Currently submitted to: Journal of Medical Internet Research
Date Submitted: Oct 16, 2026
Open Peer Review Period: Oct 18, 2026 - Dec 13, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Wearable Measures of Sleep and Sedentary Behaviour in Lewy Body Disease: A Systematic Review
ABSTRACT
Background:
Sleep disturbances, sedentary behaviour/inactivity, and circadian dysregulation are prevalent and clinically significant features of Lewy body disease (LBD) and idiopathic rapid eye movement sleep behaviour disorder (iRBD). Wearable devices are promising tools for continuous, objective, real-world assessment of these outcomes; however, no consensus exists on optimal protocols or digital outcome measures for LBD.
Objective:
This systematic review aimed to characterise the use of wearable devices for sleep, sedentary behaviour/inactivity, and circadian rhythm assessment in LBD and iRBD.
Methods:
Following PRISMA guidelines, seven databases were searched from inception to December 2024. We included quantitative original research using movement-based wearable devices to assess sleep, sedentary behaviour/inactivity, and/or circadian rhythm in LBD, or iRBD. Quality was assessed, and data were synthesised narratively.
Results:
Eighty-one studies met inclusion criteria; 89% focused on Parkinson’s disease (PD), with sleep being the most frequently assessed outcome (66.7%). Thirty-eight devices were identified, used across 13 different monitoring periods, and placed mostly on the wrist (69.1%). Sixty-seven outcome measures were identified across sleep assessment (44.8%), sedentary behaviour/inactivity (29.9%), and circadian rhythm (25.4%). Thirty-three studies examined associations between digital outcomes and clinical features, predominantly in PD.
Conclusions:
We found that wearable devices assessing sleep, sedentary behaviour/inactivity and circadian rhythm are widely used and feasible in PD, but the evidence was limited in iRBD, and Lewy body dementias. Methodology and derived digital outcomes were heterogeneous, with limited consistency or standardisation across studies, and insufficient evidence to establish the clinical validity of these measures. Nevertheless, wearable devices offer a feasible, non-invasive approach for continuous, real-world monitoring in this population. Clinical Trial: PROSPERO CRD420251046984; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251046984
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