Exploring the Relationship Between General Motor Activity and Optimal Actigraphy Sleep Configurations: A Systematic Review.

This study aimed to determine the optimal configuration of wrist actigraphy for detecting sleep-wake patterns in adults with varying categories of general motor activity (Aim 1), and to assess its validity in relation to polysomnography (Aim 2). For Aim 1, a systematic review was conducted in accordance with PRISMA and QUADAS-2 guidelines using data sources including Embase, MedlineALL, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, PsycINFO, Cinahl, and Google Scholar. For Aim 2, a meta-analysis was performed on mean sleep differences between actigraphy and polysomnography of studies that analysed actigraphy using the optimal configuration with similar categories of general motor activity. In total, 21 studies that investigated the Oakley algorithm (used by Actiwatch and Motionwatch) in various sleep-wake thresholds provided sufficient information to define the optimal threshold (Aim 1). Additionally, 39 studies (all using Actiwatch) validated the optimal threshold for the respective category of general motor activity and were used to determine its validity (Aim 2). Findings regarding Aim 1 indicated that for actigraphs using the Oakley algorithm, no threshold other than the default setting of 40 cpm minimised differences between actigraphy and polysomnography for adults with normal general motor activity. However, a threshold of 20 cpm enhanced accuracy for adults with reduced general motor activity. Due to the heterogeneity of the studies included for Aim 2, it was not possible to determine the validity of actigraphy, and thereby the minimum general motor activity needed for reliable actigraphy. Further research on customising actigraph configurations is needed.