Insufficient sleep is common: almost 30% of adults in the United States report sleeping six or fewer hours per day. Inadequate sleep can cause symptoms of drowsiness, drowsy driving, fatigue, irritability, incoordination, and attention deficits; and is associated with heart disease, obesity, and increased mortality.
The National Sleep Foundation recommends that adults aged 18 to 64 years sleep seven to nine hours per night . For those 65 years of age and older, seven to eight hours is recommended. Infants, children, and teenagers require more sleep than adults.
Maiaa, et al found that 3.6% of people in the general population reported incidences of drowsy driving (defined as nodding off or falling asleep, even just for a brief moment) during the past 30 days. People who slept less than 6 hrs per night were 1.9-2.0 times more likely to report drowsy driving than 7 hour sleepers, and people who slept less than 5 hrs were 3.6-3.8 more likely .
A frequent sleep disorder is sleep apnea (interrupted breathing), which affects an estimated 22 million Americans. People with sleep apnea may snore and gasp for air throughout the night, causing chronic sleepiness and increasing their risk of heart disease, hypertension, Type 2 diabetes, depression, and erectile dysfunction. Sleep apnea has been reported to be the single most important preventable medical cause of excessive daytime sleepiness and driving accidents.
The most common type of sleep apnea is known as obstructive sleep apnea. This occurs when the upper airway collapses in on itself due to low muscle tone during sleep, preventing air from reaching the lungs. This can result in frequent potentially dangerous pauses in breathing while asleep termed apnea, which in turn may cause oxygen levels to drop, and blood pressure and heart rate to rise. Loud snoring and waking may occur because of the struggle to breathe.
The American Sleep Apnea Association developed a screening quiz for sleep apnea :
- Are you a loud or regular snorer?
- Have you ever been observed to gasp or stop breathing during sleep?
- Do you feel tired or groggy when you wake up? Do you wake up with a headache?
- Are you often tired or fatigued during the day?
- Do you fall asleep while sitting, reading, watching television or driving?
- Do you often have problems concentrating or remembering things?
Furthermore, the American Sleep Apnea Association states:
People with these symptoms should discuss them with their healthcare provider and consider sleep testing.
The quality and quantity of sleep can be assessed by questionnaire and sleep log. A more objective assessment of sleep can be obtained with actigraphy. Actigraphy records movement sensed by an accelerometer usually worn on the wrist at home. Actigraphy is well validated and correlates with formal sleep studies done in a sleep lab. It provides useful information about sleep duration and sleep quality.
Actigraphy equipment can be obtained from a sleep specialist for short term testing at home. Alternatively, people with more chronic sleep conditions can purchase a device worn on the wrist for home use called Actiwatch actigraphy system manufactured by Phillips.
In recent years multiple manufacturers have developed Consumer Sleep Technology (CST) devices that purport to assess sleep, and are available at lower cost than the Actiwatch system. However, it is important that these devices be validated for the measurment and analysis of sleep-wake periods.
The American Academy of Sleep Medicine (AASM) has released a position statement about Consumer Sleep Technology :
In another study, Lee et al compared Fitbit Charge HR to the Actiwatch 2 in 16 healthy young adults . They found that:
An alternative to wearing a watch, The SleepScore Max by ResMed is a non-contact, bedside device that uses ultra-low power radiofrequency (RF) 100 times lower than that of a standard mobile phone to detect motion, and thus does not affect user comfort while sleeping. It detects sub-millimeter movements of the chest wall and can monitor movement and respiration without direct contact with the subject. With this technology, the device can identify sleep stages including wake, light sleep, deep sleep, and REM.
The SleepScore Max was validated by an independent sleep laboratory in 38 healthy individuals in 2018. Prelimary results are published on the SleepScore website .
A novel consumer wearable device for sleep is the Beddr SleepTuner. This device is an FDA listed product that is designed to help people analyze their beathing during sleep particularly in relation to sleeping position. It is a small device that is worn on the forehead during sleep, and monitors blood oxygen levels, heart rate, and stopped breathing events in relation to body position.
This device is a :
… wellness oximeter, a non-invasive overnight recording device that measures and displays functional oxygen saturation of
arterial hemoglobin (SpO2), stopped breathing events per hour, Heart Rate (HR), sleeping position and movement.
…The SleepTuner works in conjunction with an application that runs on a mobile phone.
2. Short and long sleep duration and risk of drowsy driving and the role of subjective sleep insufﬁciency. Maiaa Q, Grandnera MA, Findleya J, Gurubhagavatulaa I. Accident Analysis and Prevention 59(2013) 618-622.
4. Khosla S, Maryann C. Deak MC, Gault D, et al. Consumer Sleep Technology: An American Academy of Sleep Medicine Position Statement. J Clin Sleep Med. 2018 May 15; 14(5): 877–880.15.
5. Comparison of Wearable Activity Tracker with Actigraphy for Sleep Evaluation and Circadian Rest-Activity Rhythm Measurement in Healthy Young Adults. Hyun-Ah Lee, Heon-Jeong Lee1, Joung-Ho Moon, Taek Lee, Min-Gwan Kim, Hoh In, Chul-Hyun Cho, and Leen Kim. Psychiatry Investig 2017;14(2):179-185
7. Non-Contact Estimation of Sleep Staging. Zaffaroni A, Doheny DP, Gahan L, et al. EMBEC 2017, NBC 2017: pp 77-80.
8. O’Hare E, Flannagan D, Penzel T, et al. A comparison of radio-frequency biomotion sensors and actigraphy versus polysomnography for the assessment of sleep in normal subjects. Sleep Breath 2015 19:91-98.
Disclaimer: Since healthcare is complicated and personal, you should discuss these topics with your healthcare provider before applying this information to your own health. This website does not intend to diagnose or treat any disease or medical condition. Its only purpose is to assist people to monitor their health at home under the supervision of their healthcare provider.