Abstract

Improving our understanding of sleep physiology and pathophysiology is an important goal for both medical and general wellness reasons. Although the gold standard for assessing sleep remains the laboratory polysomnogram, there is an increasing interest in portable monitoring devices that provide the opportunity for assessing sleep in real-world environments such as the home. Portable devices allow repeated measurements, evaluation of temporal patterns, and self-experimentation. We review recent developments in devices designed to monitor sleep-wake activity, as well as monitors designed for other purposes that could in principle be applied in the field of sleep (such as cardiac or respiratory sensing). As the body of supporting validation data grows, these devices hold promise for a variety of health and wellness goals. From a clinical and research standpoint, the capacity to obtain longitudinal sleep-wake data may improve disease phenotyping, individualized treatment decisions, and individualized health optimization. From a wellness standpoint, commercially available devices may allow individuals to track their own sleep with the goal of finding patterns and correlations with modifiable behaviors such as exercise, diet, and sleep aids.

Highlights

  • The laboratory polysomnogram (PSG) has long been the gold standard for assessing sleep physiology in health and disease

  • The PSG has proven most useful for the diagnosis and treatment of obstructive sleep apnea (OSA), less common disorders are readily identified by laboratory PSG, including narcolepsy, rapid-eye-movement (REM) sleep behavior disorder, non-REM parasomnias, and periodic limb movements of sleep

  • We do not review devices used for detection or diagnosis of sleep apnea [1], nor do we review standard actigraphy devices [7]

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Summary

Introduction

The laboratory polysomnogram (PSG) has long been the gold standard for assessing sleep physiology in health and disease. Commercially available movement-based sleep monitors are growing increasingly common in the consumer wellness market The utility of such devices in a medically unregulated fashion remains uncertain. The personal wellness goal of sleep-monitoring in order to optimize health stands to be achieved through longitudinal monitoring and self-tracking This goal is served by portable monitoring in a variety of contexts outside of the field of sleep medicine (for review, see [6]). The present paper reviews recent developments in the area of devices that can be used for home-based sleep assessment, some of which are currently available for direct purchase in the wellness market. Validation information is provided (see Section 7 for further comments on the metrics of sensitivity, specificity, and accuracy) These devices are grouped into categories based on the type of data collected. This paper is not intended to endorse any particular device or to advise readers medically regarding diagnostics or therapeutics; it is important to recognize that nonrefreshing sleep can be associated with numerous medical and psychiatric conditions, and physician consultation is suggested for concerned readers

Sleep-Monitoring Based on Brain Activity Signals
Sleep-Monitoring Based on Autonomic Signals
Sleep-Monitoring Based on Movement
Bed-Based Sleep Monitors
Findings
Other Devices with Potential for Sleep Monitoring
Discussion
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