Actigraphy and sleep logs are used prior to Mean Sleep Latency Test (MSLT) testing to effectively interpret MSLT. The use of actigraphy was evaluated in comparison with patient-reported sleep logs in the diagnosis and treatment of hypersomnia. Patients who underwent sleep studies for evaluation of hypersomnia with actigraphy, sleep diary, polysomnogram (PSG), and MSLT in 2021 at Cleveland Clinic were included.
Mean total sleep time (TST) did not have a statistically significant difference between actigraphy and sleep logs. Of patients who had ≤ 8 hours of average TST on either sleep logs or actigraphy, 55% (11 of 20) were recorded on actigraphy alone and not on sleep logs. Fifty percent (1 of 2) had ≤ 6 hours average TST on actigraphy and not sleep logs. On MSLT, the average MSL was 12.7 ± 5.1 min, with 20% of patients with times ≤ 8 min. The MSLT had a higher false positive rate when used with actigraphy vs sleep logs: for TST ≤ 8 hours, 60% vs 47.1%; for TST ≤ 6 hours, 6.7% vs 5.9%. Actigraphy performs better than sleep logs in discriminating both MSL ≤ 8 and MSL ≤ 10 (AUC 0.67 vs 0.61, 0.72 vs 0.65, respectively). Actigraphy is more objective than sleep logs and thus less prone to human recall errors.