DOI: 10.1002/alz.

065448

D E M E N T I A C A R E A N D P S YC H O S O C I A L FA C TO R S
PODIUM PRESENTATION

DEMENTIA CARE RESEARCH (RESEARCH PROJECTS; NONPHARMACOLOGICAL)

Validity of a contactless device for long term monitoring of

sleep in a heterogenous group of older men and women

Kiran K.G. Ravindran1,2 Ciro della Monica1,2 Giuseppe Atzori2

Damion Lambert1,2 Victoria Louise Revell1,2 Derk-Jan Dijk2,3

1
UK Dementia Research Institute, Care
Research and Technology Centre, Imperial
College London and the University of Surrey,
Guildford, United Kingdom
2 highly prevalent among people living with dementia (PLWD). To facilitate management
Surrey Sleep Research Centre (SSRC),
University of Surrey, Guildford, United
Kingdom
3
UK Dementia Research Institute, Care
Research and Technology Centre, Imperial
College London, Guildford, United Kingdom
Correspondence
Kiran K.G. Ravindran, UK Dementia Research
InstituteCare Research and Technology
CentreImperial College London and the
University of Surrey, Guildford, United
Kingdom.
Email: k.guruswamyravindran@surrey.ac.uk
Abstract
Background: The incidence of sleep disturbances increases with normal aging and is
and improvement of sleep quality in PLWD, validated unintrusive contactless tech-
nologies for long term objective monitoring of sleep are needed. Here we evaluate the
ability of a contactless sleep tracker to accurately determine Time in Bed (TIB), Wake
vs Sleep and Sleep stages (wake, light, deep, and REM sleep).
Method: We deployed the Emfit (Emfit QS), a contactless sleep tracker placed under
the mattress. The Emfit uses ballistography to estimate respiration and heart rate
and sleep stages. We collected data from 16 participants (Age: Mean-72.12; SD-4.6
years [6F:10M]) at home for a 14-day period followed by a single overnight labora-
tory polysomnography (PSG) sleep assessment. The Emfit outputs a) timeseries at 30
s intervals (four sleep stages) and b) overnight summary sleep parameters. Sleep stag-
ing and sleep parameter estimation by Emfit was compared to, a) in-lab gold standard
PSG, and b) at-home wristworn accelerometer (Actiwatch spectrum (AWS)) and sleep
diary (SD) data. The epoch-to-epoch sleep staging concordance of Emfit was estimated
over the total recording interval (∼10hrs) of the PSG for the laboratory session and
between 1800hrs and 1200hrs for each SD entry for the home recordings. The con-
cordance analysis for the sleep parameters, bed entry and exit times were performed
using the summary data automatically generated by Emfit.
Result: The concordance between the four-class sleep staging of the Emfit and PSG
was poor (Figure 1). The two class (sleep/wake) analysis (Table 1) showed high sleep
classification accuracy (sensitivity) but poor wake classification accuracy (specificity)
compared to PSG. The sleep parameter estimates of Emfit also showed poor agreement
with PSG (Figure 2). The home analysis indicated excellent accuracy for Time in Bed
(TIB) (i.e., the bed entry and exit times) as registered by the SD (Table 2) and total sleep
time (TST) for both sleep diary and AWS (Figure 3).
Conclusion: : The contactless sleep tracker provides accurate information about Time
in Bed (TIB), but there is a lack of consensus of the sleep state classification with the
PSG.

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