Study Objectives To compare the 24-hour sleep assessment capabilities of two contactless sleep technologies (CSTs) to actigraphy in community-dwelling older adults. Methods We collected 7 to 14 days of data at home from 35 older adults (age: 65-83), some with medical conditions, using Withings Sleep Analyser (WSA, n=29), Emfit-QS (Emfit, n=17), a standard actigraphy device (Actiwatch Spectrum [AWS, n=34]) and a sleep diary. We compared nocturnal and daytime sleep measures estimated by the CSTs and actigraphy without sleep diary information (AWS-A) against sleep diary assisted actigraphy (AWS|SD). Results Compared to sleep diary, both CSTs accurately determined the timing of nocturnal sleep (ICC: going to bed, getting out of bed, time in bed > 0.75) whereas the accuracy of AWS-A was much lower. Compared to AWS|SD, the CSTs overestimated nocturnal total sleep time (WSA: +92.71±81.16 min; Emfit: +101.47±75.95 min) as did AWS-A (+46.95±67.26 min). The CSTs overestimated sleep efficiency (WSA: +9.19±14.26 %; Emfit: +9.41±11.05 %) whereas AWS-A estimate (-2.38±10.06 %) was accurate. About 65% (n=23) of participants reported daytime naps either in-bed or elsewhere. About 90% in-bed nap periods were accurately determined by WSA while Emfit was less accurate. All three devices estimated 24-h sleep duration with an error of ≈10% compared to the sleep diary. Conclusions CSTs accurately capture the timing of in-bed nocturnal sleep periods without the need for sleep diary information. However, improvements are needed in assessing parameters such as total sleep time, sleep efficiency and naps before these CSTs can be fully utilized in field settings.

Background: Nocturnal disturbance is frequently observed in dementia and is a major contributor to institutionalisation. Unobtrusive technology that can quantify sleep/wake and determine bed occupancy during the major nocturnal sleep episode may be beneficial for long-term clinical monitoring and the carer. Such technologies have, however, not been validated in older people. Here we assessed the performance

Contactless sleep technologies hold promise for longitudinal, unobtrusive sleep monitoring in health and disease at scale, but few have been evaluated in older people. The performance of three contactless sleep technologies (a bedside radar [Somnofy] and two under-mattress devices [Withings sleep analyser and Emfit-QS]) were compared to polysomnography and actigraphy [Actiwatch Spectrum] in a sleep laboratory study during a 10-hour time in bed period which induced mild sleep disturbance. The data were collected in a group of older men and women (n=35; 70.8±4.9 years; 14 women) several of whom had health problems and/or sleep apnoea. We conducted a comprehensive and rigorous evaluation of the devices involving estimation of robust performance metrics (both sleep summary and epoch by epoch concordance) for classification of sleep vs wake and NREM and REM sleep stages. All devices overestimated total sleep time and the sleep stage estimation was unsatisfactory in this group of older people in whom sleep efficiency was relatively low. Our findings indicate that even though these devices provide some useful information on sleep behaviour, the performance of contactless sleep technologies requires improvement before they can serve as an alternative to polysomnography and actigraphy for estimating most sleep variables in older individuals.