Clinical Applications of Mobile Health Wearable–Based Sleep Monitoring: Systematic Review

BACKGROUND: Sleep disorders are a major public health issue. Nearly 1 in 2 people experience sleep disturbances during their lifetime, with a potential harmful impact on well-being and physical and mental health. OBJECTIVE: The aim of this study was to better understand the clinical applications of wearable-based sleep monitoring; therefore, we conducted a review of the literature, including feasibility studies and clinical trials on this topic. METHODS: We searched PubMed, PsycINFO, ScienceDirect, the Cochrane Library, Scopus, and the Web of Science through June 2019. We created the list of keywords based on 2 domains: wearables and sleep. The primary selection criterion was the reporting of clinical trials using wearable devices for sleep recording in adults. RESULTS: The initial search identified 645 articles; 19 articles meeting the inclusion criteria were included in the final analysis. In all, 4 categories of the selected articles appeared. Of the 19 studies in this review, 58 % (11/19) were comparison studies with the gold standard, 21% (4/19) were feasibility studies, 15% (3/19) were population comparison studies, and 5% (1/19) assessed the impact of sleep disorders in the clinic. The samples were heterogeneous in size, ranging from 1 to 15,839 patients. Our review shows that mobile-health (mHealth) wearable–based sleep monitoring is feasible. However, we identified some major limitations to the reliability of wearable-based monitoring methods compared with polysomnography. CONCLUSIONS: This review showed that wearables provide acceptable sleep monitoring but with poor reliability. However, wearable mHealth devices appear to be promising tools for ecological monitoring.