Actigraphy versus Polysomnography to Identify Changes in the Sleep Patterns of Adults with Insomnia

Abstract

Introduction. Insomnia is the most common sleep-wake disorder worldwide. Polysomnography is the complementary exam considered the gold standard for the identification of sleep disorders. However, Actigraphy – a method easily applicable for several consecutive days –, has emerged as an alternative tool. Objective. To evaluate the effectivity of actigraphy in comparison with polysomnography, in determining the sleep patterns of adults with insomnia. Method. Integrative review with meta-analysis, on which randomized observational and clinical studies were searched in the Cochrane Library, on MEDLINE through the PUBMED Portal, in the Google Scholar and on the TRIP DATABASE meta-search engine, from November 2019. The GRADE approach was used to evaluate the quality of the evidence. The meta-analysis was performed using the Inverse-variance weighting, considering the 95% confidence interval (95% CI). Results. Six studies were included, representing 399 patients. The studies examine the effectivity of actigraphy in identifying the total sleep time, the latency, the Wake After Sleep and the sleep efficiency. It was noticed that the Actigraphy was close to polysomnography only when verifying sleep latency, with a small average difference of -1.46 (95% CI: -9.61 to 6.70 min.). The other outcomes evaluated had their values underestimated by actigraphy. The quality of the evidence was moderate and low. Conclusion. The evidence to evaluate the effectivity of actigraphy is still limited – especially when it is intended to compare it with polysomnography, since the studies found shown methodological limitations, mainly in the measurement of results.