Actigraphy technology: Informing assessment and intervention for sleep disturbances in young children

Objective: To demonstrate the clinical feasibility and utility of referring young children (ages 2 to 5 years old) presenting to an interdisciplinary pediatric sleep clinic for objective sleep assessment using actigraphy. Method: A retrospective chart review was conducted to identify young children referred for actigraphy from the sleep clinic. Each referred child wore an actigraph for approximately 1 week; caregivers completed daily sleep diaries to report on children's estimated bedtime and wake time. Treatment recommendations provided after actigraphy and treatment responses were abstracted via chart review. Results: Of the 88 young children presenting to the sleep clinic during the study period, 11 were referred for and completed actigraphy monitoring. All referred children, including those with neurodevelopmental disabilities, tolerated wearing the actigraph on their wrist. All children were shown to have sleep disturbances via actigraphy results. The most common disturbances were the frequency and duration of night wakings, which reduced total sleep time compared to published norms from a healthy, same-aged sample. All children received behavioral treatment recommendations and the majority were prescribed medication for sleep concerns. The majority of children were considered treatment responders (73%). Conclusions: Actigraphy may be a feasible and informative assessment tool for clinicians to integrate into regular practice with young children to obtain objective sleep data that may not have otherwise been available. Clinical recommendations and practical concerns (e.g., billing) of using actigraphy in an interdisciplinary pediatric setting are discussed.