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 Still, the technologies are generating consumer interest in sleep
quality, which is a positive trend, the AASM board of directors
writes in the Journal of Clinical Sleep Medicine.
"Patients bring in their devices and want to know what the numbers
mean and how we can help," said the statement's lead author Dr.
Seema Khosla, chief medical officer of the North Dakota Center for
Sleep in Fargo.
"Sleep is too important to ignore," she said in a telephone
interview. "The effects spill into every organ system."
Consumer devices and apps can help patients initially understand
their sleep concerns and spur conversations with doctors, Khosla's
team writes. However, they haven't been rigorously tested for
accuracy against the professional equipment in sleep clinics, and
they can't replace a medical evaluation.
"Patients often have anxiety when they search online for questions
about their data," Khosla said. "We want to partner with patients to
understand what they're concerned about, what their symptoms are and
what we can do."
Since most devices and apps are sold in the lifestyle/entertainment
category, they don't require regulatory approval or oversight. The
technologies claim to track and define sleep-related metrics such as
number of hours asleep, as well as movement and restlessness
overnight.
But clinicians can't really use this information since the
technologies haven't been validated. Also, the data aren't
standardized from one device or app to the next and aren't available
for doctors to analyze directly. In addition, sleep apps don't tend
to use the latest research data or national guidelines to back up
their recommendations, the authors note.
"Over time, we've learned that bad data is worse than no data,"
Khosla said. "Patients will come to me with concerns about the
number of times they woke up or how much deep sleep they got, but
once we look at the numbers and talk, we see that it's actually
quite normal."
The statement encourages doctors to be aware of consumer sleep
technologies and open to discussing the data with patients.
"We don't get enough sleep in our country, and I'm tickled that more
people are taking interest in their sleep," Khosla said. "I consider
it a win, and we need to help patients understand how to interpret
their data."
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In the future, sleep devices and apps could provide long-term data
for sleep research, allow doctors to review patients' sleep data
remotely between office visits and become part of electronic medical
records, the statement points out. Of course, this also comes with
privacy concerns for patient data, and unvalidated numbers could be
added to patient charts without doctors' prior review.
"Guidelines from an academic and clinical organization like the AASM
are a timely and welcome step in the right direction," said Dr.
Sushanth Bhat of the Division of Sleep Medicine at Hackensack
Meridian Health-JFK Medical Center in Edison, New Jersey, who wasn't
involved in the AASM statement.
Bhat and colleagues previously studied volunteers who had
in-laboratory polysomnography while using a sleep app. They found
the app's results didn't correlate with the professional equipment
for sleep efficiency, light sleep, deep sleep or the time it took to
fall asleep. It was highly accurate in sleep-wake detection but
wasn't great with specific data.
"Inexpensive consumer-oriented sleep technology will undoubtedly
have an important role to play in the future," Bhat told Reuters
Health by email. "It is crucial that consumers remember that they do
not take the place of a formal evaluation."
Dr. Lee Brooks of the Children's Hospital of Philadelphia similarly
found discrepancies between a sleep app for children and sleep-lab
results in an earlier study. "Consumers should consider their
numbers an estimate," said Brooks, who wasn't involved with the AASM
statement.
"If you're feeling terrific, awake and alert, don't create a problem
where none exists," he said by phone. "But if you're regularly
feeling sleepy or cranky, you may want to follow up on your
numbers."
SOURCE: https://bit.ly/2kj5PZW Journal of Clinical Sleep Medicine,
online May 15, 2018.
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