Use of Actigraphy for the Evaluation of Sleep Disorders and Circadian Rhythm Sleep-Wake Disorders: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment

Jul 12, 2018Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine

Using Activity Monitors to Assess Sleep and Body Clock Disorders: A Review and Analysis

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Abstract

Actigraphy was evaluated across 81 studies as an objective measure of sleep and circadian parameters.

Actigraphy provides consistent objective data that differs from patient-reported sleep logs for certain sleep parameters.
Findings support its use in adults and children with insomnia, circadian rhythm disorders, and sleep-disordered breathing.
Actigraphy is not a reliable measure for assessing periodic limb movements in both adult and pediatric patients.
The quality of evidence and balance of benefits and harms were considered in the clinical practice guideline recommendations.

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INTRODUCTION: The purpose of this systematic review is to provide supporting evidence for a clinical practice guideline on the use of actigraphy.

METHODS: The American Academy of Sleep Medicine commissioned a task force of experts in sleep medicine. A systematic review was conducted to identify studies that compared the use of actigraphy, sleep logs, and/or polysomnography. Statistical analyses were performed to determine the clinical significance of using actigraphy as an objective measure of sleep and circadian parameters. Finally, the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process was used to assess the evidence for making recommendations.

RESULTS: The literature search resulted in 81 studies that met inclusion criteria; all 81 studies provided data suitable for statistical analyses. These data demonstrate that actigraphy provides consistent objective data that is often unique from patient-reported sleep logs for some sleep parameters in adult and pediatric patients with suspected or diagnosed insomnia, circadian rhythm sleep-wake disorders, sleep-disordered breathing, central disorders of hypersomnolence, and adults with insufficient sleep syndrome. These data also demonstrate that actigraphy is not a reliable measure of periodic limb movements in adult and pediatric patients. The task force provided a detailed summary of the evidence along with the quality of evidence, the balance of benefits and harms, patient values and preferences, and resource use considerations.

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Use of Actigraphy for the Evaluation of Sleep Disorders and Circadian Rhythm Sleep-Wake Disorders: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment

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