West Virginia University, Morgantown, WV, USA.
Sleep Med. 2010 Feb;11(2):191-6. doi: 10.1016/j.sleep.2009.08.010. Epub 2010 Jan 18.
Few commercially available brands of actigraphs (ACT) have been subjected to rigorous validation with infant participants. The purpose of this study was to examine the agreement between concurrent polysomnography (PSG) and one brand of ACT (AW-64, Mitter Co. Inc.) using appropriate statistical techniques among a sample of healthy infants.
Twenty-two healthy infants (14.1+/-0.6 months) had one night of ankle ACT recording during research PSG at Kosair Children's Hospital Sleep Research Center in Louisville, Kentucky. Macroanalyses were conducted using the Bland-Altman concordance technique to assess agreement between total sleep time (TST) and wake after sleep onset (WASO) simultaneously measured by PSG and ACT, using two ACT algorithm settings. Microanalyses were also calculated to examine sensitivity, specificity, and accuracy of ACT within each PSG-identified sleep state. Correlations were calculated between PSG-identified arousals and the discrepancies between ACT and PSG.
The Bland-Altman concordance technique revealed that ACT underestimated TST by 72.25 (SD=61.48) minutes and by > or = 60 min among 54.55% of infants. Furthermore, ACT overestimated WASO by 13.85 (SD=30.94) minutes and by > or = 30 min among 40.91% of infants. Sensitivity, specificity, and accuracy analyses revealed that ACT adequately identified sleep, but poorly identified wake. PSG and ACT discrepancies were positively associated with PSG-identified arousals (r=.45).
Improved device and/or software development is needed before the AW-64 can be considered a valid method for identifying infant sleep and wake.
目前仅有少数市售的活动记录仪（ACT）品牌经过了严格的婴儿参与者验证。本研究的目的是通过肯塔基州路易斯维尔 Kosair 儿童医院睡眠研究中心的研究性多导睡眠图（PSG），使用适当的统计技术，检验一种 ACT（AW-64，Mitter Co. Inc.）与 PSG 之间的一致性，该 ACT 品牌适用于健康婴儿。
22 名健康婴儿（14.1+/-0.6 个月）在肯塔基州路易斯维尔 Kosair 儿童医院睡眠研究中心进行了一晚的踝部 ACT 记录，同时进行了 PSG 研究。使用 Bland-Altman 一致性技术进行宏观分析，评估 PSG 和 ACT 同时测量的总睡眠时间（TST）和睡眠后觉醒时间（WASO）之间的一致性，使用两种 ACT 算法设置。微分析也用于评估 ACT 在每个 PSG 确定的睡眠状态中的敏感性、特异性和准确性。计算了 PSG 确定的觉醒与 ACT 和 PSG 之间差异之间的相关性。
Bland-Altman 一致性技术显示，ACT 平均低估 TST 72.25 分钟（SD=61.48），54.55%的婴儿低估 60 分钟以上。此外，ACT 平均高估 WASO 13.85 分钟（SD=30.94），40.91%的婴儿高估 30 分钟以上。敏感性、特异性和准确性分析表明，ACT 可以充分识别睡眠，但不能充分识别清醒。PSG 和 ACT 差异与 PSG 确定的觉醒呈正相关（r=.45）。
在 AW-64 可以被认为是一种有效的方法来识别婴儿的睡眠和清醒之前，需要改进设备和/或软件开发。
