STUDY OBJECTIVES: To compare the quality and consistency in sleep measurement of a consumer wearable device and a research-grade actigraph with polysomnography (PSG) in adolescents. METHODS: Fifty-eight healthy adolescents (aged 15-19 years; 30 males) underwent overnight PSG while wearing both a Fitbit Alta HR and a Philips Respironics Actiwatch 2 (AW2) for 5 nights, with either 5 hours or 6.5 hours time in bed (TIB) and for 4 nights with 9 hours TIB. AW2 data were evaluated using two different wake and immobility thresholds. Discrepancies in estimated total sleep time (TST) and wake after sleep onset (WASO) between devices and PSG, as well as epoch-by-epoch agreements in sleep/wake classification, were assessed. Fitbit-generated sleep staging was compared to PSG. RESULTS: Fitbit and AW2 under default settings similarly underestimated TST and overestimated WASO (TST: medium setting (M10) ≤ 38 minutes, Fitbit ≤ 47 minutes; WASO: M10 ≤ 38 minutes; Fitbit ≤ 42 minutes). AW2 at the high motion threshold setting provided readings closest to PSG (TST: ≤ 12 minutes; WASO: ≤ 18 minutes). Sensitivity for detecting sleep was ≥ 90% for both wearable devices and further improved to 95% by using the high threshold (H5) setting for the AW2 (0.95). Wake detection specificity was highest in Fitbit (≥ 0.88), followed by the AW2 at M10 (≥ 0.80) and H5 thresholds (≤ 0.73). In addition, Fitbit inconsistently estimated stage N1 + N2 sleep depending on TIB, underestimated stage N3 sleep (21-46 min), but was comparable to PSG for rapid eye movement sleep. Fitbit sensitivity values for the detection of N1 + N2, N3 and rapid eye movement sleep were ≥ 0.68, ≥ 0.50, and ≥ 0.72, respectively. CONCLUSIONS: A consumer-grade wearable device can measure sleep duration as well as a research actigraph. However, sleep staging would benefit from further refinement before these methods can be reliably used for adolescents. CLINICAL TRIAL REGISTRATION: Registry: ClinicalTrials.gov; Title: The Cognitive and Metabolic Effects of Sleep Restriction in Adolescents; Identifier: NCT03333512; URL: https://clinicaltrials.gov/ct2/show/NCT03333512. CITATION: Lee XK, Chee NIYN, Ong JL, Teo TB, van Rijn E, Lo JC, Chee MWL. Validation of a consumer sleep wearable device with actigraphy and polysomnography in adolescents across sleep opportunity manipulations. J Clin Sleep Med. 2019;15(9):1337-1346.
STUDY OBJECTIVES: To compare the quality and consistency in sleep measurement of a consumer wearable device and a research-grade actigraph with polysomnography (PSG) in adolescents. METHODS: Fifty-eight healthy adolescents (aged 15-19 years; 30 males) underwent overnight PSG while wearing both a Fitbit Alta HR and a Philips Respironics Actiwatch 2 (AW2) for 5 nights, with either 5 hours or 6.5 hours time in bed (TIB) and for 4 nights with 9 hours TIB. AW2 data were evaluated using two different wake and immobility thresholds. Discrepancies in estimated total sleep time (TST) and wake after sleep onset (WASO) between devices and PSG, as well as epoch-by-epoch agreements in sleep/wake classification, were assessed. Fitbit-generated sleep staging was compared to PSG. RESULTS: Fitbit and AW2 under default settings similarly underestimated TST and overestimated WASO (TST: medium setting (M10) ≤ 38 minutes, Fitbit ≤ 47 minutes; WASO: M10 ≤ 38 minutes; Fitbit ≤ 42 minutes). AW2 at the high motion threshold setting provided readings closest to PSG (TST: ≤ 12 minutes; WASO: ≤ 18 minutes). Sensitivity for detecting sleep was ≥ 90% for both wearable devices and further improved to 95% by using the high threshold (H5) setting for the AW2 (0.95). Wake detection specificity was highest in Fitbit (≥ 0.88), followed by the AW2 at M10 (≥ 0.80) and H5 thresholds (≤ 0.73). In addition, Fitbit inconsistently estimated stage N1 + N2 sleep depending on TIB, underestimated stage N3 sleep (21-46 min), but was comparable to PSG for rapid eye movement sleep. Fitbit sensitivity values for the detection of N1 + N2, N3 and rapid eye movement sleep were ≥ 0.68, ≥ 0.50, and ≥ 0.72, respectively. CONCLUSIONS: A consumer-grade wearable device can measure sleep duration as well as a research actigraph. However, sleep staging would benefit from further refinement before these methods can be reliably used for adolescents. CLINICAL TRIAL REGISTRATION: Registry: ClinicalTrials.gov; Title: The Cognitive and Metabolic Effects of Sleep Restriction in Adolescents; Identifier: NCT03333512; URL: https://clinicaltrials.gov/ct2/show/NCT03333512. CITATION: Lee XK, Chee NIYN, Ong JL, Teo TB, van Rijn E, Lo JC, Chee MWL. Validation of a consumer sleep wearable device with actigraphy and polysomnography in adolescents across sleep opportunity manipulations. J Clin Sleep Med. 2019;15(9):1337-1346.
Authors: M Aktaruzzaman; M Migliorini; M Tenhunen; S L Himanen; A M Bianchi; R Sassi Journal: Med Biol Eng Comput Date: 2015-02-18 Impact factor: 2.602
Authors: Stephen P Wright; Tyish S Hall Brown; Scott R Collier; Kathryn Sandberg Journal: Am J Physiol Regul Integr Comp Physiol Date: 2017-01-04 Impact factor: 3.619
Authors: Nathan L Johnson; H Lester Kirchner; Carol L Rosen; Amy Storfer-Isser; Lydia N Cartar; Sonia Ancoli-Israel; Judy L Emancipator; Anna Marie Kibler; Susan Redline Journal: Sleep Date: 2007-07 Impact factor: 5.849
Authors: Jennifer C Kanady; Leslie Ruoff; Laura D Straus; Jonathan Varbel; Thomas Metzler; Anne Richards; Sabra S Inslicht; Aoife O'Donovan; Jennifer Hlavin; Thomas C Neylan Journal: J Clin Sleep Med Date: 2020-06-15 Impact factor: 4.062
Authors: Heather S L Jim; Aasha I Hoogland; Naomi C Brownstein; Anna Barata; Adam P Dicker; Hans Knoop; Brian D Gonzalez; Randa Perkins; Dana Rollison; Scott M Gilbert; Ronica Nanda; Anders Berglund; Ross Mitchell; Peter A S Johnstone Journal: CA Cancer J Clin Date: 2020-04-20 Impact factor: 508.702
Authors: Constanza M Vidal Bustamante; Alexandra M Rodman; Meg J Dennison; John C Flournoy; Patrick Mair; Katie A McLaughlin Journal: J Child Psychol Psychiatry Date: 2020-03-17 Impact factor: 8.982
Authors: Sarah Berryhill; Christopher J Morton; Adam Dean; Adam Berryhill; Natalie Provencio-Dean; Salma I Patel; Lauren Estep; Daniel Combs; Saif Mashaqi; Lynn B Gerald; Jerry A Krishnan; Sairam Parthasarathy Journal: J Clin Sleep Med Date: 2020-02-11 Impact factor: 4.062
Authors: Jonathan A Mitchell; Knashawn H Morales; Ariel A Williamson; Nicholas Huffnagle; Casey Eck; Abigail Jawahar; Lionola Juste; Alexander G Fiks; Babette S Zemel; David F Dinges Journal: Sleep Adv Date: 2021-04-15
Authors: Evan D Chinoy; Joseph A Cuellar; Kirbie E Huwa; Jason T Jameson; Catherine H Watson; Sara C Bessman; Dale A Hirsch; Adam D Cooper; Sean P A Drummond; Rachel R Markwald Journal: Sleep Date: 2021-05-14 Impact factor: 5.849
Authors: Sarah Burkart; Michael W Beets; Bridget Armstrong; Ethan T Hunt; Roddrick Dugger; Lauren von Klinggraeff; Alexis Jones; David E Brown; R Glenn Weaver Journal: J Clin Sleep Med Date: 2021-04-01 Impact factor: 4.062
Authors: Bernice M Wulterkens; Pedro Fonseca; Lieke W A Hermans; Marco Ross; Andreas Cerny; Peter Anderer; Xi Long; Johannes P van Dijk; Nele Vandenbussche; Sigrid Pillen; Merel M van Gilst; Sebastiaan Overeem Journal: Nat Sci Sleep Date: 2021-06-28