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Are wearable sleep-tracking devices reliable alternatives to Polysomnography? A Systematic Review and Meta-Analysis

dc.contributor.authorAgostinho, Margarida
dc.contributor.authorBorges, Maria
dc.contributor.authorPereira, Telmo
dc.contributor.authorBorges, Daniel Filipe
dc.contributor.authorSoares, Joana Isabel
dc.contributor.authorBorges, Daniel Filipe
dc.date.accessioned2026-05-25T09:25:37Z
dc.date.available2026-05-25T09:25:37Z
dc.date.issued2026-05-22
dc.description.abstractPolysomnography (PSG) is the reference method for characterizing sleep architecture, but it is resource-intensive and difficult to scale for large cohort assess ments. This has increased interest in wearable devices for naturalistic sleep monitoring. This systematic review and meta-analysis evaluated how wearable sleep-tracking devices compare with laboratory PSG in healthy adults across standard sleep metrics and sleep stage durations. PubMed, Scopus, Scielo, Web of Science, and the Cochrane Library were searched following PRISMA guidelines. Eligible studies included healthy adults under going simultaneous wearable and PSG recordings. Mean differences were synthesized for total sleep time, sleep latency, sleep efficiency, wake after sleep onset, and time spent in light (N1+N2), deep (N3), and REM sleep using fixed or random effects models based on heterogeneity, with significance set at p < .01. Risk of bias and applicability were assessed using QUADAS-2. Sixteen studies met the inclusion criteria, and ten contributed to the meta- analysis. Wearable devices overestimated total sleep time and sleep efficiency and underestimated wake after sleep onset, with substantial variability between devices. No device demonstrated consistently superior performance. In individual studies, the closest agreement with PSG was observed for the Oura Ring (third generation) for sleep latency and sleep efficiency, and for selected Fitbit models for deep and REM sleep. Wearable devices provide reasonable estimates of global sleep metrics and may complement PSG for population monitoring and longitudinal self-tracking. However, variable performance, methodological heterogeneity, and risk-of-bias consid erations currently limit their use as stand-alone diagnostic tools or for detailed sleep- stage characterization.por
dc.identifier.citationAgostinho, M., Borges, M., Pereira, T., Borges, D. F., & Soares, J. I. (2026). Are wearable sleep-tracking devices reliable alternatives to Polysomnography? A Systematic Review and Meta-Analysis. Behavioral Sleep Medicine, 1–13. https://doi.org/10.1080/15402002.2026.2673893
dc.identifier.doi10.1080/15402002.2026.2673893
dc.identifier.eissn1540-2010
dc.identifier.issn1540-2002
dc.identifier.urihttp://hdl.handle.net/10400.22/32429
dc.language.isoeng
dc.peerreviewedyes
dc.publisherTaylor &Francis
dc.relation.hasversionhttps://www.tandfonline.com/doi/full/10.1080/15402002.2026.2673893
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectPolysomnography (PSG)
dc.subjectSleep
dc.titleAre wearable sleep-tracking devices reliable alternatives to Polysomnography? A Systematic Review and Meta-Analysiseng
dc.typeresearch article
dspace.entity.typePublication
oaire.citation.endPage13
oaire.citation.startPage1
oaire.citation.titleBehavioral Sleep Medicine
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameBorges
person.givenNameDaniel Filipe
person.identifier3235598
person.identifier.ciencia-id0217-87F9-58DF
person.identifier.orcid0000-0003-0189-7908
person.identifier.ridJVO-1831-2024
person.identifier.scopus-author-id57912703700
relation.isAuthorOfPublicationf67e814a-8ad9-4440-820a-deaccea87bb8
relation.isAuthorOfPublication.latestForDiscoveryf67e814a-8ad9-4440-820a-deaccea87bb8

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