Fitness bracelets with sleep trackers: gadgets that can harm your health

By Yraa #able, #according, #accordingly, #accuracy, #activity, #actually, #add, #affected, #afternoon, #age, #allowed, #allows, #almost, #already, #although, #another, #any, #anything, #apnea, #arises, #asleep, #available, #average, #awake, #awakening, #based, #basis, #bed, #been, #begin, #begins, #being, #blood, #Body, #both, #breathing, #bring, #called, #calm, #cannot, #center, #century, #chin, #claims, #Clinical, #closed, #collected, #come, #compared, #complaints, #concluded, #condition, #conducted, #confirmed, #content, #cope, #correspond, #countries, #cycles, #daily, #daytime, #decreases, #deep, #designed, #determine, #determining, #developed, #Device, #devices, #did, #different, #difficulties, #doctors, #dreams, #duration, #each, #easier, #easily, #effectiveness, #elderly, #enough, #equipment, #equipped, #even, #every, #everything, #evidence, #example, #experiment, #expert, #experts, #Eye, #Eyes, #fact, #fairly, #fall, #fast, #faster, #few, #find, #fitness, #focused, #found, #frequent, #friday, #full, #gadgets, #general, #gets, #give, #gland, #Good, #Growth, #half, #harm, #he, #head, #health, #Healthy, #heart, #help, #helped, #Helps, #high, #higher, #idea, #ideal, #imagine, #immunity, #impossible, #improve, #increases, #indicators, #information, #intensity, #introduced, #just, #kind, #know, #knowledge, #lack, #last, #learn, #learned, #leaving, #less, #let, #level, #literally, #little, #long, #lot, #low, #m, #manifestations, #matter, #may, #Medical, #medicine, #mental, #methods, #models, #modern, #monitors, #motion, #move, #movements, #muscles, #naturally, #needs, #night, #norm, #nothing, #numbers, #observed, #occur, #old, #opinion, #optimal, #option, #our, #owners, #participants, #passed, #patients, #people, #per, #perfectly, #phase, #phases, #physical, #popular, #practice, #prescribed, #principle, #problems, #process, #production, #programs, #provide, #quality, #question, #rate, #rather, #raw, #real, #reality, #really, #receive, #received, #record, #reduced, #relaxed, #reliability, #reliable, #rem, #reported, #requires, #research, #rest, #restless, #restore, #restoring, #results, #return, #rhythmic, #right, #rises, #room, #rules, #say, #scientific, #scientists, #screen, #seem, #seems, #serious, #set, #show, #shows, #significantly, #simple, #size, #sleep, #Sleeping, #sleeps, #slept, #slow, #small, #snoring, #solve, #some, #someone, #something, #special, #specially, #standard, #statistics, #still, #studies, #study, #suitable, #t, #take, #takes, #task, #tell, #temperature, #tend, #term, #terms, #themselves, #theory, #therapy, #times, #tissues, #today, #track, #transferred, #treatment, #turns, #twice, #two, #under, #understand, #unnecessary, #us, #USA, #useful, #value, #various, #very, #violation, #wake, #want, #was, #way, #were, #where, #whether, #who, #whole, #why, #will, #works, #worry, #worth, #would

Sta­tis­tics say: most peo­ple in devel­oped coun­tries have prob­lems with the qual­i­ty and dura­tion of sleep. We need good sleep for our health. Today we can use sleep track­ers that seem to help solve these prob­lems, and man­u­fac­tur­ers con­fi­dent­ly report that a fit­ness bracelet and its pro­gram will help improve the qual­i­ty of sleep. How about real­ly? We will find out the opin­ion of experts about these devices: to whom they help, for whom they are use­less, and how they can harm even a healthy per­son.

How does sleep work?

How does sleep work?

Sleep qual­i­ty is based on sleep-wake cycles, non-REM (deep) sleep and REM sleep.

    During deep sleep, the body is relaxed, breathing is rhythmic and calm, pressure decreases, the brain reacts less to external stimuli. Slow sleep is the optimal phase for recuperation, and also for the production of growth hormones by the pineal gland, which helps to renew and regenerate tissues, and restore immunity.
    REM sleep helps the brain more: unnecessary information is erased, the necessary information is analyzed, transferred to long-term memory, and the number of neural connections increases. At the same time, body temperature rises, blood pressure rises, and the heart rate increases. And the body moves. The REM phase is observed 3–5 times per night.

We need both phas­es: in the slow phase, phys­i­cal health is restored, dur­ing the fast phase, men­tal abil­i­ties are restored. Accord­ing­ly, if the quan­ti­ty and/or qual­i­ty of the phas­es is dis­turbed, health suf­fers.

The ancestor of fitness bracelets with trackers: how it all began

It seems that every­thing sounds sim­ple: to rec­og­nize the phase of sleep, you just need to track your heart­beat, tem­per­a­ture and body move­ments. The task is just for a fit­ness bracelet!

The prin­ci­ple of eval­u­a­tion for track­ers is copied from the acti­graph, a motion sen­sor designed at the end of the last cen­tu­ry. It was the first “sleep track­er” that allowed track­ing sleep and wake cycles, that is, it helped sci­en­tists deter­mine whether the patient was sleep­ing or not. Some mod­els even claimed to deter­mine sleep phas­es. And in order to trust the tes­ti­mo­ny of acti­g­ra­phers, they were com­pared with the results of polysomnog­ra­phy.

A polysomno­graph is a device, or rather, a set of devices in a spe­cial­ly equipped room. A per­son sleeps in it, and the devices track lit­er­al­ly every­thing: EEG read­ings, small move­ments of the eyes under closed eye­lids, chin mus­cles, and heart rate indi­ca­tors. This “gold stan­dard” of sleep research real­ly allows you to deter­mine not only cycles, but also phas­es.

Actigraph vs. tracker bracelet

Actigraph vs.  tracker bracelet

When acti­graphs (which are the size of wrist­watch­es) were intro­duced, som­nol­o­gists nat­u­ral­ly com­pared their read­ings with polysomno­graph data. And they found that sci­en­tif­ic acti­graphs are able to deter­mine whether the patient was sleep­ing or not. And with a fair­ly high accu­ra­cy — 90% — deter­mine whether he woke up at night. And they are not very suit­able for deter­min­ing the phase of sleep, which is why patients with seri­ous prob­lems are still pre­scribed a polysomno­graph­ic study, leav­ing them overnight in a spe­cial room. That is, even an acti­graph, a med­ical device that has passed the data val­i­da­tion process, will not deter­mine the phase of sleep.

But mod­ern gad­gets are mul­ti­func­tion­al and, it seems, can do every­thing. They will appre­ci­ate the qual­i­ty of sleep, and wake up at the right time. The idea on the basis of which such track­ers are devel­oped is, in fact, sci­en­tif­ic. But with the con­fir­ma­tion of the data that the track­ers receive and process, a prob­lem aris­es: not one of such pop­u­lar devices has been val­i­dat­ed by sci­en­tif­ic research meth­ods. No com­pa­ny has con­duct­ed sleep stud­ies and com­pared their results with track­ers. That is, bracelets work based on algo­rithms writ­ten by soft­ware devel­op­ers based on some gen­er­al data. “Move a lit­tle — fast sleep, move a lot — woke up”, some­thing like this.

Expert com­ment

Neil Segal, Senior Fel­low, Cen­ter for Dig­i­tal Health Inno­va­tion, USA

After two years of com­par­ing data from con­sumer gad­gets with results from clin­i­cal med­i­cine research, we con­clud­ed that very few devices can be com­pared to real med­ical devices. The FDA rates sleep track­ers as “health-focused devices,” which means the con­sumer gets more infor­ma­tion about their health. Which? Doc­tors don’t under­stand this yet. Such track­ers are based on a good idea, but there is no evi­dence that it works. In gen­er­al, some gad­gets help peo­ple to be more active or atten­tive to them­selves, but these are the only bonus­es that we have found so far.

Same sto­ry with the “wake up on time” option. We know that it is bet­ter to get up in the phase of REM sleep, which is with dreams. In this phase, a per­son has a so-called low awak­en­ing thresh­old, it is eas­i­er to get up, the body is “warmed up”, the brain reacts faster. This phase is per­fect­ly tracked by the polysomno­graph in terms of EEG and eye move­ments. Acti­graph and track­ers can only track exter­nal indi­ca­tions, changes in the inten­si­ty of move­ments, pos­si­bly heart­beats and sounds (depend­ing on the device). The track­er mon­i­tors the num­ber of changes in its posi­tion and heart rate and decides that the fast phase has come. Then it takes into account when, accord­ing to its data, the per­son fell asleep. If more than 7 hours have passed, you can wake up the own­er.

The prob­lem is still the same: there is no con­fir­ma­tion of effec­tive­ness, even sci­en­tif­ic acti­g­ra­phers can­not cope with the exact deter­mi­na­tion of the sleep phase, what can we say about fash­ion­able gad­gets?

Sleep track­ers that show changes in body posi­tion and record sounds can real­ly help peo­ple with som­nam­bu­lism or snor­ing to tell if there was a sleep­walk­ing episode at night, or how long and how often sleep apnea episodes occur. This is a good option for col­lect­ing infor­ma­tion for the doc­tor.

Many knowledge — many sorrows

The num­ber of indi­ca­tors that sleep track­ers pro­vide is also, odd­ly enough, a prob­lem. Even if we do not take into account their reli­a­bil­i­ty, it turns out that these data will not help doc­tors in any way. Or almost noth­ing. Experts refer to these data as “raw”: their use requires med­ical knowl­edge at the lev­el of a som­nol­o­gist. And the doc­tor will again return to the ques­tion of the error of the col­lect­ed infor­ma­tion.

Mikhail Poluek­tov, sleep med­i­cine doc­tor, head of the sleep med­i­cine depart­ment, PMSMU. I. M. Sechen­ov, claims that the array of data received from the track­er can pro­vide infor­ma­tion about the dai­ly rou­tine. If a com­plaint is received that the patient does not sleep well, and the track­er shows that on Fri­day he fell asleep at 3 am, on Sat­ur­day at 5 am, and on Sun­day at 11 pm, then this is a vio­la­tion of sim­ple rules. But do you need a track­er for this? Although these data help a lot in assess­ing the qual­i­ty of sleep of the elder­ly, who “can’t fall asleep at night”, because they have already slept twice in the morn­ing and in the after­noon, but they don’t want to admit it.

That is, all infor­ma­tion from the track­er is gen­er­al, and the inter­pre­ta­tion of its val­ue in rela­tion to sleep qual­i­ty is of low val­ue. And it is impos­si­ble to pre­scribe treat­ment on its basis, except to give rec­om­men­da­tions on restor­ing the dai­ly rou­tine.

Useless or harmful?

Useless or harmful?

So far, we’ve learned that sleep track­ers are actu­al­ly of lit­tle use. Tables, graphs and var­i­ous indi­ca­tors may not cor­re­spond to real­i­ty, and their infor­ma­tion con­tent for the doc­tor is rather low. What’s wrong with track­ers?

Track­ers and the pro­grams they use to track every­thing are based on ide­al ideas about how a per­son sleeps. That is, it is based on the aver­age data of polysomno­graph­ic stud­ies, which seem to be suit­able for all peo­ple. And imme­di­ate­ly there are two dif­fi­cul­ties:

ai generated, boxing, fitness
boy, night sky, dream
clouds, background, night sky
tiger, nature, animal
ai generated, woman, flowers
    a tracker, even a scientific actigrapher, is not a polysomnograph, and it cannot track all indicators, no matter what advertising claims;
    we are all different. And each of us not only differs from another person in needs and sleep rates, but also changes with age. For example, Donald Trump at 71 years old needs 4–5 hours of sleep for full health, and this is confirmed by a polysomnograph. And in almost every person by the age of 80, the duration of the REM phase is reduced by more than half. This is also the norm.

Sur­pris­ing­ly, the most fre­quent com­plaints of sleep track­ers own­ers are not about the qual­i­ty of sleep, but about the per­for­mance of the device. He seemed to sleep well, but on the screen — only 1.5% of the REM phase (REM sleep) per night! It’s not healthy sleep at all, is it?

It would seem, what is the prob­lem? If I slept well, let the device say any­thing. I know that I slept well and was awake, did­n’t I? It turns out that we tend to trust the “sci­en­tif­ic” indi­ca­tions of bracelets more than our own well-being. So, in one exper­i­ment, peo­ple with sig­nif­i­cant­ly good sleep in the morn­ing were told that they slept bad­ly today. And this sig­nif­i­cant­ly affect­ed both well-being and day­time activ­i­ty: the par­tic­i­pants them­selves report­ed that sleep was rest­less, inter­mit­tent and did not bring rest.

So in the­o­ry, track­ing sleep qual­i­ty is use­ful: you can learn more about your body. But in prac­tice, we lack skep­ti­cism: trust in the num­bers on the screen is high­er than in your body. And this is the biggest trap of sleep track­ers!

Ortho­som­nia is a con­di­tion where a per­son is so pre­oc­cu­pied with the ques­tion of whether he sleeps well enough and for a long time that real prob­lems with sleep begin. For exam­ple, some­one begins to wor­ry about sleep­ing more time in bed with­out sleep (which som­nol­o­gists do not approve of). And the read­ings of the instru­ments in the morn­ing deter­mine the state of health for the whole day, a real obses­sion with the qual­i­ty of sleep begins. If we add to this the imper­fec­tion of track­er indi­ca­tors, one can eas­i­ly imag­ine what kind of neu­ro­sis can be “earned” in this way.

Fit­ness bracelets with track­ers are not med­ical equip­ment. They are use­ful in diag­nos­ing sleep apnea, som­nam­bu­lism, rest­less sleep, and track­ing the results of ther­a­py. But hope for oth­er indi­ca­tions and their sig­nif­i­cance for health is not worth it. The only reli­able assess­ment of the qual­i­ty of sleep is based on indi­ca­tors of brain activ­i­ty, and not on the exter­nal man­i­fes­ta­tions avail­able to pop­u­lar gad­gets.

By Yraa

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