title: The use of actigraphy in the monitoring of sleep and activity in ADHD: A meta-analysis.
abstract: Attention deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral disorder of childhood. There is an increasing need to find objective measures and markers of the disorder in order to assess the efficacy of the therapies and to improve follow-up strategies. Actigraphy is an objective method for recording motor activity and sleep parameters that has been used in many studies in ADHD. Our meta-analysis aimed to assess the current evidence on the role of actigraphy in both the detection of changes in motor activity and in sleep patterns in ADHD. A systematic review was carried out to find studies comparing children with unmedicated ADHD versus controls, using actigraphic measures as an outcome. The primary outcome measures were "sleep duration" and daytime "activity mean". As secondary outcome measures we analyzed "sleep onset latency", "sleep efficiency" and "wake after sleep onset". Twenty-four studies comprising 2179 children were included in this review. We show evidence that ADHD compared to typically developing children present a higher mean activity during structured sessions, a similar sleep duration, and a moderately altered sleep pattern. This study highlights the role of actigraphy as an objective tool for the ambulatory monitoring of sleep and activity in ADHD.
authors.affiliation: Clinical Trial Unit, University Department of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00100, Rome, Italy; Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00100, Rome, Italy. Electronic address: decrescenzo.franco@gmail.com.
authors.forename: Franco
authors.initials: F
authors.lastname: De Crescenzo
authors.affiliation: Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00100, Rome, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Licchelli
authors.affiliation: University of Rome 'Tor Vergata', Via della Ricerca Scientifica snc, 00133, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Ciabattini
authors.affiliation: Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00100, Rome, Italy.
authors.forename: Deny
authors.initials: D
authors.lastname: Menghini
authors.affiliation: Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00100, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Armando
authors.affiliation: Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00100, Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Alfieri
authors.affiliation: Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00100, Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Mazzone
authors.affiliation: Clinical Trial Unit, University Department of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00100, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pontrelli
authors.affiliation: Clinical Trial Unit, University Department of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00100, Rome, Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Livadiotti
authors.affiliation: Department of Psychology, 'Sapienza' University of Rome, Via dei Marsi 78, 00185, Rome, Italy; IRCCS Fondazione Santa Lucia, Via del Fosso di Fiorano 64, 00143, Rome, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Foti
authors.affiliation: University of Oxford, Department of Psychiatry, Warneford Hospital, Headington, Oxford, OX3 7JX, United Kingdom.
authors.forename: Digby
authors.initials: D
authors.lastname: Quested
authors.affiliation: Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00100, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Vicari
mesh_terms: D056044:Actigraphy / Q000379:methods*; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D009043:Motor Activity / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000175:diagnosis
keywords: Actigraphy; Attention-deficit disorder with hyperactivity; Children; Meta-analysis; Sleep