Validity of an algorithm for determining sleep/wake states using a new actigraph

Background: This study aimed to develop an algorithm for determining sleep/wake states by using chronological data on the amount of physical activity (activity intensity) measured with the FS-750 actigraph, a device that can be worn at the waist, allows for its data to be downloaded at home, and is suitable for use in both sleep research and remote sleep medicine. Methods: Participants were 34 healthy young adults randomly assigned to two groups, A (n = 17) and B (n = 17), who underwent an 8-hour polysomnography (PSG) in the laboratory environment. Simultaneous activity data were obtained using the FS-750 attached at the front waist. Sleep/wake state and activity intensity were calculated every 2 minutes (1 epoch). To determine the central epoch of the sleep/wake states (x), a five-variable linear model was developed using the activity intensity of Group A for five epochs (x(-2), x(-1), x, x(+1), x(+2); 10 minutes). The optimal coefficients were calculated using discriminant analysis. The agreement rate of the developed algorithm was then retested with Group B, and its validity was examined. Results: The overall agreement rates for group A and group B calculated using the sleep/wake score algorithm developed were 84.7% and 85.4%, respectively. Mean sensitivity (agreement rate for sleep state) was 88.3% and 90.0% and mean specificity (agreement rate for wakeful state) was 66.0% and 64.9%, respectively. These results confirmed comparable agreement rates between the two groups. Furthermore, when applying an estimation rule developed for the sleep parameters measured by the FS-750, no differences were found in the average values between the calculated scores and PSG results, and we also observed a correlation between the two sets of results. Thus, the validity of these evaluation indices based on measurements from the FS-750 is confirmed. Conclusions: The developed algorithm could determine sleep/wake states from activity intensity data obtained with the FS-750 with sensitivity and specificity equivalent to that determined with conventional actigraphs. The FS-750, which is smaller, less expensive, and able to take measurements over longer periods than conventional devices, is a promising tool for advancing sleep studies at home and in remote sleep medicine.