Actigraphy in the assessment of insomnia.

OBJECTIVE The present study explores the clinical utility and sensitivity of actigraphy as an outcome measure in the treatment of chronic insomnia. DESIGN Following a screening-adaptation night, polysomnography, actigraphy, and sleep-diary data were collected in the sleep laboratory for 2 baseline nights and 2 posttreatment nights. SETTING A university-affiliated sleep disorders center. PARTICIPANTS Seventeen participants with chronic primary insomnia. Mean age was 41.6 years. INTERVENTIONS Participants took part in a treatment protocol investigating different sequential treatments for insomnia (these results are reported elsewhere). MEASUREMENTS AND RESULTS Compared to polysomnography, both actigraphy and sleep-diary instruments underestimated total sleep time and sleep efficiency and overestimated total wake time. Also, actigraphy underestimated sleep-onset latency while the sleep diary overestimated it as compared to polysomnography. Actigraphy data were more accurate than sleep-diary data when compared to polysomnography. Finally, actigraphy was sensitive in detecting the effects of treatment on several sleep parameters. CONCLUSIONS These results suggest that actigraphy is a useful device for measuring treatment response and that it should be used as a complement to sleep-diary evaluation.

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