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Validation of Sleep-Tracking Technology Compared with Polysomnography in Adolescents - PubMed

️Thu Jan 01 2015

Comparative Study

Validation of Sleep-Tracking Technology Compared with Polysomnography in Adolescents

Massimiliano de Zambotti et al. Sleep. 2015.

Abstract

Study objectives: To evaluate the accuracy in measuring nighttime sleep of a fitness tracker (Jawbone UP) compared to polysomnography (PSG).

Design: Jawbone UP and PSG data were simultaneously collected from adolescents during an overnight laboratory recording. Agreements between Jawbone UP and PSG sleep outcomes were analyzed using paired t tests and Bland-Altman plots. Multiple regressions were used to investigate which PSG sleep measures predicted Jawbone UP "Sound sleep" and "Light sleep."

Setting: SRI International Human Sleep Laboratory.

Participants: Sixty-five healthy adolescents (28 females, mean age ± standard deviation [SD]: 15.8 ± 2.5 y).

Interventions: N/A.

Measurements and results: Outcomes showed good agreements between Jawbone UP and PSG for total sleep time (mean differences ± SD: -10.0 ± 20.5 min), sleep efficiency (mean differences ± SD: -1.9 ± 4.2 %), and wake after sleep onset (WASO) (mean differences ± SD: 10.6 ± 14.7 min). Overall, Jawbone UP overestimated PSG total sleep time and sleep efficiency and underestimated WASO but differences were small and, on average, did not exceed clinically meaningful cutoffs of > 30 min for total sleep time and > 5% for sleep efficiency. Multiple regression models showed that Jawbone UP "Sound sleep" measure was predicted by PSG time in N2 (β = 0.25), time in rapid eye movement (β = 0.29), and arousal index (β = -0.34). Jawbone UP "Light sleep" measure was predicted by PSG time in N2 (β = 0.48), time in N3 (β = 0.49), arousal index (β = 0.38) and awakening index (β = 0.28). Jawbone UP showed a progression from slight overestimation to underestimation of total sleep time and sleep efficiency with advancing age. All relationships were similar in boys and girls.

Conclusions: Jawbone UP shows good agreement with polysomnography in measures of total sleep time and wake after sleep onset in adolescent boys and girls. Further validation is needed in other age groups and clinical populations before advocating use of these inexpensive and easy-to-use devices in clinical sleep medicine and research.

Keywords: actigraphy; adolescence; fitness tracker; polysomnography; sleep.

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Figures

**Figure 1**
Bland-Altman plots for total sleep time (TST), sleep efficiency (SE), total wake time (TWT), sleep onset latency (SOL), and wake after sleep onset (WASO) recorded by Jawbone UP and polysomnography. Average, mean (or bias) of the differences between Jawbone UP and PSG outcomes, lower and upper agreement limits (mean difference ± 1.96 standard deviation) and 95% confidence interval for mean differences and agreement limits (dotted line) are displayed for each Bland-Altman plot.

**Figure 2**
Correlations between age and mean differences (PSG – Jawbone UP) in total sleep time (TST), sleep efficiency (SE), total wake time (TWT), sleep onset latency (SOL) and wake after sleep onset (WASO) in male and female adolescents. Pearson product-moment correlation coefficients (r) and P values are displayed on each graph separately for males and females.

Comment in

Fitness Tracker to Assess Sleep: Beyond the Market.
Poyares D, Hirotsu C, Tufik S. Poyares D, et al. Sleep. 2015 Sep 1;38(9):1351-2. doi: 10.5665/sleep.4966. Sleep. 2015. PMID: 26237767 Free PMC article. No abstract available.

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Validation of Sleep-Tracking Technology Compared with Polysomnography in Adolescents - PubMed