A survey on sleep assessment methods

Abstract

PurposeA literature review is presented that aims to summarize and compare current methods to evaluate sleep.MethodsCurrent sleep assessment methods have been classified according to different criteria; e.g., objective (polysomnography, actigraphy…) vs. subjective (sleep questionnaires, diaries…), contact vs. contactless devices, and need for medical assistance vs. self-assessment. A comparison of validation studies is carried out for each method, identifying their sensitivity and specificity reported in the literature. Finally, the state of the market has also been reviewed with respect to customers’ opinions about current sleep apps.ResultsA taxonomy that classifies the sleep detection methods. A description of each method that includes the tendencies of their underlying technologies analyzed in accordance with the literature. A comparison in terms of precision of existing validation studies and reports.DiscussionIn order of accuracy, sleep detection methods may be arranged as follows: Questionnaire < Sleep diary < Contactless devices < Contact devices < PolysomnographyA literature review suggests that current subjective methods present a sensitivity between 73% and 97.7%, while their specificity ranges in the interval 50%–96%. Objective methods such as actigraphy present a sensibility higher than 90%. However, their specificity is low compared to their sensitivity, being one of the limitations of such technology. Moreover, there are other factors, such as the patient’s perception of her or his sleep, that can be provided only by subjective methods. Therefore, sleep detection methods should be combined to produce a synergy between objective and subjective methods. The review of the market indicates the most valued sleep apps, but it also identifies problems and gaps, e.g., many hardware devices have not been validated and (especially software apps) should be studied before their clinical use.

How Does Fitbit Measure Brainwaves

“…Nevertheless, our study further found that data accuracy, despite of being a key concern in sleep research, is not necessarily a key concern when people assess the credibility of technology. In the domain of sleep medicine, sleep diaries or questionnaires that measure subjective sleep experience are routinely ranked lower than any kind of sleep-tracking devices-either contactless devices, contact devices or PSG-with respect to accuracy [42]. However, our study shows that approximately a third of the participants gave higher credence to their subjective experience over data, and another third acknowledged the importance of both subjectivity and objectivity.…”

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“…However, ESS is still the most used sleepiness score in clinical practice worldwide; for better efficiency, as we did for our SAS score , it is usually combined with other objective measurements [37]. …”

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“…Objective assessment of the usual body activity, in terms of energy consumed, may derive from actigraphy, which is a non-invasive method for monitoring rest/activity cycles. 81 To record physical activity, actigraphy devices (eg, single or multiple axis accelerometers) are usually worn on the wrist to record movements that can be used to estimate wavering parameters with the support of computerized algorithms. Subjective questionnaires may also be useful in order to obtain a different perceptive information, but they show more variability in properties of methodological effectiveness than objective measures, 82 such as accelerometer/activity monitor, as the latter allows examining the motion in free-living environments.…”