain from young children due to difficulties in wearing invasive sensors and wire. 22 One often has to rely on sleep logs recorded by parents or researchers, but training the supervised algorithm based on sleep logs may not be accurate since sleep logs can be subjective and biased. 1,2 On the other hand, HMM can also be used as a supervised method to train models and infer sleep/wake states.…”

The Meaning of Sleep Quality: A Survey of Available Technologies

“…This is the case of most of the products already surveyed in Section V-B that also exploit PPG sensors (ie. products from Garmin R , fitbit c , Xiaomi c , ActiWatch R 2 and Spectrum [70]). Not only the wristbands can be used to detection motions, but also pillows equipped with sensing units.…”

Factors Associated With Preterm Infants’ Circadian Sleep/Wake Patterns at the Hospital

“…NICU sounds or light intensity can decrease infants' nonrapid eye movement sleep, which may have detrimental effects on their neurodevelopmental outcomes (Varvara, Effrossine, Despoina, Konstantinos, & Matziou, 2016). These impacts of NICU caregiving patterns and environmental stimuli on preterm infants' sleep have been studied either by observing sleep patterns or by electroencephalography, with few studies using actigraphy over 24 hr for 3 continuous days (Mirmiran & Ariagno, 2000;Yang, Yang, & Chang, 2014). Moreover, preterm infants' sleep patterns have been associated with characteristics such as postmenstrual age (PMA;Hoppenbrouwers et al, 2005;Mirmiran & Ariagno, 2000), body weight (Ingersoll & Thoman, 1999), gender (Hintz, Kendrick, Vohr, Kenneth, & Higgins, 2006), chronological age (Tyson, Parikh, Langer, Green, & Higgins, 2008), circadian rhythm, and illness severity (Buske-Kirschbaum, Krieger, & Wilkes, 2007;Goffaux, Lafrenaye, & Morin, 2008).…”

“…Actigraphy, on the contrary, assesses sleep patterns and quality using motor activity–based measurements (So, Adamson, & Horne, 2007). One actimetry sensor, the Actiwatch, has been validated against polysomnography in 13 full-term and nine preterm infants (So et al, 2005) and with behaviorally determined sleep/wake states in preterm infants (Yang et al, 2014). Our review of the relevant literature indicates that current knowledge of preterm infants’ sleep/wake patterns during hospitalization is limited by short measurement periods (e.g., 1.5, 2, 4 hr) and was measured by observations or polysomnography (Yang et al, 2014).…”