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de Zambotti M, Goldstein C, Cook J, Menghini L, Altini M, Cheng P, Robillard R. State of the science and recommendations for using wearable technology in sleep and circadian research. Sleep 2024; 47:zsad325. [PMID: 38149978 DOI: 10.1093/sleep/zsad325] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 12/21/2023] [Indexed: 12/28/2023] Open
Abstract
Wearable sleep-tracking technology is of growing use in the sleep and circadian fields, including for applications across other disciplines, inclusive of a variety of disease states. Patients increasingly present sleep data derived from their wearable devices to their providers and the ever-increasing availability of commercial devices and new-generation research/clinical tools has led to the wide adoption of wearables in research, which has become even more relevant given the discontinuation of the Philips Respironics Actiwatch. Standards for evaluating the performance of wearable sleep-tracking devices have been introduced and the available evidence suggests that consumer-grade devices exceed the performance of traditional actigraphy in assessing sleep as defined by polysomnogram. However, clear limitations exist, for example, the misclassification of wakefulness during the sleep period, problems with sleep tracking outside of the main sleep bout or nighttime period, artifacts, and unclear translation of performance to individuals with certain characteristics or comorbidities. This is of particular relevance when person-specific factors (like skin color or obesity) negatively impact sensor performance with the potential downstream impact of augmenting already existing healthcare disparities. However, wearable sleep-tracking technology holds great promise for our field, given features distinct from traditional actigraphy such as measurement of autonomic parameters, estimation of circadian features, and the potential to integrate other self-reported, objective, and passively recorded health indicators. Scientists face numerous decision points and barriers when incorporating traditional actigraphy, consumer-grade multi-sensor devices, or contemporary research/clinical-grade sleep trackers into their research. Considerations include wearable device capabilities and performance, target population and goals of the study, wearable device outputs and availability of raw and aggregate data, and data extraction, processing, and analysis. Given the difficulties in the implementation and utilization of wearable sleep-tracking technology in real-world research and clinical settings, the following State of the Science review requested by the Sleep Research Society aims to address the following questions. What data can wearable sleep-tracking devices provide? How accurate are these data? What should be taken into account when incorporating wearable sleep-tracking devices into research? These outstanding questions and surrounding considerations motivated this work, outlining practical recommendations for using wearable technology in sleep and circadian research.
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Affiliation(s)
- Massimiliano de Zambotti
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
- Lisa Health Inc., Oakland, CA, USA
| | - Cathy Goldstein
- Sleep Disorders Center, Department of Neurology, University of Michigan-Ann Arbor, Ann Arbor, MI, USA
| | - Jesse Cook
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
| | - Luca Menghini
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
| | - Marco Altini
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Philip Cheng
- Sleep Disorders and Research Center, Henry Ford Health, Detroit, MI, USA
| | - Rebecca Robillard
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- Canadian Sleep Research Consortium, Canada
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Cook JD, Gratton MKP, Bender AM, Werthner P, Lawson D, Pedlar CR, Kipps C, Bastien CH, Samuels CH, Charest J. Sleep Health, Individual Characteristics, Lifestyle Factors, and Marathon Completion Time in Marathon Runners: A Retrospective Investigation of the 2016 London Marathon. Brain Sci 2023; 13:1346. [PMID: 37759947 PMCID: PMC10527296 DOI: 10.3390/brainsci13091346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/08/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
Despite sleep health being critically important for athlete performance and well-being, sleep health in marathoners is understudied. This foundational study explored relations between sleep health, individual characteristics, lifestyle factors, and marathon completion time. Data were obtained from the 2016 London Marathon participants. Participants completed the Athlete Sleep Screening Questionnaire (ASSQ) along with a brief survey capturing individual characteristics and lifestyle factors. Sleep health focused on the ASSQ sleep difficulty score (SDS) and its components. Linear regression computed relations among sleep, individual, lifestyle, and marathon variables. The analytic sample (N = 943) was mostly male (64.5%) and young adults (66.5%). A total of 23.5% of the sample reported sleep difficulties (SDS ≥ 8) at a severity warranting follow-up with a trained sleep provider. Middle-aged adults generally reported significantly worse sleep health characteristics, relative to young adults, except young adults reported significantly longer sleep onset latency (SOL). Sleep tracker users reported worse sleep satisfaction. Pre-bedtime electronic device use was associated with longer SOL and longer marathon completion time, while increasing SOL was also associated with longer marathon completion. Our results suggest a deleterious influence of pre-bedtime electronic device use and sleep tracker use on sleep health in marathoners. Orthosomnia may be a relevant factor in the relationship between sleep tracking and sleep health for marathoners.
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Affiliation(s)
- Jesse D. Cook
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI 53706, USA
- Department of Psychology, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Matt K. P. Gratton
- Division of Medical Informatics, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, MO 66160, USA;
- Social and Behavioral Sciences, Psychology, University of Kansas, Lawrence, KS 66045, USA
| | - Amy M. Bender
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (A.M.B.); (P.W.); (C.H.S.); (J.C.)
| | - Penny Werthner
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (A.M.B.); (P.W.); (C.H.S.); (J.C.)
| | - Doug Lawson
- Centre for Sleep and Human Performance, Calgary, AB T2X 3V4, Canada;
| | - Charles R. Pedlar
- Faculty of Sport, Allied Health, and Performance Science, Twickenham, St Mary’s University, London TW1 4SX, UK;
- Institute of Sport, Exercise and Health, University College London, London WC1E 6JB, UK;
| | - Courtney Kipps
- Institute of Sport, Exercise and Health, University College London, London WC1E 6JB, UK;
| | - Celyne H. Bastien
- École de Psychologie, Université Laval, Québec City, QC G1V 0A6, Canada;
| | - Charles H. Samuels
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (A.M.B.); (P.W.); (C.H.S.); (J.C.)
- Centre for Sleep and Human Performance, Calgary, AB T2X 3V4, Canada;
- Faculty of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Jonathan Charest
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (A.M.B.); (P.W.); (C.H.S.); (J.C.)
- Centre for Sleep and Human Performance, Calgary, AB T2X 3V4, Canada;
- École de Psychologie, Université Laval, Québec City, QC G1V 0A6, Canada;
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