JMIR Publications

ABSTRACT

Background:

Wearable sleep monitoring can extend sleep assessment into home and community settings, where older adults’ sleep duration, timing, regularity, fragmentation, and adherence patterns can be observed repeatedly over time. However, wearable-derived sleep outputs vary across devices, algorithms, wear protocols, and data-access pathways, limiting comparability across studies.

Objective:

This scoping review aimed to map how wearable devices have been used to monitor sleep longitudinally among adults aged 60 years or older living in home or community settings, with attention to device characteristics, monitoring protocols, sleep outcomes, data-processing transparency, and feasibility or usability reporting.

Methods:

This review followed Joanna Briggs Institute guidance for scoping reviews and was reported in accordance with the PRISMA Extension for Scoping Reviews. Five databases were searched, and records were screened in Covidence. Eligible studies reported wearable-derived sleep monitoring for at least 7 days among adults aged 60 years or older living in home or community settings. Data were charted using a standardized extraction workbook and synthesized descriptively across study characteristics, wearable devices, monitoring protocols, sleep metrics, processing details, adherence, and usability domains.

Results:

Searches identified 3,465 records, of which 33 studies met the final inclusion criteria. Included studies were published from 2019 to 2025 and represented 14 countries or regions. Sample sizes across studies ranged from N = 5 to N = 82955. Monitoring duration ranged from 7 to 900 days. Commercial wearables were used in 17 studies, research-grade actigraphy devices in 15 studies, and one study did not clearly specify device type. Total sleep time was the most frequently reported metric (81.8%), whereas sleep efficiency (42.4%), wake after sleep onset (27.3%), and sleep stage estimates (21.2%) were less consistently reported. Quantitative adherence metrics and usability findings were reported in a minority of studies.

Conclusions:

Longitudinal wearable sleep monitoring in older adults is expanding as a mobile health approach for naturalistic sleep assessment, but cross-study comparison is limited by heterogeneous outcome definitions and incomplete reporting of device and data-processing details. We propose a 5-domain minimum reporting framework to improve transparency and reproducibility in digital sleep health research. Future studies should report device model, wear protocol, firmware or algorithm information when available, sleep-window definitions, valid data criteria and cutoffs, missing-data handling, adherence, and usability barriers relevant to older adults.