Health apps are becoming more and more popular, but do they actually work? EcoPlus examines one app – sleep trackers – with the help of Brandy Roane, a behavioral specialist with the university of North Texas Health Science Centre.
The launch of Apple’s new iPhone which places accent on health apps, demonstrates the growing popularity of using high tech, in the form of smart phones, smart watches and other wearable devices to monitor our health. One major area, which is enjoying huge growth in this sector, is wearable sleep-tracking technology. Brandy Roane explains the use and limitations of this new technology and helps answer the question as to whether this kind of app is really useful, or just a gimmick.
What is a sleep tracker app?
Brandy Roane: The sleep tracker is very similar to a pedometer or any accelerometer – something that is measuring physical activity. The sleep tracker, whenever it is calculating your sleep, what it is looking at is, depending on a device and algorithm that estimates whether you are likely asleep or not. So, If it thinks you are asleep, it is going to say – yes, you are sleeping. And that is based on what you are doing at that moment, as well as surrounding moments. So, right before and right after, how active you are play typically into the algorithm. But it is really just a device that is estimating whether you are asleep or not, and then giving you a number at the end that says – this is how many hours you slept and things like that.
How do you use this technology so that actually get a better sleep?
Brandy Roane: How you would use it, is really looking at the numbers: looking at how much sleep it is estimating, understanding that most of these devices do underestimate sleep. So, it is more kind of to give you some guidelines. If you think about it in terms of what you are supposed to get, it is not the important piece. Any of these devices are only really as good, as the information you also have to accompany with the information. What I mean by that is – if you are not really sure how much sleep you should be getting, it is really hard to look at the device and go – okay, I think I'm getting a good amount of sleep or I'm not.
So, any time you have these devices, it is important to also know what is normal, what is expected. So, an average adult (and this is for dealing with adults, not children) should get about 7-9 hours of sleep. And it is a range, because how much sleep you need is really dependent on you as a person. Some people need more sleep than others. Others can get along fine with 7.5. That is how much their body needs to feel rejuvenated. And others need 8.5 or 9 hours to feel rejuvenated. So, you can use that number to kind of get an idea of how consistent you are from day to day. Are you tending to get the same amount of sleep every day. And that is the one thing to consider.
If you are, that is great. But then you also have to go – okay, but am I getting a sufficient sleep every day. So, even if I'm sleeping 7 hours every day, is that how much sleep my body needs? So, you include that information that trackers are giving you and you also take into consideration – do I still feel sleepy during the day, how much caffeine am I ingesting, do I notice that I'm having a drop off during the day. So, maybe even if I'm getting a consistent sleep each night according to the tracker, I'm not getting sufficient sleep.
Another thing it can help with is the timing of sleep. So, your tracker is constantly telling you that you are going to sleep about 10 o’clock at night. If instead it is telling you that, well, some nights it is 10, some nights it is 1, some nights it is 11:30, that kind of pattern lets you know that you need to develop a more consistent sleep.
Are doctors still needed to give people advice?
Brandy Roane: Unfortunately, some companies tried to include in their device bits of information that give you a feedback, like – oh, you only slept six hours at night, you should probably sleep more. The problem is – the advice it typically relies on is often form non-sleep specialist. It is a very standard advice and so it is like 8 hours. But the problem is that 8 hours is an average, it doesn’t mean that you specifically need 8 hours. You might be getting 8 hours, but if you have obstructive sleep arrhythmia that is untreated, 8 hours is going to feel like you slept 4 hours. It is important to talk to somebody else about how do I use this information, does it show that I maybe having a problem.
Are you a little uncertain that sleep trackers work?
Brandy Roane: It is not that I don’t think they are useful, I just get concerned when information is given and somebody doesn’t know what to do with it, because then, it can sometimes cause more harm than good. I'm excited that people will have access to something that gives them an idea of how much sleep they might be getting, but, again, I go back to it, you have to understand that it often underestimates sleep, particularly the devices like the Fitbit, the newer devices that are out and have all these daytime behaviors they assess, as far as your calorie expenditure, how physically active you are – those devices are geared towards physical behavior. And as a byproduct they often underestimate how much sleep you are getting, which could lead people to believe, if they do get a good night sleep, but the device tells them they slept 6.5 hours, they might think – well, all I need is 6.5 hours.
Which app or device, or both would you recommend?
Brandy Roane: Honestly, one of the better devices that I've been able to work with is the Fitbit to BodyMedia’s armband. And they have a CORE armband. It seems to work better than the Fitbit does, but I understand that it is prime to pick up movement. So, a movement can be from a dog, a bed partner, you just shifting in bed but still asleep. So, it is still going to underestimate sleep. But it seems to do a better job than some of the other devices on the market.
The problem is that these devices were really geared towards assessing active behavior. So, they are prime for that, they are less inclined to be able to really differentiate. They are not as sensitive to sleep. That device works fairly well. And I think what is important, is just understanding that it might not be exact with regards to numbers. But looking at – am I increasing how much sleep I'm getting, did I go from an estimated 6.5 hours to 7 or 7.5, and am I being more consistent from day to day, is my device showing me that I am more consistently falling asleep at the same time and more consistently waking up at the same time.