title: Assessment for the possibility of a first night effect for wrist actigraphy in adolescents.
abstract: Evidence of a 'first night effect' has been documented for polysomnography. The possibility of this has not been previously assessed in wrist actigraphy, yet may have important implications for the study design of future sleep research. We sought to examine potential evidence of a 'first night effect' for wrist actigraphy in adolescents across weekdays and weekend nights for multiple sleep outcomes.
  
  
  
  3-year prospective cohort study (Midlands Adolescent Schools Sleep Education Study).
  
  
  
  8 secondary schools in the Midlands region of the UK.
  
  
  
  Adolescents (aged 11-13 years at baseline) were recruited to the study and were requested to wear a wrist actigraph for 7 consecutive days/nights at baseline and then annually for 2 years during the second term of the academic year.
  
  
  
  We compared multiple sleep outcomes (total sleep time, wake after sleep onset, sleep efficiency, sleep onset latency, number of awakenings, length of awakenings, sleep onset time) when the device was worn on a weekday and weekend and compared these to other nights to identify possible evidence of a 'first night effect' for wrist actigraphy.
  
  
  
  No significant differences were found between any sleep outcomes when the first night of wrist actigraphy was on a weekday compared with other weekdays. When the first night was measured on a weekend (Friday), average total sleep time was significantly greater (486±5 min) compared with the second night (Saturday; 469±6 min), p=0.01.
  
  
  
  We found no evidence to support a 'first night effect' for wrist actigraphy in our adolescent sample. The first night of actigraphy data should not be disregarded in future studies that deploy this technique to measure sleep over prolonged time periods.
authors.affiliation: Department of Medicine and Clinical Research Core, Weill Cornell Medicine in New York USA, Doha, Qatar.
authors.forename: Teresa
authors.initials: T
authors.lastname: Arora
authors.affiliation: Department of Medicine and Clinical Research Core, Weill Cornell Medicine in New York USA, Doha, Qatar.
authors.forename: Omar M
authors.initials: OM
authors.lastname: Omar
authors.affiliation: Department of Medicine and Clinical Research Core, Weill Cornell Medicine in New York USA, Doha, Qatar Department of Medicine, King's College London, London, UK.
authors.forename: Shahrad
authors.initials: S
authors.lastname: Taheri
mesh_terms: D056044:Actigraphy / Q000379:methods*; D000293:Adolescent; D002648:Child; D002940:Circadian Rhythm; D005260:Female; D006801:Humans; D008297:Male; D017286:Polysomnography / Q000379:methods*; D011446:Prospective Studies; D012890:Sleep; D014953:Wrist
keywords: EPIDEMIOLOGY; PUBLIC HEALTH; SLEEP MEDICINE; STATISTICS & RESEARCH METHODS