Sleep Tracking of Two Smartwatches Against Self-Reported Logs for Circadian Rhythm and Sleep Quality Assessment in Healthy Adults

Abstract

Objectives: Although many wearable devices are used to assess sleep, their accuracy remains controversial. This study aimed to investigate the accuracy of the Actiwatch, a research-grade device, and the Fitbit, a consumer-grade device, against sleep diaries to assess sleep patterns. Methods: Twenty participants wore Fitbit and Actiwatch for two weeks and tracked their sleep patterns using sleep diaries. Total sleep time (TST), time-in-bed (TIB), sleep efficiency (SE), sleep onset latency (SOL), and wake after sleep onset (WASO) from the two devices and sleep diaries were analyzed using analysis of variance and Bland-Altman analysis. Results: The TIB measured by the sleep log, Fitbit, and Actiwatch were 420.9 minutes, 417.3 minutes, and 567.4 minutes, respectively. Compared to the sleep log, the Fitbit underestimated TST, TIB, and SE, with significant differences observed for TST (<i>p</i><0.001) and SE (<i>p</i><0.001), but not for TIB. The Actiwatch overestimated TIB (<i>p</i><0.001) and TST (<i>p</i>=0.02) and underestimated SE (<i>p</i><0.001) compared to the sleep log. The difference between the Fitbit and Actiwatch was significant for TST, TIB, and SE (all <i>p</i><0.001). Conclusions: The Fitbit showed a smaller difference than the Actiwatch when compared with the sleep logs. The Fitbit could be used as a tool to assess sleep patterns in the clinic as well as in daily life.