Official reprint from UpToDate®
www.uptodate.com ©2017 UpToDate, Inc. and/or its affiliates. All Rights Reserved.

Overview of actigraphy

S Justin Thomas, PhD
Karen Gamble, PhD
Section Editor
Susan M Harding, MD, FCCP, AGAF
Deputy Editor
April F Eichler, MD, MPH


Actigraphy is a validated method of objectively measuring sleep parameters and average motor activity over a period of days to weeks using a noninvasive accelerometer [1-4]. The accelerometer is housed in a small device that is worn like a wristwatch.

Actigraphy is more accurate than self-reported sleep duration and, as such, may be more useful than sleep diaries in the assessment of patients with suspected sleep disorders. Because actigraphy is measured in the patient's home environment, it has greater external validity for certain sleep parameters compared with in-laboratory polysomnography.

The main uses of actigraphy are to objectively measure sleep-wake cycles in patients with suspected circadian rhythm disorders and to complement self-reported sleep duration and other sleep parameters in patients with a range of sleep disorders, including insufficient sleep syndrome. Actigraphy can also provide useful follow-up information to assess treatment response.

This topic provides an overview of how actigraphy is used in adults and children with suspected sleep and circadian rhythm disorders and a brief discussion of consumer wearable devices. Clinical features and diagnosis of circadian sleep-wake rhythm disorders and other sleep disorders are presented separately. (See "Overview of circadian sleep-wake rhythm disorders" and "Classification of sleep disorders".)



Preparing the device — Actigraphy devices or actigraphs are relatively easy to use and require very little preparation. Most devices use a rechargeable lithium battery that must be charged prior to use. Battery life is influenced by several factors, including the battery type, the epoch length, and special features (eg, light sensor).

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:

Subscribers log in here

Literature review current through: Nov 2017. | This topic last updated: Jul 27, 2017.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.
  1. Morgenthaler T, Alessi C, Friedman L, et al. Practice parameters for the use of actigraphy in the assessment of sleep and sleep disorders: an update for 2007. Sleep 2007; 30:519.
  2. Marino M, Li Y, Rueschman MN, et al. Measuring sleep: accuracy, sensitivity, and specificity of wrist actigraphy compared to polysomnography. Sleep 2013; 36:1747.
  3. Sadeh A. The role and validity of actigraphy in sleep medicine: an update. Sleep Med Rev 2011; 15:259.
  4. De Weerd AW. Actigraphy, the alternative way? Front Psychiatry 2014; 5:155.
  5. Ancoli-Israel S, Martin JL, Blackwell T, et al. The SBSM Guide to Actigraphy Monitoring: Clinical and Research Applications. Behav Sleep Med 2015; 13 Suppl 1:S4.
  6. Littner M, Kushida CA, Anderson WM, et al. Practice parameters for the role of actigraphy in the study of sleep and circadian rhythms: an update for 2002. Sleep 2003; 26:337.
  7. VAN Someren EJ. Improving actigraphic sleep estimates in insomnia and dementia: how many nights? J Sleep Res 2007; 16:269.
  8. Acebo C, Sadeh A, Seifer R, et al. Estimating sleep patterns with activity monitoring in children and adolescents: how many nights are necessary for reliable measures? Sleep 1999; 22:95.
  9. Gamble KL, Motsinger-Reif AA, Hida A, et al. Shift work in nurses: contribution of phenotypes and genotypes to adaptation. PLoS One 2011; 6:e18395.
  10. Petrov ME, Clark CB, Molzof HE, et al. Sleep Strategies of Night-Shift Nurses on Days Off: Which Ones are Most Adaptive? Front Neurol 2014; 5:277.
  11. Adkins KW, Goldman SE, Fawkes D, et al. A pilot study of shoulder placement for actigraphy in children. Behav Sleep Med 2012; 10:138.
  12. Blackwell T, Ancoli-Israel S, Gehrman PR, et al. Actigraphy scoring reliability in the study of osteoporotic fractures. Sleep 2005; 28:1599.
  13. De Crescenzo F, Licchelli S, Ciabattini M, et al. The use of actigraphy in the monitoring of sleep and activity in ADHD: A meta-analysis. Sleep Med Rev 2016; 26:9.
  14. Martin JL, Hakim AD. Wrist actigraphy. Chest 2011; 139:1514.
  15. Montgomery-Downs HE, Insana SP, Bond JA. Movement toward a novel activity monitoring device. Sleep Breath 2012; 16:913.
  16. Meltzer LJ, Hiruma LS, Avis K, et al. Comparison of a Commercial Accelerometer with Polysomnography and Actigraphy in Children and Adolescents. Sleep 2015; 38:1323.
  17. Evenson KR, Goto MM, Furberg RD. Systematic review of the validity and reliability of consumer-wearable activity trackers. Int J Behav Nutr Phys Act 2015; 12:159.
  18. Fonseca P, Weysen T, Goelema MS, et al. Validation of Photoplethysmography-Based Sleep Staging Compared With Polysomnography in Healthy Middle-Aged Adults. Sleep 2017; 40.
  19. Mantua J, Gravel N, Spencer RM. Reliability of Sleep Measures from Four Personal Health Monitoring Devices Compared to Research-Based Actigraphy and Polysomnography. Sensors (Basel) 2016; 16.
  20. Centers for Disease Control and Prevention and the American Academy of Sleep Medicine. The National Healthy Sleep Awareness Project. http://sleepeducation.org/healthysleep.