Performance of consumer wearable sleep technology

Consumer sleep technology (CST) is at the core of the ongoing Internet of Things digital health revolution, with about one-third of the US population reporting regular use of CST wearables to track sleep, physical activity, and other health-related indicators. Wearables provides a low-cost and technologically advanced approach to measure sleep over time in free-living conditions, with miniaturized sensors, wireless data transfer protocols, mobile- and cloud-based platform for data management and visualization, and easy integration with other services. The unprecedented amount of data generated by CST has the potential to improve our understanding of sleep and its disorders in natural settings, providing insight into the relationship between sleep, behavior, and health. In parallel with the growing utilization of telemedicine, remote patient monitoring is becoming increasingly relevant in medicine and therefore, the use of CST will likely augment the diagnosis and management of sleep disorders. The ownership of CST by the patient, as opposed to the health system, allows for sleep tracking to take place prior to and between patient-provider interactions, which could transform the current framework of sleep medicine care delivery. Additionally, the use of CST alongside the recording of other health-metrics with digital tools (e.g., blood pressure cuffs, scales, glucometers, mobile apps for symptoms tracking) may ultimately reveal the interactions between sleep and patient comorbidities (e.g., hypertension, diabetes) in ambulatory settings. Despite this potential, CST is largely unregulated and has yet-unsolved intrinsic limitations inherent to a consumer-oriented product. For example, CST lacks major requirements of traditional clinical/research tools, including transparency in the algorithms used, control of, and access to raw data. The scientific community has been actively examining the performance of CST, considering these limitations, and continues to provide guidance on how to move forward with CST in basic and clinical sleep research. Here, we discuss performance, rationale, theoretical and practical guidelines for testing and using wearable CST.