The role of actigraphy in the assessment of central disorders of Hypersomnolence: A systematic review and meta-analysis

Maia, Susana; Soares, Joana Isabel; Borges, Daniel Filipe; Lopes, João Casalta; Gonçalves, Marta

http://hdl.handle.net/10400.22/30195

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Authors

Maia, Susana

Soares, Joana Isabel

Borges, Daniel Filipe

Lopes, João Casalta

Gonçalves, Marta

Borges, Daniel Filipe

Abstract(s)

Actigraphy provides an objective measure of sleepiness and is recommended by the American Academy of Sleep Medicine for use 7–14 days prior to multiple sleep latency testing. It plays a valuable role in the differential diagnosis of hypersomnolence. Our aim was to provide a comprehensive summary of actigraphy features in central disorders of hypersomnolence (CDH). Data were sourced from six bibliographic databases. Fixed- or random-effects models were applied to compare patients with narcolepsy type 1 (NT1) to controls. Of the 1,737 publications identified in our search, 8 studies met the inclusion criteria. The total sample consisted of 473 participants, encompassing patients with NT1, idiopathic hypersomnia (IH), hypersomnolence with normal CSF hypocretin-1 levels, Kleine–Levin syndrome (KLS), traumatic brain injury (TBI), major depressive disorder (MDD), myotonic dystrophy (MD), primary insomnia and healthy controls. Actigraphy devices varied across studies. Compared to control subjects, NT1 patients had lower total sleep time (TST), sleep efficiency and daytime motor activity, with increased wake after sleep onset, awakenings, nocturnal motor activity and longest nap duration. In KLS, TST was higher during hypersomnia episodes than during asymptomatic phases. TBI and MDD patients had a higher TST than the control group, while MD patients had a lower TST than patients with IH. Actigraphy is a valuable tool for objectively assessing sleep and can assist in detecting CDH. However, the absence of standardized guidelines limits their broader implementation in clinical practice.

Keywords

Actigraphy Central disorders of hypersomnolence Narcolepsy Sleep disorders Polysomnography

URI

http://hdl.handle.net/10400.22/30195

Citation

Maia, S., Soares, J. I., Borges, D. F., Casalta-Lopes, J., & Gonçalves, M. (2025). The role of actigraphy in the assessment of central disorders of Hypersomnolence: A aystematic review and meta-analysis. Canadian Journal of Neurological Sciences, 1–9. https://doi.org/10.1017/cjn.2025.10114