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The convergent validity of Actiwatch 2 and ActiGraph Link accelerometers in measuring total sleeping period, wake after sleep onset, and sleep efficiency in free-living condition

  • Epidemiology • Original Article
  • Published:
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Abstract

Purpose

Physical activity (PA) and sleep are important to health; thus, it is important for researchers to have valid tools to measure them. Accelerometers have been proven valid for measuring PA and sleep, but only one device does this simultaneously: the ActiGraph Link (ActiGraph, LLC); however, the sleep-monitoring function has not been validated. This study aimed to evaluate the predictive power of ActiGraph Link sleep parameters against a validated accelerometer (Actiwatch 2, Phillips Respironics Mini-Mitter).

Methods

A total of 49 Hong Kong adults aged 18–64 provided valid data on both accelerometers on their non-dominant wrist for seven consecutive days. Epochs from both accelerometers were classified as either sleep or awake using seven established algorithms (Cole-Kripke, Sadeh, Sazonov, high sensitivity threshold, medium sensitivity threshold, low sensitivity threshold, and neural network model), and these data were transformed to total sleeping period, wake after sleep onset, and sleep efficiency.

Results

The non-zero count data for both accelerometers (331,103 observations) were strongly correlated with a Spearman correlation of 0.83 (p < 0.001). The total sleeping period was highly correlated (Spearman correlation ranged from 0.74 to 0.90) regardless of the algorithms used. All algorithms yielded insignificant difference in total sleep time measured by the two accelerometers (p > 0.05) with a negligible effect size of d < 0.2. The agreement of sleep/wake status was high for all algorithms, with accuracy ranging from 93.05 % (Sadeh’s algorithm) to 96.13 % (Cole-Kripke’s algorithm).

Conclusions

Results showed that the sleep function of the ActiGraph Link performs similar to a validated accelerometer (Actiwatch 2) and provides an opportunity to measure both sleep and PA simultaneously.

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Authors and Affiliations

  1. School of Nursing, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong

    Paul H. Lee & Lorna K. P. Suen

Authors
  1. Paul H. Lee
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  2. Lorna K. P. Suen
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Corresponding author

Correspondence to Paul H. Lee.

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Funding

The Food and Health Bureau of the Hong Kong Special Administrative Region, China, provided financial support in the form of Health and Medical Research Fund (Ref 12131741). The sponsor had no role in the design or conduct of this research.

Conflict of interest

The authors declare that they have no competing interests.

Ethics approval and consent to participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Additional information

Comments:

Obstructive sleep apnoea is both underdiagnosed and undertreated. In regard to the process of diagnosis full overnight sleep studies are costly and require the use of expensive equipment, whereas the home-based studies are more convenient though less accurate. The use of a device such as the ActiGraph Link (ActiGraph, LLC), accelerometer has an advantage both for the provider and patient as it has been demonstrated that this single device is capable of monitoring both the normal levels of daily activity and sleep pattern. Physical inactivity is a major risk factor for people with OSA so having accurate recordings of physical activity will help the health professional to provide an appropriate exercise prescription. If the same device can continue to be worn at night then a 24-h profile of the individual will be possible and trends in improvement in sleep plus physical activity levels monitored with minimal burden on the patient.

Margot Skinner

Dunedin, New Zealand

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Lee, P.H., Suen, L.K.P. The convergent validity of Actiwatch 2 and ActiGraph Link accelerometers in measuring total sleeping period, wake after sleep onset, and sleep efficiency in free-living condition. Sleep Breath 21, 209–215 (2017). https://doi.org/10.1007/s11325-016-1406-0

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  • DOI: https://doi.org/10.1007/s11325-016-1406-0

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