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Okawara H, Shiraishi Y, Sato K, Nakamura M, Katsumata Y. Visually assessing work performance using a smartwatch via day-to-day fluctuations in heart rate variability. Digit Health 2024; 10:20552076241239240. [PMID: 38533307 PMCID: PMC10964452 DOI: 10.1177/20552076241239240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2024] [Indexed: 03/28/2024] Open
Abstract
Objective To optimize workplace health promotion, a simple method for quantifying allostatic load response is needed. This study examines the feasibility of optimizing objective anxiety and presenteeism monitoring using daily smartwatch-measured ultra-short heart rate variability (HRV). Methods Office workers without diagnosed disease prospectively performed 30 s HRV self-measurement each morning for two months and responded to the State-Trait Anxiety Inventory (STAI) and Work Limitation Questionnaire (WLQ). Logistic regression analysis examined daily HRV parameters in the high-trait anxiety group (HTA, STAI ≥ 40) using mean and variance HRV, age, self-reported gender, and body mass index (BMI). The ideal cutoff value enabled comparison of WLQ using the Mann-Whitney U test. Heart rate variability data were collected for 279 participants (male ratio, 83.9%; age, 42 ± 10 years) who completed questionnaires and monitored HRV for 30+ days. Results Compared to the low-trait anxiety group, HTA exhibited higher variance of the log-transformed coefficient of component variance of high-frequency component (LnccvHF) and low-frequency per HF (Lnccv L/H), in addition to differences in the means of these HRV parameters. In addition to BMI (odds ratio [OR] = 0.92, p = 0.02) and mean LnccvL/H (OR = 10.75, p < 0.01), the variance of Lnccv L/H was an independent predictor of HTA (OR = 2.39E + 8, p = 0.011). The daily Lnccv L/H dispersion group had a lower WLQ productivity loss score (p = 0.02, r = 0.17). Conclusions By focusing on HRV dispersion status, this simple and instantly applicable daily HRV monitoring system enables optimized quantitative monitoring of anxiety and productivity.
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Affiliation(s)
- Hiroki Okawara
- Department Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yasuyuki Shiraishi
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kazuki Sato
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Masaya Nakamura
- Department Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yoshinori Katsumata
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan
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Buekers J, Stas M, Aerts R, Bruffaerts N, Dujardin S, Van Nieuwenhuyse A, Van Orshoven J, Chevance G, Somers B, Aerts JM, Garcia-Aymerich J. Daily allergy burden and heart rate characteristics in adults with allergic rhinitis based on a wearable telemonitoring system. Clin Transl Allergy 2023; 13:e12242. [PMID: 37186425 PMCID: PMC10126716 DOI: 10.1002/clt2.12242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/07/2023] [Accepted: 04/03/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Allergic rhinitis includes a certain degree of autonomic imbalance. However, no information is available on how daily changes in allergy burden affect autonomic imbalance. We aimed to estimate associations between daily allergy burden (allergy symptoms and mood) and daily heart rate characteristics (resting heart rate and sample entropy, both biomarkers of autonomic balance) of adults with allergic rhinitis, based on real-world measurements with a wearable telemonitoring system. METHODS Adults with a tree pollen allergy used a smartphone application to self-report daily allergy symptoms (score 0-44) and mood (score 0-4), and a Mio Alpha 2 wristwatch to collect heart rate characteristics during two pollen seasons of hazel, alder and birch in Belgium. Associations between daily allergy burden and heart rate characteristics were estimated using linear mixed effects distributed lag models with a random intercept for individuals and adjusted for potential confounders. RESULTS Analyses included 2497 participant-days of 72 participants. A one-point increase in allergy symptom score was associated with an increase in next-day resting heart rate of 0.08 (95% CI: 0.02-0.15) beats per minute. A one-point increase in mood score was associated with an increase in same-day sample entropy of 0.80 (95% CI: 0.34-1.26) × 10-2 . No associations were found between allergy symptoms and heart rate sample entropy, nor between mood and resting heart rate. CONCLUSION Daily repeated measurements with a wearable telemonitoring system revealed that the daily allergy burden of adults with allergic rhinitis has systemic effects beyond merely the respiratory system.
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Affiliation(s)
- Joren Buekers
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Measure, Model & Manage Bioresponses (M3-BIORES), Department of Biosystems, KU Leuven, Leuven, Belgium
| | - Michiel Stas
- Measure, Model & Manage Bioresponses (M3-BIORES), Department of Biosystems, KU Leuven, Leuven, Belgium
- Division of Forest, Nature and Landscape, Department of Earth and Environmental Sciences, KU Leuven, Leuven, Belgium
| | - Raf Aerts
- Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Brussels, Belgium
- Division of Ecology, Evolution and Biodiversity Conservation, KU Leuven, Leuven, Belgium
- Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium
- KU Leuven Plant Institute, KU Leuven, Leuven, Belgium
| | - Nicolas Bruffaerts
- Mycology and Aerobiology, Sciensano (Belgian Institute of Health), Brussels, Belgium
| | - Sebastien Dujardin
- Department of Geography, University of Namur, Namur, Belgium
- Institute for Life, Earth and Environment (ILEE), University of Namur, Namur, Belgium
| | - An Van Nieuwenhuyse
- Centre of Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Department of Health Protection, Laboratoire National de Santé (LNS), Dudelange, Luxembourg
| | - Jos Van Orshoven
- Division of Forest, Nature and Landscape, Department of Earth and Environmental Sciences, KU Leuven, Leuven, Belgium
| | - Guillaume Chevance
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Ben Somers
- Division of Forest, Nature and Landscape, Department of Earth and Environmental Sciences, KU Leuven, Leuven, Belgium
- KU Leuven Plant Institute, KU Leuven, Leuven, Belgium
- KU Leuven Urban Studies Institute, KU Leuven, Leuven, Belgium
| | - Jean-Marie Aerts
- Measure, Model & Manage Bioresponses (M3-BIORES), Department of Biosystems, KU Leuven, Leuven, Belgium
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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de Vries H, Oldenhuis H, van der Schans C, Sanderman R, Kamphuis W. Does Wearable-Measured Heart Rate Variability During Sleep Predict Perceived Morning Mental and Physical Fitness? Appl Psychophysiol Biofeedback 2023. [PMID: 36622531 DOI: 10.1007/s10484-022-09578-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [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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de Vries HJ, Pennings HJM, van der Schans CP, Sanderman R, Oldenhuis HKE, Kamphuis W. Wearable-Measured Sleep and Resting Heart Rate Variability as an Outcome of and Predictor for Subjective Stress Measures: A Multiple N-of-1 Observational Study. Sensors (Basel) 2022; 23:s23010332. [PMID: 36616929 PMCID: PMC9823534 DOI: 10.3390/s23010332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/22/2022] [Accepted: 12/26/2022] [Indexed: 05/27/2023]
Abstract
The effects of stress may be alleviated when its impact or a decreased stress-resilience are detected early. This study explores whether wearable-measured sleep and resting HRV in police officers can be predicted by stress-related Ecological Momentary Assessment (EMA) measures in preceding days and predict stress-related EMA outcomes in subsequent days. Eight police officers used an Oura ring to collect daily Total Sleep Time (TST) and resting Heart Rate Variability (HRV) and an EMA app for measuring demands, stress, mental exhaustion, and vigor during 15-55 weeks. Vector Autoregression (VAR) models were created and complemented by Granger causation tests and Impulse Response Function visualizations. Demands negatively predicted TST and HRV in one participant. TST negatively predicted demands, stress, and mental exhaustion in two, three, and five participants, respectively, and positively predicted vigor in five participants. HRV negatively predicted demands in two participants, and stress and mental exhaustion in one participant. Changes in HRV lasted longer than those in TST. Bidirectional associations of TST and resting HRV with stress-related outcomes were observed at a weak-to-moderate strength, but not consistently across participants. TST and resting HRV are more consistent predictors of stress-resilience in upcoming days than indicators of stress-related measures in prior days.
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Affiliation(s)
- Herman J. de Vries
- Research Group Digital Transformation, Hanze University of Applied Sciences, 9747 AS Groningen, The Netherlands
- Department of Human Behaviour & Training, Netherlands Organization for Applied Scientific Research (TNO), 3769 DE Soesterberg, The Netherlands
- Department of Health Psychology, University Medical Center Groningen, 9700 AB Groningen, The Netherlands
| | - Helena J. M. Pennings
- Department of Human Behaviour & Training, Netherlands Organization for Applied Scientific Research (TNO), 3769 DE Soesterberg, The Netherlands
- Utrecht Center for Research and Development of Health Professions Education, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Cees P. van der Schans
- Department of Rehabilitation Medicine, University Medical Center Groningen, 9700 AB Groningen, The Netherlands
- Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences, 9747 AS Groningen, The Netherlands
| | - Robbert Sanderman
- Department of Health Psychology, University Medical Center Groningen, 9700 AB Groningen, The Netherlands
- Department of Psychology, Health and Technology, University of Twente, 7522 NB Enschede, The Netherlands
| | - Hilbrand K. E. Oldenhuis
- Research Group Digital Transformation, Hanze University of Applied Sciences, 9747 AS Groningen, The Netherlands
| | - Wim Kamphuis
- Department of Human Behaviour & Training, Netherlands Organization for Applied Scientific Research (TNO), 3769 DE Soesterberg, The Netherlands
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Himariotis AT, Coffey KF, Noel SE, Cornell DJ. Validity of a Smartphone Application in Calculating Measures of Heart Rate Variability. Sensors (Basel) 2022; 22:9883. [PMID: 36560256 PMCID: PMC9787958 DOI: 10.3390/s22249883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
The purpose of the current study was to determine the concurrent validity of the Elite HRV smartphone application when calculating heart rate variability (HRV) metrics in reference to an independent software criterion. A total of 5 minutes of R−R interval and natural log of root mean square of the successive differences (lnRMSSD) resting HRV data were simultaneously collected using two Polar H10 heart rate monitors (HRMs) in both the seated and supine positions from 22 participants (14 males, 8 females). One H10 HRM was paired with a Polar V800 watch and one with the Elite HRV application. When no artifact correction was applied, significant, but small, differences in the lnRMSSD data were observed between the software in the seated position (p = 0.022), and trivial and nonstatistically significant differences were observed in the supine position (p = 0.087). However, significant differences (p > 0.05) in the lnRMSSD data were no longer identifiable in either the seated or the supine positions when applying Very Low, Low, or Automatic artifact-correction filters. Additionally, excellent agreements (ICC3,1 = 0.938 − 0.998) and very strong to near-perfect (r = 0.889 − 0.997) relationships were observed throughout all correction levels. The Elite HRV smartphone application is a valid tool for calculating resting lnRMSSD HRV metrics.
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Affiliation(s)
- Andreas T. Himariotis
- Health Assessment Laboratory, University of Massachusetts Lowell, Lowell, MA 01854, USA
- Department of Physical Therapy and Kinesiology, University of Massachusetts Lowell, Lowell, MA 01854, USA
| | - Kyle F. Coffey
- Health Assessment Laboratory, University of Massachusetts Lowell, Lowell, MA 01854, USA
- Department of Physical Therapy and Kinesiology, University of Massachusetts Lowell, Lowell, MA 01854, USA
| | - Sabrina E. Noel
- Health Assessment Laboratory, University of Massachusetts Lowell, Lowell, MA 01854, USA
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA 01854, USA
| | - David J. Cornell
- Health Assessment Laboratory, University of Massachusetts Lowell, Lowell, MA 01854, USA
- Department of Physical Therapy and Kinesiology, University of Massachusetts Lowell, Lowell, MA 01854, USA
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de Vries H, Kamphuis W, van der Schans C, Sanderman R, Oldenhuis H. Trends in Daily Heart Rate Variability Fluctuations Are Associated with Longitudinal Changes in Stress and Somatisation in Police Officers. Healthcare (Basel) 2022; 10:144. [PMID: 35052307 DOI: 10.3390/healthcare10010144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/30/2021] [Accepted: 01/05/2022] [Indexed: 01/10/2023] Open
Abstract
The emergence of wearable sensors that allow for unobtrusive monitoring of physiological and behavioural patterns introduces new opportunities to study the impact of stress in a real-world context. This study explores to what extent within-subject trends in daily Heart Rate Variability (HRV) and daily HRV fluctuations are associated with longitudinal changes in stress, depression, anxiety, and somatisation. Nine Dutch police officers collected daily nocturnal HRV data using an Oura ring during 15–55 weeks. Participants filled in the Four-Dimensional Symptoms Questionnaire every 5 weeks. A sample of 47 five-week observations was collected and analysed using multiple regression. After controlling for trends in total sleep time, moderate-to-vigorous physical activity and alcohol use, an increasing trend in the seven-day rolling standard deviation of the HRV (HRVsd) was associated with increases in stress and somatisation over 5 weeks. Furthermore, an increasing HRV trend buffered against the association between HRVsd trend and somatisation change, undoing this association when it was combined with increasing HRV. Depression and anxiety could not be related to trends in HRV or HRVsd, which was related to observed floor effects. These results show that monitoring trends in daily HRV via wearables holds promise for automated stress monitoring and providing personalised feedback.
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