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. 2016 May 5;16(5):646.
doi: 10.3390/s16050646.

Reliability of Sleep Measures from Four Personal Health Monitoring Devices Compared to Research-Based Actigraphy and Polysomnography

Janna Mantua  1 , Nickolas Gravel  2 , Rebecca M C Spencer  3   4
Affiliations

Reliability of Sleep Measures from Four Personal Health Monitoring Devices Compared to Research-Based Actigraphy and Polysomnography

Janna Mantua et al. Sensors (Basel). .

Abstract

Polysomnography (PSG) is the "gold standard" for monitoring sleep. Alternatives to PSG are of interest for clinical, research, and personal use. Wrist-worn actigraph devices have been utilized in research settings for measures of sleep for over two decades. Whether sleep measures from commercially available devices are similarly valid is unknown. We sought to determine the validity of five wearable devices: Basis Health Tracker, Misfit Shine, Fitbit Flex, Withings Pulse O2, and a research-based actigraph, Actiwatch Spectrum. We used Wilcoxon Signed Rank tests to assess differences between devices relative to PSG and correlational analysis to assess the strength of the relationship. Data loss was greatest for Fitbit and Misfit. For all devices, we found no difference and strong correlation of total sleep time with PSG. Sleep efficiency differed from PSG for Withings, Misfit, Fitbit, and Basis, while Actiwatch mean values did not differ from that of PSG. Only mean values of sleep efficiency (time asleep/time in bed) from Actiwatch correlated with PSG, yet this correlation was weak. Light sleep time differed from PSG (nREM1 + nREM2) for all devices. Measures of Deep sleep time did not differ from PSG (SWS + REM) for Basis. These results reveal the current strengths and limitations in sleep estimates produced by personal health monitoring devices and point to a need for future development.

Keywords: actigraphy; measurement; polysomnography; validation; wearables.

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Figures

Figure 1
Figure 1
Bland-Altmann plots for total sleep time (minutes) for the Basis, the Fitbit, the Misfit, the Spectrum, and the Withings compared to PSG (adjusted values). The x-axis is the mean of the two devices, and the y-axis represents PSG minus the device. Dotted line represents two standard deviations from the mean.
Figure 2
Figure 2
Bland-Altmann plots for sleep efficiency (%) for the Basis, Fitbit, Misfit, Withings, and Actiwatch compared to PSG (adjusted values). The x-axis is the mean of the two devices, and the y-axis represents PSG minus the device. Dotted line represents two standard deviations from the mean.
Figure 3
Figure 3
Bland-Altmann plots for Deep Sleep (top row) and Light Sleep (bottom row), each in minutes, for the Basis, the Misfit, and the Withings (adjusted values). The x-axis is the mean of the two devices, and the y-axis represents PSG minus the device. Dotted line represents two standard deviations from the mean.
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