The validity of Actiwatch2 and SenseWear armband compared against polysomnography at different ambient temperature conditions

There were no validation studies on portable sleep devices under different ambient temperature, thus this study evaluated the validity of wrist Actiwatch2 (AW2) or SenseWear armband (SWA) against polysomnography (PSG) in different ambient temperatures. Nine healthy young participants (6 males, aged 23.3±4.1 y) underwent nine nights of study at ambient temperature of 17 °C, 22 °C and 29 °C in random order, after an adaptation night. They wore the AW2 and SWA while being monitored for PSG simultaneously. A linear mixed model indicated that AW2 is valid for sleep onset latency (SOL), total sleep time (TST) and sleep efficiency (SE) but significantly overestimated wake after sleep onset (WASO) at 17 °C and 22 °C. SWA is valid for WASO, TST and SE at these temperatures, but severely underestimates SOL. However, at 29 °C, SWA significantly overestimated WASO and underestimated TST and SE. Bland-Altman plots showed small biases with acceptable limits of agreement (LoA) for AW2 whereas, small biases and relatively wider LoA for most sleep variables were observed in SWA. The kappa statistic showed a moderate sleep-wake epoch agreement, with a high sensitivity but poor specificity; wake detection remains suboptimal. AW2 showed small biases for most of sleep variables at all temperature conditions, except for WASO. SWA is reliable for measures of TST, WASO and SE at 17-22 °C but not at 29 °C, and SOL approximates that of PSG only at 29 °C, thus caution is needed when monitoring sleep at different temperatures, especially in home sleep studies, in which temperature conditions are more variable.