Validation of photoplethysmography- and acceleration-based sleep staging in a community sample: comparison with polysomnography and Actiwatch

Automatic sleep staging system from wrist PPG + acceleration (MediaTek MT2511 smartwatch) validated in 75 community participants overnight vs PSG and Actiwatch Spectrum Plus. Positions consumer wrist PPG+ACC as potential Actiwatch alternative with multi-stage output.

• Form factor: wrist

Study objectivesAlthough wrist-worn consumer wearables are widely used for home sleep monitoring, few have been validated. It is unclear whether consumer wearables could be an alternative to Actiwatch. This study aimed to establish and validate an automatic sleep staging system (ASSS) utilizing photoplethysmography and acceleration data collected from a wrist-worn wearable device.MethodsSeventy-five participants from a community population underwent overnight polysomnography (PSG) while wearing a smartwatch (MT2511) and Actiwatch Spectrum Plus (Philips Respironics, Inc; Murrysville, PA, USA). Photoplethysmography and acceleration data collected from the smartwatches were utilized to build a 4-stage (wake, light sleep, deep sleep, and rapid eye movement [REM] sleep) classifier, which was validated against PSG. The performance of the sleep/wake classifier was compared with Actiwatch. All analyses were conducted separately for participants with PSG sleep efficiency (SE) ≥ 80% and SE ResultsThe 4-stage classifier and PSG showed fair overall epoch-by-epoch agreement (kappa, 0.55; 95% confidence interval, 0.52 to 0.57). The deep sleep and REM times were comparable between ASSS and PSG, while ASSS underestimated the wake time and overestimated the light sleep time among participants with SE ConclusionsOur photoplethysmography- and acceleration-based ASSS was reliable for participants with SE ≥ 80% and had a smaller bias than Actiwatch among those with SE Clinical trial registrationRegistry: ClinicalTrials.gov; Name: Validation of Sleep Healthcare System; URL: https://clinicaltrials.gov/study/NCT04252482; Identifier: NCT04252482.CitationLiu P-K, Ting N, Chiu H-C, et al. Validation of photoplethysmography- and acceleration-based sleep staging in a community sample: comparison with polysomnography and Actiwatch. J Clin Sleep Med. 2023;19(10):1797-1810.

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