title: Comparison of actigraphy immobility rules with polysomnographic sleep onset latency in children and adolescents.
abstract: OBJECTIVE
  While actigraphy has gained popularity in pediatric sleep research, questions remain about the validity of actigraphy as an estimate of sleep-wake patterns. In particular, there is little consistency in the field in terms of scoring rules used to determine sleep onset latency. The purpose of this study was to evaluate different criteria of immobility as a measure of sleep onset latency in children and adolescents.
  
  
  METHODS
  Ninety-five youth (ages 3-17 years, 46 % male) wore both the Ambulatory Monitoring Inc. Motionlogger Sleep Watch (AMI) and the Philips Respironics Mini-Mitter Actiwatch-2 (PRMM) during overnight polysomnography in a pediatric sleep lab. We examined different sleep onset latency scoring rules (3, 5, 10, 15, and 20 min of immobility) using different algorithms (Sadeh and Cole-Kripke) and sensitivity settings (low, medium, high) for the devices. Comparisons were also made across age groups (preschoolers, school-aged, adolescents) and sleep disordered breathing status (no obstructive sleep apnea [OSA], mild OSA, clinically significant OSA).
  
  
  RESULTS
  For the AMI device, shorter scoring rules performed best for children and longer scoring rules were better for adolescents, with shorter scoring rules best across sleep disordered breathing groups. For the PRMM device, medium to longer scoring rules performed best across age and sleep disordered breathing groups.
  
  
  CONCLUSIONS
  Researchers are encouraged to determine the scoring rule that best fits their population of interest. Future studies are needed with larger samples of children and adolescents to further validate actigraphic immobility as a proxy for sleep onset latency.
authors: Department of Pediatrics, National Jewish Health, 1400 Jackson Street, G311, Denver, CO, 80206, USA. meltzerl@njhealth.org.
authors: Lisa J
authors: LJ
authors: Meltzer
authors: Center for Sleep and Respiratory Neurobiology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
authors: Colleen M
authors: CM
authors: Walsh
authors: Department of Pediatrics, National Jewish Health, 1400 Jackson Street, G311, Denver, CO, 80206, USA.
authors: Ashley A
authors: AA
authors: Peightal
mesh_terms: D056044:Actigraphy / Q000295:instrumentation / Q000379:methods*; D000293:Adolescent; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity; D017286:Polysomnography / Q000295:instrumentation / Q000379:methods*; D011930:Reaction Time; D012680:Sensitivity and Specificity; D012890:Sleep; D012891:Sleep Apnea Syndromes / Q000175:diagnosis; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*
keywords: Actigraphy; Immobility; Pediatric; Sleep onset latency; Validation