Alma’s Technology: Monitoring Sleep Disturbances

A sleep monitor…really helps us detect problems early.

When Alma Jones leaves the hospital after a stroke, a number of technologies follow her home. One of those technologies looks just like the pad that Alma has used for years to cover the mattress on her bed.

Unlike her usual bedding, though, this mattress pad could help Alma avoid returning to the hospital anytime soon. It does that by monitoring Alma’s sleep patterns to detect early signs of illness or functional decline.

Alma is a fictional 83-year-old great-grandmother and the central character in CAST’s High-Tech Aging video. The video shows how Alma stays healthy by staying connected with her health care providers while remaining independent.

I’ll be exploring sleep monitoring technologies like Alma’s smart mattress pad in this 6th installment of our 12-part series on the technologies that appear in the High-Tech Aging video.

Monitoring Sleep to Assess Well-Being

How well you sleep tells caregivers a lot about how well you are, according to a recent Report to Congress on aging services technologies written by CAST and NORC at the University of Chicago. Sleep disturbances like insomnia, restlessness and obstructive sleep apnea can lead to or indicate the presence of a number of dangerous conditions that can impact health and functional status. These conditions include:

  • Urinary tract infection. Restlessness, coupled with frequent bathroom visits, can indicate the presence of this potentially serious infection.
  • Cardiovascular disease.
  • Hypertension.
  • Stroke.
  • Diabetes.
  • Daytime fatigue. This fatigue, in turn, raises the risk of falls and car accidents. It could also compromise immune function and lower quality of life.

Using Technology to Monitor Sleep

Sleep monitors document an individual’s typical nightly habits to establish trends and detect subtle changes in those habits. When a sleep monitoring system detects such deviations from established trends, it alerts professional caregivers. These alerts allow caregivers to address emerging health conditions before they become serious health issues requiring an expensive and disruptive hospitalization or hospital readmission.

There are 3 types of sleep-monitoring devices.

  1. Alma’s ballistocardiographic system features a foam bed pad that is placed between the sheet and mattress. The pad comes equipped with pressure sensors that detect physical movement during the night. Data from these sensors help Alma’s clinicians assess her sleep quality and other physiological information like heart rate and respiration. 
  2. Sleepers using actigraphy technology wear an accelerometer on their wrist. The device can distinguish between periods of sleep and wakefulness by tracking when the user moves his or her wrist. These monitors have their limitations. For one thing, they may assume a person is sleeping when, in fact, he or she is awake and resting quietly in bed. Despite the drawbacks, however, these monitors do provide a low-cost, home-based alternative to more expensive sleep-clinic assessments. 
  3. Load cells are used in sleep monitors that are under development. These cells are placed at the corners of a bed under the bedposts. They measure changes in force associated with the sleeper’s movement in bed. Load cells can also detect physiological data like heart rate and respiration. This helps clinicians monitor sleep disturbances associated with cardiac events and sleep apnea.

Selection Tips

The particular sleep-monitoring technology you select will depend on a number of factors, including:

  • How detailed you want the sleep-monitoring information to be.
  • The individual’s willingness to use or wear the technology. 

Some monitors only provide information about the amount of time the person spends in and out of bed. Other monitors assess restlessness after collecting data about the person’s movement in bed. Monitors that measure restlessness provide a better measure of sleep quality.

If you want a clinical assessment of a person’s sleep quality, choose a monitoring system that collects biometric measures. These monitors measure heart and breathing rates and some may use an electroencephalogram (EEG) to measure brain waves. The biometric monitor can provide information about the person’s sleep stages, including stages of wakefulness, rapid-eye movement (REM) and non-REM sleep. 

These monitors can also facilitate the detection of sleep apnea.

For More Information

I recommend watching the full version of the Alma video. I would encourage you to check the wellness monitoring section of CAST’s report on the State of Technology in Aging Services to find relevant information about sleep-monitoring technologies.