Practice parameters for the use of actigraphy in the military operational context: the Walter Reed Army Institute of Research Operational Research Kit-Actigraphy (WORK-A)

Jaime K Devine; Jake Choynowski; Tina Burke; Kajsa Carlsson; Vincent F Capaldi; Ashlee B McKeon; Walter J Sowden

doi:10.1186/s40779-020-00255-7

Practice parameters for the use of actigraphy in the military operational context: the Walter Reed Army Institute of Research Operational Research Kit-Actigraphy (WORK-A)

Mil Med Res. 2020 May 31;7(1):31. doi: 10.1186/s40779-020-00255-7.

Authors

Jaime K Devine¹, Jake Choynowski², Tina Burke², Kajsa Carlsson², Vincent F Capaldi², Ashlee B McKeon³, Walter J Sowden⁴

Affiliations

¹ Operational Fatigue and Performance, Institutes for Behavior Resources, Baltimore, MD, 21218, USA.
² Behavioral Biology Branch, Walter Reed Army Institute of Research, 503 Robert Grant Ave, Silver Spring, MD, 20910, USA.
³ Behavioral Biology Branch, Walter Reed Army Institute of Research, 503 Robert Grant Ave, Silver Spring, MD, 20910, USA. ashlee.b.mckeon.mil@mail.mil.
⁴ Tripler Army Medical Center, Honolulu, HI, 96859, USA.

Abstract

Background: The Walter Reed Army Institute of Research (WRAIR) Operational Research Kit-Actigraphy (WORK-A) is a set of unique practice parameters and actigraphy-derived measures for the analysis of operational military sleep patterns. The WORK-A draws on best practices from the literature and comprises 15 additional descriptive variables. Here, we demonstrate the WORK-A with a sample of United States Army Reserve Officers' Training Corps (ROTC) cadets (n = 286) during a month-long capstone pre-commissioning training exercise.

Methods: The sleep of ROTC cadets (n = 286) was measured by Philips Actiwatch devices during the 31-day training exercise. The preliminary effectiveness of the WORK-A was tested by comparing differences in sleep measures collected by Actiwatches as calculated by Philips Actiware software against WORK-A-determined sleep measures and self-report sleep collected from a subset of ROTC cadets (n = 140).

Results: Actiware sleep summary statistics were significantly different from WORK-A measures and self-report sleep (all P ≤ 0.001). Bedtimes and waketimes as determined by WORK-A major sleep intervals showed the best agreement with self-report bedtime (22:21 ± 1:30 vs. 22:13 ± 0:40, P = 0.21) and waketime (04:30 ± 2:17 vs. 04:31 ± 0:47, P = 0.68). Though still significantly different, the discrepancy was smaller between the WORK-A measure of time in bed (TIB) for major sleep intervals (352 ± 29 min) and self-report nightly sleep duration (337 ± 57 min, P = 0.006) than that between the WORK-A major TIB and Actiware TIB (177 ± 42, P ≤ 0.001).

Conclusions: Default actigraphy methods are not the most accurate methods for characterizing soldier sleep, but reliable methods for characterizing operational sleep patterns is a necessary first step in developing strategies to improve soldier readiness. The WORK-A addresses this knowledge gap by providing practice parameters and a robust variety of measures with which to profile sleep behavior in service members.

Keywords: Actigraphy; Military sleep assessment; Operational environment; Scoring methodology; Sleep-wake patterns.

Publication types

Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Actigraphy / methods*
Actigraphy / trends
Adolescent
Adult
Evaluation Studies as Topic*
Female
Humans
Male
Military Medicine / instrumentation*
Military Medicine / methods
Operations Research*
Teaching