
Dreaming about Better Sleep: Dreem, Oura and the Rest - troydavis
https://medium.com/@tombarys/dreaming-about-better-sleep-dreem-oura-and-the-rest-fb29c99f0aad
======
mettamage
Based on the short literature research I did that's visible in my other
comment, I came to some rough ideas on how to make a good sleep tracker. If
there are people who want to work on it, feel free to reach out. Creating this
as a side project might be something I was going to do anyway to learn about
data science and some simple hardware hacking. It's currently 2nd on the list
(only beaten by the 1st thing: prepping for interviews).

What I think that technically needs to happen at minimum is:

1\. Movement

2\. HRV

3\. EEG (brainwaves)

That will be the minimum viable product that may become as good as
polysomnography and bring sleep lab tech to your home. Dreem claims to be
doing this, but it isn't clear whether their claims are true.

Companies like Zeo produced presumably good results, yet they are now
bankrupt. It's quite infuriating to see. So there's a business model (or
simply an organizational problem at Zeo at the time) and I'm not clear what it
is. The tech is already here! For example, Somté PSG shows that it can be
done, and I'm simply thinking to myself: this could be more user friendly,
couldn't it? [1]

Marketing-wise, I think the following needs to happen:

1\. Get multiple unrelated universities to test your device against
polysomnography and iterate against it.

2\. Once it's within the 90% agreement range, then even make a YouTube video
about such tests. Keep testing it against the golden standard, because if you
are as good as the golden standard, then you can really state you track sleep.

3\. Also test different PSGs with each other, because while PSG is the golden
standard, no study told to what extent they actually agree on sleep metrics.
There probably are studies on it but they didn't test this (or comment on it
even, I believe) when wearables such as a Fitbit were studied as well.

4\. Make ridiculous cool claims like everyone is already doing. Really go for
the full appeal to authority, like Dreem is doing (nothing new).

[1] [https://www.compumedics.com.au/products/somte-
psg/](https://www.compumedics.com.au/products/somte-psg/)

~~~
jobigoud
I have a watch-like thingy that tracks my pulse and give interesting data
about sleep patterns but every time I sleep with it I am self conscious about
it. It emits light to track the pulse and it's annoying to have something at
my wrist.

I can't imagine having a headset and sleeping as I normally sleep. The results
wouldn't be fully representative.

~~~
mettamage
I've noticed I'd become used to it. I've gotten used to a sleeping mask and
earplugs in a similar way (they really help me).

I've noticed I don't have issues wearing something around my wrist, but I get
that that's a factor. I'm also noticing that I don't get anxious about the
data, because it's all a bit guesswork anyway, so I guess I'd want to see an
aggregate form of data if it gets more precise, so that it still feels a bit
like guesswork, unless there's something wrong in a big way.

------
fromthestart
...is this an advertisement?

Also, as appealing as the device sounds, I'm terrified of giving this kind of
personal data away to a tech company:

>Dreem works as a long-term sleep expert and one-on-one coach: it monitors
your sleep habits and sleep quality for a week, asks you for a lot of more
details about your life (day and night), and downloads your activity data from
other personal health apps

The overly suave marketing on the dreem site makes me wary as well. Between
personal data abuses and shady marketing practices, how is anyone supposed to
trust modern tech anymore?

~~~
dr_dshiv
Ad or not, one of the best sleep science overviews I've read.

I want to know whether one can get their nightly EEG data.

~~~
kbouck
The normal data export only includes summary data for each night in csv:

    
    
      Type (sleep, nap, relax)
      Start Time
      Stop Time
      Sleep Duration
      Sleep Onset Duration
      Light Sleep Duration
      Deep Sleep Duration
      REM Duration
      Wake After Sleep Onset     
      Duration
      Number of awakenings
      Position Changes
      Mean Heart Rate
      Mean Respiration CPM
      Number of Stimulations
    

Not sure if there's any way to get the raw sensor data.

There appear to be two terminals on the band which are not used by the normal
user. I assume they are for flashing the firmware on bricked devices.

------
mettamage
Disclaimer: I won't be able to find all my sources. I'm sorry for that.

I just looked into this 2 days ago! While I'm not the OP, this submission
happens to be one of the most exciting articles I found (I should've submitted
it :P). I was asking myself whether I should update my Fitbit Flex 2 to a
Fitbit Versa or an Apple Watch or anything else really.

The answer is: don't upgrade, keep the Fitbit Flex 2, it's about as good as
journalling your own sleep times and that's all I need really, a very rough
estimate. More importantly, the newer wearable devices are not good enough at
giving a reliable breakdown of your sleep that polysomnography (the gold
standard would give).

With that said: the Basic Health Tracker (doesn't exist anymore, I think),
Oura Ring, Philips Actiwatch Spectrum were all able to do things that trackers
that the Fitbit and other wearables couldn't.

Specifically:

> Only mean values of sleep efficiency (time asleep/time in bed) from
> Actiwatch correlated with PSG, yet this correlation was weak. [2]

> Light sleep time differed from PSG (nREM1 + nREM2) for all devices. Measures
> of Deep sleep time did not differ from PSG (SWS + REM) for Basis. [2]

> From EBE analysis, ŌURA ring had a 96% sensitivity to detect sleep, and
> agreement of 65%, 51%, and 61%, in detecting "light sleep" (N1), "deep
> sleep" (N2 + N3), and REM sleep, respectively. [4]

A good literature review on it is [3].

Some facts (which can be found in [3] or its cited papers):

* All trackers overestimate sleep by about 30 minutes.

* The biggest problem for all these wearable trackers are: estimating when you're simply lying awake in bed but you're not moving (it thinks you're asleep).

* Devices like the Fitbit Flex are about as accurate as sleep journalling with regards to total sleep time.

Dreem has the following issues. It's hard to see whether their scientific
papers are peer-reviewed. Yes, they produce science articles in PDF formats
but not in journals. Yes, they collaborate with universities but it isn't
clear how. Nothing is peer reviewed and almost nothing seems to be cited. This
was echoed in a Gizmodo article [1], but I figured it out myself first.

I'm not saying they aren't legit, because another thing I have noticed is that
the scientific community is a bit but not too keen on testing these devices
with the golden standard (polysomnography/PSG). There is still space for a
startup who is clearly capable of demonstrating this and other research
institutes confirming it independently for their device.

Edit: I hope I gave enough sources to make my comment a bit credible.

[1] [https://gizmodo.com/this-smart-headband-was-supposed-to-
help...](https://gizmodo.com/this-smart-headband-was-supposed-to-help-me-
sleep-bette-1822568894)

[2] obtained from abstract @
[https://www.ncbi.nlm.nih.gov/pubmed/27164110](https://www.ncbi.nlm.nih.gov/pubmed/27164110)

[3] obtained from abstract @
[https://ieeexplore.ieee.org/stamp/stamp.jsp?arnumber=8648428](https://ieeexplore.ieee.org/stamp/stamp.jsp?arnumber=8648428)

[4]
[https://www.ncbi.nlm.nih.gov/pubmed/28323455](https://www.ncbi.nlm.nih.gov/pubmed/28323455)

