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Validation study on sleep parameters by actigraphy for normal subjects

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Dear Editor:

O’Hare et al. reported the performance of three sleep monitoring devices for measuring sleep parameters in 20 normal subjects against sleep polysomnography (PSG) [1]. The authors used two non-contact radio-frequency biomotion sensors, named SleepMinder® and SleepDesign®, and an accelerometer, named Actiwatch®. Compared with sleep PSG, all three devices overestimated total sleep time and underestimated wake after sleep onset and sleep onset latency. I appreciate that the authors checked the validity of three sleep monitoring devices, including Actiwatch®, against sleep PSG. Although the agreement of sleep/wake judgment by sleep monitoring devices is satisfactory for normal subjects, the authors recognized the limitation when these devices were applied for patients with insomnia. I have a query on their study with special emphasis on Actiwatch®.

O’Hare et al. quoted a paper on selecting appropriate cutoff point for sleep-wake judgment [2], but there is no definite way to determine the best sensitivity of sleep-wake judgment for every subject. Kushida et al. found the best overall accuracy and ability to detect wakefulness using Actiwatch® and PSG, when the “high-sensitivity” setting (20 counts per minute) was used [3]. Peterson et al. adopted the default sensitivity setting (40 counts per minute), and they described the overestimation of total sleep time and underestimation of wake after sleep onset by Actiwatch® [4], which was the same study outcome by O’Hare et al.

There is a difference between brain activity and physical movement during sleep, and the discrepancy of sleep parameters between sleep PSG and sleep monitoring devices would be obvious for insomniacs [5]. Validation study of sleep parameters by SleepMinder®, SleepDesign®, and Actiwatch® as a tool for sleep/wake judgment should also be conducted in patients with sleep apnea syndrome and other sleep disorders.

References

  1. 1.

    O'Hare E, Flanagan D, Penzel T, Garcia C, Frohberg D, Heneghan C (2014) A comparison of radio-frequency biomotion sensors and actigraphy versus polysomnography for the assessment of sleep in normal subjects. Sleep Breath Mar 11. doi: 10.1007/s11325-014-0967-z

  2. 2.

    Lichstein KL, Stone KC, Donaldson J, Nau SD, Soeffing JP, Murray D, Lester KW, Aguillard RN (2006) Actigraphy validation with insomnia. Sleep 29(2):232–239

  3. 3.

    Kushida CA, Chang A, Gadkary C, Guilleminault C, Carrillo O, Dement WC (2001) Comparison of actigraphic, polysomnographic, and subjective assessment of sleep parameters in sleep-disordered patients. Sleep Med 2(5):389–396

  4. 4.

    Peterson BT, Chiao P, Pickering E, Freeman J, Zammit GK, Ding Y, Badura LL (2012) Comparison of actigraphy and polysomnography to assess effects of zolpidem in a clinical research unit. Sleep Med 13(4):419–424

  5. 5.

    Natale V, Léger D, Martoni M, Bayon V, Erbacci A (2014) The role of actigraphy in the assessment of primary insomnia: a retrospective study. Sleep Med 15(1):111–115

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There is no conflict of interest in this study.

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Correspondence to Tomoyuki Kawada.

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Kawada, T. Validation study on sleep parameters by actigraphy for normal subjects. Sleep Breath 19, 11 (2015). https://doi.org/10.1007/s11325-014-0977-x

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Keywords

  • Public Health
  • Internal Medicine
  • Cutoff Point
  • Sleep Apnea
  • Validation Study