Wearable Sleep Technology in Clinical and Research Settings

The accurate assessment of sleep is critical to better understand and evaluate its role in health and disease. The boom in wearable technology is part of the digital health revolution and is producing many novel, highly sophisticated and relatively inexpensive consumer devices collecting data from multiple sensors and claiming to extract information about users' behaviors, including sleep. These devices are now able to capture different bio-signals for determining, for example, heart rate and its variability, skin conductance, and temperature, in addition to activity. They perform 24/7, generating overwhelmingly large datasets (Big Data), with the potential of offering an unprecedented window on users' health. Unfortunately, little guidance exists within and outside the scientific sleep community for their use, leading to confusion and controversy about their validity and application. The current state-of-the-art review aims to highlight use, validation and utility of consumer wearable sleep-trackers in clinical practice and research. Guidelines for a standardized assessment of device performance is deemed necessary, and several critical factors (proprietary algorithms, device malfunction, firmware updates) need to be considered before using these devices in clinical and sleep research protocols. Ultimately, wearable sleep technology holds promise for advancing understanding of sleep health, however, a careful path forward needs to be navigated, understanding the benefits and pitfalls of this technology as applied in sleep research and clinical sleep medicine. Corresponding author, Massimiliano de Zambotti, SRI International, 333 Ravenswood Avenue, Menlo Park, CA, 94025, Tel: (650) 859-2714; Fax: (650) 859-2743; E-mail: massimiliano.dezambott@sri.com; maxdeze@gmail.com Conflict of interest. Authors declare no conflict of interest. MdZ, FB, and IC have received research funding unrelated to this work from Ebb Therapeutics Inc., Fitbit Inc., and International Flavors & Fragrances Inc. Funding. This work was supported by the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA; U01 AA021696 to IMC and FCB) and by the National Heart, Lung, and Blood Institute (NHLBI; R01HL139652 to MdZ). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. NC was supported by the University of Padua under the STARS Grants program, and the present work was carried out within the scope of the research program "Dipartimenti di Eccellenza", which is supported by a grant from MIUR to the Department of General Psychology, University of Padua. Accepted for Publication: 7 December 2018 © 2019 American College of Sports Medicine

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