Author(s):

  • Elina Kuosmanen
  • Aku Visuri
  • Saba Kheirinejad
  • Niels van Berkel
  • Heli Koskimäki
  • Denzil Ferreira
  • Simo Hosio

Abstract:

A new generation of wearable devices now enable end-users to keep track of their sleep patterns. This paper reports on a longitudinal study of 82 participants who used a state-of-the-art sleep tracking ring for an average of 65 days. We conducted interviews and questionnaires to understand changes to their lifestyle, their perceptions of the tracked information and sleep, and the overall experience of using an unobtrusive sleep tracking device. Our results indicate that such a device is suitable for long-term sleep tracking and helpful in identifying detrimental lifestyle elements that hinder sleep quality. However, tracking one’s sleep can also introduce stress or physical discomfort, potentially leading to adverse outcomes. We discuss these findings in light of related work and highlight the near-term research directions that the rapid commoditisation of sleep tracking technology enables.

Documentation:

https://doi.org/10.1145/3546720

References:
  1. Saeed Abdullah, Mark Matthews, Elizabeth L Murnane, Geri Gay, and Tanzeem Choudhury. 2014. Towards circadian computing: “early to bed and early to rise” makes some of us unhealthy and sleep deprived. In Proceedings of the 2014 ACM International Joint Conference on Pervasive and Ubiquitous Computing. 673–684.
  2. Jared S Bauer, Sunny Consolvo, Benjamin Greenstein, Jonathan Schooler, Eric Wu, Nathaniel F Watson, and Julie Kientz. 2012. ShutEye: encouraging awareness of healthy sleep recommendations with a mobile, peripheral display. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems. 1401–1410.
  3. Konrad E Bloch. 1997. Polysomnography: a systematic review. Technology and health care , Vol. 5, 4 (1997), 285–305.
  4. Virginia Braun and Victoria Clarke. 2006. Using thematic analysis in psychology. Qualitative research in psychology , Vol. 3, 2 (2006), 77–101.
  5. Daniel J Buysse. 2014. Sleep health: can we define it? Does it matter? Sleep, Vol. 37, 1 (2014), 9–17.
  6. Andrew L Chesson Jr, Richard A Ferber, June M Fry, Madeleine Grigg-Damberger, Kristyna M Hartse, Thomas D Hurwitz, Stephen Johnson, Gihan A Kader, Michael Littner, Gerald Rosen, et al. 1997. The indications for polysomnography and related procedures. Sleep, Vol. 20, 6 (1997), 423–487.
  7. Eun Kyoung Choe, Bongshin Lee, Matthew Kay, Wanda Pratt, and Julie A Kientz. 2015. SleepTight: low-burden, self-monitoring technology for capturing and reflecting on sleep behaviors. In Proceedings of the 2015 ACM International Joint Conference on Pervasive and Ubiquitous Computing. 121–132.
  8. Eun Kyoung Choe, Bongshin Lee, Haining Zhu, Nathalie Henry Riche, and Dominikus Baur. 2017. Understanding self-reflection: how people reflect on personal data through visual data exploration. In Proceedings of the 11th EAI International Conference on Pervasive Computing Technologies for Healthcare. 173–182.
  9. Eun Kyoung Choe, Nicole B Lee, Bongshin Lee, Wanda Pratt, and Julie A Kientz. 2014. Understanding quantified-selfers’ practices in collecting and exploring personal data. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems. 1143–1152.
  10. Yong K Choi, George Demiris, Shih-Yin Lin, Sarah J Iribarren, Carol A Landis, Hilaire J Thompson, Susan M McCurry, Margaret M Heitkemper, and Teresa M Ward. 2018. Smartphone applications to support sleep self-management: review and evaluation. Journal of Clinical Sleep Medicine , Vol. 14, 10 (2018), 1783–1790.
  11. James Clawson, Jessica A Pater, Andrew D Miller, Elizabeth D Mynatt, and Lena Mamykina. 2015. No longer wearing: investigating the abandonment of personal health-tracking technologies on craigslist. In Proceedings of the 2015 ACM International Joint Conference on Pervasive and Ubiquitous Computing. 647–658.
  12. Massimiliano de Zambotti, Aimee Goldstone, Stephanie Claudatos, Ian M Colrain, and Fiona C Baker. 2018. A validation study of Fitbit Charge 2? compared with polysomnography in adults. Chronobiology international , Vol. 35, 4 (2018), 465–476.
  13. Massimiliano de Zambotti, Leonardo Rosas, Ian M Colrain, and Fiona C Baker. 2019. The sleep of the ring: comparison of the =OURA sleep tracker against polysomnography. Behavioral sleep medicine , Vol. 17, 2 (2019), 124–136.
  14. Neil J Douglas, Stephen Thomas, and Mohammed A Jan. 1992. Clinical value of polysomnography. The Lancet, Vol. 339, 8789 (1992), 347–350.
  15. Daniel A Epstein, Monica Caraway, Chuck Johnston, An Ping, James Fogarty, and Sean A Munson. 2016. Beyond abandonment to next steps: understanding and designing for life after personal informatics tool use. In Proceedings of the 2016 CHI Conference on Human Factors in Computing Systems. 1109–1113.
  16. Jordan Etkin. 2016. The hidden cost of personal quantification. Journal of Consumer Research , Vol. 42, 6 (2016), 967–984.
  17. Barney G Glaser, Anselm L Strauss, and Elizabeth Strutzel. 1968. The discovery of grounded theory; strategies for qualitative research. Nursing research, Vol. 17, 4 (1968), 364.
  18. Jonathan Grudin and John Pruitt. 2002. Personas, participatory design and product development: An infrastructure for engagement. In Proc. PDC, Vol. 2.
  19. Shahab Haghayegh, Sepideh Khoshnevis, Michael H Smolensky, Kenneth R Diller, and Richard J Castriotta. 2019. Accuracy of wristband Fitbit models in assessing sleep: systematic review and meta-analysis. Journal of Medical Internet Research , Vol. 21, 11 (2019), e16273.
  20. Rikke Hagensby Jensen, Jesper Kjeldskov, and Mikael B. Skov. 2018. Assisted Shifting of Electricity Use: A Long-Term Study of Managing Residential Heating. ACM Trans. Comput.-Hum. Interact. , Vol. 25, 5, Article 25 (2018), 33 pages. https://doi.org/10.1145/3210310
  21. L Jeon and Joseph Finkelstein. 2015. Consumer sleep tracking devices: a critical review. Digital Healthcare Empowering Europeans: Proceedings of MIE2015 , Vol. 210 (2015), 458.
  22. Evangelos Karapanos, Rúben Gouveia, Marc Hassenzahl, and Jodi Forlizzi. 2016. Wellbeing in the making: peoples’ experiences with wearable activity trackers. Psychology of well-being , Vol. 6, 1 (2016), 4.
  23. Ping-Ru T Ko, Julie A Kientz, Eun Kyoung Choe, Matthew Kay, Carol A Landis, and Nathaniel F Watson. 2015. Consumer sleep technologies: a review of the landscape. Journal of Clinical Sleep Medicine , Vol. 11, 12 (2015), 1455–1461.
  24. Bhanu Prakash Kolla, Subir Mansukhani, and Meghna P Mansukhani. 2016. Consumer sleep tracking devices: a review of mechanisms, validity and utility. Expert review of medical devices , Vol. 13, 5 (2016), 497–506.
  25. Ian Li, Anind K Dey, and Jodi Forlizzi. 2011. Understanding my data, myself: supporting self-reflection with ubicomp technologies. In Proceedings of the 13th international conference on Ubiquitous computing. 405–414.
  26. Zilu Liang and Bernd Ploderer. 2016. Sleep tracking in the real world: a qualitative study into barriers for improving sleep. In Proceedings of the 28th Australian Conference on Computer-Human Interaction. 537–541.
  27. Zilu Liang and Bernd Ploderer. 2020. How does Fitbit measure brainwaves: A qualitative study into the credibility of sleep-tracking technologies. Proceedings of the ACM on Interactive, Mobile, Wearable and Ubiquitous Technologies, Vol. 4, 1 (2020), 1–29.
  28. Zilu Liang, Bernd Ploderer, Wanyu Liu, Yukiko Nagata, James Bailey, Lars Kulik, and Yuxuan Li. 2016. SleepExplorer: a visualization tool to make sense of correlations between personal sleep data and contextual factors. Personal and Ubiquitous Computing , Vol. 20, 6 (2016), 985–1000.
  29. Wanyu Liu, Bernd Ploderer, and Thuong Hoang. 2015. In bed with technology: challenges and opportunities for sleep tracking. In Proceedings of the Annual Meeting of the Australian Special Interest Group for Computer Human Interaction. 142–151.
  30. Richard MacManus. 2015. Trackers: How Technology is Helping Us Monitor & Improve Our Health. David Bateman.
  31. David F Mastin, Jeff Bryson, and Robert Corwyn. 2006. Assessment of sleep hygiene using the Sleep Hygiene Index. Journal of behavioral medicine , Vol. 29, 3 (2006), 223–227.
  32. Milad Asgari Mehrabadi, Iman Azimi, Fatemeh Sarhaddi, Anna Axelin, Hannakaisa Niela-Vilén, Saana Myllyntausta, Sari Stenholm, Nikil Dutt, Pasi Liljeberg, and Amir M Rahmani. 2020. Sleep Tracking of a Commercially Available Smart Ring and Smartwatch Against Medical-Grade Actigraphy in Everyday Settings: Instrument Validation Study. JMIR mHealth and uHealth , Vol. 8, 11 (2020), e20465.
  33. Jochen Meyer, Merlin Wasmann, Wilko Heuten, Abdallah El Ali, and Susanne CJ Boll. 2017. Identification and classification of usage patterns in long-term activity tracking. In Proceedings of the 2017 CHI conference on human factors in computing systems. 667–678.
  34. Anne B. Newman, F. Javier Nieto, Ursula Guidry, Bonnie K. Lind, Susan Redline, Eyal Shahar, Thomas G. Pickering, and Stuart F. Quan for the Sleep Heart Health Study Research Group. 2001. Relation of Sleep-disordered Breathing to Cardiovascular Disease Risk Factors : The Sleep Heart Health Study. American Journal of Epidemiology , Vol. 154, 1 (07 2001), 50–59. https://doi.org/10.1093/aje/154.1.50
  35. National Advisory Board on Research Ethics. 2019. Ethical principles of research in the humanities and social and behavioural sciences and proposals for ethical review. https://tenk.fi/sites/default/files/2021-01/Ethical_review_in_human_sciences_2020.pdf Retrieved March 22, 2022 from
  36. June J Pilcher, Douglas R Ginter, and Brigitte Sadowsky. 1997. Sleep quality versus sleep quantity: relationships between sleep and measures of health, well-being and sleepiness in college students. Journal of psychosomatic research , Vol. 42, 6 (1997), 583–596.
  37. Amon Rapp and Federica Cena. 2016. Personal informatics for everyday life: How users without prior self-tracking experience engage with personal data. International Journal of Human-Computer Studies , Vol. 94 (2016), 1–17.
  38. Ruth Ravichandran, Sang-Wha Sien, Shwetak N Patel, Julie A Kientz, and Laura R Pina. 2017. Making sense of sleep sensors: How sleep sensing technologies support and undermine sleep health. In Proceedings of the 2017 CHI Conference on Human Factors in Computing Systems. 6864–6875.
  39. John Rooksby, Mattias Rost, Alistair Morrison, and Matthew Chalmers. 2014. Personal tracking as lived informatics. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems. 1163–1172.
  40. Ibrahim Sadek, Antoine Demarasse, and Mounir Mokhtari. 2019. Internet of things for sleep tracking: wearables vs. nonwearables. Health and Technology (2019), 1–8.
  41. Anita Valanju Shelgikar, Patricia F Anderson, and Marc R Stephens. 2016. Sleep tracking, wearable technology, and opportunities for research and clinical care. Chest, Vol. 150, 3 (2016), 732–743.
  42. Patrick C Shih, Kyungsik Han, Erika Shehan Poole, Mary Beth Rosson, and John M Carroll. 2015. Use and adoption challenges of wearable activity trackers. IConference 2015 Proceedings (2015).
  43. Grace Shin, Yuanyuan Feng, Mohammad Hossein Jarrahi, and Nicci Gafinowitz. 2019. Beyond novelty effect: a mixed-methods exploration into the motivation for long-term activity tracker use. JAMIA open, Vol. 2, 1 (2019), 62–72.
  44. John M Shneerson. 2009. Sleep medicine: a guide to sleep and its disorders. John Wiley & Sons.
  45. Katta Spiel, Fares Kayali, Louise Horvath, Michael Penkler, Sabine Harrer, Miguel Sicart, and Jessica Hammer. 2018. Fitter, Happier, More Productive? The Normative Ontology of Fitness Trackers. In Extended Abstracts of the 2018 CHI Conference on Human Factors in Computing Systems (Montreal QC, Canada) (CHI EA ’18). Association for Computing Machinery, New York, NY, USA, Article alt08, 10 pages. https://doi.org/10.1145/3170427.3188401
  46. Statista. [n.d.]. Percentage of the global population that used a mobile app or fitness tracking device to track their health as of 2016, by age. https://www.statista.com/statistics/742448/global-fitness-tracking-and-technology-by-age/
  47. Katarzyna Stawarz, Anna L. Cox, and Ann Blandford. 2015. Beyond Self-Tracking and Reminders: Designing Smartphone Apps That Support Habit Formation. In Proceedings of the 33rd Annual ACM Conference on Human Factors in Computing Systems (Seoul, Republic of Korea) (CHI ’15). Association for Computing Machinery, New York, NY, USA, 2653–2662. https://doi.org/10.1145/2702123.2702230
  48. Lie Ming Tang, Jochen Meyer, Daniel A Epstein, Kevin Bragg, Lina Engelen, Adrian Bauman, and Judy Kay. 2018. Defining adherence: making sense of physical activity tracker data. Proceedings of the ACM on Interactive, Mobile, Wearable and Ubiquitous Technologies, Vol. 2, 1 (2018), 1–22.
  49. Daniel Trommler, Christiane Attig, and Thomas Franke. 2018. Trust in activity tracker measurement and its link to user acceptance. Mensch und Computer 2018-Tagungsband (2018).
  50. Norifumi Tsuno, Alain Besset, and Karen Ritchie. 2005. Sleep and depression. The Journal of Clinical Psychiatry (2005).
  51. Niels van Berkel, Chu Luo, Denzil Ferreira, Jorge Goncalves, and Vassilis Kostakos. 2015. The curse of quantified-self: an endless quest for answers. In Adjunct Proceedings of the 2015 ACM International Joint Conference on Pervasive and Ubiquitous Computing and Proceedings of the 2015 ACM International Symposium on Wearable Computers. 973–978.
  52. Matthew Walker. 2017. Why we sleep: Unlocking the power of sleep and dreams. Simon and Schuster.
  53. Mark Whooley, Bernd Ploderer, and Kathleen Gray. 2014. On the integration of self-tracking data amongst quantified self members. (2014).
  54. Rayoung Yang, Eunice Shin, Mark W Newman, and Mark S Ackerman. 2015. When fitness trackers don’t’fit’ end-user difficulties in the assessment of personal tracking device accuracy. In Proceedings of the 2015 ACM International Joint Conference on Pervasive and Ubiquitous Computing. 623–634.
The SELF Institute