Sleep-tracking devices and mobile apps can help engage users in improving sleep health

By Carolyn Crist

(Reuters Health) – Sleep-tracking devices and mobile apps can help engage users in improving sleep health, but none of the consumer technologies has been proven accurate or validated to screen for sleep disorders, the American Academy of Sleep Medicine said in a new statement.

Still, the technologies are generating consumer interest in sleep quality, which is a positive trend, the AASM board of directors writes in the Journal of Clinical Sleep Medicine.

“Patients bring in their devices and want to know what the numbers mean and how we can help,” said the statement’s lead author Dr. Seema Khosla, chief medical officer of the North Dakota Center for Sleep in Fargo.

“Sleep is too important to ignore,” she said in a telephone interview. “The effects spill into every organ system.”

Consumer devices and apps can help patients initially understand their sleep concerns and spur conversations with doctors, Khosla’s team writes. However, they haven’t been rigorously tested for accuracy against the professional equipment in sleep clinics, and they can’t replace a medical evaluation.

“Patients often have anxiety when they search online for questions about their data,” Khosla said. “We want to partner with patients to understand what they’re concerned about, what their symptoms are and what we can do.”

Since most devices and apps are sold in the lifestyle/entertainment category, they don’t require regulatory approval or oversight. The technologies claim to track and define sleep-related metrics such as number of hours asleep, as well as movement and restlessness overnight.

But clinicians can’t really use this information since the technologies haven’t been validated. Also, the data aren’t standardized from one device or app to the next and aren’t available for doctors to analyze directly. In addition, sleep apps don’t tend to use the latest research data or national guidelines to back up their recommendations, the authors note.

“Over time, we’ve learned that bad data is worse than no data,” Khosla said. “Patients will come to me with concerns about the number of times they woke up or how much deep sleep they got, but once we look at the numbers and talk, we see that it’s actually quite normal.”

The statement encourages doctors to be aware of consumer sleep technologies and open to discussing the data with patients.

“We don’t get enough sleep in our country, and I’m tickled that more people are taking interest in their sleep,” Khosla said. “I consider it a win, and we need to help patients understand how to interpret their data.”

In the future, sleep devices and apps could provide long-term data for sleep research, allow doctors to review patients’ sleep data remotely between office visits and become part of electronic medical records, the statement points out. Of course, this also comes with privacy concerns for patient data, and unvalidated numbers could be added to patient charts without doctors’ prior review.

“Guidelines from an academic and clinical organization like the AASM are a timely and welcome step in the right direction,” said Dr. Sushanth Bhat of the Division of Sleep Medicine at Hackensack Meridian Health-JFK Medical Center in Edison, New Jersey, who wasn’t involved in the AASM statement.

Bhat and colleagues previously studied volunteers who had in-laboratory polysomnography while using a sleep app. They found the app’s results didn’t correlate with the professional equipment for sleep efficiency, light sleep, deep sleep or the time it took to fall asleep. It was highly accurate in sleep-wake detection but wasn’t great with specific data.

“Inexpensive consumer-oriented sleep technology will undoubtedly have an important role to play in the future,” Bhat told Reuters Health by email. “It is crucial that consumers remember that they do not take the place of a formal evaluation.”

Dr. Lee Brooks of the Children’s Hospital of Philadelphia similarly found discrepancies between a sleep app for children and sleep-lab results in an earlier study. “Consumers should consider their numbers an estimate,” said Brooks, who wasn’t involved with the AASM statement.

“If you’re feeling terrific, awake and alert, don’t create a problem where none exists,” he said by phone. “But if you’re regularly feeling sleepy or cranky, you may want to follow up on your numbers.”

SOURCE: Journal of Clinical Sleep Medicine, online May 15, 2018.