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At least 19 recordsLinked to original sources

PubMed2001

The use of actigraphy revised: the value for clinical practice in insomnia.

In the last years, actigraphy has been used more often for clinical research and research evaluation of sleep disorders. Compared to polysomnography, actigraphy is cheap and less time-consuming. Actigraphy provides more objective information about sleep than sleep logs. Although the algorithms to score sleep and wake based on motions measured by actigraphy are still being improved, we believe that the role of actigraphy in the clinical evaluation of sleep in insomnia is limited. Instead of using actigraphy to distinguish a wakeful state from sleep in insomnia, we might better use the activity plots which the actigraph provides to get more insight into the physiological hyperarousal or restfulness of insomnia patients.

Adult↗

PubMed1995

The role of actigraphy in the evaluation of sleep disorders.

This paper, which has been reviewed and approved by the Board of Directors of the American Sleep Disorders Association, provides the background for the Standards of Practice Committee's parameters for the practice of sleep medicine in North America. The growing use of activity-based monitoring (actigraphy) in sleep medicine and sleep research has enriched and challenged traditional sleep-monitoring techniques. This review summarizes the empirical data on the validity of actigraphy in assessing sleep-wake patterns and assessing clinical and control groups ranging in age from infancy to elderly. An overview of sleep-related actigraphic studies is also included. Actigraphy provides useful measures of sleep-wake schedule and sleep quality. The data also suggest that actigraphy, despite its limitations, may be a useful, cost-effective method for assessing specific sleep disorders, such as insomnia and schedule disorders, and for monitoring their treatment process. Methodological issues such as the proper use of actigraphy and possible artifacts have not been systematically addressed in clinical research and practice.

Circadian Rhythm↗

PubMed1997

[Objective measurement of motor activity in Parkinson's disease by actigraphy. Clinical assessment of akinesia].

Actigraphy measures physiological activity by using an acceleration sensor and RAM equipped with a data logger. Since actigraphy can continuously and easily record data over a long period of time without disturbing the normal activities of subjects, it is possible to analyze a large number of subjects. Actigraphy was performed in patients with Parkinson's disease who did not exhibit trembling. Results showed that the daily motor activity of patients was lower than that of the healthy individual. Daily motor activity was also found to be correlated with Hoehn-Yahr's classification. Furthermore, side-effects due to L-dopa, such as abnormal involuntary movement and on-off phenomenon, could be objective assessed. The results of long-term actigraphic examination, conducted after anti-Parkinsonian treatment, showed that akinesia improved with time. From these findings, it is concluded that actigraphy could quantitatively assess the degree of akinesia in Parkinsonian patients. Furthermore, actigraphy may be applied to the clinical assessment of drugs.

Antiparkinson Agents↗

PubMed2000

Actigraphic monitoring (actigraphy) of circadian locomotor activity in schizophrenic patients with acute neuroleptic-induced akathisia.

BACKGROUND: Actigraphy is a quantitative method for measurement of motor activity. In the present study we used actigraphy to examine diurnal variations in locomotor activity of schizophrenic patients with neuroleptic-induced akathisia (NIA). METHOD: Thirty-two schizophrenic patients, 16 with NIA and 16 without (DSM-IV criteria) underwent 24-h actigraphic monitoring. Clinical assessments of NIA were conducted with Barnes Akathisia Scale (BAS) at 08:00, 12:00, 16:00 and 20:00. Sleep parameters (duration, latency, continuity and efficacy) were assessed by actigraphy. Sleep quality was evaluated by a self-rated sleep questionnaire. RESULTS: NIA patients demonstrated persistent higher daytime motor activity from 11:30 to 14:15 and from 18:00 to 21:00 than controls. There were no differences between the groups in nighttime motor activity, confirming clinical observations that NIA tends to disappear during sleep. Subject's sleep assessments were similar in the two groups. CONCLUSIONS: Actigraphy seems to be a reliable, non-invasive, method of measuring motor activity in patients with NIA. Its sensitivity and specificity as an objective quantitative diagnostic instrument in patients with NIA merits further investigation.

Adult↗

PubMed2000

Actigraphy to measure day structure as a therapeutic variable in the treatment of schizophrenic patients.

OBJECTIVE: A component of social skills is the ability to adapt to the social rhythms of the environment. Patients with schizophrenia are often disabled in this adaptation. Thus, structuring activities throughout the day has long been known as part of psychosocial treatments. Actigraphy as a tool to measure acitvity and circadian rhythms may even serve as an indicator for the day-structuring of schizophrenic patients. METHOD: Actigraphy was used in a patient with affective disorder and one with chronic schizophrenia for more than 2 weeks. RESULTS: In comparison to a regular 24-hour rest-activity cycle in a depressed patient, the actigraph of the patient with schizophrenia presents active phases at night, irregular activity levels at day and signs of a delayed-sleep-phase syndrome. CONCLUSION: Actigraphy could serve as a tool to investigate activity levels and circadian rest-activity phases, even in schizophrenia. There may be some further benefit of actigraphy as a tool in psychosocial treatments.

Activities of Daily Living↗

PubMed1999

Actigraphy and leg movements during sleep: a validation study.

A study comparing actigraphy and polysomnography in the detection of leg movements was performed in a group of 35 patients with sleep disorders. Visual scoring used epochs of 5-second duration, and in each epoch, electromyographic activity of tibialis anterior muscle was classified in eight types on the basis of its duration and amplitude. Activity levels of the actigraphic data were logged in 5-second intervals and stored in memory for computer retrieval. To assess the reproducibility of actigraphic detection scoring, in 10 patients actigraphic and polysomnographic data were compared during two consecutive nights. Despite a high correlation between polysomnography and actigraphy in the detection of muscular activity (r = 0.78; P = 0.001), no agreement was obtained between the two analyses according to the Bland and Altman method of concordance (mean bias: -117.5). The greater agreement was found for electromyographic activity lasting more than 3 seconds and with an amplitude of more than 50 microV. In the group of patients examined during two consecutive nights the scoring error did not differ significantly. The results demonstrated that (1) despite a significant correlation between actigraphic and polysomnographic data, actigraphy substantially underestimated leg electromyographic activity and therefore could not be used routinely for diagnostic purposes; and (2) because error scoring did not undergo significant changes across the two nights, actigraphy may be used for follow-up evaluation.

Adult↗

PubMed1998

Evaluation of human activities and sleep-wake identification using wrist actigraphy.

The purpose of this study is to investigate the count-characteristics of wrist actigraphy in basic human activities and to discuss the agreement of sleep-wake identification between polysomnography (PSG) and wrist actigraphy during nocturnal sleep. There was a distinct distribution of actigraphy counts over the studied activities. The evaluation of sleep-wake scoring using the wrist actigraphy agreed 96.9% with the polysomnographic scoring during nocturnal sleep.

Activity Cycles↗

PubMed2000

[Comparative study of actigraphy and ambulatory polysomnography in the assessment of adaptation to night shift work in nurses].

Night shift work is common in hospitals to assure continuous care. This practice, however, induces difficulties due to changes in the sleep/awake cycle of hospital workers. The aims of the present study were to validate actigraphy in comparison with polysomnography for sleep evaluation and to assess nurses' adaptation to sleep/wake cycles when on a permanent night shift schedule. Actigraphy and ambulatory polysomnography were performed in fifteen night shift nurses employed in hospital on a full time basis, during their work and their rest periods. Our first findings showed that actigraphy gave reliable results compared with polysomnography in evaluation of total sleep time. In addition, it was found that seven of the nurses exhibited, during their work periods, an approximately five-hour delay in the acrophase of their rest/activity rhythm compared with their rest periods. In contrast, five other nurses whose acrophase did not change between work and rest periods, exhibited sleep episodes of more than 100 minutes duration at work. These results confirm data in the literature and show that some nurses cannot adjust the circadian rhythm of their inner biological clock to their nocturnal schedules. Actigraphy seems to be an efficient, low cost and easy method for measuring total sleep time as well as for assessing the inability of nurses to adapt to permanent night shift work.

Adaptation, Physiological↗

PubMed1995

Practice parameters for the use of actigraphy in the clinical assessment of sleep disorders. American Sleep Disorders Association.

These clinical guidelines, which have been reviewed and approved by the Board of Directors of the American Sleep Disorders Association, provide recommendations for the practice of sleep medicine in North America for the use of actigraphy in the clinical assessment of sleep disorders. The American Sleep Disorders Association has produced these guidelines, based upon a critical review of the scientific literature, regarding the use of actigraphy in the clinical evaluation of sleep disorders. Though not indicated for the routine assessment of sleep disorders, actigraphy may be a useful adjunct, in certain circumstances, to a detailed history and examination when demonstration of multiday rest-activity patterns is necessary to diagnose, document severity, and guide proper treatment of sleep disorders.

Circadian Rhythm↗

PubMed2000

Effects of sleep loss on waking actigraphy.

STUDY OBJECTIVES: To assess the effect of sleep loss and the effect of a sedating drug on waking actigraphy DESIGN: N/A SETTING: N/A PARTICIPANTS: Seventeen healthy volunteers, aged 19-35 yrs INTERVENTIONS: Four night-day treatments presented in a Latin Square Design: placebo-8 hr time-in-bed (TIB), placebo-4 hr TIB, placebo-0 hr TIB, and diphenhydramine 50 mg-8 hr TIB. MEASUREMENTS AND RESULTS: After the appropriate TIB, medication was administered at 09:00 hr, the Multiple Sleep Latency Test at 09:30, 11:30, 13:30, 15:30, and 17:30 hr, and a 45 min performance battery at 10:30, 14:30, and 16:30 hr. Each day the volunteers wore actigraphs from 0700-1800 hrs. Decreasing TIB was associated with decreased daily mean sleep latency on the MSLT with 4 and 0 hrs differing from 8 hrs and each other. Daytime activity also was reduced by the reduced prior TIB. Increased inactivity relative to the 8 hr TIB developed between the 4 hr and 0 hr TIBs, with 4 hrs differing from 0 hrs, but not 8 hrs. Diphenhydramine 50 mg reduced mean daily sleep latency and increased percent inactive time relative to placebo. On the MSLT diphenhydramine was intermediate to 4 hr and 0 hr TIB and on actigraphy it was similar to 0 hr TIB. CONCLUSIONS: The difference in the effect of diphenhydramine on these actigraphy and MSLT may reflect the different sensitivities of the measures.

Adult↗

PubMed1997

[Clinicophysiological study of tremor in Parkinson's disease: quantitative tremor-based assessment of motor count using actigraphy].

In Parkinson's disease, resting tremor is often the initial symptom. This report focuses on the mechanism underlying tremor in Parkinson's disease and quantitative assessment of tremor. Central factors including Vim (nucleus ventralis intermedius) in the thalamus, and peripheral factors, such as acceleration of input pathways from muscle spindles via muscle tonus, are important aspects of the tremor mechanism in Parkinson's disease. It has also been suggested that tremor in Parkinson's disease is associated with parasympathetic and sympathetic dysfunctions. Objective assessments of tremor, such as the application of surface electromyography, are useful in the diagnosis and treatment of Parkinson's disease. Actigraph, as introduced herein, is a three dimensional motor sensing apparatus. Therefore, motor counts over 0.01 G can be detected by actigraphy. To date, this device has been used for evaluating akinesia in Parkinson's disease and insomnia. In this study, actigraphy was used in Parkinson patients with tremor, and it reflected motor activity in the wrist and was associated with the severity of hand tremor. Activities of daily living (ADL) are disturbed by hyperkinesia of the hand for Parkinson patients with hand tremor. We demonstrated that actigraphy is a simple and quantitative method of assessing motor activity in Parkinson patients with tremor.

Aged↗

PubMed1992

Wrist actigraphy in insomnia.

To assess the use of actigraphy in evaluating insomnia, 36 patients with a serious complaint of insomnia slept 3 nights each in the laboratory, where the usual polysomnograms (PSGs) were obtained as well as actigraphic assessments of their sleep. Patients also wore actigraphs for 7 days at home, were extensively interviewed and filled out psychometric tests. Based on all this information, the patients were then diagnosed according to the International Classification of Sleep Disorders. Averaged over the 3 nights for each insomniac, the mean discrepancy between actigram and PSG was 49 minutes per night. In three-fourths of the cases, actigram and PSG agreed to within 1 hour on the total amount of sleep per night. Discrepancies, however, were not random: In patients with psychophysiologic insomnia and in insomnia associated with psychiatric disease, the actigram typically overestimated sleep when compared with the PSG. In patients with sleep-state misperception, the actigram was either quite accurate or it underestimated sleep when compared with the PSG. Comparing laboratory with home sleep, one-third of all insomniacs slept better in the laboratory and two-thirds slept better at home. In addition, night-by-night variability was higher at home than in the laboratory. Based on our study, we now recommend actigraphy as an additional tool in the clinical evaluation of insomnia, but we believe that in complex cases it should be combined with 1 PSG night in the sleep disorders center.

Adult↗

PubMed1990

Actigraphy: a means of assessing circadian patterns in human activity.

Twenty-three diurnally active (0705-2333), healthy persons between 22 and 54 years of age and without history of sleep abnormality were monitored continuously for 120 consecutive hr (five days) by wrist actigraphy. Circadian rhythms of high amplitude were detected by cosinor analysis for each participant and for the groups of 10 males and 13 females with the average span of heightened activity timed between approximately 1330 and 1605. The circadian peak-trough difference in wrist movement was marked, equalling approximately 75% of the 24-hr mean level. In 19 of 23 participants, the 24-hr mean of wrist activity varied between 140-180 movements/min, with four persons exhibiting lesser means of 110-140 movements/min. With respect to the daytime span of activity, the mean wrist movement of individual participants ranged from 155-265 movements/min, with the majority (20/23) varying between 185-245 movements/min. During nocturnal sleep the mean wrist activity level was quite low, varying between individuals from 5 to 25 movements/min for 21 of 23 persons. Wrist actigraphy proved to be well-accepted and was a most reliable means of monitoring aspects of body movement during activity and sleep in ambulatory persons adhering to usual life habits and pursuits.

Adult↗

PubMed1996

Comparison of diurnal systolic blood pressure change as defined by wrist actigraphy, fixed time periods and cusum.

AIMS: To assess whether differences exist in nocturnal blood pressure (BP) levels and the diurnal BP change when using fixed time and wrist actigraphy methods to define the night-time period. METHODS: Untreated hypertensive (n = 48) and normotensive (n = 33) subjects (mean age 67 years: range 29-90) underwent simultaneous 24-h ambulatory BP monitoring and wrist actigraph monitoring. The diurnal BP change and nocturnal BP levels were assessed using two fixed night-time definitions-a reference period of 22.00-06.59 and also 00.00-05.59, as well as unedited and edited actigraph values and cumulative sums (cusums) analysis. RESULTS: The reference definition of night-time 22.00-06.59 resulted in the highest values for night-time BP compared to other definitions (p < 0.05), although actigraph defined night-time BP values were not significantly different from the more restrictive definition of night-time (00.00-05.59). Restrictive night-time, edited and unedited actigraph and cusums values for the day-night difference were all significantly greater than the value calculated using the reference night-time period. Dipping status changed significantly depending on which definition of night-time was used. CONCLUSIONS: Significant differences exist in nocturnal BP levels and circadian change between the various methods for defining night-time. The routine use of wrist actigraphy does not however appear to alter the value of night-time BP levels when compared to a more restrictive fixed-time definition of night-time.

Adult↗

PubMed1997

[Actigraphy: methodological limits for evaluation of sleep stages and sleep structure of healthy probands].

UNLABELLED: Purpose of the investigation was to evaluate the differences of movement density during the sleep stages and waking. 22 diurnally active, healthy, male volunteers of mean age 30.7 (+/-Standard deviation +/- 3.3) years and a Body-Mass-Index 23.6 +/- 3.3 kg/m2 participated in the study. All subjects were recorded in the sleep lab via cardiorespiratory polysomnography and wrist actigraphy (Ambulatory Monitoring, Ardsley, USA) worn on the non-dominant hand, for two consecutive nights. The activity data, consisting of the number of zero crossings (NZC) were recorded in 1-minute periods. Sleep stages were scored visually according to standard criteria. EEG- and actigraphy data were converted to the same data format (European Feature Files). Attaching the actimetry data to the sleep stages was calculated mean NZC for every sleep stage and Wake. In spite of high differences in total individual NZC we observed that most NZC occurred during Wake. NREM 1 movement density was significantly higher in 19 recordings (86%) than in any other sleep stage. In 18 cases (82%) lowest movement density was found in NREM 3/4 with significant difference to all other sleep stages. Within 50% of the recordings were found decreasing activity in the following sequence of stages: Wake > NREM 1 > REM > NREM 2 > NREM 3/4 However, in all other cases there was a varying pattern of activity. CONCLUSION: Although there is some correlation between motor activity and sleep stages, the predictive value of actimetry data analysis in the assessment of sleep structure appeared to be limited mainly by individual movement density, especially during REM and NREM 2.

Adult↗

PubMed1999

Melatonin ineffective in neuronal ceroid lipofuscinosis patients with fragmented or normal motor activity rhythms recorded by wrist actigraphy.

Melatonin was tested as a sleeping pill in five patients with neuronal ceroid lipofuscinoses. The single-blind, placebo-controlled study consisted of motor activity recordings, sleep logs, and administration of placebo or melatonin (2.5 or 5 mg). Daily motor activity rhythms were measured by wrist actigraphy during four 7-day periods (baseline, placebo, melatonin 2.5 mg, and melatonin 5 mg). The placebo or melatonin was administered in the evenings for 3 weeks, and the recordings were made during the last week of the 3-week treatment. Sleep logs were kept by the caregivers during the recordings. Based on period analyses, the activity recordings were evaluated to display a normal (24-h) or fragmented rhythm. Three patients had normal motor activity patterns during the baseline recordings, and administration of placebo or melatonin did not affect their rest/activity rhythms. Two patients had abnormally fragmented activity rhythms during the baseline periods, and administration of placebo or melatonin did not induce synchronization. According to the actigraphic data, there were no changes in activity rhythms resulting from administration of melatonin. However, based on the observations, three families reported that melatonin slightly improved the sleep quality of the patients. These controversial findings show the difficulties involved in specifying the role of melatonin in modulating sleep. Thus, we conclude that more evidence is required before the significance of melatonin as a sleeping pill is defined.

Adolescent↗

PubMed1996

Gravitational artefact in frequency spectra of movement acceleration: implications for actigraphy in young and elderly subjects.

Actigraphy, the long-term assessment of wrist movements by means of a small solid-state recorder, is widely used in a variety of human research fields, among which sheep, circadian rhythms and aging. Actigraphs assess movement with the use of accelerometers, which sense accelerations resulting from muscle force as well as accelerations due to changes in the position of the sensor in the gravitational field. In the present paper a method is described to minimise gravitational artefact in movement assessment by calculating the instantaneous acceleration vector from 3 perpendicular acceleration signals. It is shown that the power spectra of single axis acceleration signals are dominated by low-frequency components (+/- 0.25 Hz) due to gravitational artefact. Spectra of the instantaneous acceleration vector indicate that 'true' movement accelerations resulting from muscle force are present in a much wider range: from 0.25 to 11 Hz. Wrist accelerations in elderly subjects were found to be of lower amplitude and frequency as compared to young subjects. It is furthermore shown that a bandpass filter of 0.25 to 2 or 3 Hz, as has been used in commercially available actigraphs, is far from optional, and may even result in a positive bias for movement detection in the elderly. This bias may underly contradictory findings in actigraphic studies on human aging. When a bandpass filter of 0.5-11 Hz is applied to a single-axis acceleration signal, the influence of gravitational artefact and bias are minimized, and the age-related decline in activity is properly detected.

Acceleration↗

PubMed1997

Assessing sleep in psychiatric inpatients: nurse and patient reports versus wrist actigraphy.

This study was designed to evaluate the conventional techniques of assessing sleep, nursing and patient report, of inpatients on a clinical psychiatric unit. Nurses assessed sleep/wake status at hourly checks and patients completed a sleep diary. For three nights patients wore a wrist actigraph, a portable instrument which provides objective data about sleep/wake activity. The nursing and patient data obtained were compared with actigraphy data. Nursing staff evaluated sleep with satisfactory agreement (76.5% night 1 and 81.6% night 3) that improved over the first three nights of hospitalization (p < 0.03). When the nurses' report did not agree with the actigraph, they tended to overestimate sleep. Patients tended to underestimate their total sleep time and total time awake after sleep onset. Time in bed and initial sleep latency were overestimated. There was great intersubject variability, making determination of agreement impossible. This data suggest that treatment teams on psychiatric units should in general consider nursing reports of sleep more accurate than patient self-report. However, since nursing staff and patients observe different aspects of sleep, both sources of data are important to inpatient treatment teams on clinical units.

Adult↗