title: Actigraphy correctly predicts sleep behavior in infants who are younger than six months, when compared with polysomnography.
abstract: Actigraphy has been widely used in adults and children. In infants, validation of actigraphy has typically used a comparison with behaviorally determined sleep state classification rather than polysomnography (PSG). This study validated actigraphy against PSG for determining sleep and waking states in infants who were younger than 6 mo. Twenty-two healthy infants, 13 term and 9 preterm, were studied at three different matched postconceptional ages. Actigraph data were compared with PSG recordings in 1-min epochs. Agreement rate (AR), predictive value for sleep, predictive value for wake, sensitivity. and specificity were calculated and compared between activity thresholds and across ages with two-way ANOVA for repeated measures. Thirty-two validation studies were analyzed. Overall AR with PSG of 93.7 +/- 1.3 and 91.6 +/- 1.8 were obtained at 2-4 wk and 5-6 mo, respectively, at the low activity threshold setting, whereas the auto activity threshold gave the best agreement with PSG at 2-4 mo (AR 89.3 +/- 1.3%). Sensitivity values of 96.2 +/- 1.1% at 2-4 wk, 91.2 +/- 1.5% at 2-4 mo, and 94.0 +/- 1.9% were obtained at these same settings. There was no difference across ages in AR or sensitivity. PVW and specificity values were low in this study. We conclude that actigraphy is a valid method for monitoring sleep in infants who are younger than 6 mo.
authors.affiliation: Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.
authors.forename: Kevin
authors.initials: K
authors.lastname: So
authors.forename: Pat
authors.initials: P
authors.lastname: Buckley
authors.forename: T Michael
authors.initials: TM
authors.lastname: Adamson
authors.forename: Rosemary S C
authors.initials: RS
authors.lastname: Horne
mesh_terms: D000704:Analysis of Variance; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D017286:Polysomnography / Q000379:methods*; D012680:Sensitivity and Specificity; D012890:Sleep; D012894:Sleep Stages; D012893:Sleep Wake Disorders / Q000175:diagnosis; D013997:Time Factors