Sleep tracking

Last updated
The Fitbit Alta HR, a wearable device capable of monitoring a person's sleep. Fitbit Alta HR landscape.jpg
The Fitbit Alta HR, a wearable device capable of monitoring a person's sleep.

Sleep tracking is the process of monitoring a person's sleep, most commonly through measuring inactivity and movement. [2] A device that tracks a person's sleep is called a sleep tracker. [3] Sleep tracking may be beneficial in diagnosing sleep disorders. [4] As sleep abnormalities are also symptoms of mental illness or relapsing psychotic disorders, it may also be beneficial in diagnosing mental disorders and psychotic disorders as well. [4]

Contents

Polysomnography, the "gold standard" method for sleep tracking that requires attaching electrodes and monitors to the patient as they sleep, was developed in the late 1950s. [5] [6] [7] It is considered by sleep researchers as providing the most accurate sleep data, however, it is an expensive, often uncomfortable experience for patients with findings that may be skewed due to the "first night effect". [8] [4] The actigraphy, a sleep-tracking device that is worn on one's wrist, was developed in the early 1970s and uses motion sensors. [8] [9] [10] It is considered the "silver standard" method of sleep tracking, is comparably less expensive than a polysomnograph, and easier to incorporate into a patient's every day schedule as it looks and feels like a wrist-watch. [8] [11] However, it cannot track sleep-staging, is still generally expensive, and still requires a specialist to analyze the data it collects. [4] [12]

Sleep trackers are now available to consumers in many different forms such as smartphones, smartwatches, fitness trackers, and other wearable devices. [2] Compared to a polysomonograph or an actigraph, consumer sleep-tracking devices are already incorporated into the day-to-day lives of patients and are the most cost-effective sleep-tracking method for patients. [4] However, consumer sleep-tracking devices as they currently are, do not provide reliable sleep data for consumers or healthcare professionals. [4] [13] Additionally, consumer sleep tracking devices do not share their sleep tracking methods or algorithms with the public and may unintentionally undermine the sleep recommendations of health professionals or the need to seek professional help regarding improving sleep quality. [12] [14]

Devices and methods

Developed in the late 1950s, a polysomnograph, also known as a polysomnogram or a 'sleep study', is a test used to diagnose sleep disorders and is considered as the best and most reliable method to collect sleep data from individuals. [5] [6] [7] A person can undergo a polysomnograph during an overnight stay in either a hospital or in a sleep center (a laboratory). [7] Prior to the start of the polysomnograph, electrodes are attached to the individual's scalp, chin, and outer eyelids to record signals and monitors are attached to the individual's chest to record their heart rate and track their breathing as they sleep. [6] As the individual sleeps, they are monitored by polysomnograph technologist who will take notes on things such as changes in heart rate and breathing. [6] Sometimes, there is also a video camera recording individual's movement as they sleep. [6]

Developed in the early 1970s, an actigraphy device is one of the earliest devices used to track the stages of a person's sleep and identify sleep disorders. [8] It is a non-invasive wearable device shaped like a wristwatch that tracks the movement of your body with accelerometers, small motion sensors. [8] [9] [10] This device can collect data over an extended period of time, such as a few weeks or months. [9] Actigraphy devices then uses the collected data to determine if the patient is asleep or awake and can also track the individual's other sleep behaviors such as wake time. [8] [9]

Sleep tracking is now possible through consumer wearable devices such as smartwatches and fitness trackers and applications on smartphones. The features that these consumer sleep-tracking devices offer can vary depending on the device, model, and version. Some sleep-tracking devices are capable of tracking the stages of a person's sleep (light sleep, deep sleep, REM sleep), the length/duration of a person's sleep, the quality of a person's sleep, and the consistency of a person's sleep. [15] Other features offered by sleep-tracking devices may include "sleep scores" that rank how well a person slept, "smart alarms" that wake a person up within a set period of time based on the circumstances of the person's sleep, and the ability to track the amount of light and/or the temperature in the person's bedroom. [2] [15] Unlike university sleep labs, which have made their sleep algorithms public for many years, the algorithms and methods of data collection used in consumer sleep-tracking devices have not been made public as they are proprietary and can also change at any point in time without notification to the users. [14] [12]

Utilization and effectiveness

Sleep tracking can be used to track sleep abnormalities and the sleep quality of people and help healthcare providers diagnose their patients with sleep disorders. Sleep tracking can also be used for tracking sleep abnormalities that are symptoms of mental illness. [4] For example, repeated sleep disturbances have been associated with increased risks of suicide, the development of mood disorders such as depression and anxiety, and relapse of psychotic disorders. [4]

Polysomnography

Polysomnographies are considered the "gold standard" for sleep data collection. [12] [11] However, polysomnographies do not create an environment that is conducive for sleep for most patients, especially patients who already struggle with sleep abnormalities. They are typically inaccessible to the average patient and inconvenient, as they require patients to have wires clipped to their face and monitors strapped to their body, they may need to sleep outside of their typical sleeping environment, they may be uncomfortable with knowing that as they sleep they are being monitored by the polysomongraph technologist, and the test is too expensive to obtain sleep tracking data from one patient for an extended period of time. [8] [4] One night of sleep tracking using a polysomnograph and a polysomongraph technologist can cost up to $2,000. [8] There is the "one night effect" where patients will experience more difficulties with sleeping (reflected in decreased REM sleep, decreased sleep efficiency, and increased sleep latency) during their first night of sleep tracking via polysomongraphy due to the sleep tracking equipment and unusual sleeping circumstances. [8] Additionally, the data collected during a polysomnography can also be subjected to human error. [8]

Actigraphy

Actigraphies are considered "silver standard" for sleep data collection but when compared to polysomnographies are more affordable and accessible to patients. [8] [11] Because of their compact design, actigraphies collect sleep tracking data over a longer period of time from patients without requiring their patients to make major changes to their day-to-day routine or their sleeping environment. [4] The downsides of actigraphs are that they cannot track sleep staging, the storage of data collected on the device is limited, actigraphy devices are still expensive (around $1,000), and a specialist still needs to analyze the data collected from the devices to determine if there are any issues with the device's data collection. [4] [12]

Consumer devices

People can track their sleep through smartphones with consumer sleep-tracking apps, wearable devices, or a combination or both consumer sleep-tracking apps and wearable devices. Consumer sleep-tracking devices such as smartphones and activity trackers were developed primarily for the use of consumers, not for clinical use or research. [12]

In contrast to polysomonographies and actigraphies, smartphones may be easier for people to utilize for sleep tracking purposes as they may already use smartphones in their day-to-day lives. [4] Smartphones also have built-in motion-sensing accelerometers and microphone features and cloud storage. [4] Wearable consumer-sleep tracking devices have been noted to have issues with lost or unusable data due to technical or software issues. [12]

The utilization of consumer sleep-tracking devices for clinical data collection has become more widely accepted by healthcare providers because these devices are more affordable and practical compared to polysomnographies and actigraphies. [4] [13] However, consumer sleep-tracking devices still have a long way to go before they produce accurate and reliable sleep-tracking information for the utilization of sleep disorder and mental illness treatment, research, and diagnoses. [4] [13] The motion sensors in smartphones and smartwatches are not medical-grade, smartphone data alone is not enough to capture the full picture of a patient's sleep staging, and data collected from consumer sleep-tracking devices are not reliable enough as monitoring tools as they tended to over or under-estimate data such as total sleep time. [4] [13]

There is also a concern among health professionals that consumer sleep-tracking devices and applications may encourage consumers to self-diagnose in reaction to the results of their sleep grade, quality of sleep, or recorded hours of sleep from their consumer sleep-tracking device. [12] Even though the average adult needs between seven and nine hours of sleep, a consumer sleep-tracking device may encourage all of their consumers to strive for eight hours of sleep in order to get a good sleep grade. [16] This can result in consumers feeling anxious over the amount of sleep they get each night and cause them to change their sleeping behaviors in order to improve their sleep according to the consumer sleep-tracking device's algorithm. [12] Additionally, consumers may feel content with the findings of their consumer sleep-tracking devices and forgo seeking professional help. [12]

In one study conducted by Rush University Medical College and Northwestern University’s Feinberg School of Medicine, three patients who reported having unsatisfying sleep or experiencing sleep abnormalities were utilizing consumer sleep-tracking devices before seeking professional help from sleep therapists. [17] In the study, two patients were not satisfied with the findings or recommendations of the sleep therapists and did not return for a follow-up visit, citing that the recommendations of the sleep therapists did not correspond with the findings of the consumer sleep-tracking device. [17] The one patient who did return for follow-up visits and followed the recommendations of the sleep therapists, which included switching his device from sensitive mode to normal mode and decreasing his hypnotic medication, was reportedly pleased with the progress made in his sleep quality. [17]

See also

Related Research Articles

<span class="mw-page-title-main">Sleep apnea</span> Disorder involving pauses in breathing during sleep

Sleep apnea, British English sleep apnoea or sleep apnœa, is a sleep-related breathing disorder in which repetitive pauses in breathing, periods of shallow breathing, or collapse of the upper airway during sleep results in poor ventilation and sleep disruption. Each pause in breathing can last for a few seconds to a few minutes and occurs many times a night. A choking or snorting sound may occur as breathing resumes. Common symptoms include daytime sleepiness, snoring, and non restorative sleep despite adequate sleep time. Because the disorder disrupts normal sleep, those affected may experience sleepiness or feel tired during the day. It is often a chronic condition.

<span class="mw-page-title-main">Rapid eye movement sleep behavior disorder</span> Medical condition

Rapid eye movement sleep behavior disorder or REM sleep behavior disorder (RBD) is a sleep disorder in which people act out their dreams. It involves abnormal behavior during the sleep phase with rapid eye movement (REM) sleep. The major feature of RBD is loss of muscle atonia during otherwise intact REM sleep. The loss of motor inhibition leads to sleep behaviors ranging from simple limb twitches to more complex integrated movements that can be violent or result in injury to either the individual or their bedmates.

<span class="mw-page-title-main">Pulse oximetry</span> Measurement of blood oxygen saturation

Pulse oximetry is a noninvasive method for monitoring blood oxygen saturation. Peripheral oxygen saturation (SpO2) readings are typically within 2% accuracy of the more accurate reading of arterial oxygen saturation (SaO2) from arterial blood gas analysis.

Hypersomnia is a neurological disorder of excessive time spent sleeping or excessive sleepiness. It can have many possible causes and can cause distress and problems with functioning. In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), hypersomnolence, of which there are several subtypes, appears under sleep-wake disorders.

<span class="mw-page-title-main">Polysomnography</span> Multi-parameter study of sleep and sleep disorders

Polysomnography (PSG) is a multi-parameter type of sleep study and a diagnostic tool in sleep medicine. The test result is called a polysomnogram, also abbreviated PSG. The name is derived from Greek and Latin roots: the Greek πολύς, the Latin somnus ("sleep"), and the Greek γράφειν.

eHealth describes healthcare services which are supported by digital processes, communication or technology such as electronic prescribing, Telehealth, or Electronic Health Records (EHRs). The use of electronic processes in healthcare dated back to at least the 1990s. Usage of the term varies as it covers not just "Internet medicine" as it was conceived during that time, but also "virtually everything related to computers and medicine". A study in 2005 found 51 unique definitions. Some argue that it is interchangeable with health informatics with a broad definition covering electronic/digital processes in health while others use it in the narrower sense of healthcare practice using the Internet. It can also include health applications and links on mobile phones, referred to as mHealth or m-Health. Key components of eHealth include electronic health records (EHRs), telemedicine, health information exchange, mobile health applications, wearable devices, and online health information. These technologies enable healthcare providers, patients, and other stakeholders to access, manage, and exchange health information more effectively, leading to improved communication, decision-making, and overall healthcare outcomes.

Periodic limb movement disorder (PLMD) is a sleep disorder where the patient moves limbs involuntarily and periodically during sleep, and has symptoms or problems related to the movement. PLMD should not be confused with restless legs syndrome (RLS), which is characterized by a voluntary response to an urge to move legs due to discomfort. PLMD on the other hand is involuntary, and the patient is often unaware of these movements altogether. Periodic limb movements (PLMs) occurring during daytime period can be found but are considered as a symptom of RLS; only PLMs during sleep can suggest a diagnosis of PLMD.

<span class="mw-page-title-main">Somnology</span> Scientific study of sleep

Somnology is the scientific study of sleep. It includes clinical study and treatment of sleep disorders and irregularities. Sleep medicine is a subset of somnology.

Actigraphy is a non-invasive method of monitoring human rest/activity cycles. A small actigraph unit, also called an actimetry sensor, is worn for a week or more to measure gross motor activity. The unit is usually in a wristwatch-like package worn on the wrist. The movements the actigraph unit undergoes are continually recorded and some units also measure light exposure. The data can be later read to a computer and analysed offline; in some brands of sensors the data are transmitted and analysed in real time.

Parasomnias are a category of sleep disorders that involve abnormal movements, behaviors, emotions, perceptions, and dreams that occur while falling asleep, sleeping, between sleep stages, or during arousal from sleep. Parasomnias are dissociated sleep states which are partial arousals during the transitions between wakefulness, NREM sleep, and REM sleep, and their combinations.

Rhythmic movement disorder (RMD) is a neurological disorder characterized by repetitive movements of large muscle groups immediately before and during sleep often involving the head and neck. It was independently described first in 1905 by Zappert as jactatio capitis nocturna and by Cruchet as rhythmie du sommeil. The majority of RMD episodes occur during NREM sleep, although REM movements have been reported. RMD is often associated with other psychiatric conditions or mental disabilities. The disorder often leads to bodily injury from unwanted movements. Because of these incessant muscle contractions, patients' sleep patterns are often disrupted. It differs from restless legs syndrome in that RMD involves involuntary muscle contractions before and during sleep while restless legs syndrome is the urge to move before sleep. RMD occurs in both males and females, often during early childhood with symptoms diminishing with age. Many affected individuals also have other sleep related disorders, like sleep apnea. The disorder can be differentially diagnosed into small subcategories, including sleep related bruxism, thumb sucking, hypnagogic foot tremor, and rhythmic sucking, to name a few. In order to be considered pathological, the ICSD-II requires that in the sleep-related rhythmic movements should “markedly interfere with normal sleep, cause significant impairment in daytime function, or result in self-inflicted bodily injury that requires medical treatment ”.

<span class="mw-page-title-main">Circadian rhythm sleep disorder</span> Family of sleep disorders which affect the timing of sleep

Circadian rhythm sleep disorders (CRSD), also known as circadian rhythm sleep-wake disorders (CRSWD), are a family of sleep disorders which affect the timing of sleep. CRSDs arise from a persistent pattern of sleep/wake disturbances that can be caused either by dysfunction in one's biological clock system, or by misalignment between one's endogenous oscillator and externally imposed cues. As a result of this mismatch, those affected by circadian rhythm sleep disorders have a tendency to fall asleep at unconventional time points in the day. These occurrences often lead to recurring instances of disturbed rest, where individuals affected by the disorder are unable to go to sleep and awaken at "normal" times for work, school, and other social obligations. Delayed sleep phase disorder, advanced sleep phase disorder, non-24-hour sleep–wake disorder and irregular sleep–wake rhythm disorder represents the four main types of CRSD.

<span class="mw-page-title-main">Sleep medicine</span> Medical specialty devoted to the diagnosis and therapy of sleep disturbances and disorders

Sleep medicine is a medical specialty or subspecialty devoted to the diagnosis and therapy of sleep disturbances and disorders. From the middle of the 20th century, research has provided increasing knowledge of, and answered many questions about, sleep–wake functioning. The rapidly evolving field has become a recognized medical subspecialty in some countries. Dental sleep medicine also qualifies for board certification in some countries. Properly organized, minimum 12-month, postgraduate training programs are still being defined in the United States. In some countries, the sleep researchers and the physicians who treat patients may be the same people.

mHealth Medicine and public health supported by mobile devices

mHealth is an abbreviation for mobile health, a term used for the practice of medicine and public health supported by mobile devices. The term is most commonly used in reference to using mobile communication devices, such as mobile phones, tablet computers and personal digital assistants (PDAs), and wearable devices such as smart watches, for health services, information, and data collection. The mHealth field has emerged as a sub-segment of eHealth, the use of information and communication technology (ICT), such as computers, mobile phones, communications satellite, patient monitors, etc., for health services and information. mHealth applications include the use of mobile devices in collecting community and clinical health data, delivery/sharing of healthcare information for practitioners, researchers and patients, real-time monitoring of patient vital signs, the direct provision of care as well as training and collaboration of health workers.

<span class="mw-page-title-main">Wearable technology</span> Clothing and accessories incorporating computer and advanced electronic technologies

Wearable technology is any technology that is designed to be used while worn. Common types of wearable technology include smartwatches and smartglasses. Wearable electronic devices are often close to or on the surface of the skin, where they detect, analyze, and transmit information such as vital signs, and/or ambient data and which allow in some cases immediate biofeedback to the wearer.

Irregular sleep–wake rhythm disorder (ISWRD) is a rare form of circadian rhythm sleep disorder. It is characterized by numerous naps throughout the 24-hour period, no main nighttime sleep episode, and irregularity from day to day. Affected individuals have no pattern of when they are awake or asleep, may have poor quality sleep, and often may be very sleepy while they are awake. The total time asleep per 24 hours is normal for the person's age. The disorder is serious—an invisible disability. It can create social, familial, and work problems, making it hard for a person to maintain relationships and responsibilities, and may make a person home-bound and isolated.

Digital health is a discipline that includes digital care programs, technologies with health, healthcare, living, and society to enhance the efficiency of healthcare delivery and to make medicine more personalized and precise. It uses information and communication technologies to facilitate understanding of health problems and challenges faced by people receiving medical treatment and social prescribing in more personalised and precise ways. The definitions of digital health and its remits overlap in many ways with those of health and medical informatics.

<span class="mw-page-title-main">Activity tracker</span> Device or application for monitoring fitness

An activity tracker is an electronic device or app that measures and collects data about an individual's movements and physical responses, towards the goal of monitoring and improving their health, fitness or psychological wellness over time.

<span class="mw-page-title-main">Pulse watch</span> Electronic devices

A pulse watch, also known as a pulsometer or pulsograph, is an individual monitoring and measuring device with the ability to measure heart or pulse rate. Detection can occur in real time or can be saved and stored for later review. The pulse watch measures electrocardiography data while the user is performing tasks, whether it be simple daily tasks or intense physical activity. The pulse watch functions without the use of wires and multiple sensors. This makes it useful in health and medical settings where wires and sensors may be an inconvenience. Use of the device is also common in sport and exercise environments where individuals are required to measure and monitor their biometric data.

<span class="mw-page-title-main">Behavioral sleep medicine</span>

Behavioral sleep medicine (BSM) is a field within sleep medicine that encompasses scientific inquiry and clinical treatment of sleep-related disorders, with a focus on the psychological, physiological, behavioral, cognitive, social, and cultural factors that affect sleep, as well as the impact of sleep on those factors. The clinical practice of BSM is an evidence-based behavioral health discipline that uses primarily non-pharmacological treatments. BSM interventions are typically problem-focused and oriented towards specific sleep complaints, but can be integrated with other medical or mental health treatments. The primary techniques used in BSM interventions involve education and systematic changes to the behaviors, thoughts, and environmental factors that initiate and maintain sleep-related difficulties.

References

  1. ↑ Song, Victoria (March 27, 2017). "Fitbit Alta HR Review". PC Magazine . Archived from the original on April 25, 2020. Retrieved December 27, 2020.
  2. 1 2 3 O'Boyle, Britta (2022-04-25). "What is sleep tracking, how does it work and what devices offer it?". Pocket-lint. Retrieved 2023-12-09.
  3. ↑ "What Is a Sleep Tracker and Why Do You Need One". SmartWatches.org. 2015-01-27. Retrieved 2023-12-09.
  4. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Aledavood, Talayeh; Torous, John; Triana Hoyos, Ana Maria; Naslund, John A.; Onnela, Jukka-Pekka; Keshavan, Matcheri (2019-06-04). "Smartphone-Based Tracking of Sleep in Depression, Anxiety, and Psychotic Disorders". Current Psychiatry Reports. 21 (7): 49. doi:10.1007/s11920-019-1043-y. ISSN   1535-1645. PMC   6546650 . PMID   31161412.
  5. 1 2 Lorenz, Christopher P.; Williams, Adrian J. (November 2017). "Sleep apps: what role do they play in clinical medicine?". Current Opinion in Pulmonary Medicine. 23 (6): 512–516. doi:10.1097/MCP.0000000000000425. ISSN   1070-5287. PMID   28820754. S2CID   4449256.
  6. 1 2 3 4 5 "Polysomnography: MedlinePlus Medical Encyclopedia". medlineplus.gov. Retrieved 2023-11-09.
  7. 1 2 3 Fiorillo, Luigi; Puiatti, Alessandro; Papandrea, Michela; Ratti, Pietro-Luca; Favaro, Paolo; Roth, Corinne; Bargiotas, Panagiotis; Bassetti, Claudio L.; Faraci, Francesca D. (2019-12-01). "Automated sleep scoring: A review of the latest approaches". Sleep Medicine Reviews. 48: 101204. doi:10.1016/j.smrv.2019.07.007. ISSN   1087-0792. PMID   31491655. S2CID   201869097.
  8. 1 2 3 4 5 6 7 8 9 10 11 Lujan, Matthew R.; Perez-Pozuelo, Ignacio; Grandner, Michael A. (2021-08-16). "Past, Present, and Future of Multisensory Wearable Technology to Monitor Sleep and Circadian Rhythms". Frontiers in Digital Health . 3. doi: 10.3389/fdgth.2021.721919 . ISSN   2673-253X. PMC   8521807 . PMID   34713186.
  9. 1 2 3 4 "Actigraphy". stanfordhealthcare.org. Retrieved 2023-11-24.
  10. 1 2 "How Do Sleep Trackers Actually Work". Philips. Retrieved 2023-11-26.
  11. 1 2 3 Zhai, Huifang; Yan, Yonghong; He, Siqi; Zhao, Pinyong; Zhang, Bohan (17 May 2023). "Evaluation of the Accuracy of Contactless Consumer Sleep-Tracking Devices Application in Human Experiment: A Systematic Review and Meta-Analysis". Sensors. 23 (10): 4842. Bibcode:2023Senso..23.4842Z. doi: 10.3390/s23104842 . ISSN   1424-8220. PMC   10222058 . PMID   37430756.
  12. 1 2 3 4 5 6 7 8 9 10 De Zambotti, Massimiliano; Cellini, Nicola; Goldstone, Aimée; Colrain, Ian M.; Baker, Fiona C. (July 2019). "Wearable Sleep Technology in Clinical and Research Settings". Medicine & Science in Sports & Exercise. 51 (7): 1538–1557. doi:10.1249/MSS.0000000000001947. hdl:11577/3307782. ISSN   0195-9131. PMC   6579636 . PMID   30789439.
  13. 1 2 3 4 Guillodo, Elise; Lemey, Christophe; Simonnet, Mathieu; Walter, Michel; Baca-García, Enrique; Masetti, Vincent; Moga, Sorin; Larsen, Mark; Network, Hugopsy; Ropars, Juliette; Berrouiguet, Sofian (2020-04-01). "Clinical Applications of Mobile Health Wearable–Based Sleep Monitoring: Systematic Review". JMIR mHealth and uHealth. 8 (4): e10733. doi: 10.2196/10733 . PMC   7160700 . PMID   32234707.
  14. 1 2 Chen, Brian X. (2019-07-17). "The Sad Truth About Sleep-Tracking Devices and Apps". The New York Times. ISSN   0362-4331 . Retrieved 2023-11-24.
  15. 1 2 "Do Sleep Trackers Really Work?". Johns Hopkins Medicine . Archived from the original on April 24, 2019. Retrieved December 27, 2020.
  16. ↑ "Sleep and your health: MedlinePlus Medical Encyclopedia". medlineplus.gov. Retrieved 2023-12-09.
  17. 1 2 3 Baron, Kelly Glazer; Abbott, Sabra; Jao, Nancy; Manalo, Natalie; Mullen, Rebecca (2017-02-15). "Orthosomnia: Are Some Patients Taking the Quantified Self Too Far?". Journal of Clinical Sleep Medicine . 13 (2): 351–354. doi:10.5664/jcsm.6472. ISSN   1550-9389. PMC   5263088 . PMID   27855740.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.