Comparison of actigraphic, polysomnographic, and subjective assessment of sleep parameters in sleep-disordered patients.
OBJECTIVE
Comparison of polysomnography (PSG)-derived sleep parameters (total sleep time, sleep efficiency, and number of awakenings) to those derived from actigraphy and subjective questionnaires.


BACKGROUND
Actigraphy is commonly used to assist sleep specialists in the diagnosis of various sleep and circadian-rhythm disorders. However, few validation studies incorporate large sample sizes, typical sleep clinic patients, or comparisons with subjective reports of sleep parameters.


METHODS
Clinical series with 100 consecutive sleep-disordered patients (69 men, 31 women, mean age of 49+/-14.7 years) at a tertiary sleep disorders center. Sensitivity, specificity, and accuracy measures were obtained from epoch-by-epoch comparison of PSG and actigraphic data. Subjective sleep parameter data were derived from questionnaires given to subjects in the morning following their recording night.


RESULTS
We found that total sleep time and sleep efficiency did not significantly differ between PSG data and the combined data obtained from actigraphy and subjective reports. Using a high-threshold (low-wake-sensitivity) actigraphic algorithm, the number of awakenings was not significantly different from those detected by PSG.


CONCLUSIONS
We recommend the use of subjective data as an adjunct to actigraphic data in estimating total sleep time and sleep efficiency in sleep-disordered patients, especially those with disorders of excessive somnolence.
Stanford University Center of Excellence for Sleep Disorders, Stanford Sleep Disorders Clinic, 401 Quarry Road, Suite 3301, Stanford, CA 94305-5730, USA. clete@stanford.edu
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Kushida
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Chang
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Gadkary
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Guilleminault
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Carrillo
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Dement