Overnight monitoring of sleep biomechanics: A scoping review

Body position and movement during sleep is assessed for both clinical and research purposes. A diverse array of both assessment tools and classification systems are used to capture and code sleep biomechanics data.

The aim of this scoping review was to identify the assessment tools and classification systems used to examine sleep biomechanics, and the strengths and limitations of current approaches.

MEDLINE, EMBASE and CINAHL databases were searched from inception to July 2024, from which 73 publications were selected that assessed body position distribution and/or repositioning rate, for at least one night of sleep. Qualitative content analysis was completed to extract strengths and limitations of current approaches.

Nearly half (44 %) of studies assessed rate of repositioning; 26 % of studies assessed position distribution, and 30 % studies examined both rate of repositioning and position distribution. Common assessment tools were Wearable Accelerometry (26 %) and Polysomnography (22 %). The most frequent repositioning rate classification system was 90° trunk rotation (10 %) and the most frequent position distribution classification system was Supine/Left Side Lying/Right Side Lying/Prone (29 %). Strengths included richness of data set (wearable accelerometry), while limitations included cost and unfamiliar sleep environment (e.g. polysomnography).

While different methods are needed to accommodate various research and clinical needs, a frequent challenge is the lack of detail in how sleep biomechanics are recorded and coded. Wearable sensors offer significant advantages in ease of implementation and granularity of data capture. These devices, in combination with a detailed sleep biomechanics coding system, show potential as future research tools to overcome this limitation.