27 Jun Establishing normal values for paediatric night time sleep measured by actigraphy: a systematic review and meta-analysis
Galland et al. recently conducted a systematic review and meta-analysis on paediatric publications which used actigraphy, a movement sensor not all that dissimilar to the smart devices currently commonly worn to measure exercise, heart rate and the like. While we generally know that the circadian rhythms and sleep needs change as we age, this change is particularly rapid in our children. This study combines the actigraphy (objective) literature relating to our children’s sleep activity.
There is often discussion around school start times, with the argument being the current school hours are not aligned with teenager’s sleep patterns or sleep needs. The results of this study, published in the Journal of Sleep do show the difference in sleep patterns as children age.
Sleep onset tends to get later as children age. With 15-18 year olds going to bed later than 9-11 year olds. Not that this is surprising, most parents will tell you this. What is interesting is that on weekends, when presumably children are allowed to wake naturally; there is an increase in the total sleep time. This increase also increases as children age, meaning that 15-18 year olds are sleeping a lot more on weekends than they are on weekdays. They are also going to bed later on weekends. They go to bed around and hour later on weekends, and sleep in about two hours later than they do during the week, getting almost an extra hour of sleep each night on a weekend. This may be worth consideration during the discussion of optimal school start and finish times.
Statement of Significance: Actigraphy provides a greater degree of objectivity of sleep measurement than subjective reports, but despite its widespread use in paediatric sleep, there are currently no age-appropriate normative data available. However, the field has seen a growth in actigraphy studies published over the last decade to measure sleep in healthy children. As such, the current work uses systematic review, meta-analysis, and best-fit line equations to integrate published data and derive normative values for seven key actigraphy night time sleep variables across the paediatric age range. These data show typical sleep– wake developmental trends—albeit with shorter sleep than subjective reports—with clear weekday–weekend differences in the sleep patterns of older adolescents, and stability of sleep latency across all ages.
Background: Despite the widespread use of actigraphy in paediatric sleep studies, there are currently no age-related normative data.
Objectives: To systematically review the literature, calculate pooled mean estimates of actigraphy-derived paediatric night time sleep variables and to examine the magnitude of change with age.
Results: In total, 1334 articles did not meet inclusion criteria; 87 had data suitable for review and 79 were suitable for meta-analysis. There was a significant curvilinear association between both sleep onset and offset with age (p < .001). Sleep latency was stable at 19.4 min per night. There were significant differences among the older age groups between weekday and weekend/non-school days (18 studies). Total sleep time in 15–18 years old was 56 min longer, and sleep onset and offset almost 1 and 2 hours later, respectively, on weekend or non-school days.
Conclusion: These normative values have potential application to assist the interpretation of actigraphy measures from night time recordings across the paediatric age range, and aid future research.
Barbara C Galland, Michelle A Short, Philip Terrill, Gabrielle Rigney, Jillian J Haszard, Scott Coussens, Mistral Foster-Owens, Sarah N Biggs; Establishing normal values for pediatric nighttime sleep measured by actigraphy: a systematic review and meta-analysis, Sleep, Volume 41, Issue 4, 1 April 2018, zsy017, https://doi.org/10.1093/sleep/zsy017