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Advanced video technology is available for sleep-laboratories. However, low-cost equipment for screening in the home setting has not been identified and tested, nor has a methodology for analysis of video recordings been suggested.   Methods:  We investigated different combinations of hardware/software for home-videosomnography (HVS) and established a process for qualitative and quantitative analysis of HVS-recordings. A case vignette (HVS analysis for a 5.5-year-old girl with major insomnia and several co-morbidities) demonstrates how methodological considerations were addressed and how HVS added value to clinical assessment.   Results:  We suggest an “ideal set of hardware/software” that is reliable, affordable (∼$500) and portable (=2.8 kg) to conduct non-invasive HVS, which allows time-lapse analyses. The equipment consists of a net-book, a camera with infrared optics, and a video capture device. (1) We present an HVS-analysis protocol consisting of three steps of analysis at varying replay speeds: (a) basic overview and classification at 16× normal speed; (b) second viewing and detailed descriptions at 4–8× normal speed, and (c) viewing, listening, and in-depth descriptions at real-time speed. (2) We also present a custom software program that facilitates video analysis and note-taking (Annotator © ), and Optical Flow software that automatically quantifies movement for internal quality control of the HVS-recording. The case vignette demonstrates how the HVS-recordings revealed the dimension of insomnia caused by restless legs syndrome, and illustrated the cascade of symptoms, challenging behaviors, and resulting medications.   Conclusion:  The strategy of using HVS, although requiring validation and reliability testing, opens the floor for a new “observational sleep medicine,” which has been useful in describing discomfort-related behavioral movement patterns in patients with communication difficulties presenting with challenging/disruptive sleep/wake behaviors.

frontiers in psychiatry

â€œDiagnosis by Behavioral Observationâ€ Home-Videosomnography â€“ A Rigorous Ethnographic Approach to Sleep of Children with Neurodevelopmental Conditions

â€œDiagnosis by Behavioral Observationâ€ Home-Videosomnography â€“ A Rigorous Ethnographic Approach to Sleep of Children with Neurodevelopmental Conditions

â€œDiagnosis by Behavioral Observationâ€ Home-Videosomnography â€“ A Rigorous Ethnographic Approach to Sleep of Children with Neurodevelopmental Conditions