Issue Navigator

Volume 15 No. 04
Earn CME
Accepted Papers

Scientific Investigations

Optimizing Actigraphic Estimation of Sleep Duration in Suspected Idiopathic Hypersomnia

Jesse D. Cook, BS1,2; Sahand C. Eftekari1; Lydia A. Leavitt, BS1; Michael L. Prairie, BS1; David T. Plante, MD, PhD1
1Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin; 2Department of Psychology, University of Wisconsin-Madison, Madison, Wisconsin

Study Objectives:

To determine the optimal Actiwatch 2 setting configuration for the estimation of total sleep time (TST) in persons with suspected idiopathic hypersomnia.


Thirty-three patients with a diagnosis of idiopathic hypersomnia (28 female; mean age = 33.7 ± 10.5) underwent ad libitum polysomnography with concurrent use of the Actiwatch 2. Actiwatch 2 sleep-wake activity threshold (SWAT; Low, Medium, and High) and sleep immobility onset and offset (SIOO; 5, 10, 15, 20, 25, and 30 epoch) duration were modified during data processing. The resultant 18 unique setting combinations were subsequently evaluated using Bland-Altman and epoch comparison analyses to determine optimal settings relative to polysomnography.


Low SWAT + 25 Epoch SIOO displayed the least divergence from polysomnography (mean difference 3.4 minutes). Higher SWAT and lower SIOO increased sensitivity and accuracy, but at the expense of reducing specificity and the ability to accurately estimate TST.


These results demonstrate that actigraphic settings should be carefully considered when estimating sleep duration. The Low + 25 Epoch configuration is indicated as most optimal for estimating TST in persons with suspected idiopathic hypersomnia.


A commentary on this article appears in this issue on page 539.


Cook JD, Eftekari SC, Leavitt LA, Prairie ML, Plante DT. Optimizing actigraphic estimation of sleep duration in suspected idiopathic hypersomnia. J Clin Sleep Med. 2019;15(4):597–602.

Please login to continue reading the full article

Subscribers to JCSM get full access to current and past issues of the JCSM.

Login to JCSM

Not a subscriber?

Join the American Academy of Sleep Medicine and receive a subscription to JCSM with your membership

Subscribe to JCSM:  $125/volume year for individuals or $225/volume year for institutions to access all current articles and archives published in JCSM.

Download this article*:   $20 to access a PDF version of a specific article from the current issue of JCSM.

*Purchase of an article provides permission to access and print the article for personal scholarly, research and educational use. Please note: access to the article is from the computer on which the article is purchased ONLY. Purchase of the article does not permit distribution, electronic or otherwise, of the article without the written permission of the AASM. Further, purchase does not permit the posting of article text on an online forum or website.