There's recent news about the use of actigraphy in sleep medicine...

In early March, 2008, the Current Procedural Terminology (CPT) Editorial Panel accepted the American Academy of Sleep Medicine's application for a code change for actigraphy. The AASM requested the Panel change actigraphy from a Category IIII code to a Category I code. The next step is for the application to be presented at the Relative Value Scale Update Committee (RUC) meeting in April 2008.

A successful application will result in the generation of a Category I CPT code for the use of Actigraphy and is the next step toward achieving reimbursement for the use of this technology. The AASM currently cites actigraphy in the International Classification of Sleep Disorders Diagnostic & Coding Manual as a contributing technology in the assessment of sleep disorders ranging from Circadian Rhythm Disorders, Paradoxical Insomnia, and Hypersomnia.

To underline the emphasis on this effort, the Academy undertook a project to update their published Practice Parameters for the use of Actigraphy in Sleep and Circadian Rhythms. This effort resulted in a new Practice Parameter publication in the April 2007 issue of the Journal SLEEP (Morgenthaler et al. Practice Parameters for the Use of Actigraphy in the Assessment of Sleep and Sleep Disorders: An Update for 2007. SLEEP, Vol. 30, No. 4, 2007).

Because of the widespread use of Actigraphy, Respironics is working to update the existing Actiwatch technologies with the release of Actiwatch 2 and Actiwatch Spectrum. These new devices, along with new automated algorithms for identification of rest intervals in actigraphy data represent breakthrough technologies that will make actigraphy easier to implement in a clinical setting.

"With its ability to record continuously for long time periods, (Actigraphy) is more reliable than sleep logs which rely on the patients' recall of how many times they woke up or how long they slept during the night and is more reliable than observations which only capture short time periods. Actigraphy can provide information obtainable in no other practical way."

"Actigraphy is also appropriate for the assessment of and stability of treatment effects of anything from hypnotic drugs to light treatment to CPAP, particularly if assessments are done before and after the start of treatment."

- Ancoli-Israel S, Cole R, Alessi C, et al. The role of actigraphy in the study of sleep and circadian rhythms. SLEEP, Vol. 26, No. 3, 2003.

"Actigraphy provides an acceptably accurate es-timate of sleep patterns in normal, healthy adult populations and inpa-tients suspected of certain sleep disorders... Literature has been published that addresses the use of actigraphy in the evaluation of insomnia, circadian rhythm sleep disorders, sleep related breathing disor-ders, determination of response to therapy, and in the evaluation of sleep patterns among special populations... This literature, in combination with growing clinical experience with actigraphy, led to the inclusion of actigraphy as a measure of sleep duration and sleep patterns in the diagnostic criteria for several specific sleep disorders in the second edition of the International Clas-sification of Sleep Disorders."

- Morgenthaler et al. Practice Parameters for the Use of Actigraphy in the Assessment of Sleep and Sleep Disorders: An Update for 2007. SLEEP, Vol. 30, No. 4, 2007.

"Actigraphy may serve as a useful adjunct to routine clinical evaluation of insomnia, circadian-rhythm disorders, and excessive sleepiness, and may be helpful in the assessment of specific aspects of some disorders, such as insomnia and restless legs syndrome/periodic limb movement disorder."

- Littner et al. Practice Parameters for the Role of Actigraphy in the Study of Sleep and Circadian Rhythms: An Update for 2002. SLEEP, Vol. 26, No. 3, 2003.