Actigraphy in Sleep: Tracing Its Evolution From Foundations to Modern Applications

Abstract Self-report measures have been the core of behavioral sleep medicine (BSM) assessments and interventions since the field’s inception. While these remain the gold standard, there are times when objective accessible assessments are needed. The aim is to trace the development and progression of actigraphy as a key tool in sleep research and clinical practice. The authors outline the historical foundations of actigraphy, from early motion-sensing devices to modern wrist-worn accelerometers, highlighting technological advancements that have improved sensitivity, specificity, and integration with BSM. They explore the clinical application of actigraphy, presenting evidence for and against its use in assessing and treating specific sleep and circadian disorders across the life span. Additionally, the authors examine contemporary applications, including wearable consumer devices, remote patient monitoring, and big data analytics in sleep medicine. They conclude by addressing current limitations and future directions, emphasizing the need for standardization and performance evaluation.