Sleep apps: current limitations and challenges

Sleep app ownership is increasing exponentially, due to their accessibility and ease-of-use. However, there are several concerns regarding the use of sleep apps. Few sleep apps demonstrate empirical evidence to support their claims, and if they do, this evidence can be based on significant methodological limitations. In addition, there are data privacy concerns with regards to sleep apps, which share sensitive user data with business and marketing partners, unbeknownst to their users. Moreover, sleep apps may increase engagement with healthcare professionals, which may place additional strain on under-pressure sleep services. This would be compounded by the fact that some sleep apps produce many false positives, and clinicians would need more time to analyze the data provided by these apps. In the future, sleep apps must undergo rigorous validation studies and grant more autonomy to their users over how their data is shared.

Mobile Applications - Validation Study - Smartphone - Polysomnography - Sleep

Publikationsverlauf

Eingereicht: 04. Mai 2020

Angenommen: 14. Juli 2020

Artikel online veröffentlicht:
30. November 2023

• REFERENCES

• 1 Khosla S, Deak MC, Gault D, Goldstein CA, Hwang D, Kwon Y, et al. Consumer sleep technology: an American Academy of Sleep Medicine Position Statement. J Clin Sleep Med. 2018;14(5):877-80.
• 2 IHS Markit. More than six billion smartphones by 2020, IHS Markit Says [Internet]. London: IHS Markit; 2017; [access in 2020 Apr 22]. Available from: https://news.ihsmarkit.com/press-release/technology/ more-six-billion-smartphones-2020-ihs-markit-says
• 3 Sands SA, Owens RL. Does my bed partner have OSA? There’s an app for that!. J Clin Sleep Med. 2014;10(1):79-80.
• 4 Bhopi R, Nagy D, Erichsen D. Can a novel smartphone application detect periodic limb movements?. Stud Health Technol Informat. 2012;182:36-42.
• 5 Khan MN, Nock R, Gooneratne NS. Mobile devices and insomnia: understanding risks and benefits. Curr Sleep Med Rep. 2015 Dec;1(4):226-31.
• 6 Lee-Tobin PA, Ogeil RP, Savic M, Lubman DI. Rate my sleep: examining the information, function, and basis in empirical evidence within sleep applications for mobile devices. J Clin Sleep Med. 2017 Nov;13(11):1349-54.
• 7 Choi YK, Demiris G, Lin SY, Iribarren SJ, Landis CA, Thompson HJ, et al. Smartphone applications to support sleep self-management: review and evaluation. J Clin Sleep Med. 2018 Oct;14(10):1783-90.
• 8 Patel P, Kim JY, Brooks LJ. Accuracy of a smartphone application in estimating sleep in children. Sleep Breath. 2017 May;21(2):505-11.
• 9 Toon E, Davey MJ, Hollis SL, Nixon GM, Horne RSC, Biggs SN. Comparison of commercial wrist- based and smartphone accelerometers, actigraphy, and PSG in a clinical cohort of children and adolescents. J Clin Sleep Med. 2016;12(3):343-50.
• 10 Bhat S, Ferraris A, Gupta D, Mozafarian M, DeBari VA, Gushway- Henry N, et al. Is there a clinical role for smartphone sleep apps? Comparison of sleep cycle detection by a smartphone application to polysomnography. J Clin Sleep Med. 2015 Jul;11(7):709-15.
• 11 Feinberg I, Floyd TC. Systematic trends across the night in human sleep cycles. Psychophysiology. 1979;16(3):283-91.
• 12 Jewett ME, Wyatt JK, Cecco AR, Khalsa SB, Dijk DJ, Czeisler CA. Time course of sleep inertia dissipation in human performance and alertness. J Sleep Res. 1999 Mar;8(1): 1-8.
• 13 Ko PR, Kientz JA, Choe EK, Kay M, Landis CA, Watson NF. Consumer sleep technologies: a review of the landscape. J Clin Sleep Med. 2015;11(12):1455-61.
• 14 French L, Newman E, Hayward S, Polashek D, Gary M. A napping soundtrack can enhance well- being more than traditional relaxation soundtracks. Cognitive Technol. 2008;13(1):27-33.
• 15 Penzel T, Schöbel C, Fietze I. New technology to assess sleep apnea: wearables, smartphones, and accessories. F1000Research. 2018 Mar;7:413.
• 16 Nakano H, Hirayama K, Sadamitsu Y, Toshimitsu A, Fujita H, Shin S, et al. Monitoring sound to quantify snoring and sleep apnea severity using a smartphone: proof of concept. J Clin Sleep Med. 2014;10(1):73-8.
• 17 Sleep Number. Sleep number privacy policy [Internet]. Mineápolis, US: Sleep Number; 2000-2020; [access in 2020 Apr 25]. Available from: https://www.sleepnumber.com/legal-notices/privacy-policy
• 18 Robbins R, Affouf M, Seixas A, Beaugris L, Avirappattu G, Jean-Louis G. Fouryear trends in sleep duration and quality: a longitudinal study using data from a commercially available sleep tracker. J Med Internet Res. 2020;22(2):e14735.
• 19 Deloitte. 2017 Global Mobile Consumer Survey: US Edition [Internet]. New York: Deloitte; 2017; [access in 2020 Jun 7]. Available from: https://www2. deloitte.com/tr/en/pages/technology-media-and- telecommunications/ articles/global-mobile-consumer-survey-us-edition.html
• 20 Grundy Q, Chiu K, Held F, Continella A, Bero L, Holz R. Data sharing practices of medicines related apps and the mobile ecosystem: traffic, content, and network analysis. BMJ. 2019;364:I920.
• 21 Papageorgiou A, Strigkos M, Politou E, Alepis E, Solanas A, Patsakis C. Security and privacy analysis of mobile health applications: the alarming state of practice. IEEE Access. 2018;6:9390-403.
• 22 Appleby J, Kaiser Health News. A wake-up call on smart beds and sleep apps that collect your data. Time [Internet]. 2019 May; [cited 2020 Apr 28]. Available from: https://khn.org/news/a-wake-up-call-on-datacollecting- smart-beds- and-sleep-apps/
• 23 Bietz MJ, Bloss CS, Calvert S, Godino JG, Gregory J, Claffey MP, et al. Opportunities and challenges in the use of personal health data for health research. J Am Med Inform Assoc. 2016 Apr;23(e1):e42-8.
• 24 UK Government. Centre for Data Ethics and Innovation. CDEI Review of online targeting: final report and recommendations [Internet]. London, UK: Open Government Licence v3.0; 2020; [access in 2020 Jun 8]. Available from: https://www.gov.uk/government/ publications/cdei-review-of-online-targeting
• 25 INFOSEC (US). Privacy risks of sleep-tracking devices [Internet]. New York, US: INFOSEC Institute; 2014; [access in 2020 Jun 8]. Available from: https://resources.infosecinstitute.com/privacy-risks-sleep-tracking-devices/
• 26 WIRED (UK). Strava’s data lets anyone see the names (and heart rates) of people exercising on military bases [Internet]. London, UK: WIRED; 2018 Jan; [access in 2020 Apr 28]. Available from: https://www.wired.co.uk/article/strava-military-bases-area-51-mapafghanistan- gchq-military
• 27 He D, Naveed M, Gunter CA, Nahrstedt K. Security Concerns in Android mHealth Apps. AMIA Annu Symp Proc. 2014 Nov;2014:645-54.
• 28 Watson NF, Lawlor C, Raymann, Roy JEM, Choi K. Will consumer sleep technologies change the way we practice sleep medicine?. J Clin Sleep Med. 2019;15(1):159-61.
• 29 NHS (UK). Diagnostic waiting times and activity data. Leeds: NHS; 2017.
• 30 Shin H, Cho J. Unconstrained snoring detection using a smartphone during ordinary sleep. BioMed Eng OnLine. 2014;13:116.
• 31 Kim Y, Lee B, Choe EK. Investigating data accessibility of personal health apps. J Am Med Inform Assoc. 2019;26(5):412-9.
• 32 Khosla S, Deak MC, Gault D, Goldstein CA, Hwang D, Kwon Y, et al. Consumer sleep technologies: how to balance the promises of new technology with evidence-based medicine and clinical guidelines. J Clin Sleep Med. 2019;15(1):163-5.
• 33 Spadafora A. Only one in ten NHS Trusts are fully digitized. TECHRADAR PRO [Internet]. 2019; [cited 2020 Apr 26]. Available from: https://www. techradar.com/uk/news/only-one-in-ten-nhs-trusts-are-fully-digitized
• 34 Kelly JM, Strecker RE, Bianchi MT. Recent developments in home sleep-monitoring devices. ISRN Neurology. 2012;2012:768794.