A Large-Scale Study of a Sleep Tracking and Improving Device with Closed-loop and Personalized Real-time Acoustic Stimulation

Abstract

Various intervention therapies ranging from pharmaceutical to hi-tech tailored solutions have been available to treat difficulty in falling asleep commonly caused by insomnia in modern life. However, current techniques largely remain ill-suited, ineffective, and unreliable due to their lack of precise real-time sleep tracking, in-time feedback on the therapies, an ability to keep people asleep during the night, and a large-scale effectiveness evaluation. Here, we introduce a novel sleep aid system, called Earable, that can continuously sense multiple head-based physiological signals and simultaneously enable closed-loop auditory stimulation to entrain brain activities in time for effective sleep promotion. We develop the system in a lightweight, comfortable, and user-friendly headband with a comprehensive set of algorithms and dedicated own-designed audio stimuli. We conducted multiple protocols from 883 sleep studies on 377 subjects (241 women, 119 men) wearing either a gold-standard device (PSG), Earable, or both concurrently. We demonstrate that our system achieves (1) a strong correlation (0.89 +/- 0.03) between the physiological signals acquired by Earable and those from the gold-standard PSG, (2) an 87.8 +/- 5.3% agreement on sleep scoring using our automatic real-time sleep staging algorithm with the consensus scored by three sleep technicians, and (3) a successful non-pharmacological stimulation alternative to effectively shorten the duration of sleep falling by 24.1 +/- 0.1 minutes. These results show that the efficacy of Earable exceeds existing techniques in intentions to promote fast falling asleep, track sleep state accurately, and achieve high social acceptance for real-time closed-loop personalized neuromodulation-based home sleep care.