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. 2019 Apr 15;15(4):597-602.
doi: 10.5664/jcsm.7722.

Optimizing Actigraphic Estimation of Sleep Duration in Suspected Idiopathic Hypersomnia

Jesse D Cook  1   2 , Sahand C Eftekari  1 , Lydia A Leavitt  1 , Michael L Prairie  1 , David T Plante  1
Affiliations

Optimizing Actigraphic Estimation of Sleep Duration in Suspected Idiopathic Hypersomnia

Jesse D Cook et al. J Clin Sleep Med. .

Abstract

Study objectives: To determine the optimal Actiwatch 2 setting configuration for the estimation of total sleep time (TST) in persons with suspected idiopathic hypersomnia.

Methods: Thirty-three patients with a diagnosis of idiopathic hypersomnia (28 female; mean age = 33.7 ± 10.5) underwent ad libitum polysomnography with concurrent use of the Actiwatch 2. Actiwatch 2 sleep-wake activity threshold (SWAT; Low, Medium, and High) and sleep immobility onset and offset (SIOO; 5, 10, 15, 20, 25, and 30 epoch) duration were modified during data processing. The resultant 18 unique setting combinations were subsequently evaluated using Bland-Altman and epoch comparison analyses to determine optimal settings relative to polysomnography.

Results: Low SWAT + 25 Epoch SIOO displayed the least divergence from polysomnography (mean difference 3.4 minutes). Higher SWAT and lower SIOO increased sensitivity and accuracy, but at the expense of reducing specificity and the ability to accurately estimate TST.

Conclusions: These results demonstrate that actigraphic settings should be carefully considered when estimating sleep duration. The Low + 25 Epoch configuration is indicated as most optimal for estimating TST in persons with suspected idiopathic hypersomnia.

Commentary: A commentary on this article appears in this issue on page 539.

Keywords: Actiwatch; actigraphy; hypersomnolence; idiopathic hypersomnia.

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Figures

Figure 1
Figure 1. Bland-Altman mean difference summary: TST.
TST mean difference values are presented for the 18 setting combinations. The x-axis is the sleep immobility onset and offset duration. The y-axis is the mean difference value for the setting combination relative to PSG, with positive values corresponding to overestimations. Each line on the graph references a different sleep-wake activity threshold configuration. Unfilled circles = Low (20 AC). Filled squares = Medium (40 AC). Filled triangles = High (80 AC). The dashed horizontal line represents no deviation from PSG TST. AC = activity count, PSG = polysomnography, TST = total sleep time.
See this image and copyright information in PMC

Comment in

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