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I saw a talk on consumer wearables in sleep at the Sleep Trends conference this spring. There was a great presentation comparing consumer sleep trackers, and ho

by z3ugma 6y ago

I saw a talk on consumer wearables in sleep at the Sleep Trends conference this spring. There was a great presentation comparing consumer sleep trackers, and how their advertised reporting of "accuracy" can be misleading. If you do a thought experiment: let's say I make a "sleep tracker" that is just a piece of plastic, no sensor, and write an algorithm that always presumes the wearer is in stage N2 sleep. Since we spend around 50% of our night in N2 sleep, this algorithm would start with a fairly high baseline accuracy of 50%. Sensitivity and specificity are much better measurements of accuracy, because they measure the false positive and false negative rates. A comparison of Oura against a medical polysomnogram showed that while it's very good at detecting sleep, it's very bad at detecting not sleep: From https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6095823/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6095823/: "ŌURA ring had a 96% sensitivity to detect sleep, and agreement of 65%, 51%, and 61%, in detecting “light sleep” (N1+N2), “deep sleep” (N3),and REM sleep, respectively. Specificity in detecting wake was 48%" The current state of the art in sleep measurement really requires some sort of EEG measurement beyond just PPG and HR, what Oura uses. The Dreem headband is a good example (https://dreem.com/ https://dreem.com/), but it's definitely more cumbersome than a ring. It's tailored more like a medical service for insomnia than for the average consumer interested in quantified self.

marcinzm 6y ago
>It's tailored more like a medical service for insomnia than for the average consumer interested in quantified self. There used to be a EEG headband aimed at the quantified self group (cost $100 or $150) but they went out of business. Probably because for that group a fitbit like tracker was good enough. So I'm guessing the medical side and higher price point is seen as a better business model.
- scrollaway 6y ago
  Last time this came up I mentioned the Dreem headband which is still actively produced.
  - marcinzm 6y ago
    The post I replied to mentioned Dreem but they're at a $500 price point from what I can tell which is beyond the usual non-medical need consumer.
- etrautmann 6y ago
  The Zeo headband fits this description?
sradman 6y ago
Garmin acquired FirstBeat Analytics less than two weeks ago [1]. According to DC Rainmaker, "They power the vast majority of Garmin’s fitness and outdoor training-focused algorithms" but they are also used by other manufacturers. The Garmin's Sleep Stage tracking, powered by FirstBeat Analytics [2], use higher power red LEDs at night. I wonder if OURA uses a separate technique, maybe even transmissive PPG. [1] https://www.dcrainmaker.com/2020/06/garmin-acquires-firstbeat-analytics-a-quick-analysis-of-the-winners-and-losers.html https://www.dcrainmaker.com/2020/06/garmin-acquires-firstbea... [2] https://assets.firstbeat.com/firstbeat/uploads/2019/11/Firstbeat-Sleep-Solution_white-paper_short.pdf https://assets.firstbeat.com/firstbeat/uploads/2019/11/First...
- jerlam 6y ago
  The red LEDs on Garmin watches are used for SpO2 (Pulse Oximeter) tracking, not sleep tracking. They are also generally regarded as terrible[1]. [1] https://www.dcrainmaker.com/2018/06/garmin-fenix5-plus-5s-5x-in-depth-review.html#pulseox https://www.dcrainmaker.com/2018/06/garmin-fenix5-plus-5s-5x...
  - sradman 6y ago
    I was conflating two useful sleep tracking metrics, SpO2 and Sleep Stages, my bad. You are correct, Garmin’s sleep tracking does not require the red LED SpO2 to estimate sleep stages. Since the sleep stage algorithm is Machine Learning derived, it is plausible that SpO2 data could improve sleep stage predictions but that is speculation. I skimmed through the Fenix review you linked to and I didn’t see anything like your “generally regarded as terrible” claim. From the conclusion: > ...adding in Pulse Oximetry support and the ClimbPro bits, to differentiate themselves in a way not seen before. There’s no question this feature is targeted directly at the high-altitude folks that historically would have gone Suunto. Pulse Oximetry in continuous trackers is relatively new and the extra battery consumption may indeed turn out to be an unacceptable trade-off. The Oura was used by the NBA to predict COVID-19 infection. I assumed, therefore, that SpO2 was tracked. It is a useful metric and I find the possibility of having it in a finger ring form factor intriguing.
Youden 6y ago
I own a Dreem V2 headband and though it's more cumbersome than a ring, it's really not a problem. It takes me less than a minute to put it on and activate it each night and though it's a little uncomfortable at first, I got used to it quite quickly. I disagree that it's "more like a medical service for insomnia". The app does have some of your standard CBT stuff in it if you choose to use it but there's also a lot for people without major sleep problems as well. For example there's a sleep schedule function that will give you bedtime reminders and automatically wake you in the morning when you're in a light stage of sleep. As far as data, I'd say that's one of the major focuses of the app. "Sleep reports" (weekly summaries of your sleep habits) are made very prominent in the main screen of the app and contain reasonably comprehensive but very approachable pieces of data. As for accuracy, I've compared various products of various kinds such as under bed, apps and wristbands (though not Oura) and found basically everything but Dreem to be pretty garbage at doing anything more than detecting that I'm laying in a bed. I'm not convinced it's possible to detect that I'm awake but lazily delaying leaving the bed with anything but an EEG.
- Waterfall 6y ago
  What's the point after discovering what helps you sleep? I found out I don't sleep well when there's any extra light, and after that there's little benefit from my sleep tracker, except it's also a fitness tracker that I don't think is cumbersome to keep on. What does the data do for you now? I have a day's worth and then I don't care much after, history isn't very usable or actionable.
  - Youden 6y ago
    If your sleep is absolutely perfect and you never have any issues with energy or anything like that, there probably isn't a point for you. My sleep isn't perfect. I don't have insomnia but I'm terrible at keeping a sleep schedule on my own, I can have trouble falling asleep or I can be woken early for various reasons. The data helps me quantify these problems and act on them. For example I can see that I was bad at adhering to my sleep schedule and try harder. If I didn't have this data I wouldn't know that there was a problem or how bad it was. If I had trouble falling asleep or woke early, I can check the app and see how much sleep I actually got and have an idea of what my energy levels through the coming day are going to be like.

by z3ugma 6y ago

marcinzm 6y ago

>It's tailored more like a medical service for insomnia than for the average consumer interested in quantified self. There used to be a EEG headband aimed at the quantified self group (cost $100 or $150) but they went out of business. Probably because for that group a fitbit like tracker was good enough. So I'm guessing the medical side and higher price point is seen as a better business model.

scrollaway 6y ago
Last time this came up I mentioned the Dreem headband which is still actively produced.
- marcinzm 6y ago
  The post I replied to mentioned Dreem but they're at a $500 price point from what I can tell which is beyond the usual non-medical need consumer.
etrautmann 6y ago
The Zeo headband fits this description?

sradman 6y ago

Garmin acquired FirstBeat Analytics less than two weeks ago [1]. According to DC Rainmaker, "They power the vast majority of Garmin’s fitness and outdoor training-focused algorithms" but they are also used by other manufacturers. The Garmin's Sleep Stage tracking, powered by FirstBeat Analytics [2], use higher power red LEDs at night. I wonder if OURA uses a separate technique, maybe even transmissive PPG. [1] https://www.dcrainmaker.com/2020/06/garmin-acquires-firstbeat-analytics-a-quick-analysis-of-the-winners-and-losers.html https://www.dcrainmaker.com/2020/06/garmin-acquires-firstbea... [2] https://assets.firstbeat.com/firstbeat/uploads/2019/11/Firstbeat-Sleep-Solution_white-paper_short.pdf https://assets.firstbeat.com/firstbeat/uploads/2019/11/First...

jerlam 6y ago
The red LEDs on Garmin watches are used for SpO2 (Pulse Oximeter) tracking, not sleep tracking. They are also generally regarded as terrible[1]. [1] https://www.dcrainmaker.com/2018/06/garmin-fenix5-plus-5s-5x-in-depth-review.html#pulseox https://www.dcrainmaker.com/2018/06/garmin-fenix5-plus-5s-5x...
- sradman 6y ago
  I was conflating two useful sleep tracking metrics, SpO2 and Sleep Stages, my bad. You are correct, Garmin’s sleep tracking does not require the red LED SpO2 to estimate sleep stages. Since the sleep stage algorithm is Machine Learning derived, it is plausible that SpO2 data could improve sleep stage predictions but that is speculation. I skimmed through the Fenix review you linked to and I didn’t see anything like your “generally regarded as terrible” claim. From the conclusion: > ...adding in Pulse Oximetry support and the ClimbPro bits, to differentiate themselves in a way not seen before. There’s no question this feature is targeted directly at the high-altitude folks that historically would have gone Suunto. Pulse Oximetry in continuous trackers is relatively new and the extra battery consumption may indeed turn out to be an unacceptable trade-off. The Oura was used by the NBA to predict COVID-19 infection. I assumed, therefore, that SpO2 was tracked. It is a useful metric and I find the possibility of having it in a finger ring form factor intriguing.

Youden 6y ago

I own a Dreem V2 headband and though it's more cumbersome than a ring, it's really not a problem. It takes me less than a minute to put it on and activate it each night and though it's a little uncomfortable at first, I got used to it quite quickly. I disagree that it's "more like a medical service for insomnia". The app does have some of your standard CBT stuff in it if you choose to use it but there's also a lot for people without major sleep problems as well. For example there's a sleep schedule function that will give you bedtime reminders and automatically wake you in the morning when you're in a light stage of sleep. As far as data, I'd say that's one of the major focuses of the app. "Sleep reports" (weekly summaries of your sleep habits) are made very prominent in the main screen of the app and contain reasonably comprehensive but very approachable pieces of data. As for accuracy, I've compared various products of various kinds such as under bed, apps and wristbands (though not Oura) and found basically everything but Dreem to be pretty garbage at doing anything more than detecting that I'm laying in a bed. I'm not convinced it's possible to detect that I'm awake but lazily delaying leaving the bed with anything but an EEG.

Waterfall 6y ago
What's the point after discovering what helps you sleep? I found out I don't sleep well when there's any extra light, and after that there's little benefit from my sleep tracker, except it's also a fitness tracker that I don't think is cumbersome to keep on. What does the data do for you now? I have a day's worth and then I don't care much after, history isn't very usable or actionable.
- Youden 6y ago
  If your sleep is absolutely perfect and you never have any issues with energy or anything like that, there probably isn't a point for you. My sleep isn't perfect. I don't have insomnia but I'm terrible at keeping a sleep schedule on my own, I can have trouble falling asleep or I can be woken early for various reasons. The data helps me quantify these problems and act on them. For example I can see that I was bad at adhering to my sleep schedule and try harder. If I didn't have this data I wouldn't know that there was a problem or how bad it was. If I had trouble falling asleep or woke early, I can check the app and see how much sleep I actually got and have an idea of what my energy levels through the coming day are going to be like.