Comparison of Commercial Wrist-Based and Smartphone Accelerometers, Actigraphy, and PSG in a Clinical Cohort of XXXX and Adolescents.

@entity1 @entity25 @entity387
OBJECTIVE: To compare two commercial sleep devices, an accelerometer worn as a wristband (UP) and a smartphone application (MotionX 24/7), against polysomnography (PSG) and actigraphy (Actiwatch2) in a clinical pediatric sample. @entity1 AND METHODS: @entity1 and adolescents (N = 78, 65% male, mean age 8.4  4.0 y) with suspected @entity387 ( @entity387 ), simultaneously wore an actiwatch, a commercial wrist-based device and had a smartphone with a sleep application activated placed near their right shoulder, during their diagnostic PSG. Outcome variables were sleep onset latency (SOL), @entity25 ( @entity25 ), wake after sleep onset (WASO), and @entity25 ( @entity25 ). Paired comparisons were made between PSG, actigraphy, UP, and MotionX 24/7. Epoch-by-epoch comparisons determined sensitivity, specificity, and accuracy between PSG, actigraphy, and UP. Bland-Altman plots determined level of agreement. Differences in bias between @entity387 severity and developmental age were assessed. RESULTS: No differences in mean @entity25 , WASO, or @entity25 between PSG and actigraphy or PSG and UP were found. Actigraphy overestimated SOL (21 min). MotionX 24/7 underestimated SOL (12 min) and WASO (63 min), and overestimated @entity25 (106 min) and @entity25 (17%). UP showed good sensitivity (0.92) and accuracy (0.86) but poor specificity (0.66) when compared to PSG. Bland-Altman plots showed similar levels of bias in both actigraphy and UP. Bias did not differ by @entity387 severity, however was affected by age. CONCLUSIONS: When compared to PSG, UP was analogous to Actiwatch2 and may have some clinical utility in @entity1 with @entity387 . MotionX 24/7 did not accurately reflect sleep or wake and should be used with caution.
