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      The Sleep of the Ring: Comparison of the ŌURASleep TrackerAgainst Polysomnography

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          Abstract

          Objective/Background.

          Toevaluate the performance of a multi-sensor sleep-tracker (ŌURA ring) against polysomnography (PSG) in measuring sleep and sleep stages.

          Participants.

          Forty-one healthy adolescents and young adults (13 females; Age: 17.2±2.4y).

          Methods.

          Sleep data were recorded using the ŌURA ring and standard PSG on a single laboratory overnight. Metrics were compared using Bland-Altman plots and epoch-by-epoch (EBE) analysis.

          Results.

          Summary variables for sleep onset latency (SOL), total sleep time (TST) and wake after sleep onset (WASO) were not different between ŌURA ring and PSG. PSG-ŌURA discrepancies for WASO were greater in participants with more PSG-defined WASO (p<.001). Compared with PSG, ŌURA ring underestimated PSG N3 (~20 min) and overestimated PSG REM (~17 min) (p<.05). PSG-ŌURA differences for TST and WASO lay within the ≤30 min a-priori-set clinically satisfactory ranges for 87.8% and 85.4% of the sample, respectively. From EBE analysis, ŌURA ring had a 96% sensitivity to detect sleep,and agreement of 65%, 51%, and 61%, in detecting “light sleep” (N1+N2), “deep sleep” (N3),and REM sleep, respectively. Specificity in detecting wake was 48%. Similarly to PSG-N3 (p<.001), “deep sleep” detected with the ŌURA ring was negatively correlated with advancing age (p=.001). ŌURA ring correctly categorized 90.9%, 81.3%, and 92.9% into PSG-defined TST ranges of <6h, 6–7h, >7h, respectively.

          Conclusions.

          Multi-sensor sleep trackers, such as the ŌURA ringhave the potential for detecting outcomes beyond binary sleep/wake using sources of informationin additionto motion. While these first results could be viewed as promising, future development and validation is needed.

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          Most cited references24

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          Objective measurements of sleep for non-laboratory settings as alternatives to polysomnography--a systematic review.

          Sleep disturbance influences human health. To examine sleep patterns, it is advisable to utilize valid subjective and objective measures. Laboratory-based polysomnography (PSG) is deemed the gold standard to measure sleep objectively, but is impractical for long-term and home utilization (e.g. resource-demanding, difficult to use). Hence, alternative devices have been developed. This study aimed to review the literature systematically, providing an overview of available objective sleep measures in non-laboratory settings as an alternative to PSG. To identify relevant articles, a specific search strategy was run in EMBASE, PubMed, CINAHL, PsycInfo and Compendex (Engineering Village 2). In addition, reference lists of retrieved articles were screened and experts within this research field were contacted. Two researchers, using specified in/exclusion criteria, screened identified citations independently in three stages: on title, abstract and full text. Data from included articles were extracted and inserted into summarizing tables outlining the results. Of the 2217 electronically identified citations, 35 studies met the inclusion criteria. Additional searches revealed eight papers. Psychometric characteristics of nine different objective measures of sleep pattern alternatives to PSG [(bed) actigraphy, observation, bed sensors, eyelid movement- and non-invasive arm sensors, a sleep switch and a remote device] were evaluated. Actigraphy is used widely and has been validated in several populations. Alternative devices to measure sleep patterns are becoming available, but most remain at prototype stage and are validated insufficiently. Future research should concentrate on the development and further validation of non-invasive, inexpensive and user-friendly sleep measures for non-laboratory settings. © 2010 European Sleep Research Society.
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            Adolescent changes in the homeostatic and circadian regulation of sleep.

            Sleep deprivation among adolescents is epidemic. We argue that this sleep deprivation is due in part to pubertal changes in the homeostatic and circadian regulation of sleep. These changes promote a delayed sleep phase that is exacerbated by evening light exposure and incompatible with aspects of modern society, notably early school start times. In this review of human and animal literature, we demonstrate that delayed sleep phase during puberty is likely a common phenomenon in mammals, not specific to human adolescents, and we provide insight into the mechanisms underlying this phenomenon.
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              Is Open Access

              Reliability of Sleep Measures from Four Personal Health Monitoring Devices Compared to Research-Based Actigraphy and Polysomnography

              Polysomnography (PSG) is the “gold standard” for monitoring sleep. Alternatives to PSG are of interest for clinical, research, and personal use. Wrist-worn actigraph devices have been utilized in research settings for measures of sleep for over two decades. Whether sleep measures from commercially available devices are similarly valid is unknown. We sought to determine the validity of five wearable devices: Basis Health Tracker, Misfit Shine, Fitbit Flex, Withings Pulse O2, and a research-based actigraph, Actiwatch Spectrum. We used Wilcoxon Signed Rank tests to assess differences between devices relative to PSG and correlational analysis to assess the strength of the relationship. Data loss was greatest for Fitbit and Misfit. For all devices, we found no difference and strong correlation of total sleep time with PSG. Sleep efficiency differed from PSG for Withings, Misfit, Fitbit, and Basis, while Actiwatch mean values did not differ from that of PSG. Only mean values of sleep efficiency (time asleep/time in bed) from Actiwatch correlated with PSG, yet this correlation was weak. Light sleep time differed from PSG (nREM1 + nREM2) for all devices. Measures of Deep sleep time did not differ from PSG (SWS + REM) for Basis. These results reveal the current strengths and limitations in sleep estimates produced by personal health monitoring devices and point to a need for future development.
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                Author and article information

                Journal
                101149327
                32171
                Behav Sleep Med
                Behav Sleep Med
                Behavioral sleep medicine
                1540-2002
                1540-2010
                27 July 2018
                21 March 2017
                Mar-Apr 2019
                21 September 2018
                : 17
                : 2
                : 124-136
                Affiliations
                1. Center for Health Sciences, SRI International, Menlo Park, CA, USA
                2. Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
                3. Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
                Author notes
                [* ] Corresponding author: Massimiliano de Zambotti, PhD, SRI International, 333 Ravenswood Avenue, Menlo Park, CA, 94025. massimiliano.dezambotti@ 123456sri.com
                Article
                PMC6095823 PMC6095823 6095823 nihpa1500634
                10.1080/15402002.2017.1300587
                6095823
                28323455
                1b8a0162-dada-4d39-885e-cb45cd32c464
                History
                Categories
                Article

                adolescence,wearables,actigraphy,Polysomnography,Multisensory

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