"Diagnosis by behavioral observation" home-videosomnography - a rigorous ethnographic approach to sleep of XXXX with neurodevelopmental conditions.

@entity1 @entity146 @entity4531 @entity22
INTRODUCTION: Advanced video technology is available for sleep-laboratories. However, low-cost equipment for screening in the home setting has not been identified and tested, nor has a methodology for analysis of video recordings been suggested. METHODS: We investigated different combinations of hardware/software for home-videosomnography (HVS) and established a process for qualitative and quantitative analysis of HVS-recordings. A case vignette (HVS analysis for a 5.5-year-old @entity1 with major @entity22 and several co-morbidities) demonstrates how methodological considerations were addressed and how HVS added value to clinical assessment. RESULTS: We suggest an "ideal set of hardware/software" that is reliable, affordable (    500) and portable (=2.8   kg) to conduct non-invasive HVS, which allows time-lapse analyses. The equipment consists of a net-book, a camera with infrared optics, and a video capture device. (1) We present an HVS-analysis protocol consisting of three steps of analysis at varying replay speeds: (a) basic overview and classification at 16* normal speed; (b) second viewing and detailed descriptions at 4-8* normal speed, and (c) viewing, listening, and in-depth descriptions at real-time speed. (2) We also present a custom software program that facilitates video analysis and note-taking (Annotator(  )), and Optical Flow software that automatically quantifies movement for internal quality control of the HVS-recording. The case vignette demonstrates how the HVS-recordings revealed the dimension of @entity22 caused by @entity4531 , and illustrated the cascade of symptoms, @entity146 , and resulting medications. CONCLUSION: The strategy of using HVS, although requiring validation and reliability testing, opens the floor for a new "observational sleep medicine," which has been useful in describing discomfort-related behavioral movement patterns in @entity1 with communication difficulties presenting with challenging/disruptive sleep/wake behaviors.
