The untapped potential of ballistographic technology in behavioural sleep medicine

Insomnia is the most prevalent sleep disorder globally, for which Cognitive Behavior Therapy for Insomnia (CBT-I) is the first-line treatment. We argue that under-mattress ballistography has the potential to enhance CBT-I delivery by providing treatment-relevant sleep metrics – sleep onset latency, wake after sleep onset, and sleep efficiency, with fewer limitations than polysomnography/actigraphy and consumer-wearable technologies. Validation studies show strong timing accuracy and acceptable sleep–wake classification. Integrating these metrics with CBT-I may improve decision-making, adherence, and outcomes. Future pragmatic trials and validation studies in psychiatric populations are needed.