Background: There is growing interest in using wearable devices to remotely monitor patient behaviors. However, there has been little evaluation of the feasibility of using these technologies to monitor sleep patterns, particularly among more high-risk patients. Objective: To evaluate how patients with ischemic heart disease used wearable devices to monitor their sleep and identify differences in characteristics of patients with higher versus lower utilization. Methods: We evaluated wearable device data from a previously conducted clinical trial testing the use of wearable devices with personalized goal-setting and financial incentives. Patients with ischemic heart disease established a sleep baseline and then were followed for 6 months. The proportion of days that sleep data was collected was compared over the 6 months and by study arm. Characteristics of patients were compared to groups with high, low, or no sleep data. Results: The sample comprised 99 patients with ischemic heart disease, among which 79% used the wearable device to track their sleep. During the 6-month trial, sleep data was collected on 60% of patient-days. These rates declined over time from 77% in months 1-2 to 58% in months 3-4 to 46% in months 5-6. Sleep data was collected at higher rates among the intervention group compared to control (67% vs. 55%, p<0.001). In the main intervention period (months 3-4), patients with higher rates of sleep data were on average older (p<0.05), had a history of smoking (p<0.01), and had higher rates of commercial health insurance (p<0.05). Conclusions: Among patients with ischemic heart disease in a physical activity trial, a high proportion used wearable devices to track their sleep, however rates declined over time. The study of sleep patterns with wearable devices is feasible, and future research should consider larger evaluations coupled with behavioral interventions Clinical Trial: https://www.clinicaltrials.gov. Unique identifier: NCT02531022
