Kang Seung-Gul, Kang Jae Myeong, Ko Kwang-Pil, Park Seon-Cheol, Mariani Sara, Weng Jia
Department of Psychiatry, Gil Medical Center, Gachon University, School of Medicine, Incheon, Republic of Korea.
Department of Psychiatry, Gil Medical Center, Gachon University, School of Medicine, Incheon, Republic of Korea.
J Psychosom Res. 2017 Jun;97:38-44. doi: 10.1016/j.jpsychores.2017.03.009. Epub 2017 Mar 23.
To compare the accuracy of the commercial Fitbit Flex device (FF) with polysomnography (PSG; the gold-standard method) in insomnia disorder patients and good sleepers.
Participants wore an FF and actigraph while undergoing overnight PSG. Primary outcomes were intraclass correlation coefficients (ICCs) of the total sleep time (TST) and sleep efficiency (SE), and the frequency of clinically acceptable agreement between the FF in normal mode (FFN) and PSG. The sensitivity, specificity, and accuracy of detecting sleep epochs were compared among FFN, actigraphy, and PSG.
The ICCs of the TST between FFN and PSG in the insomnia (ICC=0.886) and good-sleepers (ICC=0.974) groups were excellent, but the ICC of SE was only fair in both groups. The TST and SE were overestimated for FFN by 6.5min and 1.75%, respectively, in good sleepers, and by 32.9min and 7.9% in the insomnia group with respect to PSG. The frequency of acceptable agreement of FFN and PSG was significantly lower (p=0.006) for the insomnia group (39.4%) than for the good-sleepers group (82.4%). The sensitivity and accuracy of FFN in an epoch-by-epoch comparison with PSG was good and comparable to those of actigraphy, but the specificity was poor in both groups.
The ICC of TST in the FFN-PSG comparison was excellent in both groups, and the frequency of agreement was high in good sleepers but significantly lower in insomnia patients. These limitations need to be considered when applying commercial sleep trackers for clinical and research purposes in insomnia.
比较商业Fitbit Flex设备（FF）与多导睡眠图（PSG；金标准方法）在失眠症患者和睡眠良好者中的准确性。
参与者在接受夜间PSG检查时佩戴FF和活动记录仪。主要结局指标为总睡眠时间（TST）和睡眠效率（SE）的组内相关系数（ICC），以及正常模式下FF（FFN）与PSG之间临床可接受一致性的频率。比较了FFN、活动记录仪和PSG在检测睡眠时段方面的敏感性、特异性和准确性。
失眠组（ICC = 0.886）和睡眠良好者组（ICC = 0.974）中FFN与PSG之间TST的ICC极佳，但两组中SE的ICC仅为中等。与PSG相比，睡眠良好者中FFN对TST和SE的高估分别为6.5分钟和1.75%，失眠组中分别为32.9分钟和7.9%。失眠组（39.4%）中FFN与PSG可接受一致性的频率显著低于睡眠良好者组（82.4%）（p = 0.006）。FFN与PSG逐时段比较的敏感性和准确性良好，与活动记录仪相当，但两组的特异性均较差。
两组中FFN - PSG比较中TST的ICC均极佳，睡眠良好者的一致性频率较高，但失眠患者显著较低。在将商业睡眠追踪器用于失眠症的临床和研究目的时，需要考虑这些局限性。
