Polysomnography (PSG) is the gold standard for measuring sleep, but this method is cumbersome, costly, and sometimes does not reflect naturalistic sleep patterns. Leading technology companies have developed non-wearable sleep… Click to show full abstract
Polysomnography (PSG) is the gold standard for measuring sleep, but this method is cumbersome, costly, and sometimes does not reflect naturalistic sleep patterns. Leading technology companies have developed non-wearable sleep tracking devices that have attracted public interest. However, the accuracy of these devices has either been shown to be poor or the validation tests have not been conducted by independent laboratories without potential conflicts of interest. Relative to PSG and actigraphy, and under conditions of both normal and restricted sleep, we assessed the accuracy of early and newer versions of a non-wearable sleep tracking device (Beddit, Apple Inc.). Participants were 35 healthy young adults (Mage=18.97, SD=0.95 years; 77.14% female; 42.86% Caucasian). We randomly assigned them to go to bed at 10:30pm (normal sleep) or 1:30am (restricted sleep) in a controlled sleep laboratory environment. Lights-on was 7:00am for all participants. Sleep was measured by the early version (3.0) or newer version (3.5) of a non-wearable device that uses a sensor strip to measure movement, heart rate, and breathing. We also measured PSG, wristband actigraphy, and self-report. For each device, we tested accuracy against PSG for total sleep time (TST), sleep efficiency (SE%), sleep onset latency (SOL), and wake after sleep onset (WASO). While the early version displayed poor reliability (ICCs<0.30), the newer version of the non-wearable device yielded excellent reliability with PSG under both normal and restricted sleep conditions. Not only was agreement excellent for TST (ICC=0.96) and SE% (ICC=0.98), but agreement was also excellent for the notoriously difficult metrics of SOL (ICC=0.92) and WASO (ICC=0.92). This newer version significantly outperformed clinical grade actigraphy (ICCs often in the 0.40 to 0.75 range), and self-reported sleep (ICCs often below 0.40). Surprisingly, a non-wearable device demonstrated greater agreement with PSG than clinical grade actigraphy. Though the field has generally been skeptical of commercial non-wearable devices, this independent validation provides optimism that some such devices would be efficacious for research in healthy adults. Future work is needed to test the validity of this device in older adults and clinical populations. National Science Foundation (1920730 and 1943323)
               
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