Validation of Consumer and Research-Grade Activity Monitors Against Polysomnography in Healthy Adults

Abstract

Activity monitoring devices claiming to measure sleep have increased in popularity within research and consumer settings. However, validation studies on many of these devices are lacking. We examined twenty-nine healthy adults (Mage = 32.4, SDage = 11.6) overnight using three activity monitors (Actiwatch Spectrum Pro standard and sensitive settings, Fitbit One, Jawbone UP2) and polysomnography. We evaluated agreement between each device and polysomnography on total sleep time (TST) and sleep efficiency (SE). Clinically meaningful limits of agreement were set at ±30 minutes for TST and ±5% for SE. Each activity monitor overestimated TST and SE compared to polysomnography, and except for Actiwatch Spectrum Pro in sensitive setting, exceeded clinically meaningful agreement limits. Using Actiwatch Spectrum Pro sensitive as the gold standard, both consumer devices overestimated TST and SE, but their mean errors were generally not clinically meaningful (except Fitbit One’s error for SE). Actiwatch Spectrum Pro in its sensitive setting may be a valid substitute for polysomnography when measuring TST and SE. Choice of consumer device as an actigraphy replacement will depend on context. Jawbone UP2 shows closer agreement with Actiwatch Spectrum Pro, though Fitbit One demonstrates less variation in TST and SE estimations.

Building the Bridge: Outlining Steps Toward an Applied Sleep-and-Memory Research Program

“…In fact, the last couple of years have seen a stark rise in the use of activity monitors marketed as fitness trackers but also claiming to allow the assessment of sleep quality. Unfortunately, the producers of these trackers do not provide validity assessments, and there is a lack of correspondence between these consumer-grade devices and the gold standard of EEG in the sleep lab (e.g., Jumabhoy et al, 2020). Nevertheless, these devices may be useful in combination with sleep-hygiene measures to track and improve individual sleep quality.…”