Clinical ReviewFeeling validated yet? A scoping review of the use of consumer-targeted wearable and mobile technology to measure and improve sleep
Introduction
Consumer-targeted fitness devices, most of them containing sleep monitoring capabilities, are rapidly growing in their popularity. Sales of these devices nearly doubled from 2014 to 2015 and grew by 67% in the first quarter of 2016, compared to the previous year [1]. In addition, 72% of U.S. adult consumers report owning a smartphone [2]. Given that sleep monitoring smartphone applications are a top selling category [3], nearly 3 of 4 U.S. consumers have access to a device with the potential to record sleep. Despite most consumer-targeted wearable and mobile sleep tracking technologies being classified as low risk fitness devices rather than medical devices by the Federal Drug Administration (FDA) [4], surveys suggest that sleep is reported as the most interesting health measure to automatically track [5]. Previous reviews have comprehensively evaluated the types of devices, web and mobile applications aimed at consumer sleep [6] as well as the evidence for the validity for monitoring sleep [7] and applications for sleep disorders screening [8]. These reviews demonstrate the large number of devices aimed at estimating sleep and screening for sleep disorders and consistently found relatively sparse published validity data. In many cases, claims of these sleep tracking devices and applications outweigh the evidence to support them.
In this review, we investigate the research literature to determine how these technologies were being used and whether they used as intervention tools for sleep behavior change. We chose to use a scoping review methodology to map and summarize the evidence. Scoping reviews are a type of systematic qualitative review that consists of formalized methods for “mapping” the research in a field. The process includes a well-defined and in depth search strategy as well as processes to identify areas of emphasis and analytical interpretation [9]. This is an appropriate review methodology for a diverse area with insufficient studies to conduct a quantitative review.
Section snippets
Overview
We used the framework for conducting scoping reviews proposed by Arksey and O'Malley [10] and, consistent with the evolving standards for scoping reviews, initiated the review process by developing a protocol that defined our objectives and mapped out our methods [11]. The steps of the review included the following: 1. Defining the research question, 2. Identifying relevant studies, 3 Study selection, 4. Charting the data and 5. Collating, summarizing, and reporting results.
Research question
The main research
Study selection
A flow diagram of the scientific literature search and selection criteria is listed in Fig. 1. The total number of studies included in the analysis, number and reasons for exclusion are included.
Study characteristics
The most common study location was the United States (n = 20) but studies were also based in Canada (n = 1), Europe (UK n = 5, Belgium n = 1, Finland n = 1, Italy n = 1), Australia (n = 3), Israel n = 1, Asia (Korea n = 3, China n = 1, Japan n = 1, India n = 1) and Argentina (n = 1). There were also
Discussion
The purpose of this study was to survey the scientific literature to evaluate the potential for consumer-targeted wearable and mobile sleep monitoring technologies in sleep research and interventions. As wearable and mobile sleep monitoring technologies become more widely used, it is important to understand the opportunities and limitations in the use of these devices. Movements such as the “quantified self” and the “internet of things (IOT)” demonstrate an increasing ability to collect
Conflicts of interest
The authors have no conflicts of interest.
Acknowledgments
This work was supported in part by grants by the National Institute of Health 1K23 HL109110, K08 MH112878 and 5T32 HL007909. We gratefully acknowledge the contribution of Olivia DeYonker in the preparation of this manuscript and to Hrayr Attarian, MD for comments on our manuscript.
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