Validity and clinical utility of a wrist-worn device against polysomnography

腕戴式设备与多导睡眠图相比的有效性和临床实用性

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Abstract

OBJECTIVE: Sleep-wearable technology has developed rapidly. However, few carried out validation in the real clinical settings. This study aimed to validate the performance of a consumer-grade sleep-tracking device compared to polysomnography (PSG) in participants from sleep clinics. METHODS: Participants referred to sleep clinic from 2021 to 2023 were recruited. Demographics and sleep questionnaires were also collected. All participants completed the PSG test in a sleep laboratory, along with a smart watch (HUAWEI WATCH GT2) that collected movement and heart rate signals using built-in sensors. Epoch-by-epoch agreement analysis and the Bland-Altman method were applied to evaluate the performance of smart watch. RESULTS: 98 participants were included in this study. 82 of them were men, with a mean age of 45.3 ± 10.6 years. The smart watch had a high sensitivity (95.9%), accuracy (87.3%), positive predictive value (72.2%), and relatively low specificity (47.9%) for sleep/wake performance. Sleep staging comparisons were mixed. Comparing to PSG, although smart watch tended to overestimate total sleep time (+28.7 min, P = 0.001), sleep efficiency (+5.94%, P < 0.001), sleep onset latency (+8.53 min, P < 0.001) and underestimate wake after sleep onset (-37.00 min, P < 0.001), acceptable agreement was observed in sleep/wake detection (Kappa coefficient>0.4), total sleep time and sleep efficiency (intraclass correlation coefficient>0.4). This agreement was less satisfactory in patients with OSA or insomnia. CONCLUSION: This study compared the performance of a consumer-grade sleep-tracking device with that of PSG. The HUAWEI WATCH GT2 exhibited high agreement in sleep/wake detection. Such devices could be used as alternatives for successive sleep detection and could provide significant benefits to sleep hygiene with more advanced algorithms in the future.

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