AUTHOR=Hall Wendy A. , Liva Sarah , Moynihan Melissa , Saunders Roy 

TITLE=A Comparison of Actigraphy and Sleep Diaries for Infants’ Sleep Behavior

JOURNAL=Frontiers in Psychiatry

VOLUME=6

YEAR=2015

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2015.00019

DOI=10.3389/fpsyt.2015.00019

ISSN=1664-0640

ABSTRACT=<p>Detecting the effectiveness of behavioral interventions to reduce infant night-waking requires valid sleep measures. Although viewed as an objective measure, actigraphy has overestimated night-waking. Sleep diaries are criticized for only documenting night-waking with infant crying. To support potential outcome measure validity, we examined differences between sleep diaries and actigraphy in detecting night-waking and sleep duration. We recruited 5.5 to 8-month-old infants for a behavioral sleep intervention trial conducted from 2009 to 2011. Intervention (sleep education and support) and control groups (safety education and support) collected infant diary and actigraphy data for 5 days. We compared night-time sleep actigraphy with diary data at baseline (194 cases), and 6 weeks (166 cases) and 24 weeks post-education (118 cases). We hypothesized numbers of wakes and wakes of ≥20 min would be higher and longest sleep time and total sleep time shorter by actigraphy compared with diaries. Using paired <italic>t</italic>-tests, there were significantly more actigraphy night wakes than diary wakes at baseline (<italic>t</italic> = 29.14, <italic>df</italic> = 193, <italic>p</italic> &lt; 0.001), 6 weeks (<italic>t</italic> = 23.99, <italic>df</italic> = 165, <italic>p</italic> &lt; 0.001), and 24 weeks (<italic>t</italic> = 22.01, <italic>df</italic> = 117, <italic>p</italic> &lt; 0.001); and significantly more night wakes of ≥20 min by actigraphy than diary at baseline (<italic>t</italic> = 5.03, <italic>df</italic> = 183, <italic>p</italic> &lt; 0.001), and 24 weeks (<italic>t</italic> = 2.19, <italic>df</italic> = 107, <italic>p</italic> &lt; 0.05), but not 6 weeks (<italic>t</italic> = 1.37, <italic>df</italic> = 156, n.s.). Longest sleep duration was significantly higher by diary than actigraphy at baseline (<italic>t</italic> = 14.71, <italic>df</italic> = 186, <italic>p</italic> &lt; 0.001), 6 weeks (<italic>t</italic> = 7.94, <italic>df</italic> = 158, <italic>p</italic> &lt; 0.001), and 24 weeks (<italic>t</italic> = 17.18, <italic>df</italic> = 114, <italic>p</italic> &lt; 0.001). Night sleep duration was significantly higher by diary than actigraphy at baseline (<italic>t</italic> = 9.46, <italic>df</italic> = 185, <italic>p</italic> &lt; 0.001), 6 weeks (<italic>t</italic> = 13.34, <italic>df</italic> = 158, <italic>p</italic> &lt; 0.001), and 24 weeks (<italic>t</italic> = 13.48, <italic>df</italic> = 114, <italic>p</italic> &lt; 0.001). Discrepancies in actigraphy and diary data may indicate accurate actigraphy recording of movement but not sleep given active infant sleep and self-soothing.</p>