Sleep and Breathing

, Volume 17, Issue 1, pp 411–417

Accuracy of computer algorithms and the human eye in scoring actigraphy


  • Kathleen Boyne
    • Divison of PulmonologyThe Children’s Hospital of Philadelphia
  • David D. Sherry
    • Division of RheumatologyThe Children’s Hospital of Philadelphia
  • Paul R. Gallagher
    • Biostatistics Core of the Clinical and Translational Research Center (CTRC)The Children’s Hospital of Philadelphia
  • Margaret Olsen
    • Division of RheumatologyThe Children’s Hospital of Philadelphia
    • Divison of PulmonologyThe Children’s Hospital of Philadelphia
Original Article

DOI: 10.1007/s11325-012-0709-z

Cite this article as:
Boyne, K., Sherry, D.D., Gallagher, P.R. et al. Sleep Breath (2013) 17: 411. doi:10.1007/s11325-012-0709-z



The purpose of this study is to determine the optimal scoring method and parameter settings of actigraphy by comparison to simultaneous polysomnography (PSG).


Fifteen studies of simultaneous PSG and actigraphy were completed in adolescents (mean age = 16.3 years) and analyzed. Scoring actigraphy by the human eye was compared to a commercial computerized algorithm using various parameters. The PSG was considered the reference standard.


There was a better correlation between actigraphy and PSG sleep start/end, total sleep time, wake after sleep onset, and sleep efficiency when the rest period was determined by the human (mean r = 0.640) rather than auto-set by the software (r = 0.406). The best results came when the rest intervals were set based on the PSG (r = 0.694). Scoring the printed actogram by the human eye was superior to the auto analyses as well (r = 0.575). Higher correlations and lower biases were obtained from lower wake threshold settings (low and medium) and higher immobility times (10 and 15 min).


Visual scoring by simple inspection of the actigraphy tracing had a reasonable correlation with the gold standard PSG. Accurate determination of the rest interval is important in scoring actigraphy. Scoring actigraphy by the human eye is superior to this computer algorithm when auto-setting major rest periods. A low wake threshold and 10–15 min of immobility for sleep onset and sleep end yield the most accurate computerized results. Auto-setting major rest intervals should be avoided to set start/end of rest intervals; adjustments for artifacts and/or a sleep diary for comparison are helpful.


ActigraphyPolysomnographySleepReference standardsVisual scoringComputer scoring

Copyright information

© Springer-Verlag 2012