Using mobile technology to monitor sleep in bipolar disorder: an observational pilot

Background: Sleep disturbance is a feature of Bipolar Disorder (BD) during both acute and euthymic periods and reliably predicts relapse. Increasingly, mobile technologies are being used to track psychobiological markers of mental health disorders. This study investigated the feasibility of the Fitbit Charge HR to monitor sleep in individuals with BD over a 12-month period. We also assessed whether changes in the sleep patterns corresponded with changes in mood-states. Methods: Sleep and mood were monitored in twelve participants with BD over a 12-month period. Measures were administered at baseline, 1-week, 3-, 6-, 9- and 12-months. Sleep data was collected daily using Fitbit Charge HR devices provided to participants. Results: Self-reported and Fitbit sleep measures were moderately correlated. Cumulative sum charts were used to explore the relationship between shifts in sleep patterns and mood. Total Sleep Time demonstrated a positive relationship with changes in mood amongst some participants. There was little variability in hypomanic/manic symptoms across the sample, limiting the scope of the analysis. Limitations: The small sample size, technological difficulties, and high attrition rate reduced the integrity of results. Conclusions: The Fitbit Charge HR device provides adequate reliability when compared to subjective sleep measures and may be an effective way to monitor changes in mood-states in individuals with BD. Improved methodology for long term monitoring is needed to ensure greater reliability of data.