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Comparison of multichannel and single-channel wrist-based devices with polysomnography to measure sleep in children and adolescents.

Authors
  • Burkart, Sarah1
  • Beets, Michael W1
  • Armstrong, Bridget1
  • Hunt, Ethan T1
  • Dugger, Roddrick1
  • von Klinggraeff, Lauren1
  • Jones, Alexis1
  • Brown, David E2
  • Weaver, R Glenn1
  • 1 Department of Exercise Science, University of South Carolina, Columbia, South Carolina.
  • 2 Department of Pediatrics, University of South Carolina School of Medicine, Columbia, South Carolina.
Type
Published Article
Journal
Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
Publication Date
Apr 01, 2021
Volume
17
Issue
4
Pages
645–652
Identifiers
DOI: 10.5664/jcsm.8980
PMID: 33174529
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To compare sleep parameters produced by the Fitbit Charge 3 (Fitbit) and Actigraph GT9X accelerometer (Actigraph) to polysomnography in children and adolescents. Participants (n = 56, ages 9.2 ± 3.3 years) wore a Fitbit and an Actigraph on their nondominant wrist concurrently with polysomnography during an overnight observation at a children's sleep laboratory. Total sleep time, sleep efficiency, wake after sleep onset, sleep onset, and sleep offset were extracted from the Fitabase and Actilife software packages, respectively, with the Sadeh algorithm. Bland-Altman plots were used to assess the agreement between wearable devices and polysomnography. Seventy-nine percent of participants were diagnosed with OSA. Compared with polysomnography, the Fitbit and the Actigraph underestimated total sleep time by 6.1 minutes (absolute mean bias [AMB] = 27.7 minutes) and 31.5 minutes (AMB = 38.2 minutes), respectively. The Fitbit overestimated sleep efficiency by 3.0% (AMB = 6.3%), and the Actigraph underestimated sleep efficiency by 12.9% (AMB = 13.2%). The Fitbit overestimated wake after sleep onset by 18.8 minutes (AMB = 23.9 minutes), and the Actigraph overestimated wake after sleep onset by 56.1 minutes (AMB = 54.7 minutes). In addition, the Fitbit and the Actigraph underestimated sleep onset by 1.2 minutes (AMB = 13.9 minutes) and 10.2 minutes (AMB = 18.1 minutes), respectively. Finally, the Fitbit and the Actigraph overestimated sleep offset by 6.0 minutes (AMB = 12.0 minutes) and 10.5 minutes (AMB = 12.6 minutes). Linear regression indicated significant trends, with the Fitbit underestimating wake after sleep onset and sleep efficiency at higher values. The Fitbit provided comparable and in some instances better sleep estimates with polysomnography compared to the Actigraph. Findings support the use of multichannel devices to measure sleep in children and adolescents. Additional studies are needed in healthy children over several nights and in free-living settings. © 2021 American Academy of Sleep Medicine.

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