JMIR Publications

ABSTRACT

Background:

The popularity of sleep-tracking wearables has surged worldwide. Yet, there are significant gaps in understanding the real-life implications of this phenomenon. While wearables may offer insights about sleep and promote sleep health awareness, evidence remains mixed on whether they lead to improved sleep outcomes or fuel sleep anxiety.

Objective:

The present study aimed to: 1) determine the prevalence and sociodemographic predictors of using sleep wearables in Canada, 2) evaluate the perceived effects of wearable use on sleep and stress, 3) compare sleep and healthcare-seeking behaviours in users and non-users, and 4) investigate the moderating effects of wearable use on the association between sleep and anxiety.

Methods:

An online survey investigating sleep and mental health was distributed to a representative sample of 1,200 Canadians. The survey included questions on demographics, wearables use, sleep patterns, healthcare-seeking behaviours, insomnia (ISI-3) and anxiety (GAD-7) symptoms. Analyses relied on descriptive statistics and logistic regression (aims 1 and 2), multivariate analyses of covariance and chi-squared analyses (aim 3), and multiple regression (aim 4).

Results:

Among the 1,200 respondents (53% female, 16 to 88 years old), 19% (n=231) reported having used a wearable device to monitor sleep. Several sociodemographic variables were associated with an increased likelihood of using wearables including: younger age, being retired, being part of a racialized minority group, earning a higher income, having greater healthcare coverage, having a sleep disorder, and having a mental disorder (χ2(14)=110.2, p<.001). Of all wearable users, 45% felt that using sleep wearables had a positive effect on their sleep and stress levels, while 4% noted a negative effect. Compared to non-users, wearable users reported 13 minutes longer sleep onset latency (F(1,1151)=5.21, p=.023, np2=.005), slept about 1 hour less (F(1,1143)=31.60, p<.001, np2=.027), and endorsed more severe insomnia symptoms (F(1,1119)=4.04, p=.045, np2=.004). After adjusting for the presence of sleep disorders, only the differences in sleep duration remained. The proportion of wearable users was almost twice as high in those having informed a healthcare provider about sleep difficulties (X2(2)=35.4, p.001) and in those having used sleep medications (X2(3)=38.7, p<.001). Wearable use was identified as a moderator of the effect of anxiety symptoms on sleep duration, with wearable users showing a steeper decline in total sleep time as anxiety increased compared to non-users (F(1, 1165)=17.5, p<.001). A similar effect was observed in the subgroup without sleep disorders.

Conclusions:

One in five Canadians acknowledged having used sleep wearables. Predictors including younger age, higher income, and having a sleep or mental disorder. Although many individuals reported positive effects of sleep wearables, wearables use strengthened the link between short sleep and anxiety. Expanding our understanding of the factors associated with beneficial versus detrimental use of sleep wearables may help support more informed applications.