Preliminary Agreement on Tracking Sleep Between a Wrist-Worn Device Fitbit Alta and Consensus Sleep Diary

Background: Sleep is related to various kinds of health outcomes. Many studies traditionally collect data on sleep using questionnaires or sleep diaries. An increasing popular alternative is a wrist-worn device. The accuracy of these devices is uncertain, and assessment of this accuracy is important.
Introduction: The purpose of this study is to compare consensus sleep diary (CSD) and an actigraphy-based wrist-worn device (Fitbit Alta™ [Fitbit, San Francisco, CA]) measurements of total sleep time (TST), sleep onset latency, wake time after sleep onset, number of awakenings, and sleep efficiency.
Materials and Methods: Ten healthy young adults (50% female, 100% Asian) in the age range between 20 to 24 years old wore a Fitbit Alta around their nondominated hand during seven consecutive nights. The participants also filled in a CSD every day.
Results: On average, the wrist-worn device (Fitbit Alta) recorded a TST per night of 437.15 min, which is 5.46 min shorter on average than the CSD recorded (442.61 min). Bland–Altman plots indicate that there is large variance in the sleep recorded between Fitbit™ (Fitbit, San Francisco, CA) and CSD. For example, Fitbit recorded 2.15 more awakenings per night than CSD, which is equal to 13.09 min on average longer wake time after sleep onset.
Conclusion: Fitbit and CSD show significant differences in recording sleep. We find that for most sleep metrics, the level of disagreement is small enough for the devices to be interchangeably used except for recording wakes during the night.