Actigraphy helps assess and manage sleep disorders

Actigraphy, the use of a portable device that records movement over extended periods of time, and has been used extensively in the study of sleep and circadian rhythms, provides an acceptably accurate estimate of sleep patterns in normal, healthy adult populations and in-patients suspected of certain sleep disorders, according to practice parameters published in the April 1st issue of the journal SLEEP.

The practice parameters, authored by the American Academy of Sleep Medicine's (AASM) Standards of Practice Committee, were developed as a guide to the appropriate use of actigraphy, both as a diagnostic tool in the evaluation of sleep disorders and as an outcome measure of treatment efficacy in clinical settings with appropriate patient populations.

Actigraphy is indicated to assist in the evaluation of patients with advanced sleep phase syndrome, delayed sleep phase syndrome, and shift work disorder. Additionally, there is some evidence to support the use of actigraphy in the evaluation of patients suspected of jet lag disorder and non-24 hour sleep/wake syndrome. Further, when polysomnography is not available, actigraphy is indicated to estimate total sleep time in patients with obstructive sleep apnea.

In patients with insomnia and hypersomnia, there is evidence to support the use of actigraphy in the characterization of circadian rhythms and sleep patterns and disturbances. In assessing response to therapy, actigraphy has proven useful as an outcome measure in patients with circadian rhythms and insomnia.

In older adults, actigraphy characterizes sleep and circadian patterns and documents treatment responses. Similarly, in normal infants and children, as well as special pediatric populations, actigraphy has proven useful for delineating sleep patterns and documenting treatment responses.

"This evidence based review and update of the indications for actigraphy use provides sleep clinicians with needed evidence for where actigraphy may be helpful, and where it is unlikely to be helpful," said Timothy Morgenthaler, MD, of the Mayo Clinic in Rochester, Minn., one of the committee members. "Because there is substantial evidence to indicate actigraphy is indicated for evaluation and management of specific common sleep disorders, we are hopeful that clinicians, and insurers, will become more aware of its usefulness and more familiar with its application. We believe that applying these recommendations will result in a higher quality of patient care in certain circumstances."

Those who think they might have a sleep disorder are urged to discuss their problem with their primary care physician, who will issue a referral to a sleep specialist.