Most people have occasional bad nights and many regularly have bad sleep, feel unrefreshed in the morning or feel groggy during the day. Over the past 10-15 years scientific data has linked bad sleep to serious medical disorders includinghypertension/cardiovascular disease，，，，diabetes，，，，mood disorders，，，，总体死亡率乃至obesity。
同时,睡眠不好回答的健康后果e widely reported in news media. Suddenly, poor sleep became a major public concern and millions of people wanted to know if they have a sleep problem. This explosive popular demand presented a great opportunity forconsumer device制造商，他们忠实地做出了回应。数十种声称可以监视/改善睡眠的消费产品可用，费用不到$20。
Medical-Grade Sleep Monitoring
The patient spends a full-night being monitored by >20 sensors that record brain activity, various aspects of breathing, electrocardiogram, limb movements and body position.
The gold standard for sleep evaluation, the in-laboratory polysomnogram, is vastly different to evaluation by consumer products. Here, the patient spends a full-night being monitored by >20 sensors that record brain activity, various aspects of breathing, electrocardiogram, limb movements and body position. The recording is continuously supervised by technologists who can identify and fix technical problems thereby ensuring an adequate study.
The extensive recorded data is reviewed by a highly-trained technologist, a process that takes 1-3 hours, to determine how much time was spent awake and in light, moderate, deep and in REM sleep, number of brief arousals and frank awakenings, presence, number and type of breathing abnormalities, and number of abnormal movements. Body movements, the main monitored parameter in consumer products, play no role in determining quality of sleep in these in-laboratory tests.
医疗设备行业如何响应需求不断增长
最初，医疗设备行业引入了实验室系统的便携式版本用于家庭用途。这些仍然需要专业技术人员应用传感器并为数据评分。成本或等待时间几乎没有下降。
This was followed by several medical-grade systems with limited signals designed specifically for home diagnosis of sleep apnea (Home Sleep Apnea Tests）。These do not require expert technologists to set up at home or to score. However, without brain monitoring, the impact of sleep apnea on sleep quality is not determined. This, along with a high failure/inconclusive rate, has limited the use of these monitors to patients withhigh pre-test probability of moderate/severe sleep apnea。
Based on the idea that people tend to move less when asleep, monitoring of body movement (actigraphy) was evaluated as a cheap, convenient way to monitor sleep quality. Validation studies showed that in normal subjects and insomniacs, actigraphy missed, on average,二-thirds of awake time因为许多患者醒着时一动不动。
相比之下，在某些疾病中，入睡期间有过度运动（例如睡眠呼吸暂停和周期性limb动态）可能会通过up to 200 minutes。由于这些问题，使用动作法来评估临床睡眠医学中的睡眠质量是limited to specific applications。
最后，随着微处理器和digital scoring of the EEG至少有三个可以由患者应用的小型便携式脑监视器，收集的数据是数字评分的最近become可用的。These have the potential of providing high quality, affordable and comprehensive sleep evaluation at home.
消费者睡眠监视器
只要标签指出该设备不打算用于医疗用途，任何事情就会发生。
鼓励早期有关使用行为的报告，运动检测技术的简单性以及缺乏监管要求来验证制造商提出的主张，导致消费者睡眠监测器的扩散。只要标签指出该设备不打算用于医疗用途，任何事情就会发生。
字面上地hundreds of such devices became available，主要由运动探测器组成戴在手腕周围或内部sensorsor智能手机placed under or on top of the mattress. One device employs远程无线电波s to detect motion and breathing pattern.
How Accurate are Consumer Sleep Monitors?
在这些设备的众多设备中，只有少数（n = 7个设备）已进行了针对多个多摄影术的适当验证研究。其中，四个完成了healthy, mostly young, adults，两个healthy children and adolescents，两个失眠patients, and one each in adults withdepression，，，，children with sleep apneaand睡眠呼吸暂停的成年人。
More research is clearly needed to establish validity of other devices, tested under other circumstances, and in other disorders. However, even with the limited information available certain conclusions can be made. More details can be found in二最近的reviews。
- 与艺术学一样，在健康的成年人和失眠或抑郁症的成年人中，消费者设备高估了睡眠时间，并错过了大约三分之二的清醒时间。
- 在健康的儿童和青少年中，高估睡眠时间和缺少清醒时间并不那么突出。有趣的是，这些系统的错误开始出现在13岁左右，并且随着年龄的增长而逐渐增加。这可能是因为，alas，，，，children do not spend much time being quiet when awake at night.
- 即使睡眠/清醒时间的平均结果接近多个多摄影数据，单个结果也可以通过大量数量与实际个人值不同。
- There is no convincing support for the claim that these devices distinguish light from deep sleep or REM from non-REM sleep.
Implications for the Individual Consumer
Consumer products do have a number of positives: they provide useful information in population-wide tracking of bedtime/wake-time patterns, they serve to increase awareness of sleep issues among users and their physicians, and they demonstrate society’s urgent desire to understand and improve sleep – needs that the medical community must address. However, at present, their value as a screening tool for assessing sleep quality in a single individual isquestionable。
由于它们倾向于低估清醒时间，因此，当存在睡眠障碍时，这些设备可能会导致错误的放心。
不应通过声称该设备具有一个平均的agreement of 80% or 90% with polysomnography. What is of relevance to the individual consumer is how much difference may exist between his/her result and the truth. Available data indicate that these differences are sufficiently large that no meaningful information can be obtained with respect to an individual’s sleep quality.
由于它们倾向于低估清醒时间，因此，当存在睡眠障碍时，这些设备可能会导致错误的放心。相反，在不存在疾病的情况下，可能会得分过多。许多人在睡眠期间有良性的身体运动或躺在床上的时间比睡眠需求更长（不是每个人都需要7个小时的睡眠）。
总之,直到成为availabl科学数据e to recommend specific devices for do-it-yourself screening for sleep disorders, it is advisable not to rely on the currently available consumer products. In the meantime, one should seek medical advice if he/she is frequently unrefreshed in the morning or feels sleepy during the day, or if there are indications of disturbances during sleep, such as messy bedcovers in the morning or bedpartner reporting habitual snoring particularly with breathing interruptions, excessive/unusual movement or kicking…etc.
几种消费产品提供的反馈可以改善睡眠。这些主张的有效性取决于评估睡眠质量的准确性，并证明结果从夜晚到夜晚都是一致的。据我所知，没有这样的证据。当以下设备指导必须超过没有指导的更改时，睡眠时间的变化随着遵循指南的重复使用而变化。此外，没有科学的证据表明，在没有任何症状的情况下，将清醒时间减少了几分钟，因为它已经处于正常范围（例如<40分钟）对健康有益。
Why not check out our other guest blog by Dr. Magdy Younes on睡眠分析waking up to the digital age.
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