There have been limited studies of the validation of actigraphy for the determination of sleep and wake in children and in this study we aimed to compare wrist actigraphy with polysomnography (PSG). We studied 45 children (29 M/16 F), aged between 1 and 12 years (5.8 +/- 2.7 years, mean +/- SD). Actigraphic data were collected during standard overnight PSG. Data from the actiwatch were analysed over four separate activity threshold settings (low, medium, high, auto). Actigraphic data were compared epoch-by-epoch with the matching PSG. Sleep time was not different from PSG values for the low or auto activity thresholds, but was significantly less on the medium and high activity thresholds (P < 0.05). In contrast, the low and auto activity thresholds significantly underestimated wake time (P < 0.05), whilst that recorded on the medium and high activity thresholds were not different to PSG values. Agreement rates across the thresholds were all high ranging from 85.1% to 88.6%. Predictive value for sleep and sensitivity were also high with values ranging from 91.6% to 94.9% and 90.1% to 97.7%, respectively. In contrast, predictive value for wake and specificity were low ranging between 46.7-65.6% and 39.4-68.9%, respectively. There was no effect of subject age, OAHI or PSG arousal index on AR for any of the activity thresholds. We conclude that actigraphy is a reliable method for determining sleep in children when compared against PSG. Actigraphy may be a useful tool in paediatric sleep clinics and research.

译文

关于确定儿童睡眠和觉醒的动作学验证的研究有限,在这项研究中,我们旨在将手腕动作学与多导睡眠图 (PSG) 进行比较。我们研究了45名儿童 (29 M/16 F),年龄在1至12岁之间 (5.8/- 2.7岁,平均/- SD)。在标准夜间PSG期间收集了活动数据。在四个独立的活动阈值设置 (低,中,高,自动) 上分析了来自actiwatch的数据。活动性数据与匹配的PSG进行了逐个比较。睡眠时间与低或自动活动阈值的PSG值没有差异,但在中高活动阈值上明显较少 (P <0.05)。相反,低活动阈值和自动活动阈值显着低估了唤醒时间 (P <0.05),而在中高活动阈值上记录的唤醒时间与PSG值没有差异。从85.1% 到88.6%,跨阈值的协议率都很高。睡眠和敏感性的预测值也很高,分别为91.6% 至94.9% 和90.1% 至97.7%。相反,唤醒和特异性的预测值分别在46.7-65.6% 和39.4-68.9% 之间较低。对于任何活动阈值,受试者年龄,OAHI或PSG唤醒指数对AR均无影响。我们得出的结论是,与PSG相比,活动描记法是确定儿童睡眠的可靠方法。Actigraphy可能是儿科睡眠诊所和研究中的有用工具。

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