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Meguro T, Takayama F, Hammarlund H, Honjo M. Effects of a mobile health intervention on health-related outcomes in Japanese office workers: a pilot study. Int J Occup Med Environ Health 2024; 37:153-164. [PMID: 38375630 PMCID: PMC11142403 DOI: 10.13075/ijomeh.1896.02317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/17/2024] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVES The purpose of the current study was to explore the effects of a mobile health (mHealth) intervention based on the Persuasive System Design (PSD) model on health-related outcomes among office workers. MATERIAL AND METHODS The authors conducted a trial that consisted of a 4-week baseline and an 8-week intervention period by reference to 23 office workers in a private research company. The mHealth application was developed to improve these workers' daily step count, decrease their sedentary time, and increase their sleep duration in accordance with the PSD model. The app features included at least 1 principal factor from each of the 4 main categories of the PSD model (primary task support, dialogue support, system credibility support, and social support). The objective health-related variables were measured using a smartwatch (Fitbit Luxe) that was synchronized with the application using the Fitbit Web Application Programming Interface. Subjects used the app, which included self-monitoring, personalized messages, education, and a competition system for users, during the intervention period. RESULTS Sedentary time exhibited a significant decrease (a median reduction of 14 min/day, p < 0.05) during the intervention period. No significant differences in daily step count and sleep duration were observed between the baseline and intervention periods. CONCLUSIONS This study suggests that the mHealth intervention based on the PSD model was useful for reducing sedentary time among office workers. Given that many previous studies on this topic have not been based on any theories, future studies should investigate the impact of structured selection behavior change theories on health-related outcomes among office workers. Int J Occup Med Environ Health. 2024;37(2):153-64.
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Affiliation(s)
- Takumi Meguro
- KDDI Research, Inc., Life Science Laboratories, Saitama, Japan
| | | | | | - Masaru Honjo
- KDDI Research, Inc., Life Science Laboratories, Saitama, Japan
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Kubala AG, Roma PG, Jameson JT, Sessoms PH, Chinoy ED, Rosado LR, Viboch TB, Schrom BJ, Rizeq HN, Gordy PS, Hirsch LDA, Biggs LAT, Russell DW, Markwald RR. Advancing a U.S. navy shipboard infrastructure for sleep monitoring with wearable technology. APPLIED ERGONOMICS 2024; 117:104225. [PMID: 38219375 DOI: 10.1016/j.apergo.2024.104225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/20/2023] [Accepted: 01/03/2024] [Indexed: 01/16/2024]
Abstract
Development of fatigue management solutions is critical to U.S. Navy populations. This study explored the operational feasibility and acceptability of commercial wearable devices (Oura Ring and ReadiBand) in a warship environment with 845 Sailors across five ship cohorts during at-sea operations ranging from 10 to 31 days. Participants were required to wear both devices and check-in daily with research staff. Both devices functioned as designed in the environment and reliably collected sleep-wake data. Over 10,000 person-days at-sea, overall prevalence of Oura and ReadiBand use was 69% and 71%, respectively. Individual use rates were 71 ± 38% of days underway for Oura and 59 ± 34% for ReadiBand. Analysis of individual factors showed increasing device use and less device interference with age, and more men than women found the devices comfortable. This study provides initial support that commercial wearables can contribute to infrastructures for operational fatigue management in naval environments.
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Affiliation(s)
- Andrew G Kubala
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA; Military and Veterans Health Solutions, Leidos Inc., San Diego, CA, USA
| | - Peter G Roma
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA; Military and Veterans Health Solutions, Leidos Inc., San Diego, CA, USA
| | - Jason T Jameson
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA; Military and Veterans Health Solutions, Leidos Inc., San Diego, CA, USA
| | - Pinata H Sessoms
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA
| | - Evan D Chinoy
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA
| | - Luis R Rosado
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA; Military and Veterans Health Solutions, Leidos Inc., San Diego, CA, USA
| | - Trevor B Viboch
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA; Military and Veterans Health Solutions, Leidos Inc., San Diego, CA, USA
| | - Brandon J Schrom
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA; Military and Veterans Health Solutions, Leidos Inc., San Diego, CA, USA
| | - Hedaya N Rizeq
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA; Military and Veterans Health Solutions, Leidos Inc., San Diego, CA, USA
| | - Prayag S Gordy
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA; Military and Veterans Health Solutions, Leidos Inc., San Diego, CA, USA
| | | | - Lcdr Adam T Biggs
- Psychological Health and Resilience Department, Military Population Health Directorate, Naval Health Research Center, San Diego, CA, USA
| | - Dale W Russell
- Commander Naval Surface Force, U.S. Pacific Fleet, San Diego, CA, USA; Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Rachel R Markwald
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA.
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Merrigan JJ, Stone JD, Kraemer WJ, Friend C, Lennon K, Vatne EA, Hagen JA. Analysis of Sleep, Nocturnal Physiology, and Physical Demands of NCAA Women's Ice Hockey Across a Championship Season. J Strength Cond Res 2024; 38:694-703. [PMID: 38513177 DOI: 10.1519/jsc.0000000000004678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
ABSTRACT Merrigan, JJ, Stone, JD, Kraemer, WJ, Friend, C, Lennon, K, Vatne, EA, and Hagen, JA. Analysis of sleep, nocturnal physiology, and physical demands of NCAA women's ice hockey across a championship season. J Strength Cond Res 38(4): 694-703, 2024-The aims of this study were to evaluate the (a) relationships between daily physical demands and nighttime sleep, heart rate (HR), and heart rate variability (HRV); (b) weekly changes in physical demands and sleep; and (c) differences among positions and between training and competition during a competitive season in National Collegiate Athletic Association (NCAA) women's ice hockey. Twenty-five NCAA Division I women's ice hockey athletes wore a sensor at night to monitor sleep quantity or quality (e.g., time asleep and sleep efficiency) and physiology (e.g., HR and HRV). During training and competitions (31 regular season and 7 postseason), athletes wore performance monitoring systems to assess workload demands (e.g., training impulse and TRIMP). As internal workload (TRIMP, Time >80% of HRmax, Average HR) during training or competition increased, nocturnal HRV decreased, HR increased, and Sleep Duration, Sleep Score, and Readiness Score decreased that night. Across the season, athletes experienced lower HRV, but exhibited longer sleep durations. Training Distance, Duration, Time >80% HRmax, Average HR, and TRIMP decreased, whereas competition Total Distance, Duration, and TRIMP increased across weeks throughout the season. There were differences across positions and season blocks when evaluating these data at the mesocycle level. Athletes slept longer before competition compared with training, but physiological data did not differ. Competitions had greater physiological demands than training. We speculate that the increased focus on sleep hygiene, as evidenced by the increase in sleep over the season, may have served as a recovery aid to combat physiological stress of accumulated demands of competitions that increased over time into postseason tournaments.
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Affiliation(s)
- Justin J Merrigan
- Human Performance Collaborative, Office of Research, The Ohio State University, Columbus, Ohio
| | | | - William J Kraemer
- Human Performance Collaborative, Office of Research, The Ohio State University, Columbus, Ohio
- Department of Athletics, The Ohio State University, Columbus, Ohio
- Department of Human Sciences, The Ohio State University, Columbus, Ohio
| | | | - Kevin Lennon
- Department of Athletics, The Ohio State University, Columbus, Ohio
| | - Emaly A Vatne
- Human Performance Collaborative, Office of Research, The Ohio State University, Columbus, Ohio
- Department of Athletics, The Ohio State University, Columbus, Ohio
- Department of Human Sciences, The Ohio State University, Columbus, Ohio
| | - Josh A Hagen
- Human Performance Collaborative, Office of Research, The Ohio State University, Columbus, Ohio
- Department of Integrated Systems Engineering, The Ohio State University, Columbus, Ohio
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Schyvens AM, Van Oost NC, Aerts JM, Masci F, Peters B, Neven A, Dirix H, Wets G, Ross V, Verbraecken J. Accuracy of Fitbit Charge 4, Garmin Vivosmart 4, and WHOOP Versus Polysomnography: Systematic Review. JMIR Mhealth Uhealth 2024; 12:e52192. [PMID: 38557808 PMCID: PMC11004611 DOI: 10.2196/52192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 02/01/2024] [Accepted: 02/01/2024] [Indexed: 04/04/2024] Open
Abstract
Background Despite being the gold-standard method for objectively assessing sleep, polysomnography (PSG) faces several limitations as it is expensive, time-consuming, and labor-intensive; requires various equipment and technical expertise; and is impractical for long-term or in-home use. Consumer wrist-worn wearables are able to monitor sleep parameters and thus could be used as an alternative for PSG. Consequently, wearables gained immense popularity over the past few years, but their accuracy has been a major concern. Objective A systematic review of the literature was conducted to appraise the performance of 3 recent-generation wearable devices (Fitbit Charge 4, Garmin Vivosmart 4, and WHOOP) in determining sleep parameters and sleep stages. Methods Per the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement, a comprehensive search was conducted using the PubMed, Web of Science, Google Scholar, Scopus, and Embase databases. Eligible publications were those that (1) involved the validity of sleep data of any marketed model of the candidate wearables and (2) used PSG or an ambulatory electroencephalogram monitor as a reference sleep monitoring device. Exclusion criteria were as follows: (1) incorporated a sleep diary or survey method as a reference, (2) review paper, (3) children as participants, and (4) duplicate publication of the same data and findings. Results The search yielded 504 candidate articles. After eliminating duplicates and applying the eligibility criteria, 8 articles were included. WHOOP showed the least disagreement relative to PSG and Sleep Profiler for total sleep time (-1.4 min), light sleep (-9.6 min), and deep sleep (-9.3 min) but showed the largest disagreement for rapid eye movement (REM) sleep (21.0 min). Fitbit Charge 4 and Garmin Vivosmart 4 both showed moderate accuracy in assessing sleep stages and total sleep time compared to PSG. Fitbit Charge 4 showed the least disagreement for REM sleep (4.0 min) relative to PSG. Additionally, Fitbit Charge 4 showed higher sensitivities to deep sleep (75%) and REM sleep (86.5%) compared to Garmin Vivosmart 4 and WHOOP. Conclusions The findings of this systematic literature review indicate that the devices with higher relative agreement and sensitivities to multistate sleep (ie, Fitbit Charge 4 and WHOOP) seem appropriate for deriving suitable estimates of sleep parameters. However, analyses regarding the multistate categorization of sleep indicate that all devices can benefit from further improvement in the assessment of specific sleep stages. Although providers are continuously developing new versions and variants of wearables, the scientific research on these wearables remains considerably limited. This scarcity in literature not only reduces our ability to draw definitive conclusions but also highlights the need for more targeted research in this domain. Additionally, future research endeavors should strive for standardized protocols including larger sample sizes to enhance the comparability and power of the results across studies.
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Affiliation(s)
- An-Marie Schyvens
- Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital, Edegem, Belgium
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Wilrijk, Belgium
| | | | | | | | - Brent Peters
- Transportation Research Institute (IMOB), School of Transportation Sciences, UHasselt, Hasselt, Belgium
| | - An Neven
- Transportation Research Institute (IMOB), School of Transportation Sciences, UHasselt, Hasselt, Belgium
| | - Hélène Dirix
- Transportation Research Institute (IMOB), School of Transportation Sciences, UHasselt, Hasselt, Belgium
| | - Geert Wets
- Transportation Research Institute (IMOB), School of Transportation Sciences, UHasselt, Hasselt, Belgium
| | - Veerle Ross
- Transportation Research Institute (IMOB), School of Transportation Sciences, UHasselt, Hasselt, Belgium
- Faresa, Evidence-Based Psychological Centre, Hasselt, Belgium
| | - Johan Verbraecken
- Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital, Edegem, Belgium
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Wilrijk, Belgium
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Henson J, Covenant A, Hall AP, Herring L, Rowlands AV, Yates T, Davies MJ. Waking Up to the Importance of Sleep in Type 2 Diabetes Management: A Narrative Review. Diabetes Care 2024; 47:331-343. [PMID: 38394635 DOI: 10.2337/dci23-0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/27/2023] [Indexed: 02/25/2024]
Abstract
For the first time, the latest American Diabetes Association/European Association for the Study of Diabetes (ADA/EASD) consensus guidelines have incorporated a growing body of evidence linking health outcomes associated with type 2 diabetes to the movement behavior composition over the whole 24-h day. Of particular note, the importance of sleep as a key lifestyle component in the management of type 2 diabetes is promulgated and presented using three key constructs: quantity, quality, and timing (i.e., chronotype). In this narrative review we highlight some of the key evidence justifying the inclusion of sleep in the latest consensus guidelines by examining the associations of quantity, quality, and timing of sleep with measures of glycemia, cardiovascular disease risk, and mortality. We also consider potential mechanisms implicated in the association between sleep and type 2 diabetes and provide practical advice for health care professionals about initiating conversations pertaining to sleep in clinical care. In particular, we emphasize the importance of measuring sleep in a free-living environment and provide a summary of the different methodologies and targets. In summary, although the latest ADA/EASD consensus report highlights sleep as a central component in the management of type 2 diabetes, placing it, for the first time, on a level playing field with other lifestyle behaviors (e.g., physical activity and diet), the evidence base for improving sleep (beyond sleep disorders) in those living with type 2 diabetes is limited. This review should act as a timely reminder to incorporate sleep into clinical consultations, ongoing diabetes education, and future interventions.
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Affiliation(s)
- Joseph Henson
- NIHR Leicester Biomedical Research Centre, Diabetes Research Centre, College of Life Sciences, University of Leicester, U.K
| | - Alix Covenant
- NIHR Leicester Biomedical Research Centre, Diabetes Research Centre, College of Life Sciences, University of Leicester, U.K
| | - Andrew P Hall
- University Hospitals of Leicester NHS Trust, Leicester, U.K
- Hanning Sleep Laboratory, Leicester General Hospital, Leicester, U.K
| | - Louisa Herring
- NIHR Leicester Biomedical Research Centre, Diabetes Research Centre, College of Life Sciences, University of Leicester, U.K
- University Hospitals of Leicester NHS Trust, Leicester, U.K
| | - Alex V Rowlands
- NIHR Leicester Biomedical Research Centre, Diabetes Research Centre, College of Life Sciences, University of Leicester, U.K
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Thomas Yates
- NIHR Leicester Biomedical Research Centre, Diabetes Research Centre, College of Life Sciences, University of Leicester, U.K
| | - Melanie J Davies
- NIHR Leicester Biomedical Research Centre, Diabetes Research Centre, College of Life Sciences, University of Leicester, U.K
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Irrera F, Gumiero A, Zampogna A, Boscari F, Avogaro A, Gazzanti Pugliese di Cotrone MA, Patera M, Della Torre L, Picozzi N, Suppa A. Multisensor Integrated Platform Based on MEMS Charge Variation Sensing Technology for Biopotential Acquisition. SENSORS (BASEL, SWITZERLAND) 2024; 24:1554. [PMID: 38475089 DOI: 10.3390/s24051554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024]
Abstract
We propose a new methodology for long-term biopotential recording based on an MEMS multisensor integrated platform featuring a commercial electrostatic charge-transfer sensor. This family of sensors was originally intended for presence tracking in the automotive industry, so the existing setup was engineered for the acquisition of electrocardiograms, electroencephalograms, electrooculograms, and electromyography, designing a dedicated front-end and writing proper firmware for the specific application. Systematic tests on controls and nocturnal acquisitions from patients in a domestic environment will be discussed in detail. The excellent results indicate that this technology can provide a low-power, unexplored solution to biopotential acquisition. The technological breakthrough is in that it enables adding this type of functionality to existing MEMS boards at near-zero additional power consumption. For these reasons, it opens up additional possibilities for wearable sensors and strengthens the role of MEMS technology in medical wearables for the long-term synchronous acquisition of a wide range of signals.
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Affiliation(s)
- Fernanda Irrera
- Department of Information Engineering, Electronics and Telecommunications, Sapienza University of Rome, 00185 Rome, Italy
| | | | - Alessandro Zampogna
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | | | - Angelo Avogaro
- Department of Medicine, University of Padua, 35122 Padua, Italy
| | | | - Martina Patera
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | | | | | - Antonio Suppa
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
- IRCCS Neuromed, 86077 Pozzilli, Italy
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Jang H, Lee S, Son Y, Seo S, Baek Y, Mun S, Kim H, Kim I, Kim J. Exploring Variations in Sleep Perception: Comparative Study of Chatbot Sleep Logs and Fitbit Sleep Data. JMIR Mhealth Uhealth 2023; 11:e49144. [PMID: 37988148 PMCID: PMC10698662 DOI: 10.2196/49144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/11/2023] [Accepted: 10/18/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Patient-generated health data are important in the management of several diseases. Although there are limitations, information can be obtained using a wearable device and time-related information such as exercise time or sleep time can also be obtained. Fitbits can be used to acquire sleep onset, sleep offset, total sleep time (TST), and wakefulness after sleep onset (WASO) data, although there are limitations regarding the depth of sleep and satisfaction; therefore, the patient's subjective response is still important information that cannot be replaced by wearable devices. OBJECTIVE To effectively use patient-generated health data related to time such as sleep, it is first necessary to understand the characteristics of the time response recorded by the user. Therefore, the aim of this study was to analyze the characteristics of individuals' time perception in comparison with wearable data. METHODS Sleep data were acquired for 2 weeks using a Fitbit. Participants' sleep records were collected daily through chatbot conversations while wearing the Fitbit, and the two sets of data were statistically compared. RESULTS In total, 736 people aged 30-59 years were recruited for this study, and the sleep data of 543 people who wore a Fitbit and responded to the chatbot for more than 7 days on the same day were analyzed. Research participants tended to respond to sleep-related times on the hour or in 30-minute increments, and each participant responded within the range of 60-90 minutes from the value measured by the Fitbit. On average for all participants, the chat responses and the Fitbit data were similar within a difference of approximately 15 minutes. Regarding sleep onset, the participant response was 8 minutes and 39 seconds (SD 58 minutes) later than that of the Fitbit data, whereas with respect to sleep offset, the response was 5 minutes and 38 seconds (SD 57 minutes) earlier. The participants' actual sleep time (AST) indicated in the chat was similar to that obtained by subtracting the WASO from the TST measured by the Fitbit. The AST was 13 minutes and 39 seconds (SD 87 minutes) longer than the time WASO was subtracted from the Fitbit TST. On days when the participants reported good sleep, they responded 19 (SD 90) minutes longer on the AST than the Fitbit data. However, for each sleep event, the probability that the participant's AST was within ±30 and ±60 minutes of the Fitbit TST-WASO was 50.7% and 74.3%, respectively. CONCLUSIONS The chatbot sleep response and Fitbit measured time were similar on average and the study participants had a slight tendency to perceive a relatively long sleep time if the quality of sleep was self-reported as good. However, on a participant-by-participant basis, it was difficult to predict participants' sleep duration responses with Fitbit data. Individual variations in sleep time perception significantly affect patient responses related to sleep, revealing the limitations of objective measures obtained through wearable devices.
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Affiliation(s)
- Hyunchul Jang
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Siwoo Lee
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Yunhee Son
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Sumin Seo
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Younghwa Baek
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Sujeong Mun
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Hoseok Kim
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Icktae Kim
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Junho Kim
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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Ravindran KKG, della Monica C, Atzori G, Lambert D, Hassanin H, Revell V, Dijk DJ. Contactless and longitudinal monitoring of nocturnal sleep and daytime naps in older men and women: a digital health technology evaluation study. Sleep 2023; 46:zsad194. [PMID: 37471049 PMCID: PMC10566241 DOI: 10.1093/sleep/zsad194] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/16/2023] [Indexed: 07/21/2023] Open
Abstract
STUDY OBJECTIVES To compare the 24-hour sleep assessment capabilities of two contactless sleep technologies (CSTs) to actigraphy in community-dwelling older adults. METHODS We collected 7-14 days of data at home from 35 older adults (age: 65-83), some with medical conditions, using Withings Sleep Analyser (WSA, n = 29), Emfit QS (Emfit, n = 17), a standard actigraphy device (Actiwatch Spectrum [AWS, n = 34]), and a sleep diary (n = 35). We compared nocturnal and daytime sleep measures estimated by the CSTs and actigraphy without sleep diary information (AWS-A) against sleep-diary-assisted actigraphy (AWS|SD). RESULTS Compared to sleep diary, both CSTs accurately determined the timing of nocturnal sleep (intraclass correlation [ICC]: going to bed, getting out of bed, time in bed >0.75), whereas the accuracy of AWS-A was much lower. Compared to AWS|SD, the CSTs overestimated nocturnal total sleep time (WSA: +92.71 ± 81.16 minutes; Emfit: +101.47 ± 75.95 minutes) as did AWS-A (+46.95 ± 67.26 minutes). The CSTs overestimated sleep efficiency (WSA: +9.19% ± 14.26%; Emfit: +9.41% ± 11.05%), whereas AWS-A estimate (-2.38% ± 10.06%) was accurate. About 65% (n = 23) of participants reported daytime naps either in bed or elsewhere. About 90% in-bed nap periods were accurately determined by WSA while Emfit was less accurate. All three devices estimated 24-hour sleep duration with an error of ≈10% compared to the sleep diary. CONCLUSIONS CSTs accurately capture the timing of in-bed nocturnal sleep periods without the need for sleep diary information. However, improvements are needed in assessing parameters such as total sleep time, sleep efficiency, and naps before these CSTs can be fully utilized in field settings.
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Affiliation(s)
- Kiran K G Ravindran
- Surrey Sleep Research Centre, University of Surrey, Guildford, UK
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, UK, and University of Surrey, Guildford, UK
| | - Ciro della Monica
- Surrey Sleep Research Centre, University of Surrey, Guildford, UK
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, UK, and University of Surrey, Guildford, UK
| | - Giuseppe Atzori
- Surrey Sleep Research Centre, University of Surrey, Guildford, UK
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, UK, and University of Surrey, Guildford, UK
| | - Damion Lambert
- Surrey Sleep Research Centre, University of Surrey, Guildford, UK
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, UK, and University of Surrey, Guildford, UK
| | - Hana Hassanin
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, UK, and University of Surrey, Guildford, UK
- Surrey Clinical Research Facility, Faculty of Health and Medical Sciences, School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | - Victoria Revell
- Surrey Sleep Research Centre, University of Surrey, Guildford, UK
| | - Derk-Jan Dijk
- Surrey Sleep Research Centre, University of Surrey, Guildford, UK
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, UK, and University of Surrey, Guildford, UK
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Willoughby AR, Alikhani I, Karsikas M, Chua XY, Chee MWL. Country differences in nocturnal sleep variability: Observations from a large-scale, long-term sleep wearable study. Sleep Med 2023; 110:155-165. [PMID: 37595432 DOI: 10.1016/j.sleep.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/10/2023] [Accepted: 08/09/2023] [Indexed: 08/20/2023]
Abstract
STUDY OBJECTIVES Country or regional differences in sleep duration are well-known, but few large-scale studies have specifically evaluated sleep variability, either across the work week, or in terms of differences in weekday and weekend sleep. METHODS Sleep measures, obtained over 50 million night's sleep from ∼220,000 wearable device users in 35 countries, were analysed. Each person contributed an average of ∼242 nights of data. Multiple regression was used to assess the impact country of residence had on sleep duration, timing, efficiency, weekday sleep variability, weekend sleep extension and social jetlag. RESULTS Nocturnal sleep was shorter and had a later onset in Asia than other regions. Despite this, sleep efficiency was lower and weekday sleep variability was higher. Weekend sleep extension was longer in Europe and the USA than in Asia, and was only partially related to weekday sleep duration. There were also cross-country differences in social jetlag although the regional differences were less distinct than for weekend sleep extension. CONCLUSIONS In addition to regional differences in sleep duration, cross-country differences in sleep variability and weekend sleep extension suggest that using the latter as an indicator of sleep debt may need to be reconsidered. In countries exhibiting both short sleep and high weekday sleep variability, a culturally different means of coping with inadequate sleep is likely. Country or region differences in culture, particularly those related to work, merit closer examination as factors influencing the variability in normative sleep patterns around the world.
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Affiliation(s)
- Adrian R Willoughby
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, 12 Science Drive 2, Singapore, 117549, Singapore
| | - Iman Alikhani
- Oura Health Oy, Oulu, Elektroniikkatie 10, 90590, Finland
| | - Mari Karsikas
- Oura Health Oy, Oulu, Elektroniikkatie 10, 90590, Finland
| | - Xin Yu Chua
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, 12 Science Drive 2, Singapore, 117549, Singapore
| | - Michael W L Chee
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, 12 Science Drive 2, Singapore, 117549, Singapore.
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Rugvedh P, Gundreddy P, Wandile B. The Menstrual Cycle's Influence on Sleep Duration and Cardiovascular Health: A Comprehensive Review. Cureus 2023; 15:e47292. [PMID: 38022155 PMCID: PMC10656370 DOI: 10.7759/cureus.47292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
The menstrual cycle, a fundamental biological process in women, extends its influence beyond reproduction, impacting sleep duration and cardiovascular health. This comprehensive review delves into the intricate connections that bind these three vital aspects of women's health. Beginning with thoroughly exploring the menstrual cycle, we uncover its phases and the dynamic hormonal fluctuations that underlie each stage. We pay special attention to estrogen and progesterone, the primary sex hormones orchestrating the menstrual cycle. With their rhythmic rise and fall, these hormones orchestrate events, affecting sleep duration, sleep patterns, and various indicators of cardiovascular well-being. The review examines how the menstrual cycle influences sleep patterns, exploring the nuanced changes in sleep duration observed throughout menstrual phases. We elucidate the contributing factors, encompassing hormonal fluctuations, the impact of pain and discomfort, and the significance of emotional and psychological factors. All of these elements collectively contribute to variations in sleep quality. Shifting our focus to the cardiovascular system, we investigate the bidirectional relationships between sleep disturbances and cardiovascular conditions, emphasizing the need to address sleep-related issues in the context of cardiovascular risk. The menstrual cycle is analyzed as a pivotal mediator in these intricate connections, exploring how hormonal fluctuations across menstrual phases can influence sleep patterns and cardiovascular health. This analysis provides valuable insights into the complex causality web. As clinical implications emerge, we emphasize the importance of tailoring healthcare strategies for individuals with irregular menstrual cycles. We explore potential interventions, from personalized care and hormone management to lifestyle adjustments, to improve sleep and cardiovascular well-being. In conclusion, this comprehensive review sheds light on the interplay between the menstrual cycle, sleep duration, and cardiovascular health. It underscores the urgent necessity for personalized healthcare approaches and preventive strategies, empowering women to navigate these intricate relationships. Ultimately, through a nuanced understanding of these interactions, we can work towards enhancing women's overall well-being and reducing cardiovascular risk within the context of menstrual cycle-related influences.
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Affiliation(s)
- Padigela Rugvedh
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ppavani Gundreddy
- Anatomy, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Bhushan Wandile
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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11
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Rao C, Di Lascio E, Demanse D, Marshall N, Sopala M, De Luca V. Association of digital measures and self-reported fatigue: a remote observational study in healthy participants and participants with chronic inflammatory rheumatic disease. Front Digit Health 2023; 5:1099456. [PMID: 37426890 PMCID: PMC10324580 DOI: 10.3389/fdgth.2023.1099456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Background Fatigue is a subjective, complex and multi-faceted phenomenon, commonly experienced as tiredness. However, pathological fatigue is a major debilitating symptom associated with overwhelming feelings of physical and mental exhaustion. It is a well-recognized manifestation in chronic inflammatory rheumatic diseases, such as Sjögren's Syndrome and Systemic Lupus Erythematosus and an important predictor of patient's health-related quality of life (HRQoL). Patient reported outcome questions are the key instruments to assess fatigue. To date, there is no consensus about reliable quantitative assessments of fatigue. Method Observational data for a period of one month were collected from 296 participants in the United States. Data comprised continuous multimodal digital data from Fitbit, including heart rate, physical activity and sleep features, and app-based daily and weekly questions covering various HRQoL factors including pain, mood, general physical activity and fatigue. Descriptive statistics and hierarchical clustering of digital data were used to describe behavioural phenotypes. Gradient boosting classifiers were trained to classify participant-reported weekly fatigue and daily tiredness from multi-sensor and other participant-reported data, and extract a set of key predictive features. Results Cluster analysis of Fitbit parameters highlighted multiple digital phenotypes, including sleep-affected, fatigued and healthy phenotypes. Features from participant-reported data and Fitbit data both contributed as key predictive features of weekly physical and mental fatigue and daily tiredness. Participant answers to pain and depressed mood-related daily questions contributed the most as top features for predicting physical and mental fatigue, respectively. To classify daily tiredness, participant answers to questions on pain, mood and ability to perform daily activities contributed the most. Features related to daily resting heart rate and step counts and bouts were overall the most important Fitbit features for the classification models. Conclusion These results demonstrate that multimodal digital data can be used to quantitatively and more frequently augment pathological and non-pathological participant-reported fatigue.
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Affiliation(s)
- Chaitra Rao
- Translational Medicine, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - Elena Di Lascio
- Translational Medicine, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - David Demanse
- Global Drug Development, Novartis Pharma AG, Basel, Switzerland
| | - Nell Marshall
- Research and Insights, Evidation Health, Inc., San Mateo, CA, United States
| | - Monika Sopala
- Global Drug Development, Novartis Pharma AG, Basel, Switzerland
| | - Valeria De Luca
- Translational Medicine, Novartis Institutes for Biomedical Research, Basel, Switzerland
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12
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Zhai H, Yan Y, He S, Zhao P, Zhang B. Evaluation of the Accuracy of Contactless Consumer Sleep-Tracking Devices Application in Human Experiment: A Systematic Review and Meta-Analysis. SENSORS (BASEL, SWITZERLAND) 2023; 23:4842. [PMID: 37430756 DOI: 10.3390/s23104842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 07/12/2023]
Abstract
Compared with the gold standard, polysomnography (PSG), and silver standard, actigraphy, contactless consumer sleep-tracking devices (CCSTDs) are more advantageous for implementing large-sample and long-period experiments in the field and out of the laboratory due to their low price, convenience, and unobtrusiveness. This review aimed to examine the effectiveness of CCSTDs application in human experiments. A systematic review and meta-analysis (PRISMA) of their performance in monitoring sleep parameters were conducted (PROSPERO: CRD42022342378). PubMed, EMBASE, Cochrane CENTRALE, and Web of Science were searched, and 26 articles were qualified for systematic review, of which 22 provided quantitative data for meta-analysis. The findings show that CCSTDs had a better accuracy in the experimental group of healthy participants who wore mattress-based devices with piezoelectric sensors. CCSTDs' performance in distinguishing waking from sleeping epochs is as good as that of actigraphy. Moreover, CCSTDs provide data on sleep stages that are not available when actigraphy is used. Therefore, CCSTDs could be an effective alternative tool to PSG and actigraphy in human experiments.
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Affiliation(s)
- Huifang Zhai
- Faculty of Architecture and Urban Planning, Chongqing University, Chongqing 400044, China
- Key Laboratory of New Technology for Construction of Cities in Mountain Area, Chongqing University, Chongqing 400044, China
| | - Yonghong Yan
- Faculty of Architecture and Urban Planning, Chongqing University, Chongqing 400044, China
- Key Laboratory of New Technology for Construction of Cities in Mountain Area, Chongqing University, Chongqing 400044, China
| | - Siqi He
- College of Landscape Architecture, Nanjing Forestry University, Nanjing 210037, China
| | - Pinyong Zhao
- College of Mathematics and Statistics, Chongqing University, Chongqing 400044, China
| | - Bohan Zhang
- Faculty of Engineering, The University of Sydney, Camperdown, NSW 2006, Australia
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13
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Marcus GM, Rosenthal DG, Nah G, Vittinghoff E, Fang C, Ogomori K, Joyce S, Yilmaz D, Yang V, Kessedjian T, Wilson E, Yang M, Chang K, Wall G, Olgin JE. Acute Effects of Coffee Consumption on Health among Ambulatory Adults. N Engl J Med 2023; 388:1092-1100. [PMID: 36947466 PMCID: PMC10167887 DOI: 10.1056/nejmoa2204737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
BACKGROUND Coffee is one of the most commonly consumed beverages in the world, but the acute health effects of coffee consumption remain uncertain. METHODS We conducted a prospective, randomized, case-crossover trial to examine the effects of caffeinated coffee on cardiac ectopy and arrhythmias, daily step counts, sleep minutes, and serum glucose levels. A total of 100 adults were fitted with a continuously recording electrocardiogram device, a wrist-worn accelerometer, and a continuous glucose monitor. Participants downloaded a smartphone application to collect geolocation data. We used daily text messages, sent over a period of 14 days, to randomly instruct participants to consume caffeinated coffee or avoid caffeine. The primary outcome was the mean number of daily premature atrial contractions. Adherence to the randomization assignment was assessed with the use of real-time indicators recorded by the participants, daily surveys, reimbursements for date-stamped receipts for coffee purchases, and virtual monitoring (geofencing) of coffee-shop visits. RESULTS The mean (±SD) age of the participants was 39±13 years; 51% were women, and 51% were non-Hispanic White. Adherence to the random assignments was assessed to be high. The consumption of caffeinated coffee was associated with 58 daily premature atrial contractions as compared with 53 daily events on days when caffeine was avoided (rate ratio, 1.09; 95% confidence interval [CI], 0.98 to 1.20; P = 0.10). The consumption of caffeinated coffee as compared with no caffeine consumption was associated with 154 and 102 daily premature ventricular contractions, respectively (rate ratio, 1.51; 95% CI, 1.18 to 1.94); 10,646 and 9665 daily steps (mean difference, 1058; 95% CI, 441 to 1675); 397 and 432 minutes of nightly sleep (mean difference, 36; 95% CI, 25 to 47); and serum glucose levels of 95 mg per deciliter and 96 mg per deciliter (mean difference, -0.41; 95% CI, -5.42 to 4.60). CONCLUSIONS In this randomized trial, the consumption of caffeinated coffee did not result in significantly more daily premature atrial contractions than the avoidance of caffeine. (Funded by the University of California, San Francisco, and the National Institutes of Health; CRAVE ClinicalTrials.gov number, NCT03671759.).
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Affiliation(s)
- Gregory M Marcus
- From the Division of Cardiology (G.M.M., G.N., E.W., M.Y., K.C., G.W., J.E.O.), the Department of Epidemiology and Biostatistics (E.V.), and the School of Medicine (K.O., S.J., V.Y.), University of California, San Francisco, San Francisco, the University of California, Irvine, School of Medicine, Irvine (C.F.); and the University of California, Berkeley, Berkeley (D.Y., T.J.)
| | - David G Rosenthal
- From the Division of Cardiology (G.M.M., G.N., E.W., M.Y., K.C., G.W., J.E.O.), the Department of Epidemiology and Biostatistics (E.V.), and the School of Medicine (K.O., S.J., V.Y.), University of California, San Francisco, San Francisco, the University of California, Irvine, School of Medicine, Irvine (C.F.); and the University of California, Berkeley, Berkeley (D.Y., T.J.)
| | - Gregory Nah
- From the Division of Cardiology (G.M.M., G.N., E.W., M.Y., K.C., G.W., J.E.O.), the Department of Epidemiology and Biostatistics (E.V.), and the School of Medicine (K.O., S.J., V.Y.), University of California, San Francisco, San Francisco, the University of California, Irvine, School of Medicine, Irvine (C.F.); and the University of California, Berkeley, Berkeley (D.Y., T.J.)
| | - Eric Vittinghoff
- From the Division of Cardiology (G.M.M., G.N., E.W., M.Y., K.C., G.W., J.E.O.), the Department of Epidemiology and Biostatistics (E.V.), and the School of Medicine (K.O., S.J., V.Y.), University of California, San Francisco, San Francisco, the University of California, Irvine, School of Medicine, Irvine (C.F.); and the University of California, Berkeley, Berkeley (D.Y., T.J.)
| | - Christina Fang
- From the Division of Cardiology (G.M.M., G.N., E.W., M.Y., K.C., G.W., J.E.O.), the Department of Epidemiology and Biostatistics (E.V.), and the School of Medicine (K.O., S.J., V.Y.), University of California, San Francisco, San Francisco, the University of California, Irvine, School of Medicine, Irvine (C.F.); and the University of California, Berkeley, Berkeley (D.Y., T.J.)
| | - Kelsey Ogomori
- From the Division of Cardiology (G.M.M., G.N., E.W., M.Y., K.C., G.W., J.E.O.), the Department of Epidemiology and Biostatistics (E.V.), and the School of Medicine (K.O., S.J., V.Y.), University of California, San Francisco, San Francisco, the University of California, Irvine, School of Medicine, Irvine (C.F.); and the University of California, Berkeley, Berkeley (D.Y., T.J.)
| | - Sean Joyce
- From the Division of Cardiology (G.M.M., G.N., E.W., M.Y., K.C., G.W., J.E.O.), the Department of Epidemiology and Biostatistics (E.V.), and the School of Medicine (K.O., S.J., V.Y.), University of California, San Francisco, San Francisco, the University of California, Irvine, School of Medicine, Irvine (C.F.); and the University of California, Berkeley, Berkeley (D.Y., T.J.)
| | - Defne Yilmaz
- From the Division of Cardiology (G.M.M., G.N., E.W., M.Y., K.C., G.W., J.E.O.), the Department of Epidemiology and Biostatistics (E.V.), and the School of Medicine (K.O., S.J., V.Y.), University of California, San Francisco, San Francisco, the University of California, Irvine, School of Medicine, Irvine (C.F.); and the University of California, Berkeley, Berkeley (D.Y., T.J.)
| | - Vivian Yang
- From the Division of Cardiology (G.M.M., G.N., E.W., M.Y., K.C., G.W., J.E.O.), the Department of Epidemiology and Biostatistics (E.V.), and the School of Medicine (K.O., S.J., V.Y.), University of California, San Francisco, San Francisco, the University of California, Irvine, School of Medicine, Irvine (C.F.); and the University of California, Berkeley, Berkeley (D.Y., T.J.)
| | - Tara Kessedjian
- From the Division of Cardiology (G.M.M., G.N., E.W., M.Y., K.C., G.W., J.E.O.), the Department of Epidemiology and Biostatistics (E.V.), and the School of Medicine (K.O., S.J., V.Y.), University of California, San Francisco, San Francisco, the University of California, Irvine, School of Medicine, Irvine (C.F.); and the University of California, Berkeley, Berkeley (D.Y., T.J.)
| | - Emily Wilson
- From the Division of Cardiology (G.M.M., G.N., E.W., M.Y., K.C., G.W., J.E.O.), the Department of Epidemiology and Biostatistics (E.V.), and the School of Medicine (K.O., S.J., V.Y.), University of California, San Francisco, San Francisco, the University of California, Irvine, School of Medicine, Irvine (C.F.); and the University of California, Berkeley, Berkeley (D.Y., T.J.)
| | - Michelle Yang
- From the Division of Cardiology (G.M.M., G.N., E.W., M.Y., K.C., G.W., J.E.O.), the Department of Epidemiology and Biostatistics (E.V.), and the School of Medicine (K.O., S.J., V.Y.), University of California, San Francisco, San Francisco, the University of California, Irvine, School of Medicine, Irvine (C.F.); and the University of California, Berkeley, Berkeley (D.Y., T.J.)
| | - Kathleen Chang
- From the Division of Cardiology (G.M.M., G.N., E.W., M.Y., K.C., G.W., J.E.O.), the Department of Epidemiology and Biostatistics (E.V.), and the School of Medicine (K.O., S.J., V.Y.), University of California, San Francisco, San Francisco, the University of California, Irvine, School of Medicine, Irvine (C.F.); and the University of California, Berkeley, Berkeley (D.Y., T.J.)
| | - Grace Wall
- From the Division of Cardiology (G.M.M., G.N., E.W., M.Y., K.C., G.W., J.E.O.), the Department of Epidemiology and Biostatistics (E.V.), and the School of Medicine (K.O., S.J., V.Y.), University of California, San Francisco, San Francisco, the University of California, Irvine, School of Medicine, Irvine (C.F.); and the University of California, Berkeley, Berkeley (D.Y., T.J.)
| | - Jeffrey E Olgin
- From the Division of Cardiology (G.M.M., G.N., E.W., M.Y., K.C., G.W., J.E.O.), the Department of Epidemiology and Biostatistics (E.V.), and the School of Medicine (K.O., S.J., V.Y.), University of California, San Francisco, San Francisco, the University of California, Irvine, School of Medicine, Irvine (C.F.); and the University of California, Berkeley, Berkeley (D.Y., T.J.)
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Does Wearable-Measured Heart Rate Variability During Sleep Predict Perceived Morning Mental and Physical Fitness? Appl Psychophysiol Biofeedback 2023; 48:247-257. [PMID: 36622531 DOI: 10.1007/s10484-022-09578-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2022] [Indexed: 01/10/2023]
Abstract
The emergence of wearable sensor technology may provide opportunities for automated measurement of psychophysiological markers of mental and physical fitness, which can be used for personalized feedback. This study explores to what extent within-subject changes in resting heart rate variability (HRV) during sleep predict the perceived mental and physical fitness of military personnel on the subsequent morning. Participants wore a Garmin wrist-worn wearable and filled in a short morning questionnaire on their perceived mental and physical fitness during a period of up to 46 days. A custom-built smartphone app was used to directly retrieve heart rate and accelerometer data from the wearable, on which open-source algorithms for sleep detection and artefact filtering were applied. A sample of 571 complete observations in 63 participants were analyzed using linear mixed models. Resting HRV during sleep was a small predictor of perceived physical fitness (marginal R2 = .031), but not of mental fitness. The items on perceived mental and physical fitness were strongly correlated (r = .77). Based on the current findings, resting HRV during sleep appears to be more related to the physical component of perceived fitness than its mental component. Recommendations for future studies include improvements in the measurement of sleep and resting HRV, as well as further investigation of the potential impact of resting HRV as a buffer on stress-related outcomes.
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15
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Botella-Serrano M, Velasco JM, Sánchez-Sánchez A, Garnica O, Hidalgo JI. Evaluating the influence of sleep quality and quantity on glycemic control in adults with type 1 diabetes. Front Endocrinol (Lausanne) 2023; 14:998881. [PMID: 36896174 PMCID: PMC9989462 DOI: 10.3389/fendo.2023.998881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 01/19/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Sleep quality disturbances are frequent in adults with type 1 diabetes. However, the possible influence of sleep problems on glycemic variability has yet to be studied in depth. This study aims to assess the influence of sleep quality on glycemic control. MATERIALS AND METHODS An observational study of 25 adults with type 1 diabetes, with simultaneous recording, for 14 days, of continuous glucose monitoring (Abbott FreeStyle Libre system) and a sleep study by wrist actigraphy (Fitbit Ionic device). The study analyzes, using artificial intelligence techniques, the relationship between the quality and structure of sleep with time in normo-, hypo-, and hyperglycemia ranges and with glycemic variability. The patients were also studied as a group, comparing patients with good and poor sleep quality. RESULTS A total of 243 days/nights were analyzed, of which 77% (n = 189) were categorized as poor quality and 33% (n = 54) as good quality. Linear regression methods were used to find a correlation (r =0.8) between the variability of sleep efficiency and the variability of mean blood glucose. With clustering techniques, patients were grouped according to their sleep structure (characterizing this structure by the number of transitions between the different sleep phases). These clusters showed a relationship between time in range and sleep structure. CONCLUSIONS This study suggests that poor sleep quality is associated with lower time in range and greater glycemic variability, so improving sleep quality in patients with type 1 diabetes could improve their glycemic control.
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Affiliation(s)
- Marta Botella-Serrano
- Endocrinology and Nutrition Service, Hospital Universitario Príncipe de Asturias, Madrid, Spain
- *Correspondence: Marta Botella-Serrano, ; Jose Manuel Velasco, ; J. Ignacio Hidalgo,
| | - Jose Manuel Velasco
- Computer Architecture and Automation Department, Universidad Complutense de Madrid, Madrid, Spain
- *Correspondence: Marta Botella-Serrano, ; Jose Manuel Velasco, ; J. Ignacio Hidalgo,
| | | | - Oscar Garnica
- Computer Architecture and Automation Department, Universidad Complutense de Madrid, Madrid, Spain
| | - J. Ignacio Hidalgo
- Computer Architecture and Automation Department, Universidad Complutense de Madrid, Madrid, Spain
- *Correspondence: Marta Botella-Serrano, ; Jose Manuel Velasco, ; J. Ignacio Hidalgo,
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Niela-Vilen H, Azimi I, Suorsa K, Sarhaddi F, Stenholm S, Liljeberg P, Rahmani AM, Axelin A. Comparison of Oura Smart Ring Against ActiGraph Accelerometer for Measurement of Physical Activity and Sedentary Time in a Free-Living Context. Comput Inform Nurs 2022; 40:856-862. [PMID: 35234703 DOI: 10.1097/cin.0000000000000885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Smart rings, such as the Oura ring, might have potential in health monitoring. To be able to identify optimal devices for healthcare settings, validity studies are needed. The aim of this study was to compare the Oura smart ring estimates of steps and sedentary time with data from the ActiGraph accelerometer in a free-living context. A cross-sectional observational study design was used. A convenience sample of healthy adults (n = 42) participated in the study and wore an Oura smart ring and an ActiGraph accelerometer on the non-dominant hand continuously for 1 week. The participants completed a background questionnaire and filled out a daily log about their sleeping times and times when they did not wear the devices. The median age of the participants (n = 42) was 32 years (range, 18-46 years). In total, 191 (61% of the potential) days were compared. The Oura ring overestimated the step counts compared with the ActiGraph. The mean difference was 1416 steps (95% confidence interval, 739-2093 steps). Daily sedentary time was also overestimated by the ring; the mean difference was 17 minutes (95% confidence interval, -2 to 37 minutes). The use of the ring in nursing interventions needs to be considered.
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Affiliation(s)
- Hannakaisa Niela-Vilen
- Author Affiliations: Departments of Nursing Science (Dr Niela-Vilen) and Computing (Drs Azimi and Liljeberg, and Ms Sarhaddi), University of Turku; and Department of Public Health and Centre for Population Health Research (Drs Suorsa and Stenholm), University of Turku and Turku University Hospital, Finland; Department of Electrical Engineering and Computer Science and School of Nursing (Dr Rahmani), University of California, Irvine; and Departments of Nursing Science and of Obstetrics and Gynaecology, University of Turku and Turku University Hospital (Dr Axelin), Finland
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Tump D, Narayan N, Verbiest V, Hermsen S, Goris A, Chiu CD, Van Stiphout R. Stressors and Destressors in Working From Home Based on Context and Physiology From Self-Reports and Smartwatch Measurements: International Observational Study Trial. JMIR Form Res 2022; 6:e38562. [DOI: 10.2196/38562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/21/2022] [Accepted: 09/22/2022] [Indexed: 11/11/2022] Open
Abstract
Background
The COVID-19 pandemic has greatly boosted working from home as a way of working, which is likely to continue for most companies in the future, either in fully remote or in hybrid form. To manage stress levels in employees working from home, insights into the stressors and destressors in a home office first need to be studied.
Objective
We present an international remote study with employees working from home by making use of state-of-the-art technology (ie, smartwatches and questionnaires through smartphones) first to determine stressors and destressors in people working from home and second to identify smartwatch measurements that could represent these stressors and destressors.
Methods
Employees working from home from 3 regions of the world (the United States, the United Kingdom, and Hong Kong) were asked to wear a smartwatch continuously for 7 days and fill in 5 questionnaires each day and 2 additional questionnaires before and after the measurement week. The entire study was conducted remotely. Univariate statistical analyses comparing variable distributions between low and high stress levels were followed by multivariate analysis using logistic regression, considering multicollinearity by using variance inflation factor (VIF) filtering.
Results
A total of 202 people participated, with 198 (98%) participants finishing the experiment. Stressors found were other people and daily life getting in the way of work (P=.05), job intensity (P=.01), a history of burnout (P=.03), anxiety toward the pandemic (P=.04), and environmental noise (P=.01). Destressors found were access to sunlight (P=.02) and fresh air (P<.001) during the workday and going outdoors (P<.001), taking breaks (P<.001), exercising (P<.001), and having social interactions (P<.001). The smartwatch measurements positively related to stress were the number of active intensity periods (P<.001), the number of highly active intensity periods (P=.04), steps (P<.001), and the SD in the heart rate (HR; P<.001). In a multivariate setting, only a history of burnout (P<.001) and family and daily life getting in the way of work (P<.001) were positively associated with stress, while self-reports of social activities (P<.001) and going outdoors (P=.03) were negatively associated with stress. Stress prediction models based on questionnaire data had a similar performance (F1=0.51) compared to models based on automatic measurable data alone (F1=0.47).
Conclusions
The results show that there are stressors and destressors when working from home that should be considered when managing stress in employees. Some of these stressors and destressors are (in)directly measurable with unobtrusive sensors, and prediction models based on these data show promising results for the future of automatic stress detection and management.
Trial Registration
Netherlands Trial Register NL9378; https://trialsearch.who.int/Trial2.aspx?TrialID=NL9378
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Klier K, Wagner M. Agreement of Sleep Measures-A Comparison between a Sleep Diary and Three Consumer Wearable Devices. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22166189. [PMID: 36015949 PMCID: PMC9413956 DOI: 10.3390/s22166189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/16/2022] [Accepted: 08/16/2022] [Indexed: 05/28/2023]
Abstract
Nowadays, self-tracking and optimization are widely spread. As sleep is essential for well-being, health, and peak performance, the number of available consumer technologies to assess individual sleep behavior is increasing rapidly. However, little is known about the consumer wearables' usability and reliability for sleep tracking. Therefore, the aim of the present study was to compare the sleep measures of wearable devices with a standardized sleep diary in young healthy adults in free-living conditions. We tracked night sleep from 30 participants (19 females, 11 males; 24.3 ± 4.2 years old). Each wore three wearables and simultaneously assessed individual sleep patterns for four consecutive nights. Wearables and diaries correlated substantially regarding time in bed (Range CCCLin: 0.74-0.84) and total sleep time (Range CCCLin: 0.76-0.85). There was no sufficient agreement regarding the measures of sleep efficiency (Range CCCLin: 0.05-0.34) and sleep interruptions (Range CCCLin: -0.02-0.10). Finally, these results show wearables to be an easy-to-handle, time- and cost-efficient alternative to tracking sleep in healthy populations. Future research should develop and empirically test the usability of such consumer sleep technologies.
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Rentz LE, Bryner RW, Ramadan J, Rezai A, Galster SM. Full-Body Photobiomodulation Therapy Is Associated with Reduced Sleep Durations and Augmented Cardiorespiratory Indicators of Recovery. Sports (Basel) 2022; 10:sports10080119. [PMID: 36006085 PMCID: PMC9414854 DOI: 10.3390/sports10080119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 11/29/2022] Open
Abstract
Research is emerging on the use of Photobiomodulation therapy (PBMT) and its potential for augmenting human performance, however, relatively little research exists utilizing full-body administration methods. As such, further research supporting the efficacy of whole-body applications of PBMT for behavioral and physiological modifications in applicable, real-world settings are warranted. The purpose of this analysis was to observe cardiorespiratory and sleep patterns surrounding the use of full-body PBMT in an elite cohort of female soccer players. Members of a women’s soccer team in a “Power 5 conference” of the National Collegiate Athletic Association (NCAA) were observed across one competitive season while wearing an OURA Ring nightly and a global positioning system (GPS) sensor during training. Within-subject comparisons of cardiorespiratory physiology, sleep duration, and sleep composition were evaluated the night before and after PBMT sessions completed as a standard of care for team recovery. Compared to pre-intervention, mean heart rate (HR) was significantly lower the night after a PBMT session (p = 0.0055). Sleep durations were also reduced following PBMT, with total sleep time (TST) averaging 40 min less the night after a session (p = 0.0006), as well as significant reductions in light sleep (p = 0.0307) and rapid eye movement (REM) sleep durations (p = 0.0019). Sleep durations were still lower following PBMT, even when controlling for daily and accumulated training loads. Enhanced cardiorespiratory indicators of recovery following PBMT, despite significant reductions in sleep duration, suggest that it may be an effective modality for maintaining adequate recovery from the high stress loads experienced by elite athletes.
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Affiliation(s)
- Lauren E. Rentz
- Division of Exercise Physiology, West Virginia University School of Medicine, Morgantown, WV 26506, USA;
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26506, USA; (J.R.); (A.R.); (S.M.G.)
- Correspondence:
| | - Randy W. Bryner
- Division of Exercise Physiology, West Virginia University School of Medicine, Morgantown, WV 26506, USA;
| | - Jad Ramadan
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26506, USA; (J.R.); (A.R.); (S.M.G.)
| | - Ali Rezai
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26506, USA; (J.R.); (A.R.); (S.M.G.)
| | - Scott M. Galster
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26506, USA; (J.R.); (A.R.); (S.M.G.)
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20
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Klier K, Seiler K, Wagner M. Influence of esports on Sleep and Stress. ZEITSCHRIFT FUR SPORTPSYCHOLOGIE 2022. [DOI: 10.1026/1612-5010/a000368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Abstract. Recreative sleep and a low stress level are important health- and performance-enhancing factors in daily life. The present investigation examines the influence of esports on sleep and stress. In a counterbalanced within-subjects design, 44 participants (37 males, 7 females, 25.2 ± 4.6 years old) completed both a gaming and a nongaming session on two consecutive evenings. We assessed individual sleep duration and individual stress parameters via a Garmin® smartwatch in addition to a short subjective scale. The results show that, in the gaming condition, total sleep time was significantly lower than in the nongaming condition ( p = .003). The participants’ stress level was significantly increased after gaming compared to nongaming ( p = .005). Future research should not only examine the long-term effects of esports on health longitudinally, but also establish suitable sleep interventions and stress coping strategies.
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Affiliation(s)
- Kristina Klier
- Institute of Sports Science, Department of Human Sciences, Universität der Bundeswehr München, Germany
| | - Kirstin Seiler
- Institute of Sports Science, Department of Human Sciences, Universität der Bundeswehr München, Germany
| | - Matthias Wagner
- Institute of Sports Science, Department of Human Sciences, Universität der Bundeswehr München, Germany
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21
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Hodges PW, van den Hoorn W. A vision for the future of wearable sensors in spine care and its challenges: narrative review. JOURNAL OF SPINE SURGERY (HONG KONG) 2022; 8:103-116. [PMID: 35441093 PMCID: PMC8990399 DOI: 10.21037/jss-21-112] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 11/29/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE This review aimed to: (I) provide a brief overview of some topical areas of current literature regarding applications of wearable sensors in the management of low back pain (LBP); (II) present a vision for a future comprehensive system that integrates wearable sensors to measure multiple parameters in the real world that contributes data to guide treatment selection (aided by artificial intelligence), uses wearables to aid treatment support, adherence and outcome monitoring, and interrogates the response of the individual patient to the prescribed treatment to guide future decision support for other individuals who present with LBP; and (III) consider the challenges that will need to be overcome to make such a system a reality. BACKGROUND Advances in wearable sensor technologies are opening new opportunities for the assessment and management of spinal conditions. Although evidence of improvements in outcomes for individuals with LBP from the use of sensors is limited, there is enormous future potential. METHODS Narrative review and literature synthesis. CONCLUSIONS Substantial research is underway by groups internationally to develop and test elements of this system, to design innovative new sensors that enable recording of new data in new ways, and to fuse data from multiple sources to provide rich information about an individual's experience of LBP. Together this system, incorporating data from wearable sensors has potential to personalise care in ways that were hitherto thought impossible. The potential is high but will require concerted effort to develop and ultimately will need to be feasible and more effective than existing management.
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Affiliation(s)
- Paul W Hodges
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Wolbert van den Hoorn
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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22
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Chinoy ED, Cuellar JA, Jameson JT, Markwald RR. Performance of Four Commercial Wearable Sleep-Tracking Devices Tested Under Unrestricted Conditions at Home in Healthy Young Adults. Nat Sci Sleep 2022; 14:493-516. [PMID: 35345630 PMCID: PMC8957400 DOI: 10.2147/nss.s348795] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/21/2022] [Indexed: 12/22/2022] Open
Abstract
PURPOSE Commercial wearable sleep-tracking devices are growing in popularity and in recent studies have performed well against gold standard sleep measurement techniques. However, most studies were conducted in controlled laboratory conditions. We therefore aimed to test the performance of devices under naturalistic unrestricted home sleep conditions. PARTICIPANTS AND METHODS Healthy young adults (n = 21; 12 women, 9 men; 29.0 ± 5.0 years, mean ± SD) slept at home under unrestricted conditions for 1 week using a set of commercial wearable sleep-tracking devices and completed daily sleep diaries. Devices included the Fatigue Science Readiband, Fitbit Inspire HR, Oura ring, and Polar Vantage V Titan. Participants also wore a research-grade actigraphy watch (Philips Respironics Actiwatch 2) for comparison. To assess performance, all devices were compared with a high performing mobile sleep electroencephalography headband device (Dreem 2). Analyses included epoch-by-epoch and sleep summary agreement comparisons. RESULTS Devices accurately tracked sleep-wake summary metrics (ie, time in bed, total sleep time, sleep efficiency, sleep latency, wake after sleep onset) on most nights but performed best on nights with higher sleep efficiency. Epoch-by-epoch sensitivity (for sleep) and specificity (for wake), respectively, were as follows: Actiwatch (0.95, 0.35), Fatigue Science (0.94, 0.40), Fitbit (0.93, 0.45), Oura (0.94, 0.41), and Polar (0.96, 0.35). Sleep stage-tracking performance was mixed, with high variability. CONCLUSION As in previous studies, all devices were better at detecting sleep than wake, and most devices compared favorably to actigraphy in wake detection. Devices performed best on nights with more consolidated sleep patterns. Unrestricted sleep TIB differences were accurately tracked on most nights. High variability in sleep stage-tracking performance suggests that these devices, in their current form, are still best utilized for tracking sleep-wake outcomes and not sleep stages. Most commercial wearables exhibited promising performance for tracking sleep-wake in real-world conditions, further supporting their consideration as an alternative to actigraphy.
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Affiliation(s)
- Evan D Chinoy
- Sleep, Tactical Efficiency, and Endurance Laboratory, Warfighter Performance Department, Naval Health Research Center, San Diego, CA, USA.,Leidos, Inc., San Diego, CA, USA
| | - Joseph A Cuellar
- Sleep, Tactical Efficiency, and Endurance Laboratory, Warfighter Performance Department, Naval Health Research Center, San Diego, CA, USA.,Leidos, Inc., San Diego, CA, USA
| | - Jason T Jameson
- Sleep, Tactical Efficiency, and Endurance Laboratory, Warfighter Performance Department, Naval Health Research Center, San Diego, CA, USA.,Leidos, Inc., San Diego, CA, USA
| | - Rachel R Markwald
- Sleep, Tactical Efficiency, and Endurance Laboratory, Warfighter Performance Department, Naval Health Research Center, San Diego, CA, USA
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23
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Ghorbani S, Golkashani HA, Chee NIYN, Teo TB, Dicom AR, Yilmaz G, Leong RLF, Ong JL, Chee MWL. Multi-Night at-Home Evaluation of Improved Sleep Detection and Classification with a Memory-Enhanced Consumer Sleep Tracker. Nat Sci Sleep 2022; 14:645-660. [PMID: 35444483 PMCID: PMC9015046 DOI: 10.2147/nss.s359789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 03/31/2022] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To evaluate the benefits of applying an improved sleep detection and staging algorithm on minimally processed multi-sensor wearable data collected from older generation hardware. PATIENTS AND METHODS 58 healthy, East Asian adults aged 23-69 years (M = 37.10, SD = 13.03, 32 males), each underwent 3 nights of PSG at home, wearing 2nd Generation Oura Rings equipped with additional memory to store raw data from accelerometer, infra-red photoplethysmography and temperature sensors. 2-stage and 4-stage sleep classifications using a new machine-learning algorithm (Gen3) trained on a diverse and independent dataset were compared to the existing consumer algorithm (Gen2) for whole-night and epoch-by-epoch metrics. RESULTS Gen 3 outperformed its predecessor with a mean (SD) accuracy of 92.6% (0.04), sensitivity of 94.9% (0.03), and specificity of 78.5% (0.11); corresponding to a 3%, 2.8% and 6.2% improvement from Gen2 across the three nights, with Cohen's d values >0.39, t values >2.69, and p values <0.01. Notably, Gen 3 showed robust performance comparable to PSG in its assessment of sleep latency, light sleep, rapid eye movement (REM), and wake after sleep onset (WASO) duration. Participants <40 years of age benefited more from the upgrade with less measurement bias for total sleep time (TST), WASO, light sleep and sleep efficiency compared to those ≥40 years. Males showed greater improvements on TST and REM sleep measurement bias compared to females, while females benefitted more for deep sleep measures compared to males. CONCLUSION These results affirm the benefits of applying machine learning and a diverse training dataset to improve sleep measurement of a consumer wearable device. Importantly, collecting raw data with appropriate hardware allows for future advancements in algorithm development or sleep physiology to be retrospectively applied to enhance the value of longitudinal sleep studies.
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Affiliation(s)
- Shohreh Ghorbani
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Hosein Aghayan Golkashani
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Nicholas I Y N Chee
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Teck Boon Teo
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Andrew Roshan Dicom
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Gizem Yilmaz
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ruth L F Leong
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ju Lynn Ong
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Michael W L Chee
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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24
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Alameri F, Aldaheri N, Almesmari S, Basaloum M, Albeshr NA, Simsekler MCE, Ugwuoke NV, Dalkilinc M, Al Qubaisi M, Campos LA, Almahmeed W, Alefishat E, Al Tunaiji H, Baltatu OC. Burnout and Cardiovascular Risk in Healthcare Professionals During the COVID-19 Pandemic. Front Psychiatry 2022; 13:867233. [PMID: 35444572 PMCID: PMC9014179 DOI: 10.3389/fpsyt.2022.867233] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/25/2022] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION The objective of this study was to investigate the psychosocial and cardiovascular markers in healthcare professionals during the COVID-19 pandemic. METHODS This was a STROBE compliant, blended exploratory study. Residents, staff physicians, nurses, and auxiliary healthcare professionals from both inpatient and outpatient medicine services were recruited using a planned random probability sample. The Maslach Burnout Inventory (MBI), Fuster-BEWAT score (FBS), and socio-demographic factors, as well as sleep quality, were studied. The correlations between burnout severity and cardiovascular risk were examined using multivariable linear regression models adjusted for confounding variables, such as sociodemographic and anthropometric characteristics. RESULTS The regression analysis with FBS as the outcome showed a negative association between cardiovascular health and emotional exhaustion [Coef.(95%CI): -0.029 (-0.048, -0.01), p = 0.002]. The higher the emotional exhaustion the lower the cardiovascular health. Further, the model showed a positive association between personal accomplishment and cardiovascular health [Coef.(95%CI): 0.045 (0.007, 0.082), p = 0.02]. Emotional exhaustion was significantly positive correlated with REM sleep and light average (Spearman's rank correlation: 0.37 and 0.35, respectively, with P < 0.05). CONCLUSION The data from this study show that healthcare practitioners who are with burnout and emotional exhaustion have an elevated cardiovascular risk, however, causality cannot be determined. As an adaptive response to stressful situations, REM sleep increases. The findings of this study may be relevant in creating preventive strategies for burnout and cardiovascular risk reduction or prevention. CLINICAL TRIAL REGISTRATION [www.ClinicalTrials.gov], identifier [NCT04422418].
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Affiliation(s)
- Fayeza Alameri
- Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Noura Aldaheri
- Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | | | - Manea Basaloum
- Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | | | | | - Nnamdi Valbosco Ugwuoke
- Department of Pharmacology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | | | - Mai Al Qubaisi
- Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Luciana Aparecida Campos
- Department of Public Health and Epidemiology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates.,Center of Innovation, Technology and Education (CITE) at Anhembi Morumbi University - Anima Institute, São José dos Campos, Brazil
| | - Wael Almahmeed
- Heart and Vascular Institute - Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | - Eman Alefishat
- Department of Pharmacology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates.,Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan.,Center for Biotechnology, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Hashel Al Tunaiji
- Zayed Military Hospital, Abu Dhabi, United Arab Emirates.,Academic and Research Committee, Zayed Military University, Abu Dhabi, United Arab Emirates
| | - Ovidiu Constantin Baltatu
- Department of Pharmacology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates.,Department of Public Health and Epidemiology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates.,Center of Innovation, Technology and Education (CITE) at Anhembi Morumbi University - Anima Institute, São José dos Campos, Brazil
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25
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Ash GI, Stults-Kolehmainen M, Busa MA, Gaffey AE, Angeloudis K, Muniz-Pardos B, Gregory R, Huggins RA, Redeker NS, Weinzimer SA, Grieco LA, Lyden K, Megally E, Vogiatzis I, Scher L, Zhu X, Baker JS, Brandt C, Businelle MS, Fucito LM, Griggs S, Jarrin R, Mortazavi BJ, Prioleau T, Roberts W, Spanakis EK, Nally LM, Debruyne A, Bachl N, Pigozzi F, Halabchi F, Ramagole DA, Janse van Rensburg DC, Wolfarth B, Fossati C, Rozenstoka S, Tanisawa K, Börjesson M, Casajus JA, Gonzalez-Aguero A, Zelenkova I, Swart J, Gursoy G, Meyerson W, Liu J, Greenbaum D, Pitsiladis YP, Gerstein MB. Establishing a Global Standard for Wearable Devices in Sport and Exercise Medicine: Perspectives from Academic and Industry Stakeholders. Sports Med 2021; 51:2237-2250. [PMID: 34468950 PMCID: PMC8666971 DOI: 10.1007/s40279-021-01543-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2021] [Indexed: 10/20/2022]
Abstract
Millions of consumer sport and fitness wearables (CSFWs) are used worldwide, and millions of datapoints are generated by each device. Moreover, these numbers are rapidly growing, and they contain a heterogeneity of devices, data types, and contexts for data collection. Companies and consumers would benefit from guiding standards on device quality and data formats. To address this growing need, we convened a virtual panel of industry and academic stakeholders, and this manuscript summarizes the outcomes of the discussion. Our objectives were to identify (1) key facilitators of and barriers to participation by CSFW manufacturers in guiding standards and (2) stakeholder priorities. The venues were the Yale Center for Biomedical Data Science Digital Health Monthly Seminar Series (62 participants) and the New England Chapter of the American College of Sports Medicine Annual Meeting (59 participants). In the discussion, stakeholders outlined both facilitators of (e.g., commercial return on investment in device quality, lucrative research partnerships, and transparent and multilevel evaluation of device quality) and barriers (e.g., competitive advantage conflict, lack of flexibility in previously developed devices) to participation in guiding standards. There was general agreement to adopt Keadle et al.'s standard pathway for testing devices (i.e., benchtop, laboratory, field-based, implementation) without consensus on the prioritization of these steps. Overall, there was enthusiasm not to add prescriptive or regulatory steps, but instead create a networking hub that connects companies to consumers and researchers for flexible guidance navigating the heterogeneity, multi-tiered development, dynamicity, and nebulousness of the CSFW field.
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Affiliation(s)
- Garrett I Ash
- Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
- Center for Medical Informatics, Yale University, New Haven, CT, USA
| | - Matthew Stults-Kolehmainen
- Digestive Health Multispecialty Clinic, Yale-New Haven Hospital, New Haven, CT, USA
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Michael A Busa
- Center for Human Health and Performance, Institute for Applied Life Sciences, University of Massachusetts Amherst, Amherst, MA, USA
- Department of Kinesiology, University of Massachusetts, Amherst, MA, USA
| | - Allison E Gaffey
- Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
- Department of Internal Medicine (Cardiovascular Medicine), Yale School of Medicine, New Haven, CT, USA
| | | | - Borja Muniz-Pardos
- GENUD Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Zaragoza, Spain
| | - Robert Gregory
- Department of Health and Movement Sciences, Southern Connecticut State University, New Haven, CT, USA
| | - Robert A Huggins
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs, CT, USA
| | | | | | | | | | | | - Ioannis Vogiatzis
- Department of Sport, Exercise and Rehabilitation, School Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
- European Respiratory Society (ERS), Digital Health Working Group, Lausanne, Switzerland
| | - LaurieAnn Scher
- Consumer Technology Association Working Groups for Health Technology Standards, Washington, DC, USA
- Fitscript LLC, New Haven, CT, USA
| | - Xinxin Zhu
- Center for Biomedical Data Science, Yale School of Medicine, New Haven, CT, USA
| | - Julien S Baker
- Faculty of Sports Science, Ningbo University, Ningbo, China
- School of Health and Life Sciences, Institute for Clinical Exercise and Health Science, University of the West of Scotland, South Lanarkshire, Scotland, UK
- Department of Sport, Physical Education and Health, Centre for Health and Exercise Science Research, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Cynthia Brandt
- Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
- Center for Medical Informatics, Yale University, New Haven, CT, USA
- Emergency Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Michael S Businelle
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Tobacco Settlement Endowment Trust Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, USA
| | - Lisa M Fucito
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Yale Cancer Center, New Haven, CT, USA
- Smilow Cancer Hospital, Yale-New Haven Hospital, New Haven, CT, USA
| | - Stephanie Griggs
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Robert Jarrin
- Department of Emergency Medicine, George Washington University, Washington, DC, USA
- Department of Biochemistry and Molecular and Cellular Biology, Georgetown University Medical Center, Washington, DC, USA
| | - Bobak J Mortazavi
- Department of Computer Science and Engineering, Texas A&M University, College Station, TX, USA
| | | | - Walter Roberts
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Elias K Spanakis
- University of Maryland School of Medicine, Baltimore, MD, USA
- Division of Endocrinology, Baltimore Veterans Affairs Medical Center, Maryland, USA
| | - Laura M Nally
- Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | - Andre Debruyne
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- European Federation of Sports Medicine Associations (EFSMA), Lausanne, Switzerland
| | - Norbert Bachl
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- European Federation of Sports Medicine Associations (EFSMA), Lausanne, Switzerland
- Institute of Sports Science, University of Vienna, Vienna, Austria
- Austrian Institute of Sports Medicine, Vienna, Austria
| | - Fabio Pigozzi
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- European Federation of Sports Medicine Associations (EFSMA), Lausanne, Switzerland
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
- Villa Stuart Sport Clinic, FIFA Medical Center of Excellence, Rome, Italy
| | - Farzin Halabchi
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Sports and Exercise Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Dimakatso A Ramagole
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Dina C Janse van Rensburg
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Bernd Wolfarth
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- Department of Sports Medicine, Humboldt University and Charité University School of Medicine, Berlin, Germany
| | - Chiara Fossati
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Sandra Rozenstoka
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- European Federation of Sports Medicine Associations (EFSMA), Lausanne, Switzerland
- FIMS Collaboration Centre of Sports Medicine, Sports Laboratory, Riga, Latvia
| | - Kumpei Tanisawa
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Mats Börjesson
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- Department of Molecular and Clinical Medicine, Center for Health and Performance, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
- Department of MGA, Region of Western Sweden, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - José Antonio Casajus
- GENUD Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Zaragoza, Spain
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
| | - Alex Gonzalez-Aguero
- GENUD Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Zaragoza, Spain
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
| | - Irina Zelenkova
- GENUD Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Zaragoza, Spain
- I.M. Sechenov First Moscow State Medical University (Sechenov University, Ministry of Health of Russia, Moscow, Russia
| | - Jeroen Swart
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- Division of Physiological Sciences and HPALS Research Centre, FIMS Collaboration Centre of Sports Medicine, University of Cape Town, Cape Town, South Africa
| | - Gamze Gursoy
- Program in Computational Biology and Bioinformatics, Yale University, New Haven, CT, USA
| | - William Meyerson
- Duke Psychiatry and Behavioral Sciences, Duke Medicine, Durham, NC, USA
- Department of Molecular Biophysics and Biochemistry, Yale University, New Haven, CT, USA
| | - Jason Liu
- Program in Computational Biology and Bioinformatics, Yale University, New Haven, CT, USA
| | - Dov Greenbaum
- Program in Computational Biology and Bioinformatics, Yale University, New Haven, CT, USA
- Zvi Meitar Institute for Legal Implications of Emerging Technologies, Interdisciplinary Center Herzliya, Herzliya, Israel
- Harry Radyzner Law School, Interdisciplinary Center Herzliya, Herzliya, Israel
| | - Yannis P Pitsiladis
- Centre for Stress and Age-related Disease, University of Brighton, Brighton, UK.
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland.
- European Federation of Sports Medicine Associations (EFSMA), Lausanne, Switzerland.
| | - Mark B Gerstein
- Program in Computational Biology and Bioinformatics, Yale University, New Haven, CT, USA
- Department of Molecular Biophysics and Biochemistry, Yale University, New Haven, CT, USA
- Department of Computer Science, Yale University, New Haven, CT, USA
- Department of Statistics and Data Science, Yale University, New Haven, CT, USA
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26
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Kholghi M, Szollosi I, Hollamby M, Bradford D, Zhang Q. A validation study of a ballistocardiograph sleep tracker EMFIT QS against polysomnography. J Clin Sleep Med 2021; 18:1203-1210. [PMID: 34705630 DOI: 10.5664/jcsm.9754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Consumer home sleep trackers provide a great opportunity for longitudinal objective sleep monitoring. Non-wearable sleep devices cause little to no disruption in the daily life routine and need little maintenance. However, their validity needs further investigation. This study aims to evaluate the accuracy of sleep outcomes of EMFIT Quantified Sleep (QS), an unobtrusive non-wearable sleep tracker based on ballistocardiography, against polysomnography (PSG). METHODS 62 sleep-lab patients underwent a single clinical PSG with measures simultaneously collected through PSG and EMFIT QS. Resting heart rate (HR), Total Sleep Time (TST), Wake After Sleep Onset (WASO), Sleep Onset Latency (SOL) and duration in sleep stages, collected from the two devices, compared using paired t-tests and their agreement analyzed using Bland-Altman plots. Additionally, continuous HR and sleep stages in 30-seconds epochs were evaluated. RESULTS EMFIT QS data loss occurred in 47% of participants. In the remaining 33 participants (15 females, with mean age of 53.7±16.5), EMFIT QS overestimated TST by 177.5±119.4 minutes (p<0.001) and underestimated WASO by 44.74±68.81 minutes (p<0.001). It accurately measured average resting HR and was able to distinguish SOL with some accuracy. However, the agreement between EMFIT QS and PSG on sleep-wake detection was very low (kappa=0.13, p<0.001), EMFIT QS failed to distinguish sleep stages. CONCLUSIONS A consensus between PSG and EMFIT QS was found in SOL and average HR. There was significant discrepancy and lack of consensus in other sleep outcomes. These findings indicated that further development is necessary before using EMFIT QS in clinical and research settings. CLINICAL TRIAL REGISTRATION Registry: Australian New Zealand Clinical Trials Registry; Name: Sleep parameter validation of a consumer home sleep monitoring device, EMFIT Quantified Sleep (QS), against Polysomnography; Identifier: ACTRN12621000600842; URL: https://www.anzctr.org.au/ACTRN12621000600842.aspx.
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Affiliation(s)
| | - Irene Szollosi
- Sleep Disorders Centre, The Prince Charles Hospital, Brisbane, QLD, Australia
| | - Mitchell Hollamby
- Sleep Disorders Centre, The Prince Charles Hospital, Brisbane, QLD, Australia
| | | | - Qing Zhang
- Health & Biosecurity, CSIRO, Brisbane, QLD, Australia
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Niotis K, Saif N, Simonetto M, Wu X, Yan P, Lakis JP, Ariza IE, Buckholz AP, Sharma N, Fink ME, Isaacson RS. Feasibility of a wearable biosensor device to characterize exercise and sleep in neurology residents. Expert Rev Med Devices 2021; 18:1123-1131. [PMID: 34632903 DOI: 10.1080/17434440.2021.1990038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Research suggests optimizing sleep, exercise and work-life balance may improve resident physician burnout. Wearable biosensors may allow residents to detect and correct poor sleep and exercise habits before burnout develops. Our objectives were to evaluate the feasibility of a wearable biosensor to characterize exercise/sleep in neurology residents and examine its relationship to self-reported, validated survey measures. We also assessed the device's impact on well-being and barriers to use. METHODS This prospective cohort study evaluated the WHOOP Strap 2.0 in neurology residents. Participants completed regular online surveys, including self-reported hours of sleep/exercise, and validated sleep/exercise scales at 3-month intervals. Autonomic, exercise, and sleep measures were obtained from WHOOP. Changes were evaluated over time via linear regression. Survey and WHOOP metrics were compared using Pearson correlations. RESULTS Sixteen (72.7%) of 22 eligible participants enrolled. Eleven (68.8%) met the minimum usage requirement (6+ months) and were classified as 'consecutive wearers.' Significant increases were found in sleep duration and exercise intensity. Moderate-to-low correlations were found between survey responses and WHOOP measures. Most (73%) participants reported a positive impact on well-being. Barriers to use included 'Forgetting to wear' (20%) and 'not motivational' (23.3%). CONCLUSION Wearable biosensors may be a feasible tool to evaluate sleep/exercise in residents.
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Affiliation(s)
- Kellyann Niotis
- 2019-2020 McGraw Fellow in Neurology Research; Department of Neurology, Weill Cornell Medicine and New York-Presbyterian, New York, NY, USA
| | - Nabeel Saif
- Department of Neurology, Weill Cornell Medicine, New York, NY, USA
| | - Marialaura Simonetto
- Departments of Internal Medicine and Neurology, Weill Cornell Medicine and New York-Presbyterian, New York, NY, USA
| | - Xian Wu
- Division of Biostatistics and Epidemiology, Weill Cornell Medicine and Department of Healthcare Policy & Research, New York-Presbyterian, New York, NY, USA
| | - Peter Yan
- Department of Neurology, Beth Israel Deaconess Hospital-Milton Center for Specialty Care, Milton, MA, USA
| | - Jessica P Lakis
- Office of Development, New York-Presbyterian, New York, NY, USA
| | | | - Adam P Buckholz
- Department of Internal Medicine, Weill Cornell Medicine and New York-Presbyterian, New York, NY, USA
| | | | - Matthew E Fink
- Department of Neurology, Weill Cornell Medicine, New York, NY, USA
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Massar SAA, Ng ASC, Soon CS, Ong JL, Chua XY, Chee NIYN, Lee TS, Chee MWL. Reopening after lockdown: The influence of working-from-home and digital device use on sleep, physical activity, and wellbeing following COVID-19 lockdown and reopening. Sleep 2021; 45:6390581. [PMID: 34636396 PMCID: PMC8549292 DOI: 10.1093/sleep/zsab250] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/09/2021] [Indexed: 12/02/2022] Open
Abstract
Study Objectives COVID-19 lockdowns drastically affected sleep, physical activity, and wellbeing. We studied how these behaviors evolved during reopening the possible contributions of continued working from home and smartphone usage. Methods Participants (N = 198) were studied through the lockdown and subsequent reopening period, using a wearable sleep/activity tracker, smartphone-delivered ecological momentary assessment (EMA), and passive smartphone usage tracking. Work/study location was obtained through daily EMA ascertainment. Results Upon reopening, earlier, shorter sleep and increased physical activity were observed, alongside increased self-rated stress and poorer evening mood ratings. These reopening changes were affected by post-lockdown work arrangements and patterns of smartphone usage. Individuals who returned to work or school in-person tended toward larger shifts to earlier sleep and wake timings. Returning to in-person work/school also correlated with more physical activity. Contrary to expectation, there was no decrease in objectively measured smartphone usage after reopening. A cluster analysis showed that persons with relatively heavier smartphone use prior to bedtime had later sleep timings and lower physical activity. Conclusions These observations indicate that the reopening after lockdown was accompanied by earlier sleep timing, increased physical activity, and altered mental wellbeing. Moreover, these changes were affected by work/study arrangements and smartphone usage patterns.
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Affiliation(s)
- Stijn A A Massar
- Sleep and Cognition Laboratory, Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore
| | - Alyssa S C Ng
- Sleep and Cognition Laboratory, Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore
| | - Chun Siong Soon
- Sleep and Cognition Laboratory, Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore
| | - Ju Lynn Ong
- Sleep and Cognition Laboratory, Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore
| | - Xin Yu Chua
- Sleep and Cognition Laboratory, Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore
| | - Nicholas I Y N Chee
- Sleep and Cognition Laboratory, Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore
| | - Tih Shih Lee
- Laboratory of Neurobehavioral Genomics, Neuroscience and Behavioral Disorders Programme, Duke-NUS Medical School, Singapore
| | - Michael W L Chee
- Sleep and Cognition Laboratory, Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore
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Wan EY, Ghanbari H, Akoum N, Itzhak Attia Z, Asirvatham SJ, Chung EH, Dagher L, Al-Khatib SM, Stuart Mendenhall G, McManus DD, Pathak RK, Passman RS, Peters NS, Schwartzman DS, Svennberg E, Tarakji KG, Turakhia MP, Trela A, Yarmohammadi H, Marrouche NF. HRS White Paper on Clinical Utilization of Digital Health Technology. CARDIOVASCULAR DIGITAL HEALTH JOURNAL 2021; 2:196-211. [PMID: 35265910 PMCID: PMC8890053 DOI: 10.1016/j.cvdhj.2021.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This collaborative statement from the Digital Health Committee of the Heart Rhythm Society provides everyday clinical scenarios in which wearables may be utilized by patients for cardiovascular health and arrhythmia management. We describe herein the spectrum of wearables that are commercially available for patients, and their benefits, shortcomings and areas for technological improvement. Although wearables for rhythm diagnosis and management have not been examined in large randomized clinical trials, undoubtedly the usage of wearables has quickly escalated in clinical practice. This document is the first of a planned series in which we will update information on wearables as they are revised and released to consumers.
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Affiliation(s)
- Elaine Y. Wan
- Division of Cardiology, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA
| | | | | | | | | | | | - Lilas Dagher
- Tulane Research Innovation for Arrhythmia Discoveries (TRIAD), Heart and Vascular Institute, Tulane University School of Medicine, New Orleans, LA, USA
| | | | | | | | - Rajeev K. Pathak
- Cardiac Electrophysiology Unit, Department of Cardiology, Canberra Hospital and Health Services, Australian National University, Canberra, Australia
| | - Rod S. Passman
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | | | - Emma Svennberg
- Karolinska Institutet, Department of Medicine Huddinge, Karolinska University Hospital, Stockholm, Sweden
| | - Khaldoun G. Tarakji
- Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Mintu P. Turakhia
- Department of Medicine, Stanford University, Stanford, California; Veterans Affairs Palo Alto Health Care System, Palo Alto, California, and Center for Digital Health, Stanford, CA, USA
| | - Anthony Trela
- Lucile Packard Children’s Hospital, Pediatric Cardiology, Palo Alto, CA, USA
| | - Hirad Yarmohammadi
- Division of Cardiology, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA
| | - Nassir F. Marrouche
- Tulane Research Innovation for Arrhythmia Discoveries (TRIAD), Heart and Vascular Institute, Tulane University School of Medicine, New Orleans, LA, USA
- Address reprint requests and correspondence: Dr Nassir F. Marrouche, Cardiac Electrophysiology, Tulane University School of Medicine, 1430 Tulane Avenue, Box 8548, New Orleans, LA 70112.
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Stephenson MD, Thompson AG, Merrigan JJ, Stone JD, Hagen JA. Applying Heart Rate Variability to Monitor Health and Performance in Tactical Personnel: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8143. [PMID: 34360435 PMCID: PMC8346173 DOI: 10.3390/ijerph18158143] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/13/2021] [Accepted: 07/27/2021] [Indexed: 12/17/2022]
Abstract
Human performance optimization of tactical personnel requires accurate, meticulous, and effective monitoring of biological adaptations and systemic recovery. Due to an increased understanding of its importance and the commercial availability of assessment tools, the use of heart rate variability (HRV) to address this need is becoming more common in the tactical community. Measuring HRV is a non-invasive, practical method for objectively assessing a performer's readiness, workload, and recovery status; when combined with additional data sources and practitioner input, it provides an affordable and scalable solution for gaining actionable information to support the facilitation and maintenance of operational performance. This narrative review discusses the non-clinical use of HRV for assessing, monitoring, and interpreting autonomic nervous system resource availability, modulation, effectiveness, and efficiency in tactical populations. Broadly, HRV metrics represent a complex series of interactions resulting from internal and external stimuli; therefore, a general overview of HRV applications in tactical personnel is discussed, including the influence of occupational specific demands, interactions between cognitive and physical domains, and recommendations on implementing HRV for training and recovery insights into critical health and performance outcomes.
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Affiliation(s)
- Mark D. Stephenson
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26505, USA; (A.G.T.); (J.J.M.); (J.D.S.); (J.A.H.)
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Rentz LE, Ulman HK, Galster SM. Deconstructing Commercial Wearable Technology: Contributions toward Accurate and Free-Living Monitoring of Sleep. SENSORS (BASEL, SWITZERLAND) 2021; 21:5071. [PMID: 34372308 PMCID: PMC8348972 DOI: 10.3390/s21155071] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/09/2021] [Accepted: 07/23/2021] [Indexed: 01/07/2023]
Abstract
Despite prolific demands and sales, commercial sleep assessment is primarily limited by the inability to "measure" sleep itself; rather, secondary physiological signals are captured, combined, and subsequently classified as sleep or a specific sleep state. Using markedly different approaches compared with gold-standard polysomnography, wearable companies purporting to measure sleep have rapidly developed during recent decades. These devices are advertised to monitor sleep via sensors such as accelerometers, electrocardiography, photoplethysmography, and temperature, alone or in combination, to estimate sleep stage based upon physiological patterns. However, without regulatory oversight, this market has historically manufactured products of poor accuracy, and rarely with third-party validation. Specifically, these devices vary in their capacities to capture a signal of interest, process the signal, perform physiological calculations, and ultimately classify a state (sleep vs. wake) or sleep stage during a given time domain. Device performance depends largely on success in all the aforementioned requirements. Thus, this review provides context surrounding the complex hardware and software developed by wearable device companies in their attempts to estimate sleep-related phenomena, and outlines considerations and contributing factors for overall device success.
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Affiliation(s)
| | | | - Scott M. Galster
- Human Performance Innovation Center, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26505, USA; (L.E.R.); (H.K.U.)
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Altini M, Kinnunen H. The Promise of Sleep: A Multi-Sensor Approach for Accurate Sleep Stage Detection Using the Oura Ring. SENSORS (BASEL, SWITZERLAND) 2021; 21:4302. [PMID: 34201861 PMCID: PMC8271886 DOI: 10.3390/s21134302] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 06/20/2021] [Accepted: 06/22/2021] [Indexed: 11/26/2022]
Abstract
Consumer-grade sleep trackers represent a promising tool for large scale studies and health management. However, the potential and limitations of these devices remain less well quantified. Addressing this issue, we aim at providing a comprehensive analysis of the impact of accelerometer, autonomic nervous system (ANS)-mediated peripheral signals, and circadian features for sleep stage detection on a large dataset. Four hundred and forty nights from 106 individuals, for a total of 3444 h of combined polysomnography (PSG) and physiological data from a wearable ring, were acquired. Features were extracted to investigate the relative impact of different data streams on 2-stage (sleep and wake) and 4-stage classification accuracy (light NREM sleep, deep NREM sleep, REM sleep, and wake). Machine learning models were evaluated using a 5-fold cross-validation and a standardized framework for sleep stage classification assessment. Accuracy for 2-stage detection (sleep, wake) was 94% for a simple accelerometer-based model and 96% for a full model that included ANS-derived and circadian features. Accuracy for 4-stage detection was 57% for the accelerometer-based model and 79% when including ANS-derived and circadian features. Combining the compact form factor of a finger ring, multidimensional biometric sensory streams, and machine learning, high accuracy wake-sleep detection and sleep staging can be accomplished.
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Affiliation(s)
- Marco Altini
- Oura Health, Elektroniikkatie 10, 90590 Oulu, Finland;
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands
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Trait-like nocturnal sleep behavior identified by combining wearable, phone-use, and self-report data. NPJ Digit Med 2021; 4:90. [PMID: 34079043 PMCID: PMC8172635 DOI: 10.1038/s41746-021-00466-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/03/2021] [Indexed: 12/11/2022] Open
Abstract
Using polysomnography over multiple weeks to characterize an individual’s habitual sleep behavior while accurate, is difficult to upscale. As an alternative, we integrated sleep measurements from a consumer sleep-tracker, smartphone-based ecological momentary assessment, and user-phone interactions in 198 participants for 2 months. User retention averaged >80% for all three modalities. Agreement in bed and wake time estimates across modalities was high (rho = 0.81–0.92) and were adrift of one another for an average of 4 min, providing redundant sleep measurement. On the ~23% of nights where discrepancies between modalities exceeded 1 h, k-means clustering revealed three patterns, each consistently expressed within a given individual. The three corresponding groups that emerged differed systematically in age, sleep timing, time in bed, and peri-sleep phone usage. Hence, contrary to being problematic, discrepant data across measurement modalities facilitated the identification of stable interindividual differences in sleep behavior, underscoring its utility to characterizing population sleep and peri-sleep behavior.
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Topalidis P, Florea C, Eigl ES, Kurapov A, Leon CAB, Schabus M. Evaluation of a Low-Cost Commercial Actigraph and Its Potential Use in Detecting Cultural Variations in Physical Activity and Sleep. SENSORS 2021; 21:s21113774. [PMID: 34072347 PMCID: PMC8198913 DOI: 10.3390/s21113774] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/13/2021] [Accepted: 05/19/2021] [Indexed: 01/02/2023]
Abstract
The purpose of the present study was to evaluate the performance of a low-cost commercial smartwatch, the Xiaomi Mi Band (MB), in extracting physical activity and sleep-related measures and show its potential use in addressing questions that require large-scale real-time data and/or intercultural data including low-income countries. We evaluated physical activity and sleep-related measures and discussed the potential application of such devices for large-scale step and sleep data acquisition. To that end, we conducted two separate studies. In Study 1, we evaluated the performance of MB by comparing it to the GT3X (ActiGraph, wGT3X-BT), a scientific actigraph used in research, as well as subjective sleep reports. In Study 2, we distributed the MB across four countries (Austria, Germany, Cuba, and Ukraine) and investigated physical activity and sleep among these countries. The results of Study 1 indicated that MB step counts correlated highly with the scientific GT3X device, but did display biases. In addition, the MB-derived wake-up and total-sleep-times showed high agreement with subjective reports, but partly deviated from GT3X predictions. Study 2 revealed similar MB step counts across countries, but significant later wake-up and bedtimes for Ukraine than the other countries. We hope that our studies will stimulate future large-scale sensor-based physical activity and sleep research studies, including various cultures.
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Affiliation(s)
- Pavlos Topalidis
- Laboratory for Sleep, Cognition & Consciousness Research, Department of Psychology & Centre for Cognitive Neuroscience Salzburg (CCNS), Paris-Lodron University of Salzburg, 5020 Salzburg, Austria; (P.T.); (C.F.); (E.-S.E.)
| | - Cristina Florea
- Laboratory for Sleep, Cognition & Consciousness Research, Department of Psychology & Centre for Cognitive Neuroscience Salzburg (CCNS), Paris-Lodron University of Salzburg, 5020 Salzburg, Austria; (P.T.); (C.F.); (E.-S.E.)
| | - Esther-Sevil Eigl
- Laboratory for Sleep, Cognition & Consciousness Research, Department of Psychology & Centre for Cognitive Neuroscience Salzburg (CCNS), Paris-Lodron University of Salzburg, 5020 Salzburg, Austria; (P.T.); (C.F.); (E.-S.E.)
| | - Anton Kurapov
- Department of Experimental and Applied Psychology, Faculty of Psychology, Taras Shevchenko National University of Kyiv, 03680 Kyiv, Ukraine;
| | | | - Manuel Schabus
- Laboratory for Sleep, Cognition & Consciousness Research, Department of Psychology & Centre for Cognitive Neuroscience Salzburg (CCNS), Paris-Lodron University of Salzburg, 5020 Salzburg, Austria; (P.T.); (C.F.); (E.-S.E.)
- Correspondence: ; Tel.: +43-662-8044-5113
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Komarzynski S, Wreglesworth NI, Griffiths D, Pecchia L, Subbe CP, Hughes SF, Davies EH, Innominato PF. Embracing Change: Learnings From Implementing Multidimensional Digital Remote Monitoring in Oncology Patients at a District General Hospital During the COVID-19 Pandemic. JCO Clin Cancer Inform 2021; 5:216-220. [PMID: 33606562 DOI: 10.1200/cci.20.00136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
| | - Nicholas I Wreglesworth
- Oncology Department, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor, UK.,School of Medical Sciences, Bangor University, Bangor, UK
| | - Dawn Griffiths
- Oncology Department, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor, UK
| | | | - Christian P Subbe
- School of Medical Sciences, Bangor University, Bangor, UK.,Acute and Critical Care Medicine, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor, UK
| | - Stephen F Hughes
- North Wales Clinical Research Centre, Betsi Cadwaladr University Health Board, Wrexham, UK
| | | | - Pasquale F Innominato
- Oncology Department, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor, UK.,Cancer Chronotherapy Team, Warwick Medical School, University of Warwick, Coventry, UK.,European Laboratory U935, Institut National de la Santé et de la Recherche Médicale (INSERM), Paris-Saclay University, Villejuif, France
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