title: Challenges and Emerging Technologies within the Field of Pediatric Actigraphy.
abstract: Actigraphy as an objective measure of sleep and wakefulness in infants and children has gained popularity over the last 20 years. However, the field lacks published guidelines for sleep-wake identification within pediatric age groups. The scoring rules vary greatly and although sensitivity (sleep agreement with polysomnography) is usually high, a significant limitation remains in relation to specificity (wake agreement). Furthermore, accurate algorithm output and sleep-wake summaries usually require prior entry from daily logs of sleep-wake periods and artifact-related information (e.g., non-wear time), involving significant parent co-operation. Scoring criteria for daytime naps remains an unexplored area. Many of the problems facing accuracy of measurement are inherent within the field of actigraphy itself, particularly where sleep periods containing significant movements are erroneously classified as wake, and within quiet wakefulness when no movements are detected, erroneously classified as sleep. We discuss the challenges of actigraphy for pediatric sleep, briefly describe the technical basis and consider a number of technological approaches that may facilitate improved classification of errors in sleep-wake discrimination.
authors.affiliation: Department of Women's and Children's Health, University of Otago , Dunedin , New Zealand.
authors.forename: Barbara
authors.initials: B
authors.lastname: Galland
authors.affiliation: Department of Medicine, University of Otago , Dunedin , New Zealand.
authors.forename: Kim
authors.initials: K
authors.lastname: Meredith-Jones
authors.affiliation: School of Information Technology and Electrical Engineering, The University of Queensland , Brisbane, QLD , Australia.
authors.forename: Philip
authors.initials: P
authors.lastname: Terrill
authors.affiliation: Department of Medicine, University of Otago , Dunedin , New Zealand.
authors.forename: Rachael
authors.initials: R
authors.lastname: Taylor
keywords: accelerometer; actigraphy; child; infant; pediatric; physical activity; sleep; wake