0808 Comparison of Actigraphy to Polysomnography in the Measurement of Nocturnal Sleep in Children with Craniopharyngioma

Abstract

Introduction: Craniopharyngioma is a rare brain tumor located in the suprasellar region that often extends to the hypothalamus. Given this location, children who undergo resection are at greater risk for excessive daytime sleepiness (EDS) that interferes with psychosocial function, academic performance and quality of life. Polysomnography (PSG) and Multiple Sleep Latency Tests (MSLT) are gold standards for diagnosing sleep disorders. When monitoring response to treatment, however, they are time-intensive, costly, and do not offer an in vivo measure of typical sleep. We assessed the sensitivity, specificity, and accuracy of actigraphy in measuring nocturnal sleep in comparison to PSG. Methods: Fifty children with craniopharyngioma (3 to 20 years) were assessed with overnight PSG and concurrent actigraphy after surgical resection and prior to proton therapy. PSG and actigraphy data were synchronized utilizing an epoch-by-epoch comparison method. Sensitivity, specificity, and accuracy were calculated using measures of true wake, true sleep, false wake, and false sleep, calculated based on the percentage of agreement between PSG versus actigraphy. In addition, paired samples t-tests evaluated differences in sleep outcome variables between the two measures. Results: Actigraphy was 93% sensitive and 87% accurate in measuring sleep versus wakefulness in comparison to PSG, while specificity was poor (55%). Actigraphy was a reliable measure of sleep efficiency, however, significant differences were found for total sleep time (TST; p=.002) and wake after sleep onset (WASO; p