Consumer Sleep Technologies: A Review of the Landscape

Abstract

Objective: To review sleep related consumer technologies, including mobile electronic device "apps," wearable devices, and other technologies. Validation and methodological transparency, the effect on clinical sleep medicine, and various social, legal, and ethical issues are discussed. C onsumer sleep technologies (CSTs) are increasingly popular computer-based systems available to the general public for the purpose of improving or self-monitoring sleep. Their primary goals include sleep induction, wake induction, selfguided sleep assessment, entertainment, social connection, information sharing, and sleep education. There is scant literature discussing these technologies.1,2 Despite a paucity of clinical validation with traditional sleep technologies (e.g., polysomnography (PSG), multiple sleep latency testing (MSLT), and clinical-grade actigraphy), CSTs are here to stay because of their innovative nature, convenience, and affordability.Although adoption rates are not available, sleep-tracking products such as Fitbit and Jawbone are top sellers in consumer health products.3,4 The highest-funded health device on Kickstarter was a sleep monitor, which garnered more than $2.4 million in fi nancial backing. 5 A recent search for "sleep" in the Apple iTunes app store returned over 500 different sleep related applications, or "apps," available for download 6 ; similar searches on Android and Microsoft's app stores return hundreds of results. 7,8 Certain apps boast more than fi ve million downloads; one of the top fi ve paid apps in 2014 on iTunes was a sleep tracker and alarm clock. 9 We use the metaphor "over-the-counter" to describe these CSTs, because they are mostly available without a prescription or clinical guidance. Clinical sleep specialists should be aware of these increasingly popular technologies, as patients may request interpretation of derived data. This paper aims to provide a general overview of CSTs and their potential social, ethical, legal, and clinical effect. Although rapid development of these technologies obviates an exhaustive review, we outline some of the more popular, illustrative, or innovative technologies to give sleep specialists an idea of the recent landscape. Consumer Sleep Technologies: A Review of the Landscape METHODSWe searched PubMed and the digital libraries of the Association for Computing Machinery and Institute of Electrical and Electronics Engineers (where technology developers publish peer-reviewed articles), with search terms including "sleep technology," "sleep app," and "sleep monitoring." We eliminated articles that were not relevant to sleep (e.g., applications for controlling a computer's hibernation mode). We ran similar searches on Google, specifi cally focusing on consumer technology-related websites such as MIT Technology Review, 10

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