Wearable technologies for developing sleep and circadian biomarkers: a summary of workshop discussions

Abstract

The "International Biomarkers Workshop on Wearables in Sleep and Circadian Science" was held at the 2018 SLEEP Meeting of the Associated Professional Sleep Societies. The workshop brought together experts in consumer sleep technologies and medical devices, sleep and circadian physiology, clinical translational research, and clinical practice. The goals of the workshop were: (1) characterize the term "wearable" for use in sleep and circadian science and identify relevant sleep and circadian metrics for wearables to measure; (2) assess the current use of wearables in sleep and circadian science; (3) identify current barriers for applying wearables to sleep and circadian science; and (4) identify goals and opportunities for wearables to advance sleep and circadian science. For the purposes of biomarker development in the sleep and circadian fields, the workshop included the terms "wearables," "nearables," and "ingestibles." Given the state of the current science and technology, the limited validation of wearable devices against gold standard measurements is the primary factor limiting large-scale use of wearable technologies for sleep and circadian research. As such, the workshop committee proposed a set of best practices for validation studies and guidelines regarding how to choose a wearable device for research and clinical use. To complement validation studies, the workshop committee recommends the development of a public data repository for wearable data. Finally, sleep and circadian scientists must actively engage in the development and use of wearable devices to maintain the rigor of scientific findings and public health messages based on wearable technology.

Keywords: actigraphy; biomarker; circadian misalignment; insufficient sleep; polysomnography; short sleep; sleep disorders; sleep loss; sleep tracker; wearable.

Figure 1.

Sensitivity and specificity (upper panel) for different wearable devices tested against PSG. Sensitivity and specificity for research/clinical-grade actigraphy is also presented when standard actigraphy and wearable devices were simultaneously tested against PSG. Information about devices and population used in each study are displayed in the bottom panel. Only data for wearables used in ‘normal’ setting are presented. Refer to the text for discussion about the ‘sensitive’ setting.