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Smart beds use sensors to measure sleep duration and quality. You can view the data it collects as you sleep with an app. Some smart beds provide tips and make adjustments for you, such as raising your head if you snore.
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yipengge/Getty ImagesWhen it comes to getting a good night’s sleep, you’ve likely heard that it’s best to keep your device out of it. With that in mind, turning to technology for a restful night’s sleep may seem a little contradictory.
However, by tracking your sleep and learning from the data, you may be able to sleep more soundly.
Smart beds are one of the latest ways to do just that.
Like smartphones, smart beds differ from model to model. Typically, they’re fitted with sensors that measure things like sleep duration and quality.
This information is then available to view on an app and can be used to make adjustments to your routine.
Certain models offer features like temperature control, position control, and the ability to adjust firmness. Some may even prevent snoring by gently raising your head.
“Although expensive, smart beds are becoming ever more popular,” says Rosey Davidson, infant sleep consultant and CEO of Just Chill Baby Sleep. “They use embedded technology in the mattress to measure how we sleep, and they adjust according to our sleeping position.”
Davidson says some models will use your sleep data to offer sleep-related tips, while others will make the adjustments for you.
For example, some models automatically change the firmness and temperature of your mattress to better suit your needs.
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As well as making for a better night’s sleep, these adjustments may positively impact your health.
Peter Polos, PhD, a sleep medicine specialist for Sleep Number, says smart beds can be critical for connecting the dots with potential health problems.
Polos says smart beds can measure biometrics like:
These metrics are combined with an algorithm to estimate when your sleep stages take place. This can help you gain an understanding of what’s preventing you from sleeping soundly.
Then, you can create an optimal sleep environment that’s tailored to your needs.
What might that mean for your long and short-term health? Let’s look at some of the pros of smart beds.
For most of us, the level of tiredness we feel in the mornings is the only indication we get of how well we’ve slept the night before. A smart bed can help you identify sleep issues you weren’t previously aware of.
Some examples include:
Having metrics about your sleep stats can be helpful in identifying certain health issues.
“Research from Sleep Number has shown that smart beds could potentially detect and track the development of symptoms for COVID-19 and influenza,” says Polos.
Another example is restless legs syndrome.
“This diagnosis is typically made by patient history. However, the metrics available can be used to reinforce the diagnosis, and also to monitor the response to treatment,” he says.
Few of us function well when we’re tired.
“Disruption [to our sleeping habits] can often impact how we feel the next day—and might leave us feeling sluggish and struggling to stay awake or even pay attention throughout the day,” says Polos.
Where short-term health is concerned, not sleeping soundly can impact our cognitive abilities. In addition, Polos says the metabolic activity of the brain is at its greatest during the REM stage of sleep.
“In order to learn and retain what we need to, the proper amount of sleep and sleep stages are important,” he says.
Smart beds can help you identify how much time you spend in each sleep phase and some can make suggestions to make sure you’re getting enough sleep in each.
How well you sleep affects many aspects of your health, including your hormones.
“The circadian rhythm has an influence on hormone release,” says Polos. “For example, growth hormone (HGH), which is pivotal in muscle recovery and growth, is released in slow-wave sleep.”
Polos notes that disruption or reduction of this stage has a direct effect on the release of HGH.
Another important hormone regulated by sleep is insulin, pointing to a link between diabetes and sleep.
—Peter Polos, PhD
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While they offer plenty of benefits, smart beds have a few downsides.
However, Davidson warns that there is a risk of becoming obsessed with the numbers.
“We can get so obsessed with the idea of a good night’s sleep that it becomes unhealthy, and the more we worry about sleep, the worse it can become,” she points out. “You may wake up feeling rested, and then when you look at your data and see the numbers, it might leave you feeling disappointed.”
“A smart mattress can remind you of the importance of healthy sleep habits, and encourage you to prioritize rest. However, no technology will ever replace the intricate architecture of our sleep biology,” says Davidson.
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She says the best conditions for sleep are:
“If we have lots of technology in our sleep space we can become distracted and stimulated,” she points out.
Some smart beds also have a TV that emerges from the end of the bed, emitting varying levels of light that could disrupt your sleep, she adds.
“We want our bodies to be able to regulate themselves without external input,” says Davidson. “Personally, I prefer the old-fashioned way, where you can just kick off your blankets or duvet if you are hot.”
Davidson believes smart beds can improve comfort and may be beneficial to those with injuries or long-term chronic pain.
However, she says you can emulate most of what a smart bed does with a few simple tweaks.
“Use cotton, breathable bedding and bedclothes so that your body can regulate its own temperature,” she advises. “If it’s hot, open a window or use a fan. If it’s cold, add a layer or use a [thicker] duvet.”
Other daily habits that may help include:
With their high price point, smart beds aren’t easily accessible to everyone.
Implementing healthy habits like those mentioned above can go a long way toward getting you deep, restful sleep. Plus, they’re mostly free!
—Rosey Davidson
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If you’ve decided to purchase a smart bed, you might be wondering what to do with all that sleep data. While you may be able to spot some patterns yourself, your best bet may be to consult a specialist.
“If an individual notices they aren’t sleeping well and are trying different methods, I typically recommend consulting a sleep specialist who can evaluate your sleep and help you work through whatever challenges you’re facing,” says Polos.
In this case, sharing your smart bed sleep data can be a major asset.
“It can help health care practitioners acquire an accurate, real-world, longitudinal view of your sleep health over time,” says Polos.
While this data won’t replace a formal study, Polos says it can support diagnosis and clarify the need for additional tests.
If a smart bed is out of your budget or—like Davidson—you prefer the old-fashioned way, there are plenty of adjustments you can try for a better night’s rest.
Polos recommends the following:
Restful sleep is essential to long-term and short-term health. It can affect everything from your energy levels and concentration to your hormones.
A smart bed can help you understand sleep-related data such as sleep quality, movements, heart rate, and more.
However, smart beds are not a cure-all. Some users may find tech in their sleep space distracting, and implementing sound sleep habits, like those listed above, may work best.
Victoria Stokes is a writer from the United Kingdom. When she’s not writing about her favorite topics, personal development, and well-being, she usually has her nose stuck in a good book. Victoria lists coffee, cocktails, and the color pink among some of her favorite things. Find her on Instagram.
The purpose of this study was to examine nurses' perceptions of the smart mattress equipped with Internet of things, which are incorporated into patients' beds. In addition, their concerns and suggestions about smart mattress were explored. A total of 349 nurses in a tertiary hospital participated in a cross-sectional survey. Data were collected using questionnaires. Descriptive statistical analysis was used for survey data, whereas content analysis was used for qualitative data from open-ended questions. The participants' intention to accept the smart mattresses was 12.5 (SD, 1.73) on average, indicating a high level of acceptance. The participants expected the smart mattresses to decrease their physical work burden, improve work efficiency, and prevent pressure ulcers. However, they were concerned about an increase in other aspects of their workload and in patient safety problems due to false alarms, inaccuracies, and malfunctions of the device. Nurses suggested various features that can be integrated into smart mattress. It is critical to address nurses' perceptions, expectations, and concerns during the conceptual and developmental stage of new technology in order to improve the usability, acceptance, and adoption of smart mattresses and other new innovations in hospital settings.
Thus, the purposes of this study were to describe nurses' perceptions about the IoT-based smart mattress that included an automatic rotating function for repositioning, weight measurement feature, and a vital signs measurement function. The perceptions about the smart mattress were examined in terms of usefulness, ease of use, intention to accept, degree of assistance, necessity, and expected outcomes. In addition, nurses' concerns as well as suggestions for additional necessary features based on their working departments were explored.
Although nurses are one of the key stakeholders who ensure the safe use of medical equipment and devices, little is known about nurses' perceptions, concerns, and suggestions regarding a smart mattress for patient care. According to the technology acceptance model, 20 an individual's behavioral intention in the use of technology is affected by perceived usefulness and ease of use. The model assumes that high level of behavioral intention leads to actual use. When a new technology such as smart mattress is introduced, it is important to investigate how nurses perceive smart mattresses in order to improve their usability and acceptance of new technologies in healthcare services. In addition, the smart features that can be incorporated to the mattresses may vary, depending on their working departments such as internal medicine ward, surgical ward, and ICU due to the needs and characteristics of patients. Because smart mattresses are expected to promote individualized care as IoT hub, 7 , 10 , 11 , 21 it is necessary to explore which features may be in need among various working department in hospital.
Recently, medical beds and mattresses have been upgraded with technological advances, such as sensors, Internet of Things (IoT), big data, artificial intelligence, and robotics. 7 – 9 Precise sensors attached to mattresses can monitor patient conditions and accurately measure patients' biometric data, which the sensors can send to a web cloud server that maintains electronic medical records. 7 , 10 , 11 In particular, remote patient monitoring without direct contact has become critical in order to reduce cross-infection between nurses and patients with highly communicable infectious diseases. In the advent of the coronavirus disease (COVID-19) pandemic, interest in mattresses equipped with smart features has continued to increase. 12 – 14 Thus, improving the quality and features of medical beds has become important in enhancing the safety and well-being of both patients and nurses. 15 – 19
Medical beds are essential in providing care for patients. Most nursing practices, such as monitoring vital signs, are done while patients are on their beds. However, various patient safety accidents, such as falls and bedsores, can also occur because of patients staying in bed. 1 – 3 In particular, patients who cannot or do not move in bed are at high risk of developing bedsores when they are not properly cared for after urination or defecation and/or when foreign substances or objects such as wrinkled sheets and intravenous lines compress the patients' skin. 4 , 5 In addition, because the bed mattress is placed at a certain height above the floor, patients who are unable to remain stable on the bed, have a poor ability to adjust their legs, and/or suffer from lower limb weakness have a high risk of falling. 6 Nurses provide various nursing services for patients while the patients are lying on the bed, including body weight measurement, body position change, bathing, fecal treatment, and moving patients to another bed. These activities require a great deal of physical exertion from nurses.
The study was approved by the appropriate institutional review board. Nurses voluntarily participated in the study. In the survey URL, before answering the questionnaire online, the participants were asked to respond to the consent question of whether they agreed to be involved in this research. The questionnaire did not include personal information that could identify the participants. The collected data were managed in an unidentifiable form for each participant, which were stored in two research computers that were double-locked.
The SPSS 26.0 software program (IBM Inc., Armonk, NY, USA) was used for data analysis of quantitative data. The descriptive statistics included frequency, percentage, mean, and SD. The participants' responses to open-ended questions were analyzed for themes. Three coders were involved with coding and descriptive content analysis. The first and second coders analyzed the participants' responses and created code summaries independently, which were then discussed and modified based on the input from the third coder. Review of the category data yielded themes and subthemes that described the concerns and suggestions for additional features. The codes were revised by grouping and collapsing them when commonalities were apparent. The classified themes were described in terms of frequency, by counting the number of comments. Detailed record keeping was made for an audit trail that provided the evidence and consistency in analysis processes.
In addition, the degree of necessity as perceived by nurses was measured using a five-item Likert scale, which ranged from “none” to “strongly agree.” The degree of assistance in the nurses' physical and mental work burden was measured with a numerical scale of −10 to +10 points; 0 meant no changes, −10 means a full increase in the burden, and +10 means a full decrease in the burden. A five-item Likert scale ranging from “none” to “strongly agree” was also used to measure the expected functional performance outcomes of smart mattress. The content validity of the additional items was confirmed by six experts who were asked to rate each item based on relevance, clarity, and appropriateness on the seven-point scale. They included two nursing faculty members, two doctoral students with clinical experience, one nursing department manager, one head nurse, and one RN.
The participants were also asked about their perceptions regarding the IoT-based smart mattresses, which included an automatic rotating function for repositioning, weight measurement feature, and a vital sign (respiratory rate, heart rate) measurement function. Based on Technology Acceptance Model, the 10-item instrument of perceived usefulness (four items), perceived ease of use (four items), and intention to accept a smart mattress (two items) was used. 20 The instrument was a seven-point Likert scale consisting of 1 point (not at all) to 7 points (absolutely). It has been used extensively in previous studies, which have reported its reliability and validity. 20 , 22 , 23 The items of the Korean version 22 were modified for this study. The internal consistency and reliability of the Korean version were measured using Cronbach's α. The reliabilities in this study were 0.937 for perceived usefulness, 0.913 for perceived ease of use, and 0.890 for intention to use.
The desired additional features varied, depending on the participants' clinical work department (Table ). The features that the participants stated for smart mattresses were detailed with examples in Supplemental Digital Content 1 ( http://links.lww.com/CIN/A195 ). The participants from all of the departments hoped to have additional features (eg, smart television, automated over-bed tables, and a vibrating function), which would need to be attached and integrated into the smart mattresses. Those from all of the departments except the emergency department mentioned skin pressure–related features, such as back massage and air mattress functions. Those from all of the departments except the operating room (OR) indicated that they would like smart mattresses to have excretion-related features, including a stool emission sensor or the allowance of defecation in bed without the need for diapers. The additional features that assist bed-making and cleaning were cited by all of the participants but those in the outpatient department. Other desired features that were desired by many departments were related to telemonitoring, fall prevention, temperature and humidity control, alarm and alerts, body measurement, body position, moving and transferring, emergency readiness, and convenient use.
The mean score of perceived usefulness was 23.76 (SD, 3.65), whereas that of the perceived ease of use was 22.72 (SD, 4.16). Their intention to accept the smart mattresses was 12.5 (SD, 1.73) on average. Whereas 87.6% stated that its adaptation in healthcare is very much or moderately necessary, 88.3% of the participants perceived the smart mattress to be assistive in their workload from a moderate to great extent. The most expected functional performance outcomes of smart mattress were a decrease in nurses' physical burden, followed by increased work efficiency. In addition, they expected pressure ulcer prevention in patient care. The expected functional performance outcomes of smart mattress are detailed in Figure .
The mean age of the participants was 30.9 (SD, 6.19) years, and 95.4% of them were women. Among a total of 349 participants, 79.7% had a bachelor's degree, 8.3% were studying for a master's degree, and 8.0% had a master's degree. Regarding each participant's working department, 88 (25.1%) worked at an internal medicine ward, 68 (19.5%) in a surgical ward, and 43 (12.3%) in an ICU. Other participants (n = 54 [15.5%]) worked in laboratory, anesthesiology unit, anesthesia recovery room, angiography room, and coordinator team. Their total clinical experience was 7.6 (SD, 6.18) years on average, whereas their clinical experience in their current workplace was 3.6 (SD, 3.65) years. The participants performed as many as 19.4 (SD, 23.60) patients' position changes per week on average. The mean number of vital sign measurement per day was 24.4 times. The mean number of weight measurements per day was 5.6 (SD, 7.30). Table presents the general characteristics of participants.
The findings show that a smart mattress is perceived as highly assistive and necessary. The participants were also positive regarding its usefulness, ease of use, and intention to accept if it was introduced in a healthcare environment. They perceived that smart mattresses would be helpful for a range of improvements in patient care, such as pressure ulcer prevention, contactless infection prevention, fall prevention, and sleep improvement. The reason for these perceptions was that the participants were recruited from a tertiary hospital that is known as one of the most innovative hospitals, equipped with the highest level of medical information technology in South Korea. Nurses in this hospital may have been exposed to advanced technologies, such as remote patient monitoring with alerts. The results are consistent with those in previous studies, in that people greatly exposed to technology generally have a positive attitude toward technology and highly evaluate the need for the introduction of a new device.21,22
We found that the benefit that the participants most expected was a decrease in physical burden if the smart mattress included an automatic rotating function for repositioning, weight measurement feature, and vital sign (respiratory rate, heart rate) measurement function. When there is a high frequency of patient transfers due to examinations, surgery, hospitalization, discharge, and other such reasons, patient lifting is a concern, as the task can lead to physical injuries for nurses.25,26 Previous studies have shown that providing physical assistance in relation to nurses' tasks can prevent these injuries and improve the quality of nursing care in the long run.27,28
Other studies have reported that the introduction of new devices or technologies can also increase the burden of other aspects of work,29–31 which can partly explain the concerns that the participants expressed in this study. Some participants pointed out that too many or excessive features can cause problems, which can result in a decrease in patient safety and increased workload. It was suggested to focus on essential functions that can be useful for most of the departments rather than covering all possible functions. The participants recognized that they will need to make a greater effort to learn in order to adopt a new smart mattress in their clinical practice. There were also concerns about alarms and alerts that frequently ring unnecessarily. Although emergency alarms are useful for monitoring abnormal symptoms of many patients assigned to nurses, alarm fatigue due to frequent alarms can occur.32 Unnecessary alarms result in an increased number of inquiries from patients and their caregivers.33,34 In order to reduce the fatigue brought about by false alarms while quickly responding to emergencies, it is suggested that the alarm setting needs to be precisely set at the appropriate numerical value and can be reset manually when necessary. In addition, the participants expressed reservations regarding inaccuracies of the information generated by smart mattresses and were concerned about the possibility of patient safety accidents due to device malfunction and such inaccuracies. Previous research identified that technical errors act as obstacles to adopting technology.35
The findings of this study indicate that the participants in all of the departments wanted features that facilitate the users' experiences. For example, there are some desired features that were particularly important for the caring of bedridden patients. Nurses working at both ICUs and the nationally designated COVID-19 wards wished for additional features related to body position change, skin pressure, excretion, and bed-making and cleaning. Patients in ICUs have various equipment and tubes attached to them, such as the E-tube, C-line, Foley catheter, and A-line, and nurses need to always be cautious about the possibility of the removal of equipment while performing nursing activities, such as position change.36 In addition, because patients in ICUs are unable to get out of bed on their own, patient excretion, including urination and defecation, needs to be taken care of while they are in bed. Temperature and humidity control is also important in the event of the use of continuous renal replacement therapy and extracorporeal membrane oxygenation, which could reduce the patients' body temperature.37 However, it is extremely difficult for patients to wear clothes other than the patient gown; thus, warmers are often used. However, warmers make a lot of noise, and there is a risk of patient burns; this leads to a high demand for the warming feature in smart mattresses. Although hypothermic therapy is often performed to provide proper cooling for patients' post–cardiopulmonary resuscitation or patients who have a fever, the equipment for hypothermic therapy is not only quite expensive and burdensome but is also difficult to operate. These may be reasons why nurses in ICUs need the cooling feature. However, the participants in both the ICU and the nationally designated COVID-19 wards did not ask features related to alarms or alerts, emergency readiness, and falls. It was speculated that this is because sufficient alarms, 24-hour patient monitoring, and other emergency readiness systems have already been established in the ICU. However, alerts and alarms were frequently desired by nurses in many other departments. It was also believed that the demand of the fall-related feature was not high in ICUs because patients are bedridden and cannot get out of bed.
The desired features reflected the characteristics of emergency rooms, where numerous patients are admitted, transferred, and discharged within a short amount of time. Because of frequent admissions and discharges, the participants from the emergency department wanted features related to frequent bed preparation, and patient transfer, and the high risk of falling due to frequent patient movements. However, according to a previous study, because of the relatively short duration of hospital stay, nurses from this department seem to have a low demand for other features, such as the skin pressure–related feature.38 Interestingly, the participants in the outpatient clinic wished for all of the aforementioned desired features except one related to body position change. It was speculated that they responded based on not only their current work experience but also previous ones, as most of them had worked in various departments prior to their move to the outpatient clinic. The participants who worked in the OR wanted various features except for those related to body position change and convenient use. This could be because of the characteristics of the OR, where patients maintain the same posture39 without clothes for a prescribed amount of time. It was also speculated that nurses in the OR wished for most of the desired features because of the aseptic requirement in ORs, which poses a difficulty in the frequent assessment of patients' condition.
Therefore, a variety of potential developments of smart mattresses can be expected in the future. The nurses who worked in the internal medicine wards responded on all categories of the additionally desired features except for that of body position change. It was considered that they did not consider any additional body position change–related features because they were asked to suggest additional features for a smart mattress that already includes an automatic rotating function for repositioning, weight measurement feature, and vital sign (respiratory rate, heart rate) measurement function. Because patients of the internal medicine department often have multiple diseases, it was speculated that the nurses stationed here had a lot of suggestions regarding the features added to smart mattresses.40 However, the findings suggest that the specific features that were desired may vary greatly according not only to the specialty but also to unique characteristics of a care environment. Therefore, it is critical to examine the needs and preferences of not only nurses but also patients in various clinical settings when a new technology or device is considered.
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