Actigraphy: Metrics reveal it is not a valid tool for determining sleep in neonates

J Sleep Res. 2021 Jul 22:e13444. doi: 10.1111/jsr.13444. Online ahead of print.ABSTRACTStudy of emerging sleep-wake patterns in neonates is important for promptly identifying and treating abnormal sleep behaviours to ensure healthy infant development and neurobehavioral outcomes. Current methods to assess sleep are costly, labour intensive, and particularly difficult to implement in fragile, hospitalised infants requiring intensive medical care. The aim of the present study was to assess the validity of actigraphy as a tool for detecting sleep in preterm infants, using polysomnography (PSG) as the "gold standard". A total of 10 neonates (mean [SD] 35.8 [1.2] weeks post-menstrual age; five female) hospitalised since birth for prematurity each participated in one 8-10 hr session during which PSG and actigraphy were recorded simultaneously. Inter-feed minute-by-minute PSG Sleep-Wake scores were compared to concurrent actigraph epochs categorised as either "Sleep" or "Wake" using three separate movement-per-minute thresholds (≤20, ≤40, ≤80). Tool validity was assessed using five metrics. A key finding was that for each of the movement thresholds there was high agreement rate, sensitivity, and predictive value of sleep (85.2%-97.2%), whereas specificity and predictive value of wake remained low (12%-46%). Receiver operating characteristic curve analysis also revealed low discriminatory power of actigraphy for estimating sleep (area under the curve = 0.636; Youden's Index J =...
Source: Journal of Sleep Research - Category: Sleep Medicine Authors: Source Type: research