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Volume 15 No. 11
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Accepted Papers

Scientific Investigations

Validation of Fitbit Charge 2 and Fitbit Alta HR Against Polysomnography for Assessing Sleep in Adults With Obstructive Sleep Apnea

Fernando Moreno-Pino1,2,*; Alejandro Porras-Segovia3,4,*; Pilar López-Esteban5; Antonio Artés1,2; Enrique Baca-García3,6,7,8,9,10
1Universidad Carlos III de Madrid, Leganés, Spain; 2Gregorio Marañón Health Research Institute, Madrid, Spain; 3Department of Psychiatry, University Hospital Jimenez Diaz Foundation, Madrid, Spain; 4International School for Postgraduate Studies, University of Granada, Granada, Spain; 5Neurophysiology Service, University Hospital HLA Moncloa, Madrid, Spain; 6Department of Psychiatry, Madrid Autonomous University, Madrid, Spain; 7Department of Psychiatry, University Hospital Rey Juan Carlos, Mostoles, Spain; 8Department of Psychiatry, General Hospital of Villalba, Madrid, Spain; 9Department of Psychiatry, University Hospital Infanta Elena, Valdemoro, Spain; 10Universidad Catolica del Maule, Talca, Chile; *Contributed equally

Study Objectives:

Consumer wearable devices may be a helpful method of assessing sleep, but validation is required for their use in clinical practice. Our aim was to validate two models of Fitbit sleep trackers that rely on both accelerometer and heart rate sensors against polysomnography in participants with obstructive sleep apnea (OSA).


Participants were adults presenting with symptoms of OSA and attending our outpatient sleep clinic. A polysomnography (PSG) was applied to all participants at the same time they were wearing a Fitbit sleep tracker. Using paired t tests and Bland-Altman plots, we compared the sleep measures provided by the wearable devices with those obtained by PSG. Since Fitbit devices’ automatic detection of sleep start time can cause bias, we performed a correction using Huber loss function-based linear regression and a leave-one-out strategy.


Our sample consisted of 65 patients. Diagnosis of OSA was confirmed on 55 (84.6%). There were statistically significant differences between PSG and Fitbit measures for all sleep outcomes but rapid eye movement sleep. Fitbit devices overestimated total sleep time, and underestimated wake after sleep onset and sleep onset latency. After correction of bias, Fitbit-delivered measures of sleep onset latency did not significantly differ of those provided by PSG.


Fitbit wearable devices showed an acceptable sensitivity but poor specificity. Consumer sleep trackers still have insufficient accuracy for clinical settings, especially in clinical populations. Solving technical issues and optimizing clinically-oriented features could make them apt for their use in clinical practice in a nondistant future.


Moreno-Pino F, Porras-Segovia A, López-Esteban P, Artés A, Baca-García E. Validation of Fitbit Charge 2 and Fitbit Alta HR against polysomnography for assessing sleep in adults with obstructive sleep apnea. J Clin Sleep Med. 2019;15(11):1645–1653.

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