They Know When You're Awake ; New Generation of Apps and Devices May Provide a Path to Better Sleep

By Miller, Claire Cain | International New York Times, March 12, 2014 | Go to article overview

They Know When You're Awake ; New Generation of Apps and Devices May Provide a Path to Better Sleep


Miller, Claire Cain, International New York Times


A new generation of apps and devices may provide a way to improve sleep.

Computers and mobile devices are enemies of a good night's sleep, interrupting slumber with text alerts and disrupting natural sleep rhythms with their glowing blue screens. But a new generation of apps and devices may also be the way to improve sleep. Manufacturers are coming out with gadgets like cellphone alarm clocks that wake people at the most opportune point in their sleep cycle and heart rate monitors that people strap on at night, part of a broader movement to improve health by quantifying behavior.

While a person can count calories consumed or miles walked without the help of a digital tracking device, it's nearly impossible to track sleep without assistance. Studies have shown that people do not accurately recall night waking, and that the more sleep-deprived they are, the more they underestimate their impairment.

Doctors often focus on diet and exercise and overlook sleep, though it affects things like workplace productivity, driving skills, sociability and weight. Some researchers say the new technology can help focus attention on the problem.

"These devices are really exciting because it's a way of engaging people with interest about their sleep, which has been a challenge on the health behavior front," said Aric A. Prather, an assistant professor of psychiatry at the University of California in San Francisco, who researches the relationship between sleep and stress. "Things improve when the data is at the front of their consciousness."

Yet sleep scientists also warn that the devices could have little more than a placebo effect -- or, worse, endanger patients by masking a sleep disorder that needs medical attention. "A lot of the marketing and claims are not substantiated" by peer-reviewed scientific studies, said Hawley Montgomery-Downs, director of the sleep research laboratory at West Virginia University.

Studies show that consumer sleep-trackers typically can't replicate the experience of patients spending the night in a hospital sleep lab, where electrodes attached to their heads measure things like blood oxygen level and eye movement. Known as polysomnography, this comprehensive recording of the biophysiological changes taking place during sleep is considered the gold standard for sleep studies.

Dr. Montgomery-Downs studied the Fitbit, a wristband that analyzes sleep and exercise by measuring movement, and determined that it overestimated sleep time and quality by mistakenly tracking wakefulness as sleep.

Still, David Claman, director of the sleep disorders center at U.C.S.F. Medical Center at Mount Sinai, said data from sleep- tracking devices could be useful.

"As a sleep specialist, I can't give a person a clean bill of health based on the apps that are available," Dr. Claman said. "But if the device says there's too much movement, I do find that to be a helpful justification to go along with a more detailed sleep study evaluation."

The devices can also encourage behavior modification in healthy people who simply want to improve their sleep, he said, particularly by giving people a more accurate idea of its quantity. …

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