Detecting Sleep and Nonwear in 24-h Wrist Accelerometer Data from the National Health and Nutrition Examination Survey

Introduction Estimating physical activity, sedentary behavior, and sleep from wrist-worn accelerometer data requires reliable detection of sensor nonwear and sensor wear during both sleep and wake. Purpose This study aimed to develop an algorithm that simultaneously identifies sensor wake-wear, sleep-wear, and nonwear in 24-h wrist accelerometer data collected with or without filtering. Methods Using sensor data labeled with polysomnography (n = 21) and directly observed wake-wear data (n = 31) from healthy adults, and nonwear data from sensors left at various locations in a home (n = 20), we developed an algorithm to detect nonwear, sleep-wear, and wake-wear for "idle sleep mode" (ISM) filtered data collected in the 2011-2014 National Health and Nutrition Examination Survey. The algorithm was then extended to process original raw data collected from devices without ISM filtering. Both algorithms were further validated using a polysomnography-based sleep and wake-wear data set (n = 22) and diary-based wake-wear and nonwear labels from healthy adults (n = 23). Classification performance (F1 scores) was compared with four alternative approaches. Results The F1 score of the ISM-based algorithm on the training data set using leave-one-subject-out cross-validation was 0.95 +/- 0.13. Validation on the two independent data sets yielded F1 scores of 0.84 +/- 0.60 for the data set with sleep-wear and wake-wear and 0.94 +/- 0.04 for the data set with wake-wear and nonwear. The F1 score when using original, raw data was 0.96 +/- 0.08 for the training data sets and 0.86 +/- 0.18 and 0.97 +/- 0.04 for the two independent validation data sets. The algorithm performed comparably or better than the alternative approaches on the data sets. Conclusions A novel machine-learning algorithm was designed to recognize wake-wear, sleep-wear, and nonwear in 24-h wrist-worn accelerometer data that are applicable for ISM-filtered data or original raw data.