Accuracy, Utility and Applicability of the WHOOP Wearable Monitoring Device in Health, Wellness and Performance - a systematic review

Introduction The WHOOP wearable device is gaining popularity in clinical and performance applications with the ability to track sleep and heart rate parameters and provide feedback on recovery and strain. With the claims on potential benefits, a critical evaluation of the underlying scientific literature and the accuracy of these devices is imperative. Methods Authors systematically reviewed studies examining the accuracy and clinical applications of the WHOOP device. Results The WHOOP appears to have acceptable accuracy for two-stage sleep and heart rate metrics, but depending on the study, room for improvement for four-stage sleep and heart rate variability identification. There are numerous preliminary studies looking at the WHOOP’s ability to track and/or influence sleep and exercise behaviours at the cohort and/or population level. The impact of athletic performance and/or objective sleep is limited based on existing studies. Discussion The clinical application for the WHOOP, given the acceptable accuracy levels, continues to expand. Uses have included impact on sports performance, correlation with medical conditions (i.e. cognitive dysfunction), sleep and health behaviours in various populations. Limitations of existing accuracy trials include variable design and reporting metrics, while results from non-accuracy trials require further clinical validation for response rate and effect size. Conclusion The WHOOP wearable device has acceptable accuracy for sleep and cardiac variables to be used in clinical studies where a baseline can be established and, ideally, other clinical outcomes and gold standard tools can be employed.