Actigraphy vs. Polysomnography: Complementary Tools or Competing Technologies?

An actigraphy watch. Actigrafo, Actigrafia

Sleep monitoring is essential for diagnosing and managing sleep disorders. Two widely used tools in the field are actigraphy and polysomnography (PSG). Though often viewed as alternatives, they serve different purposes and can complement each other when used strategically.

Actigraphy involves wearing a wristwatch-like device that tracks movement over extended periods, usually days or weeks. It estimates sleep patterns based on activity levels. Polysomnography, on the other hand, is a comprehensive overnight test conducted in a sleep lab. It records brain waves, oxygen levels, heart rate, breathing, and eye and leg movements.


Accuracy vs. Accessibility

Polysomnography is considered the gold standard for diagnosing sleep disorders like sleep apnea, narcolepsy, and parasomnias. It offers detailed physiological data, making it ideal for in-depth analysis. However, it requires a clinical setting, is expensive, and can be inconvenient for patients.

Actigraphy, while less precise, excels in long-term sleep tracking and assessing circadian rhythm disorders. It’s portable, cost-effective, and better suited for evaluating habitual sleep patterns in real-life settings.


Use Cases: When to Use Each

  • Use Polysomnography when:

    • A specific diagnosis is needed (e.g., sleep apnea)

    • There's a need to assess complex sleep disorders

    • Precise physiological data is required

  • Use Actigraphy when:

    • Monitoring sleep-wake cycles over time

    • Evaluating insomnia or circadian rhythm disorders

    • Assessing the effectiveness of sleep interventions


Better Together: A Complementary Approach

Rather than competing, actigraphy and PSG often work best in tandem. For example, a patient with suspected insomnia may first undergo actigraphy to track sleep patterns at home. If abnormalities are detected, PSG can follow for a detailed diagnosis.

In pediatric sleep research or for patients with disabilities who may struggle with overnight lab stays, actigraphy offers a practical solution, with PSG used selectively for confirmation.


Conclusion

Ultimately, choosing between actigraphy and polysomnography depends on the clinical question, the patient's needs, and the context. While PSG provides depth, actigraphy offers breadth. Used together, they can offer a more complete picture of a person’s sleep health.

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