What do researchers want in a consumer sleep technology?
Jaime K. Devine, Lindsay P. Schwartz, Steven R. Hursh · SLEEP · 2021
Both scientific literature and the consumer market seem to agree that sleep is important. The number of consumer sleep technologies (CSTs) available for purchase, as well as the popularity of sleep tracking in general, is continually growing. However, companies that develop and manufacture CSTs are disconnected from the sleep research community and appear largely ambivalent about designing devices that appeal to sleep medicine professionals. One could argue that the scientific caliber of a device’s sleep measurement is a low priority to CST developers because accuracy does not result in greater economic success. A recent class-action lawsuit against wearables company Fitbit, Inc. begs to differ. The plaintiffs in Brickman et al. v. Fitbit Inc. were consumers who had paid upward of $30 extra for sleep-tracking Fitbit One, Fitbit Ultra, or Fitbit Flex devices as opposed to the non-sleep-tracking version of these devices. The plaintiffs alleged that the fitness device’s sleep-tracking capability was defective and accused Fitbit Inc. of false advertisement. The class-action lawsuit was finally settled in 2019 when it was ruled that Fitbit Inc. would reimburse individuals who had purchased a Fitbit-branded wearable with sleep tracking between September 1, 2009 and October 27, 2014 in the amount of $12.50 [1]. The accuracy and validity of sleep tracking in CSTs are important to sleep medicine professionals and consumers. Brickman et al. v. Fitbit Inc. indicates that a device’s accuracy in measuring sleep is worth between $12.50 and $30.00 USD to the consumer, but the value of validity to sleep researchers remains unquantified. Scientists are not generally known for their wealth but do constitute an important consumer market. Research-grade actigraphs can cost upwards toward $1000 per device, and multiple devices are required for sleep research studies. Establishing the sleep science community’s price point for device features and validity may help CST developers understand the importance of scientific design. Behavioral economics is a field of science that applies behavioral science within economic frameworks, using economic concepts such as demand curves, open and closed economies, elasticity, and complementary and substitutable goods to help explain decision-making behavior [2–4]. Validated behavioral economic demand procedures known as purchase tasks have been essential for advancing research across behavioral science by allowing for experimental evaluation of demand across a range of hypothetical circumstances. Purchase tasks require respondents to report their willingness to obtain a commodity at different prices, level of effort, or some other qualifying trade-off and can provide a snapshot of consumption intentions under different market conditions. Hypothetical purchase tasks simulate demand and can predict actual consumption [5]. Hypothetical purchase tasks in behavioral economics have been applied to consumer behavior as well as in addiction research, and recently, even demand for a COVID-19 vaccine [5–7]. Behavioral economics can be easily applied to the assessment of sleep medicine professionals’ economic demand for CST validation and device features. Moreover, it is an assessment in which CST developers and manufacturers are likely to be interested. Opening a line of communication between sleep researchers and CST developers is important for innovation and may be best achieved through an area of mutual interest. To this end, we are developing an anonymous survey for sleep medicine professionals who conduct human research related to sleep, circadian rhythm, or fatigue in real-world environments to provide their professional opinions on CST capabilities, device features, validation practices, and economic demand for CSTs through a hypothetical purchase task. The survey can be found at https://ibrinc.org/researchersurvey or by visiting https://ibrinc.org/research-study-participation/. The survey is being conducted anonymously through the Qualtrics online platform. No identifying information will be requested or collected from respondents. We are planning for the survey to be active during the annual Associated Professional Sleep Societies SLEEP meeting in order to maximize the community’s awareness and participation. Furthermore, while researchers and clinicians acknowledge that CSTs have changed the landscape of sleep medicine, it must be noted that our community maintains a very cautious position on the accuracy of any device to measure sleep outside the laboratory. Insufficient validation has been identified as the primary barrier inhibiting the use of CSTs or wearables in sleep and circadian science [8–10], but most validation studies are done in the laboratory comparing a CST against gold-standard polysomnography and actigraphy [9]. It could be considered heresy to even suggest that measures that have been designed and validated in a controlled environment may not be the most salient metrics for assessing sleep, rhythmicity, or fatigue in the field. For this reason, a second (equally important) aim of the survey will be to establish an honest consensus opinion from as many field-based sleep researchers as possible about best practices for measuring sleep in real-world environments. It is our hope that establishing researcher demand and consensus opinion will be the first step toward bridging the communication gap between the sleep research community and CST developers. Working together would not only benefit the scientists and businessmen but could ultimately lead to the generation of superior CSTs which effectively improve sleep health for the general populace. The authors declare no commercial or financial relationships that could be construed as a conflict of interest.