Comparison of Actigraphy Algorithms for Evaluating Pediatric Sleep

Keywords

actigraphy - algorithm - pediatric sleep - sleep - sleep diary

Introduction: Actigraphy provides objective circadian rhythm assessment through a wrist-attached accelerometer, which acquires raw motor data. It consists of a great alternative to polysomnography due to its ability to collect data from a subject's household, in a longitudinal manner. Thus, its use can be especially appealing in the study of pediatric sleep patterns. The rendering of the motor data into sleep and wake parameters is possible through the use of specific algorithms. However, actigraphy still presents several limitations, particularly concerning the validation of algorithms. Therefore, defining standards of comparability and methods to be used in pediatric sleep research is an ongoing challenge.

Objective: The aim of this study was to analyze the agreement between two different algorithms commonly used in Condor Instruments’ actigraphs, in order to allow future comparisons between studies with distinct methodologies.

Methods: To assess the pediatric sleep, 17 children aged 23 to 37 months were invited to wear a Condor Instruments LTDA actigraph on their left ankle for one week. Their mothers were instructed to record the children's sleep routine in a sleep diary. In total, 14 records were completed and analyzed using two different algorithms: Cole-Kripke and Condor Instruments LTDA. The sleep parameters evaluated for comparison included total sleep time, wake after sleep onset (WASO) and number of awakenings. Additionally, 13 records were used to compare the Condor Instruments LTDA algorithm with the sleep diary information.

Results: Both algorithms were comparable on the total sleep time parameter and the total time in bed was similar between algorithm and sleep diary, with a median of 605,5 and 627,9 minutes (p>0,05). However, the parameters WASO and number of awakenings presented a significant difference between algorithms (p<0,05). Sleep diary analysis also demonstrated that the parents’ perception of the babies' sleep is closer to total time in bed than total sleep time. Therefore, the parental analysis overestimated the total sleep time (586,6 vs 549,7 minutes) and underestimated the number of awakenings (zero vs 13,5) in relation to actigraph analysis (p<0,05).

Conclusion: These results demonstrate the need to formulate new algorithms in view of the lack of standardization of methodologies in pediatric sleep assessment with actigraphy, which makes it difficult to compare studies in literature.

Die Autoren geben an, dass kein Interessenkonflikt besteht.

Publikationsverlauf

Artikel online veröffentlicht:
16. September 2025