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Hausenblas HA, Lynch T, Hooper S, Shrestha A, Rosendale D, Gu J. Magnesium-L-threonate improves sleep quality and daytime functioning in adults with self-reported sleep problems: A randomized controlled trial. Sleep Med X 2024; 8:100121. [PMID: 39252819 PMCID: PMC11381753 DOI: 10.1016/j.sleepx.2024.100121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 07/23/2024] [Accepted: 08/14/2024] [Indexed: 09/11/2024] Open
Abstract
Objective/Background Sleep problems challenge overall wellbeing. Magnesium has been implicated to benefit sleep, although the clinical evidences varied based on the magnesium source used. Magnesium L-threonate (MgT) is a promising intervention due to its brain bioavailability and effects on cognition, memory and mood. We investigated MgT supplementation on sleep quality and daily function. Patients/methods Eighty 35-55-year-olds with self-assessed sleep problems participated in a randomized, double-blind, placebo-controlled, parallel-arm study, taking 1 g/day of MgT or placebo for 21 days. Sleep and daily behaviors were measured subjectively using standardized questionnaires including the Insomnia Severity Index, Leeds Sleep Evaluation Questionnaire, and Restorative Sleep Questionnaire, and objectively using an Oura ring. The Profile of Mood States questionnaire and a daily diary were used to evaluate mood, energy and productivity, and record any safety concerns. Results The MgT group maintained good sleep quality and daytime functioning, while placebo declined. From objective Oura ring measurements, MgT significantly (p < 0.05) improved vs placebo deep sleep score, REM sleep score, light sleep time, and activity and readiness parameters activity score, activity daily movement score, readiness score, readiness activity balance, and readiness sleep balance. From subjective questionnaires, MgT significantly (p < 0.05) improved vs placebo behavior upon awakening, energy and daytime productivity, grouchiness, mood and mental alertness. MgT was safe and well tolerated. Conclusions This showed MgT improved sleep quality, especially deep/REM sleep stages, improved mood, energy, alertness, and daily activity and productivity. These are consistent with how MgT works in neuron cells and animal models, suggesting broader positive impacts on overall brain health.
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Zhao F, Balthazaar S, Hiremath SV, Nightingale TE, Panza GS. Enhancing Spinal Cord Injury Care: Using Wearable Technologies for Physical Activity, Sleep, and Cardiovascular Health. Arch Phys Med Rehabil 2024; 105:1997-2007. [PMID: 38972475 DOI: 10.1016/j.apmr.2024.06.014] [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: 02/16/2024] [Revised: 06/13/2024] [Accepted: 06/24/2024] [Indexed: 07/09/2024]
Abstract
Wearable devices have the potential to advance health care by enabling real-time monitoring of biobehavioral data and facilitating the management of an individual's health conditions. Individuals living with spinal cord injury (SCI) have impaired motor function, which results in deconditioning and worsening cardiovascular health outcomes. Wearable devices may promote physical activity and allow the monitoring of secondary complications associated with SCI, potentially improving motor function, sleep, and cardiovascular health. However, several challenges remain to optimize the application of wearable technologies within this population. One is striking a balance between research-grade and consumer-grade devices in terms of cost, accessibility, and validity. Additionally, limited literature supports the validity and use of wearable technology in monitoring cardio-autonomic and sleep outcomes for individuals with SCI. Future directions include conducting performance evaluations of wearable devices to precisely capture the additional variation in movement and physiological parameters seen in those with SCI. Moreover, efforts to make the devices small, lightweight, and inexpensive for consumer ease of use may affect those with severe motor impairments. Overcoming these challenges holds the potential for wearable devices to help individuals living with SCI receive timely feedback to manage their health conditions and help clinicians gather comprehensive patient health information to aid in diagnosis and treatment.
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Affiliation(s)
- Fei Zhao
- Department of Health Care Sciences, Program of Occupational Therapy, Wayne State University, Detroit, MI; John D. Dingell VA Medical Center, Research and Development, Detroit, MI
| | - Shane Balthazaar
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada; Department of Cardiology, University Hospitals Birmingham National Health Service (NHS) Foundation Trust, Birmingham, United Kingdom
| | - Shivayogi V Hiremath
- Department of Health and Rehabilitation Sciences, Temple University, Philadelphia, PA
| | - Tom E Nightingale
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada.
| | - Gino S Panza
- Department of Health Care Sciences, Program of Occupational Therapy, Wayne State University, Detroit, MI; John D. Dingell VA Medical Center, Research and Development, Detroit, MI.
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Triana AM, Salmi J, Hayward NMEA, Saramäki J, Glerean E. Longitudinal single-subject neuroimaging study reveals effects of daily environmental, physiological, and lifestyle factors on functional brain connectivity. PLoS Biol 2024; 22:e3002797. [PMID: 39378200 PMCID: PMC11460715 DOI: 10.1371/journal.pbio.3002797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 08/08/2024] [Indexed: 10/10/2024] Open
Abstract
Our behavior and mental states are constantly shaped by our environment and experiences. However, little is known about the response of brain functional connectivity to environmental, physiological, and behavioral changes on different timescales, from days to months. This gives rise to an urgent need for longitudinal studies that collect high-frequency data. To this end, for a single subject, we collected 133 days of behavioral data with smartphones and wearables and performed 30 functional magnetic resonance imaging (fMRI) scans measuring attention, memory, resting state, and the effects of naturalistic stimuli. We find traces of past behavior and physiology in brain connectivity that extend up as far as 15 days. While sleep and physical activity relate to brain connectivity during cognitively demanding tasks, heart rate variability and respiration rate are more relevant for resting-state connectivity and movie-watching. This unique data set is openly accessible, offering an exceptional opportunity for further discoveries. Our results demonstrate that we should not study brain connectivity in isolation, but rather acknowledge its interdependence with the dynamics of the environment, changes in lifestyle, and short-term fluctuations such as transient illnesses or restless sleep. These results reflect a prolonged and sustained relationship between external factors and neural processes. Overall, precision mapping designs such as the one employed here can help to better understand intraindividual variability, which may explain some of the observed heterogeneity in fMRI findings. The integration of brain connectivity, physiology data and environmental cues will propel future environmental neuroscience research and support precision healthcare.
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Affiliation(s)
- Ana María Triana
- Department of Computer Science, School of Science, Aalto University, Espoo, Finland
- Department of Neuroscience and Biomedical Engineering, School of Science, Aalto University, Espoo, Finland
| | - Juha Salmi
- Department of Neuroscience and Biomedical Engineering, School of Science, Aalto University, Espoo, Finland
- Aalto Behavioral Laboratory, Aalto Neuroimaging, Aalto University, Espoo, Finland
- MAGICS, Aalto Studios, Aalto University, Espoo, Finland
- Unit of Psychology, Faculty of Education and Psychology, Oulu University, Oulu, Finland
| | | | - Jari Saramäki
- Department of Computer Science, School of Science, Aalto University, Espoo, Finland
| | - Enrico Glerean
- Department of Neuroscience and Biomedical Engineering, School of Science, Aalto University, Espoo, Finland
- Advanced Magnetic Imaging Centre, Aalto University, Espoo, Finland
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Xu YX, Wang SS, Wan YH, Su PY, Tao FB, Sun Y. Association of sleep fragmentation with general and abdominal obesity: a population-based longitudinal study. Int J Obes (Lond) 2024; 48:1258-1265. [PMID: 38806646 DOI: 10.1038/s41366-024-01547-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 05/11/2024] [Accepted: 05/16/2024] [Indexed: 05/30/2024]
Abstract
OBJECTIVE To evaluate the causal relationship between sleep fragmentation (SF) parameters with general and abdominal obesity in free-living conditions. METHODS SF parameters were assessed by ActiGraph accelerometers for 7 consecutive days. Obesity was measured at baseline and 1-year follow-up with InBody S10 body composition analyzer. RESULTS At baseline, the mean age of the study population was 18.7 years old (SD = 0.9) and 139 (35.7%) were male. Each 1-unit increase of baseline sleep fragmentation index (SFI) was associated with 0.08 kg/m2-increase of body mass index (BMI) (95% CI: 0.03, 0.14), 0.20%-increase of percentage of body fat (PBF) (95% CI: 0.07, 0.32), 0.15 kg-increase of fat mass (FM) (95% CI: 0.03, 0.27), 0.15 cm-increase of waist circumference (WC) (95% CI: 0.03, 0.26) and 0.91 cm2-increase of visceral fat area (VFA) (95% CI: 0.36, 1.46) at the 1-year follow-up. In addition, each 1-unit increase of baseline SFI was associated with 15% increased risk of general obesity (OR = 1.15, 95% CI = 1.04-1.28; p = 0.006) and 7% increased risk of abdominal obesity (OR = 1.07, 95% CI = 1.01-1.13; p = 0.021) in the following year. CONCLUSIONS Fragmented sleep is independently associated with an increased risk of both general and abdominal obesity. The result highlights SF as a modifiable risk factor for the prevention and treatment of obesity.
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Affiliation(s)
- Yu-Xiang Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Shan-Shan Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yu-Hui Wan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Pu-Yu Su
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Fang-Biao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Ying Sun
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.
- Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.
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Morimoto M, Nawari A, Savic R, Marmor M. Exploring the Potential of a Smart Ring to Predict Postoperative Pain Outcomes in Orthopedic Surgery Patients. SENSORS (BASEL, SWITZERLAND) 2024; 24:5024. [PMID: 39124071 PMCID: PMC11314787 DOI: 10.3390/s24155024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 07/26/2024] [Accepted: 08/01/2024] [Indexed: 08/12/2024]
Abstract
Poor pain alleviation remains a problem following orthopedic surgery, leading to prolonged recovery time, increased morbidity, and prolonged opioid use after hospitalization. Wearable device data, collected during postsurgical recovery, may help ameliorate poor pain alleviation because a patient's physiological state during the recovery process may be inferred from sensor data. In this study, we collected smart ring data from 37 inpatients following orthopedic surgery and developed machine learning models to predict if a patient had postsurgical poor pain alleviation. Machine learning models based on the smart ring data were able to predict if a patient had poor pain alleviation during their hospital stay with an accuracy of 70.0%, an F1-score of 0.769, and an area under the receiver operating characteristics curve of 0.762 on an independent test dataset. These values were similar to performance metrics from existing models that rely on static, preoperative patient factors. Our results provide preliminary evidence that wearable device data may help control pain after orthopedic surgery by incorporating real-time, objective estimates of a patient's pain during recovery.
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Affiliation(s)
- Michael Morimoto
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA 94158, USA; (M.M.); (R.S.)
| | - Ashraf Nawari
- School of Medicine, University of California, San Francisco, CA 94143, USA;
| | - Rada Savic
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA 94158, USA; (M.M.); (R.S.)
| | - Meir Marmor
- Orthopaedic Trauma Institute, University of California, San Francisco, CA 94110, USA
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Sauter C, Diemar J, Terebaite V. Usability of digital health devices in clinical trials. Expert Rev Pharmacoecon Outcomes Res 2024. [PMID: 39076077 DOI: 10.1080/14737167.2024.2384545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 06/27/2024] [Accepted: 07/22/2024] [Indexed: 07/31/2024]
Affiliation(s)
| | - Jacob Diemar
- H. Lundbeck A/S, Ottiliavej 9, Copenhagen, Denmark
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7
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Jafarlou S, Azimi I, Lai J, Wang Y, Labbaf S, Nguyen B, Qureshi H, Marcotullio C, Borelli JL, Dutt ND, Rahmani AM. Objective monitoring of loneliness levels using smart devices: A multi-device approach for mental health applications. PLoS One 2024; 19:e0298949. [PMID: 38900745 PMCID: PMC11189241 DOI: 10.1371/journal.pone.0298949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 02/01/2024] [Indexed: 06/22/2024] Open
Abstract
Loneliness is linked to wide ranging physical and mental health problems, including increased rates of mortality. Understanding how loneliness manifests is important for targeted public health treatment and intervention. With advances in mobile sending and wearable technologies, it is possible to collect data on human phenomena in a continuous and uninterrupted way. In doing so, such approaches can be used to monitor physiological and behavioral aspects relevant to an individual's loneliness. In this study, we proposed a method for continuous detection of loneliness using fully objective data from smart devices and passive mobile sensing. We also investigated whether physiological and behavioral features differed in their importance in predicting loneliness across individuals. Finally, we examined how informative data from each device is for loneliness detection tasks. We assessed subjective feelings of loneliness while monitoring behavioral and physiological patterns in 30 college students over a 2-month period. We used smartphones to monitor behavioral patterns (e.g., location changes, type of notifications, in-coming and out-going calls/text messages) and smart watches and rings to monitor physiology and sleep patterns (e.g., heart-rate, heart-rate variability, sleep duration). Participants reported their loneliness feeling multiple times a day through a questionnaire app on their phone. Using the data collected from their devices, we trained a random forest machine learning based model to detect loneliness levels. We found support for loneliness prediction using a multi-device and fully-objective approach. Furthermore, behavioral data collected by smartphones generally were the most important features across all participants. The study provides promising results for using objective data to monitor mental health indicators, which could provide a continuous and uninterrupted source of information in mental healthcare applications.
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Affiliation(s)
- Salar Jafarlou
- Donald Bren School of Information and Computer Sciences, University of California, Irvine, Irvine, California, United States of America
| | - Iman Azimi
- Donald Bren School of Information and Computer Sciences, University of California, Irvine, Irvine, California, United States of America
- Institute for Future Health, University of California, Irvine, Irvine, California, United States of America
| | - Jocelyn Lai
- Department of Psychological Science, University of California, Irvine, Irvine, California, United States of America
| | - Yuning Wang
- Department of Computing, University of Turku, Turku, Finland
| | - Sina Labbaf
- Donald Bren School of Information and Computer Sciences, University of California, Irvine, Irvine, California, United States of America
| | - Brenda Nguyen
- Department of Psychological Science, University of California, Irvine, Irvine, California, United States of America
| | - Hana Qureshi
- Department of Psychological Science, University of California, Irvine, Irvine, California, United States of America
| | - Christopher Marcotullio
- Department of Psychological Science, University of California, Irvine, Irvine, California, United States of America
| | - Jessica L. Borelli
- Department of Cognitive Science, University of California, Irvine, Irvine, California, United States of America
| | - Nikil D. Dutt
- Donald Bren School of Information and Computer Sciences, University of California, Irvine, Irvine, California, United States of America
| | - Amir M. Rahmani
- Donald Bren School of Information and Computer Sciences, University of California, Irvine, Irvine, California, United States of America
- Institute for Future Health, University of California, Irvine, Irvine, California, United States of America
- School of Nursing, University of California, Irvine, Irvine, California, United States of America
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8
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Marhefkova N, Sládek M, Sumová A, Dubsky M. Circadian dysfunction and cardio-metabolic disorders in humans. Front Endocrinol (Lausanne) 2024; 15:1328139. [PMID: 38742195 PMCID: PMC11089151 DOI: 10.3389/fendo.2024.1328139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 04/16/2024] [Indexed: 05/16/2024] Open
Abstract
The topic of human circadian rhythms is not only attracting the attention of clinical researchers from various fields but also sparking a growing public interest. The circadian system comprises the central clock, located in the suprachiasmatic nucleus of the hypothalamus, and the peripheral clocks in various tissues that are interconnected; together they coordinate many daily activities, including sleep and wakefulness, physical activity, food intake, glucose sensitivity and cardiovascular functions. Disruption of circadian regulation seems to be associated with metabolic disorders (particularly impaired glucose tolerance) and cardiovascular disease. Previous clinical trials revealed that disturbance of the circadian system, specifically due to shift work, is associated with an increased risk of type 2 diabetes mellitus. This review is intended to provide clinicians who wish to implement knowledge of circadian disruption in diagnosis and strategies to avoid cardio-metabolic disease with a general overview of this topic.
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Affiliation(s)
- Natalia Marhefkova
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czechia
- First Faculty of Medicine, Charles University, Prague, Czechia
| | - Martin Sládek
- Institute of Physiology, The Czech Academy of Sciences, Prague, Czechia
| | - Alena Sumová
- Institute of Physiology, The Czech Academy of Sciences, Prague, Czechia
| | - Michal Dubsky
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czechia
- First Faculty of Medicine, Charles University, Prague, Czechia
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Breus M, Hooper SL, Lynch T, Barragan M, Hausenblas HA. Effectiveness of a grid mattress on adults' sleep quality and health: A quasi-experimental intervention study. Health Sci Rep 2024; 7:e2046. [PMID: 38638888 PMCID: PMC11025355 DOI: 10.1002/hsr2.2046] [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: 11/15/2023] [Revised: 03/22/2024] [Accepted: 03/28/2024] [Indexed: 04/20/2024] Open
Abstract
Background and aims Despite that 93% of people indicate that a mattress plays a pivotal role in achieving high-quality sleep, there is a scarcity of research investigating the influence of mattresses on sleep quality, pain, and mood in nonclinical poor sleepers. The purpose was to examine the effectiveness of a pressure-releasing medium-firm grid mattress on sleep and health outcomes (e.g., mood, pain, daytime fatigue) of adults with nonclinical insomnia symptoms using a quasi-experimental design. Methods Participants were 39 adults (mean age = 45.29) with nonclinical insomnia (i.e., occasional sleeplessness). Following 1 week of baseline assessments on their current mattress, they slept on a pressure-relieving grid mattress for 8 weeks. Participants completed self-report assessments of the Pittsburgh Sleep Quality Index, Berlin Questionnaire, Insomnia Severity Index, Restorative Sleep Questionnaire, Perceived Stress Scale, Profile of Mood States, Daytime Fatigue Scale, Pain and Sleep Questionnaire, and Brief Pain Inventory at Baseline and Weeks 1, 2, 3, 4, and 8. Participants continually wore an Oura Ring to objectively assess sleep and daytime activity. The data were collected from January 2022 to April 2022 and were stored electronically. Repeated-measures analyses of variance were used to analyze mean time differences. Results Self-reported sleep quality, perceived pain, perceived stress, mood, and daytime fatigue improved significantly from Baseline to Week 8, p's < 0.05. Objective Oura Ring validated the self-reported sleep and daytime activity outcomes with improvements in sleep duration, time awake during the night, light sleep, deep sleep, and total sleep time, p's < 0.05. No significant time effects were evidenced for rapid eye movement sleep. No adverse events were reported. Conclusion The grid mattress is a simple, noninvasive, and nonpharmacological intervention that improved adults sleep quality and health. Controlled trials are encouraged to examine the effects of this mattress in a variety of populations and environments.
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Affiliation(s)
| | | | - Tarah Lynch
- School of Applied Health Sciences, Brooks Rehabilitation College of Healthcare SciencesJacksonville UniversityJacksonvilleFloridaUSA
| | - Martin Barragan
- School of Applied Health Sciences, Brooks Rehabilitation College of Healthcare SciencesJacksonville UniversityJacksonvilleFloridaUSA
| | - Heather A. Hausenblas
- School of Applied Health Sciences, Brooks Rehabilitation College of Healthcare SciencesJacksonville UniversityJacksonvilleFloridaUSA
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Bloomfield LSP, Fudolig MI, Kim J, Llorin J, Lovato JL, McGinnis EW, McGinnis RS, Price M, Ricketts TH, Dodds PS, Stanton K, Danforth CM. Predicting stress in first-year college students using sleep data from wearable devices. PLOS DIGITAL HEALTH 2024; 3:e0000473. [PMID: 38602898 PMCID: PMC11008774 DOI: 10.1371/journal.pdig.0000473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 02/16/2024] [Indexed: 04/13/2024]
Abstract
Consumer wearables have been successful at measuring sleep and may be useful in predicting changes in mental health measures such as stress. A key challenge remains in quantifying the relationship between sleep measures associated with physiologic stress and a user's experience of stress. Students from a public university enrolled in the Lived Experiences Measured Using Rings Study (LEMURS) provided continuous biometric data and answered weekly surveys during their first semester of college between October-December 2022. We analyzed weekly associations between estimated sleep measures and perceived stress for participants (N = 525). Through mixed-effects regression models, we identified consistent associations between perceived stress scores and average nightly total sleep time (TST), resting heart rate (RHR), heart rate variability (HRV), and respiratory rate (ARR). These effects persisted after controlling for gender and week of the semester. Specifically, for every additional hour of TST, the odds of experiencing moderate-to-high stress decreased by 0.617 or by 38.3% (p<0.01). For each 1 beat per minute increase in RHR, the odds of experiencing moderate-to-high stress increased by 1.036 or by 3.6% (p<0.01). For each 1 millisecond increase in HRV, the odds of experiencing moderate-to-high stress decreased by 0.988 or by 1.2% (p<0.05). For each additional breath per minute increase in ARR, the odds of experiencing moderate-to-high stress increased by 1.230 or by 23.0% (p<0.01). Consistent with previous research, participants who did not identify as male (i.e., female, nonbinary, and transgender participants) had significantly higher self-reported stress throughout the study. The week of the semester was also a significant predictor of stress. Sleep data from wearable devices may help us understand and to better predict stress, a strong signal of the ongoing mental health epidemic among college students.
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Affiliation(s)
- Laura S. P. Bloomfield
- Gund Institute for Environment, University of Vermont, Burlington, Vermont, United States of America
- Department of Mathematics & Statistics, University of Vermont, Burlington, Vermont, United States of America
- Vermont Complex Systems Center, University of Vermont, Burlington, Vermont, United States of America
| | - Mikaela I. Fudolig
- Department of Mathematics & Statistics, University of Vermont, Burlington, Vermont, United States of America
- Vermont Complex Systems Center, University of Vermont, Burlington, Vermont, United States of America
| | - Julia Kim
- Vermont Complex Systems Center, University of Vermont, Burlington, Vermont, United States of America
| | - Jordan Llorin
- Vermont Complex Systems Center, University of Vermont, Burlington, Vermont, United States of America
| | - Juniper L. Lovato
- Vermont Complex Systems Center, University of Vermont, Burlington, Vermont, United States of America
| | - Ellen W. McGinnis
- Department of Social Science and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America
- Center for Remote Patient and Participant Monitoring, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Ryan S. McGinnis
- Center for Remote Patient and Participant Monitoring, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America
- Department of Biomedical Engineering, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Matt Price
- Vermont Complex Systems Center, University of Vermont, Burlington, Vermont, United States of America
- Department of Psychological Science, University of Vermont, Burlington, Vermont, United States of America
| | - Taylor H. Ricketts
- Gund Institute for Environment, University of Vermont, Burlington, Vermont, United States of America
- Rubenstein School of Environment and Natural Resources, University of Vermont, Burlington, Vermont, United States of America
| | - Peter Sheridan Dodds
- Vermont Complex Systems Center, University of Vermont, Burlington, Vermont, United States of America
- Department of Computer Science, University of Vermont, Burlington, Vermont, United States of America
| | - Kathryn Stanton
- Vermont Complex Systems Center, University of Vermont, Burlington, Vermont, United States of America
| | - Christopher M. Danforth
- Gund Institute for Environment, University of Vermont, Burlington, Vermont, United States of America
- Department of Mathematics & Statistics, University of Vermont, Burlington, Vermont, United States of America
- Vermont Complex Systems Center, University of Vermont, Burlington, Vermont, United States of America
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11
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Jafarzadeh Esfahani M, Sikder N, Ter Horst R, Daraie AH, Appel K, Weber FD, Bevelander KE, Dresler M. Citizen neuroscience: Wearable technology and open software to study the human brain in its natural habitat. Eur J Neurosci 2024; 59:948-965. [PMID: 38328991 DOI: 10.1111/ejn.16227] [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: 01/22/2023] [Revised: 11/09/2023] [Accepted: 11/30/2023] [Indexed: 02/09/2024]
Abstract
Citizen science allows the public to participate in various stages of scientific research, including study design, data acquisition, and data analysis. Citizen science has a long history in several fields of the natural sciences, and with recent developments in wearable technology, neuroscience has also become more accessible to citizen scientists. This development was largely driven by the influx of minimal sensing systems in the consumer market, allowing more do-it-yourself (DIY) and quantified-self (QS) investigations of the human brain. While most subfields of neuroscience require sophisticated monitoring devices and laboratories, the study of sleep characteristics can be performed at home with relevant noninvasive consumer devices. The strong influence of sleep quality on waking life and the accessibility of devices to measure sleep are two primary reasons citizen scientists have widely embraced sleep research. Their involvement has evolved from solely contributing to data collection to engaging in more collaborative or autonomous approaches, such as instigating ideas, formulating research inquiries, designing research protocols and methodology, acting upon their findings, and disseminating results. In this article, we introduce the emerging field of citizen neuroscience, illustrating examples of such projects in sleep research. We then provide overviews of the wearable technologies for tracking human neurophysiology and various open-source software used to analyse them. Finally, we discuss the opportunities and challenges in citizen neuroscience projects and suggest how to improve the study of the human brain outside the laboratory.
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Affiliation(s)
| | - Niloy Sikder
- Donders Institute for Brain, Behaviour, and Cognition, Radboudumc, Nijmegen, The Netherlands
- Faculty of Technology and Bionics, Rhine-Waal University of Applied Sciences, Kleve, Germany
| | - Rob Ter Horst
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Amir Hossein Daraie
- Donders Institute for Brain, Behaviour, and Cognition, Radboudumc, Nijmegen, The Netherlands
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Frederik D Weber
- Donders Institute for Brain, Behaviour, and Cognition, Radboudumc, Nijmegen, The Netherlands
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Kirsten E Bevelander
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Primary and Community Care, Radboud University and Medical Center, Nijmegen, The Netherlands
| | - Martin Dresler
- Donders Institute for Brain, Behaviour, and Cognition, Radboudumc, Nijmegen, The Netherlands
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12
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Bini C, Hjelm C, Hellström A, Årestedt K, Broström A, Sandlund C. How patients with insomnia interpret and respond to the consensus sleep diary: a cognitive interview study. J Patient Rep Outcomes 2024; 8:19. [PMID: 38376583 PMCID: PMC10879077 DOI: 10.1186/s41687-024-00695-y] [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: 04/26/2023] [Accepted: 02/01/2024] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVE/BACKGROUND The Consensus Sleep Diary (CSD) is widely used to assess subjective sleep. Psychometric evaluations and focus-groups support its validity and clinical usefulness, but further research into its validity is needed. The aim of the study was to evaluate a Swedish translation of the CSD regarding test content and response processes in patients with insomnia. PATIENTS/METHODS In connection with translating the CSD into Swedish, we used cognitive interviewing to evaluate test content and the response process, that is, how people make decisions when responding to survey items. Cognitive interviews were conducted with 13 primary health care patients with insomnia disorder (mean age, 49 years; SD 15.5). Iterative, reparative analysis was used to investigate test content. Descriptive deductive analysis was used to investigate interview transcripts for the themes of the cognitive model: comprehension, retrieval, decision process, and judgement. Together, the themes explain the response process when responding to a patient-reported outcome measure. RESULTS The overall comprehension of the CSD could be affected by poor adherence to the instructions (comprehension). Patients had difficulty with recall if they did not complete the diary immediately in the morning and just before bedtime (retrieval). They could have problems deciding how to respond to certain items because they imbued sleep-related concepts with extra meaning (decision process), and had trouble finding response alternatives nuanced enough to describe their experience of sleep and tiredness (judgement). CONCLUSIONS This study contributes knowledge on how the instrument is perceived and used by care-seeking patients with insomnia. In this context, the CSD exhibits known flaws such as memory lapses if the diary is not filled in directly in the morning. To increase the accuracy of patients' responses, therapists should support patients in reading the instructions.
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Affiliation(s)
- Christina Bini
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Alfred Nobels allé 23, Huddinge, SE-141 83, Sweden.
- Academic Primary Health Care Centre, Region Stockholm, Solnavägen 1E, Stockholm, 113 65, Sweden.
| | - Carina Hjelm
- Department of Health, Medicine and Care, Nursing and Reproductive Health, Linköping University, Linköping, 581 83, Sweden
| | - Amanda Hellström
- Faculty of Health and Life Sciences, Linnaeus University, Universitetskajen 1, Kalmar, SE-392 31, Sweden
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences, Linnaeus University, Universitetskajen 1, Kalmar, SE-392 31, Sweden
- Department of Research, Region Kalmar, Lasarettsvägen 8, Kalmar, SE-39185, Sweden
| | - Anders Broström
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, 551 11, Sweden
- Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, 581 85, Sweden
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Vestlandet, 5020, Norway
| | - Christina Sandlund
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Alfred Nobels allé 23, Huddinge, SE-141 83, Sweden
- Academic Primary Health Care Centre, Region Stockholm, Solnavägen 1E, Stockholm, 113 65, Sweden
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Seol J, Chiba S, Kawana F, Tsumoto S, Masaki M, Tominaga M, Amemiya T, Tani A, Hiei T, Yoshimine H, Kondo H, Yanagisawa M. Validation of sleep-staging accuracy for an in-home sleep electroencephalography device compared with simultaneous polysomnography in patients with obstructive sleep apnea. Sci Rep 2024; 14:3533. [PMID: 38347028 PMCID: PMC10861536 DOI: 10.1038/s41598-024-53827-1] [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: 10/30/2023] [Accepted: 02/05/2024] [Indexed: 02/15/2024] Open
Abstract
Efforts to simplify standard polysomnography (PSG) in laboratories, especially for obstructive sleep apnea (OSA), and assess its agreement with portable electroencephalogram (EEG) devices are limited. We aimed to evaluate the agreement between a portable EEG device and type I PSG in patients with OSA and examine the EEG-based arousal index's ability to estimate apnea severity. We enrolled 77 Japanese patients with OSA who underwent simultaneous type I PSG and portable EEG monitoring. Combining pulse rate, oxygen saturation (SpO2), and EEG improved sleep staging accuracy. Bland-Altman plots, paired t-tests, and receiver operating characteristics curves were used to assess agreement and screening accuracy. Significant small biases were observed for total sleep time, sleep latency, awakening after falling asleep, sleep efficiency, N1, N2, and N3 rates, arousal index, and apnea indexes. All variables showed > 95% agreement in the Bland-Altman analysis, with interclass correlation coefficients of 0.761-0.982, indicating high inter-instrument validity. The EEG-based arousal index demonstrated sufficient power for screening AHI ≥ 15 and ≥ 30 and yielded promising results in predicting apnea severity. Portable EEG device showed strong agreement with type I PSG in patients with OSA. These suggest that patients with OSA may assess their condition at home.
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Affiliation(s)
- Jaehoon Seol
- Faculty of Health and Sports Sciences, University of Tsukuba, Tsukuba, Ibaraki, 305-8574, Japan.
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-2 Kasuga, Tsukuba, Ibaraki, 305-8550, Japan.
- Department of Frailty Research, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, 474-8511, Japan.
| | - Shigeru Chiba
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-2 Kasuga, Tsukuba, Ibaraki, 305-8550, Japan
| | - Fusae Kawana
- Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, 113-8421, Japan
| | - Saki Tsumoto
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-2 Kasuga, Tsukuba, Ibaraki, 305-8550, Japan
- Ph.D. Program in Humanics, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Minori Masaki
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-2 Kasuga, Tsukuba, Ibaraki, 305-8550, Japan
- Ph.D. Program in Humanics, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | | | | | | | | | - Hiroyuki Yoshimine
- Department of Respiratory Medicine, Inoue Hospital, Nagasaki, Nagasaki, 850-0045, Japan
| | - Hideaki Kondo
- Department of General Medicine, Institute of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8102, Japan
| | - Masashi Yanagisawa
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-2 Kasuga, Tsukuba, Ibaraki, 305-8550, Japan.
- S'UIMIN, Inc., Tokyo, 151-0061, Japan.
- Life Science Center for Survival Dynamics (TARA), University of Tsukuba, Ibaraki, 305-8577, Japan.
- R&D Center for Frontiers of Mirai in Policy and Technology (F-MIRAI), University of Tsukuba, Ibaraki, 305-8575, Japan.
- Department of Molecular Genetics, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA.
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14
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Radtke MD, Steinberg FM, Scherr RE. Methods for Assessing Health Outcomes Associated with Food Insecurity in the United States College Student Population: A Narrative Review. Adv Nutr 2024; 15:100131. [PMID: 37865221 PMCID: PMC10831897 DOI: 10.1016/j.advnut.2023.10.004] [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: 04/05/2023] [Revised: 10/03/2023] [Accepted: 10/12/2023] [Indexed: 10/23/2023] Open
Abstract
In the United States, college students experience disproportionate food insecurity (FI) rates compared to the national prevalence. The experience of acute and chronic FI has been associated with negative physical and mental health outcomes in this population. This narrative review aims to summarize the current methodologies for assessing health outcomes associated with the experience of FI in college students in the United States. To date, assessing the health outcomes of FI has predominately consisted of subjective assessments, such as self-reported measures of dietary intake, perceived health status, stress, depression, anxiety, and sleep behaviors. This review, along with the emergence of FI as an international public health concern, establishes the need for novel, innovative, and objective biomarkers to evaluate the short- and long-term impacts of FI on physical and mental health outcomes in college students. The inclusion of objective biomarkers will further elucidate the relationship between FI and a multitude of health outcomes to better inform strategies for reducing the pervasiveness of FI in the United States college student population.
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Affiliation(s)
- Marcela D Radtke
- Propel Postdoctoral Fellow, Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford University, Palo Alto, CA, USA 94305
| | | | - Rachel E Scherr
- Family, Interiors, Nutrition & Apparel Department, San Francisco State University, 1600 Holloway Avenue, San Francisco, CA, USA, 94132; Scherr Nutrition Science Consulting, San Francisco, CA, 94115.
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Erdélyi A, Pálfi E, Tűű L, Nas K, Szűcs Z, Török M, Jakab A, Várbíró S. The Importance of Nutrition in Menopause and Perimenopause-A Review. Nutrients 2023; 16:27. [PMID: 38201856 PMCID: PMC10780928 DOI: 10.3390/nu16010027] [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: 11/28/2023] [Revised: 12/14/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Menopause is associated with an increased prevalence of obesity, metabolic syndrome, cardiovascular diseases, and osteoporosis. These diseases and unfavorable laboratory values, which are characteristic of this period in women, can be significantly improved by eliminating and reducing dietary risk factors. Changing dietary habits during perimenopause is most effectively achieved through nutrition counseling and intervention. To reduce the risk factors of all these diseases, and in the case of an already existing disease, dietary therapy led by a dietitian should be an integral part of the treatment. The following review summarizes the recommendations for a balanced diet and fluid intake, the dietary prevention of cardiovascular diseases, the role of sleep, and the key preventive nutrients in menopause, such as vitamin D, calcium, vitamin C, B vitamins, and protein intake. In summary, during the period of perimenopause and menopause, many lifestyle factors can reduce the risk of developing all the diseases (cardiovascular disease, insulin resistance, type 2 diabetes mellitus, osteoporosis, and tumors) and symptoms characteristic of this period.
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Affiliation(s)
- Aliz Erdélyi
- Hungarian Dietetic Association, 1034 Budapest, Hungary; (A.E.); (Z.S.)
- EndoCare Institute, Endocrinology Center, 1037 Budapest, Hungary; (L.T.); (K.N.)
| | - Erzsébet Pálfi
- Faculty of Health Sciences, Department of Dietetics and Nutritional Sciences, Semmelweis University, 1088 Budapest, Hungary
| | - László Tűű
- EndoCare Institute, Endocrinology Center, 1037 Budapest, Hungary; (L.T.); (K.N.)
- School of PhD Studies, Semmelweis University, 1085 Budapest, Hungary
| | - Katalin Nas
- EndoCare Institute, Endocrinology Center, 1037 Budapest, Hungary; (L.T.); (K.N.)
- School of PhD Studies, Semmelweis University, 1085 Budapest, Hungary
| | - Zsuzsanna Szűcs
- Hungarian Dietetic Association, 1034 Budapest, Hungary; (A.E.); (Z.S.)
- School of PhD Studies, Semmelweis University, 1085 Budapest, Hungary
| | - Marianna Török
- EndoCare Institute, Endocrinology Center, 1037 Budapest, Hungary; (L.T.); (K.N.)
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary;
| | - Attila Jakab
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
| | - Szabolcs Várbíró
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary;
- Department of Obstetrics and Gynecology, University of Szeged, 6725 Szeged, Hungary
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16
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Helakari H, Järvelä M, Väyrynen T, Tuunanen J, Piispala J, Kallio M, Ebrahimi SM, Poltojainen V, Kananen J, Elabasy A, Huotari N, Raitamaa L, Tuovinen T, Korhonen V, Nedergaard M, Kiviniemi V. Effect of sleep deprivation and NREM sleep stage on physiological brain pulsations. Front Neurosci 2023; 17:1275184. [PMID: 38105924 PMCID: PMC10722275 DOI: 10.3389/fnins.2023.1275184] [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: 08/09/2023] [Accepted: 11/02/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Sleep increases brain fluid transport and the power of pulsations driving the fluids. We investigated how sleep deprivation or electrophysiologically different stages of non-rapid-eye-movement (NREM) sleep affect the human brain pulsations. Methods Fast functional magnetic resonance imaging (fMRI) was performed in healthy subjects (n = 23) with synchronous electroencephalography (EEG), that was used to verify arousal states (awake, N1 and N2 sleep). Cardiorespiratory rates were verified with physiological monitoring. Spectral power analysis assessed the strength, and spectral entropy assessed the stability of the pulsations. Results In N1 sleep, the power of vasomotor (VLF < 0.1 Hz), but not cardiorespiratory pulsations, intensified after sleep deprived vs. non-sleep deprived subjects. The power of all three pulsations increased as a function of arousal state (N2 > N1 > awake) encompassing brain tissue in both sleep stages, but extra-axial CSF spaces only in N2 sleep. Spectral entropy of full band and respiratory pulsations decreased most in N2 sleep stage, while cardiac spectral entropy increased in ventricles. Discussion In summary, the sleep deprivation and sleep depth, both increase the power and harmonize the spectral content of human brain pulsations.
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Affiliation(s)
- Heta Helakari
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Matti Järvelä
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Tommi Väyrynen
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Johanna Tuunanen
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Johanna Piispala
- Clinical Neurophysiology, Oulu University Hospital, Oulu, Finland
| | - Mika Kallio
- Clinical Neurophysiology, Oulu University Hospital, Oulu, Finland
| | - Seyed Mohsen Ebrahimi
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Valter Poltojainen
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Janne Kananen
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Clinical Neurophysiology, Oulu University Hospital, Oulu, Finland
| | - Ahmed Elabasy
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Niko Huotari
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Lauri Raitamaa
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Timo Tuovinen
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Vesa Korhonen
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Maiken Nedergaard
- Center of Translational Neuromedicine, University of Copenhagen, Copenhagen, Denmark
- Center of Translational Neuromedicine, University of Rochester, Rochester, NY, United States
| | - Vesa Kiviniemi
- Oulu Functional Neuroimaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
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Micarelli A, Viziano A, Arena M, Misici I, Di Benedetto A, Carbini V, Micarelli B, Alessandrini M. Changes in sleep performance and chronotype behaviour after vestibular rehabilitation in unilateral vestibular hypofunction. J Laryngol Otol 2023; 137:1349-1358. [PMID: 36524555 DOI: 10.1017/s0022215122002602] [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] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This study aimed to investigate changes in sleep parameters and self-perceived sleep quality in unilateral vestibular hypofunction participants after vestibular rehabilitation. METHOD Forty-six unilateral vestibular hypofunction participants (before and after vestibular rehabilitation) along with a control group of 60 healthy patients underwent otoneurological examination, a one-week actigraphy sleep analysis and a series of self-report and performance measures. RESULTS After vestibular rehabilitation, unilateral vestibular hypofunction participants showed a significant score decrease in the Pittsburgh Sleep Quality Index, a self-rated reliable questionnaire depicting sleep quality during the last month, as well as a reduction in sleep onset latency and an increase in total sleep time, indicating an objective improvement in sleep quality as measured by actigraphy analysis. However, after vestibular rehabilitation, unilateral vestibular hypofunction participants still showed statistically significant differences with respect to the control group in both self-rated and objective measurements of sleep quality. CONCLUSION Vestibular rehabilitation may impact on sleep performance and chronotype behaviour, possibly by opposing long-term structural changes along neural pathways entangled in sleep activity because of the deafferentation of the vestibular nuclei.
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Affiliation(s)
- A Micarelli
- Unit of Neuroscience, Rehabilitation and Sensory Organs, Uniter Onlus, Rome, Italy
| | - A Viziano
- Department of Clinical Sciences and Translational Medicine, ENT Unit, University of Rome Tor Vergata, Italy
| | - M Arena
- Unit of Neuroscience, Rehabilitation and Sensory Organs, Uniter Onlus, Rome, Italy
| | - I Misici
- Unit of Neuroscience, Rehabilitation and Sensory Organs, Uniter Onlus, Rome, Italy
| | - A Di Benedetto
- Unit of Neuroscience, Rehabilitation and Sensory Organs, Uniter Onlus, Rome, Italy
- Occupational Therapy Unit, IRCCS Santa Lucia Foundation, Rome, Italy
| | - V Carbini
- Unit of Neuroscience, Rehabilitation and Sensory Organs, Uniter Onlus, Rome, Italy
| | - B Micarelli
- Unit of Neuroscience, Rehabilitation and Sensory Organs, Uniter Onlus, Rome, Italy
| | - M Alessandrini
- Department of Clinical Sciences and Translational Medicine, ENT Unit, University of Rome Tor Vergata, 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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Masoumian Hosseini M, Masoumian Hosseini ST, Qayumi K, Hosseinzadeh S, Sajadi Tabar SS. Smartwatches in healthcare medicine: assistance and monitoring; a scoping review. BMC Med Inform Decis Mak 2023; 23:248. [PMID: 37924029 PMCID: PMC10625201 DOI: 10.1186/s12911-023-02350-w] [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: 07/12/2023] [Accepted: 10/22/2023] [Indexed: 11/06/2023] Open
Abstract
Smartwatches have become increasingly popular in recent times because of their capacity to track different health indicators, including heart rate, patterns of sleep, and physical movements. This scoping review aims to explore the utilisation of smartwatches within the healthcare sector. According to Arksey and O'Malley's methodology, an organised search was performed in PubMed/Medline, Scopus, Embase, Web of Science, ERIC and Google Scholar. In our search strategy, 761 articles were returned. The exclusion/inclusion criteria were applied. Finally, 35 articles were selected for extracting data. These included six studies on stress monitoring, six on movement disorders, three on sleep tracking, three on blood pressure, two on heart disease, six on covid pandemic, three on safety and six on validation. The use of smartwatches has been found to be effective in diagnosing the symptoms of various diseases. In particular, smartwatches have shown promise in detecting heart diseases, movement disorders, and even early signs of COVID-19. Nevertheless, it should be emphasised that there is an ongoing discussion concerning the reliability of smartwatch diagnoses within healthcare systems. Despite the potential advantages offered by utilising smartwatches for disease detection, it is imperative to approach their data interpretation with prudence. The discrepancies in detection between smartwatches and their algorithms have important implications for healthcare use. The accuracy and reliability of the algorithms used are crucial, as well as high accuracy in detecting changes in health status by the smartwatches themselves. This calls for the development of medical watches and the creation of AI-hospital assistants. These assistants will be designed to help with patient monitoring, appointment scheduling, and medication management tasks. They can educate patients and answer common questions, freeing healthcare providers to focus on more complex tasks.
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Affiliation(s)
- Mohsen Masoumian Hosseini
- Department of E-Learning in Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
- CyberPatient Research Affiliate, Interactive Health International, Department of the surgery, University of British Columbia, Vancouver, Canada
| | - Seyedeh Toktam Masoumian Hosseini
- CyberPatient Research Affiliate, Interactive Health International, Department of the surgery, University of British Columbia, Vancouver, Canada.
- Department of Nursing, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
| | - Karim Qayumi
- Professor at Department of Surgery, University of British Columbia, Vancouver, Canada
| | - Shahriar Hosseinzadeh
- CyberPatient Research Coordinator, Interactive Health International, Department of Surgery, University of British Columbia, Vancouver, Canada
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Kennedy KE, Wills CC, Holt C, Grandner MA. A randomized, sham-controlled trial of a novel near-infrared phototherapy device on sleep and daytime function. J Clin Sleep Med 2023; 19:1669-1675. [PMID: 37141002 PMCID: PMC10476031 DOI: 10.5664/jcsm.10648] [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: 01/09/2023] [Revised: 04/28/2023] [Accepted: 05/01/2023] [Indexed: 05/05/2023]
Abstract
STUDY OBJECTIVES Near-infrared light exhibits several therapeutic properties, but little is known about the benefits to sleep and daytime function. The purpose of this study was to investigate the effects of red and near-infrared exposure before bed on sleep and next-day function. METHODS Thirty adults (30-60 y) with a self-reported sleep complaint but without a sleep disorder participated in a randomized, sham-controlled study for a duration of 5 weeks. After a 2-week baseline period, participants wore either a cervical red light/near-infrared-emitting collar (combined: 660 nm, 740 nm, 810 nm, and 870 nm) or sham device every other night before bed for 3 weeks. Sleep was measured using actigraphy and sleep diaries. Mood and performance were assessed using weekly self-reported surveys and debrief interviews. RESULTS Objective sleep parameters, as measured by actigraphy, did not differ between the active or sham groups, but improved self-reported sleep, as well as perceived improvements in relaxation and mood, were observed among active but not sham users. Both active and sham users improved in Insomnia Severity Index score by the end of the trial. CONCLUSIONS Red and near-infrared exposure to the head and neck before bed may offer potential therapeutic benefits to sleep and daytime function, but further work needs to be done to determine optimal dose parameters, wavelengths, and milliwatt power level. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Name: Phase II Study-Trial of a Phototherapy Light Device to Improve Sleep Health (PHOTONS); URL: https://clinicaltrials.gov/ct2/show/NCT05116358; Identifier: NCT05116358. CITATION Kennedy KER, Wills CCA, Holt C, Grandner MA. A randomized, sham-controlled trial of a novel near-infrared phototherapy device on sleep and daytime function. J Clin Sleep Med. 2023;19(9):1669-1675.
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Affiliation(s)
- Kathryn E.R. Kennedy
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine–Tucson, Tucson, Arizona
| | - Chloe C.A. Wills
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine–Tucson, Tucson, Arizona
| | - Catie Holt
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine–Tucson, Tucson, Arizona
| | - Michael A. Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine–Tucson, Tucson, Arizona
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Sarhaddi F, Azimi I, Niela-Vilen H, Axelin A, Liljeberg P, Rahmani AM. Maternal Social Loneliness Detection Using Passive Sensing Through Continuous Monitoring in Everyday Settings: Longitudinal Study. JMIR Form Res 2023; 7:e47950. [PMID: 37556183 PMCID: PMC10448281 DOI: 10.2196/47950] [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: 04/06/2023] [Revised: 06/17/2023] [Accepted: 06/19/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Maternal loneliness is associated with adverse physical and mental health outcomes for both the mother and her child. Detecting maternal loneliness noninvasively through wearable devices and passive sensing provides opportunities to prevent or reduce the impact of loneliness on the health and well-being of the mother and her child. OBJECTIVE The aim of this study is to use objective health data collected passively by a wearable device to predict maternal (social) loneliness during pregnancy and the postpartum period and identify the important objective physiological parameters in loneliness detection. METHODS We conducted a longitudinal study using smartwatches to continuously collect physiological data from 31 women during pregnancy and the postpartum period. The participants completed the University of California, Los Angeles (UCLA) loneliness questionnaire in gestational week 36 and again at 12 weeks post partum. Responses to this questionnaire and background information of the participants were collected through our customized cross-platform mobile app. We leveraged participants' smartwatch data from the 7 days before and the day of their completion of the UCLA questionnaire for loneliness prediction. We categorized the loneliness scores from the UCLA questionnaire as loneliness (scores≥12) and nonloneliness (scores<12). We developed decision tree and gradient-boosting models to predict loneliness. We evaluated the models by using leave-one-participant-out cross-validation. Moreover, we discussed the importance of extracted health parameters in our models for loneliness prediction. RESULTS The gradient boosting and decision tree models predicted maternal social loneliness with weighted F1-scores of 0.897 and 0.872, respectively. Our results also show that loneliness is highly associated with activity intensity and activity distribution during the day. In addition, resting heart rate (HR) and resting HR variability (HRV) were correlated with loneliness. CONCLUSIONS Our results show the potential benefit and feasibility of using passive sensing with a smartwatch to predict maternal loneliness. Our developed machine learning models achieved a high F1-score for loneliness prediction. We also show that intensity of activity, activity pattern, and resting HR and HRV are good predictors of loneliness. These results indicate the intervention opportunities made available by wearable devices and predictive models to improve maternal well-being through early detection of loneliness.
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Affiliation(s)
| | - Iman Azimi
- Department of Computer Science, University of California, Irvine, CA, United States
- Institute for Future Health, University of California, Irvine, CA, United States
| | | | - Anna Axelin
- Department of Nursing Science, University of Turku, Turku, Finland
- Department of Obstetrics and Gynaecology, Turku University Hospital, Turku, Finland
- Faculty of Medicine, University of Turku, Turku, Finland
| | - Pasi Liljeberg
- Department of Computing, University of Turku, Turku, Finland
| | - Amir M Rahmani
- Department of Computer Science, University of California, Irvine, CA, United States
- Institute for Future Health, University of California, Irvine, CA, United States
- School of Nursing, University of California, Irvine, CA, United States
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22
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Gaiduk M, Seepold R, Martínez Madrid N, Ortega JA. Assessing the Feasibility of Replacing Subjective Questionnaire-Based Sleep Measurement with an Objective Approach Using a Smartwatch. SENSORS (BASEL, SWITZERLAND) 2023; 23:6145. [PMID: 37447992 DOI: 10.3390/s23136145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/29/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023]
Abstract
In order to ensure sufficient recovery of the human body and brain, healthy sleep is indispensable. For this purpose, appropriate therapy should be initiated at an early stage in the case of sleep disorders. For some sleep disorders (e.g., insomnia), a sleep diary is essential for diagnosis and therapy monitoring. However, subjective measurement with a sleep diary has several disadvantages, requiring regular action from the user and leading to decreased comfort and potential data loss. To automate sleep monitoring and increase user comfort, one could consider replacing a sleep diary with an automatic measurement, such as a smartwatch, which would not disturb sleep. To obtain accurate results on the evaluation of the possibility of such a replacement, a field study was conducted with a total of 166 overnight recordings, followed by an analysis of the results. In this evaluation, objective sleep measurement with a Samsung Galaxy Watch 4 was compared to a subjective approach with a sleep diary, which is a standard method in sleep medicine. The focus was on comparing four relevant sleep characteristics: falling asleep time, waking up time, total sleep time (TST), and sleep efficiency (SE). After evaluating the results, it was concluded that a smartwatch could replace subjective measurement to determine falling asleep and waking up time, considering some level of inaccuracy. In the case of SE, substitution was also proved to be possible. However, some individual recordings showed a higher discrepancy in results between the two approaches. For its part, the evaluation of the TST measurement currently does not allow us to recommend substituting the measurement method for this sleep parameter. The appropriateness of replacing sleep diary measurement with a smartwatch depends on the acceptable levels of discrepancy. We propose four levels of similarity of results, defining ranges of absolute differences between objective and subjective measurements. By considering the values in the provided table and knowing the required accuracy, it is possible to determine the suitability of substitution in each individual case. The introduction of a "similarity level" parameter increases the adaptability and reusability of study findings in individual practical cases.
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Affiliation(s)
- Maksym Gaiduk
- Department of Computer Science, HTWG Konstanz-University of Applied Sciences, 78462 Konstanz, Germany
| | - Ralf Seepold
- Department of Computer Science, HTWG Konstanz-University of Applied Sciences, 78462 Konstanz, Germany
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23
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Auxier J, Asgari Mehrabadi M, Rahmani AM, Axelin A. A Descriptive Comparative Pilot Study: Association Between Use of a Self-monitoring Device and Sleep and Stress Outcomes in Pregnancy. Comput Inform Nurs 2023; 41:457-466. [PMID: 36730074 PMCID: PMC10241436 DOI: 10.1097/cin.0000000000000958] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Pregnancy is a challenging time for maintaining quality sleep and managing stress. Digital self-monitoring technologies are popular because of assumed increased patient engagement leading to an impact on health outcomes. However, the actual association between wear time of such devices and improved sleep/stress outcomes remains untested. Here, a descriptive comparative pilot study of 20 pregnant women was conducted to examine associations between wear time (behavioral engagement) of self-monitoring devices and sleep/stress pregnancy outcomes. Women used a ring fitted to their finger to monitor sleep/stress data, with access to a self-monitoring program for an average of 9½ weeks. Based on wear time, participants were split into two engagement groups. Using a linear mixed-effects model, the high engagement group showed higher levels of stress and a negative trend in sleep duration and quality. The low engagement group showed positive changes in sleep duration, and quality and experienced below-normal sleep onset latency at the start of the pilot but trended toward normal levels. Engagement according to device wear time was not associated with improved outcomes. Further research should aim to understand how engagement with self-monitoring technologies impacts sleep/stress outcomes in pregnancy.
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Mortazavi BJ, Martinez-Brockman JL, Tessier-Sherman B, Burg M, Miller M, Nowroozilarki Z, Adams OP, Maharaj R, Nazario CM, Nunez M, Nunez-Smith M, Spatz ES. Classification of blood pressure during sleep impacts designation of nocturnal nondipping. PLOS DIGITAL HEALTH 2023; 2:e0000267. [PMID: 37310958 PMCID: PMC10263317 DOI: 10.1371/journal.pdig.0000267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 05/03/2023] [Indexed: 06/15/2023]
Abstract
The identification of nocturnal nondipping blood pressure (< 10% drop in mean systolic blood pressure from awake to sleep periods), as captured by ambulatory blood pressure monitoring, is a valuable element of risk prediction for cardiovascular disease, independent of daytime or clinic blood pressure measurements. However, capturing measurements, including determination of wake/sleep periods, is challenging. Accordingly, we sought to evaluate the impact of different definitions and algorithms for defining sleep onset on the classification of nocturnal nondipping. Using approaches based upon participant self-reports, applied definition of a common sleep period (12 am -6 am), manual actigraphy, and automated actigraphy we identified changes to the classification of nocturnal nondipping, and conducted a secondary analysis on the potential impact of an ambulatory blood pressure monitor on sleep. Among 61 participants in the Eastern Caribbean Health Outcomes Research Network hypertension study with complete ambulatory blood pressure monitor and sleep data, the concordance for nocturnal nondipping across methods was 0.54 by Fleiss' Kappa (depending on the method, 36 to 51 participants classified as having nocturnal nondipping). Sleep quality for participants with dipping versus nondipping was significantly different for total sleep length when wearing the ambulatory blood pressure monitor (shorter sleep duration) versus not (longer sleep duration), although there were no differences in sleep efficiency or disturbances. These findings indicate that consideration of sleep time measurements is critical for interpreting ambulatory blood pressure. As technology advances to detect blood pressure and sleep patterns, further investigation is needed to determine which method should be used for diagnosis, treatment, and future cardiovascular risk.
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Affiliation(s)
- Bobak J. Mortazavi
- Department of Computer Science & Engineering, Texas A&M University, College Station, Texas, United States of America
- Center for Remote Health Technologies and Systems, Texas A&M University, College Station, Texas, United States of America
- Yale/Yale New Haven Health System Corporation Center for Outcomes Research and Evaluation, New Haven, Connecticut, United States of America
| | - Josefa L. Martinez-Brockman
- Equity Research and Innovation Center, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Baylah Tessier-Sherman
- Equity Research and Innovation Center, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Matthew Burg
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
- Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Mary Miller
- Equity Research and Innovation Center, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Zhale Nowroozilarki
- Department of Computer Science & Engineering, Texas A&M University, College Station, Texas, United States of America
| | - O. Peter Adams
- Department of Family Medicine, Faculty of Medical Sciences, University of the West Indies, Cave Hill, Barbados
| | - Rohan Maharaj
- Department of Paraclinical Sciences, University of the West Indies, Saint Augustine, Trinidad
| | - Cruz M. Nazario
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
| | - Maxine Nunez
- School of Nursing, University of the Virgin Islands, US Virgin Islands
| | - Marcella Nunez-Smith
- Equity Research and Innovation Center, Yale School of Medicine, New Haven, Connecticut, United States of America
- Section of General Internal Medicine, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Erica S. Spatz
- Yale/Yale New Haven Health System Corporation Center for Outcomes Research and Evaluation, New Haven, Connecticut, United States of America
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
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Cho E, Kim S, Heo SJ, Shin J, Hwang S, Kwon E, Lee S, Kim S, Kang B. Machine learning-based predictive models for the occurrence of behavioral and psychological symptoms of dementia: model development and validation. Sci Rep 2023; 13:8073. [PMID: 37202454 DOI: 10.1038/s41598-023-35194-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 05/14/2023] [Indexed: 05/20/2023] Open
Abstract
The behavioral and psychological symptoms of dementia (BPSD) are challenging aspects of dementia care. This study used machine learning models to predict the occurrence of BPSD among community-dwelling older adults with dementia. We included 187 older adults with dementia for model training and 35 older adults with dementia for external validation. Demographic and health data and premorbid personality traits were examined at the baseline, and actigraphy was utilized to monitor sleep and activity levels. A symptom diary tracked caregiver-perceived symptom triggers and the daily occurrence of 12 BPSD classified into seven subsyndromes. Several prediction models were also employed, including logistic regression, random forest, gradient boosting machine, and support vector machine. The random forest models revealed the highest area under the receiver operating characteristic curve (AUC) values for hyperactivity, euphoria/elation, and appetite and eating disorders; the gradient boosting machine models for psychotic and affective symptoms; and the support vector machine model showed the highest AUC. The gradient boosting machine model achieved the best performance in terms of average AUC scores across the seven subsyndromes. Caregiver-perceived triggers demonstrated higher feature importance values across the seven subsyndromes than other features. Our findings demonstrate the possibility of predicting BPSD using a machine learning approach.
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Affiliation(s)
- Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, 50-1, Yonsei-Ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Sujin Kim
- Department of Nursing, Yong-In Arts and Science University, Gyeonggi-do, Korea
| | - Seok-Jae Heo
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Jinhee Shin
- College of Nursing, Woosuk University, Jeollabuk-do, Korea
| | - Sinwoo Hwang
- Korea Armed Forces Nursing Academy, Daejeon, Korea
| | - Eunji Kwon
- Korea Armed Forces Nursing Academy, Daejeon, Korea
| | | | | | - Bada Kang
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, 50-1, Yonsei-Ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Kristiansson E, Fridolfsson J, Arvidsson D, Holmäng A, Börjesson M, Andersson-Hall U. Validation of Oura ring energy expenditure and steps in laboratory and free-living. BMC Med Res Methodol 2023; 23:50. [PMID: 36829120 PMCID: PMC9950693 DOI: 10.1186/s12874-023-01868-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 02/16/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND Commercial activity trackers are increasingly used in research and compared with research-based accelerometers are often less intrusive, cheaper, with improved storage and battery capacity, although typically less validated. The present study aimed to determine the validity of Oura Ring step-count and energy expenditure (EE) in both laboratory and free-living. METHODS Oura Ring EE was compared against indirect calorimetry in the laboratory, followed by a 14-day free-living study with 32 participants wearing an Oura Ring and reference monitors (three accelerometers positioned at hip, thigh, and wrist, and pedometer) to evaluate Oura EE variables and step count. RESULTS Strong correlations were shown for Oura versus indirect calorimetry in the laboratory (r = 0.93), and versus reference monitors for all variables in free-living (r ≥ 0.76). Significant (p < 0.05) mean differences for Oura versus reference methods were found for laboratory measured sitting (- 0.12 ± 0.28 MET), standing (- 0.27 ± 0.33 MET), fast walk (- 0.82 ± 1.92 MET) and very fast run (- 3.49 ± 3.94 MET), and for free-living step-count (2124 ± 4256 steps) and EE variables (MET: - 0.34-0.26; TEE: 362-494 kcal; AEE: - 487-259 kcal). In the laboratory, Oura tended to underestimate EE with increasing discrepancy as intensity increased. The combined activities and slow running in the laboratory, and all MET placements, TEE hip and wrist, and step count in free-living had acceptable measurement errors (< 10% MAPE), whereas the remaining free-living variables showed close to (≤13.2%) acceptable limits. CONCLUSION This is the first study investigating the validity of Oura Ring EE against gold standard methods. Oura successfully identified major changes between activities and/or intensities but was less responsive to detailed deviations within activities. In free-living, Oura step-count and EE variables tightly correlated with reference monitors, though with systemic over- or underestimations indicating somewhat low intra-individual validity of the ring versus the reference monitors. However, the correlations between the devices were high, suggesting that the Oura can detect differences at group-level for active and total energy expenditure, as well as step count.
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Affiliation(s)
- Emilia Kristiansson
- Center for Health and Performance, Department of Food and Nutrition, and Sport Science Faculty of Education, University of Gothenburg, Gothenburg, Sweden
- Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jonatan Fridolfsson
- Center for Health and Performance, Department of Food and Nutrition, and Sport Science Faculty of Education, University of Gothenburg, Gothenburg, Sweden
| | - Daniel Arvidsson
- Center for Health and Performance, Department of Food and Nutrition, and Sport Science Faculty of Education, University of Gothenburg, Gothenburg, Sweden
| | - Agneta Holmäng
- Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mats Börjesson
- Center for Health and Performance, Department of Food and Nutrition, and Sport Science Faculty of Education, University of Gothenburg, Gothenburg, Sweden
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Ulrika Andersson-Hall
- Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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Ghosh A, Nag S, Gomes A, Gosavi A, Ghule G, Kundu A, Purohit B, Srivastava R. Applications of Smart Material Sensors and Soft Electronics in Healthcare Wearables for Better User Compliance. MICROMACHINES 2022; 14:121. [PMID: 36677182 PMCID: PMC9862021 DOI: 10.3390/mi14010121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/25/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
The need for innovation in the healthcare sector is essential to meet the demand of a rapidly growing population and the advent of progressive chronic ailments. Over the last decade, real-time monitoring of health conditions has been prioritized for accurate clinical diagnosis and access to accelerated treatment options. Therefore, the demand for wearable biosensing modules for preventive and monitoring purposes has been increasing over the last decade. Application of machine learning, big data analysis, neural networks, and artificial intelligence for precision and various power-saving approaches are used to increase the reliability and acceptance of smart wearables. However, user compliance and ergonomics are key areas that need focus to make the wearables mainstream. Much can be achieved through the incorporation of smart materials and soft electronics. Though skin-friendly wearable devices have been highlighted recently for their multifunctional abilities, a detailed discussion on the integration of smart materials for higher user compliance is still missing. In this review, we have discussed the principles and applications of sustainable smart material sensors and soft electronics for better ergonomics and increased user compliance in various healthcare devices. Moreover, the importance of nanomaterials and nanotechnology is discussed in the development of smart wearables.
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Affiliation(s)
- Arnab Ghosh
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai 400076, India
| | - Sagnik Nag
- Department of Biotechnology, School of Biosciences & Technology, Vellore Institute of Technology (VIT), Tiruvalam Road, Vellore 632014, Tamil Nadu, India
| | - Alyssa Gomes
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai 400076, India
| | - Apurva Gosavi
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai 400076, India
| | - Gauri Ghule
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai 400076, India
| | - Aniket Kundu
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai 400076, India
| | - Buddhadev Purohit
- DTU Bioengineering, Technical University of Denmark, Søltofts Plads 221, 2800 Kongens Lyngby, Denmark
| | - Rohit Srivastava
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai 400076, India
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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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29
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Auxier J, Savolainen KT, Bender M, Rahmani AM, Sarhaddi F, Azimi I, Axelin AM. Exploring access as a process of adaptation in a self-monitoring perinatal eHealth system: Mixed-method study from a socio-material perspective (Preprint). JMIR Form Res 2022; 7:e44385. [PMID: 37184929 DOI: 10.2196/44385] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/10/2023] [Accepted: 03/27/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND The development and quality assurance of perinatal eHealth self-monitoring systems is an upcoming area of inquiry in health science. Building patient engagement into eHealth development as a core component has potential to guide process evaluation. Access, 1 attribute of patient engagement, is the focus of study here. Access to eHealth self-monitoring programs has the potential to influence pregnancy health and wellness outcomes. Little is known about how pregnant users' ability to obtain resources is influenced by their own adaptive activities and the mediating activities of eHealth systems during the process of real-world testing of these systems. OBJECTIVE Here, we examine the patient engagement process of access occurring during the adaptation of eHealth self-monitoring use from a sociomaterial perspective. METHODS In this mixed methods convergent evaluation design, we interviewed women about perceptions of the adaptation process of using an eHealth self-monitoring system. Deductive analysis was conducted guided by the definition of access as an attribute of patient engagement. After initial qualitative and quantitative data collection and analysis, participants were spilt based on their level of use of the eHealth system (physical wear time of self-monitoring device). Content analysis was then conducted according to user group, using a conceptual matrix developed from ontological perspectives of sociomateriality. RESULTS Pregnant users' adaptive activities and the mediation activities of the eHealth system represent a cocreation process that resulted in user group-specific characteristics of accessing and using the system. The high- and low-use groups experienced different personal adaptation and eHealth mediation during this process of cocreation. Differences were noted between high- and low-use groups, with the high-use group giving attention to developing skills in recording and interpreting data and the low-use group discussing the manual adding of activities to the system and how the system worked best for them when they used it in their mother tongue. CONCLUSIONS A cocreation process between pregnant users and the eHealth system was identified, illustrating access as a useful core component of perinatal eHealth self-monitoring systems. Researchers and clinicians can observe reasons for why pregnant users access eHealth systems in unique ways based on their personal preferences, habits, and values. Mediation activities of the eHealth system and the different user adaptive activities represent a cocreation process between the users and the eHealth system that is necessary for the personalization of perinatal eHealth systems.
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Kheirinejad S, Visuri A, Ferreira D, Hosio S. "Leave your smartphone out of bed": quantitative analysis of smartphone use effect on sleep quality. PERSONAL AND UBIQUITOUS COMPUTING 2022; 27:447-466. [PMID: 36405389 PMCID: PMC9643910 DOI: 10.1007/s00779-022-01694-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
Smartphones have become an integral part of people's everyday lives. Smartphones are used across all household locations, including in the bed at night. Smartphone screens and other displays emit blue light, and exposure to blue light can affect one's sleep quality. Thus, smartphone use prior to bedtime could disrupt the quality of one's sleep, but research lacks quantitative studies on how smartphone use can influence sleep. This study combines smartphone application use data from 75 participants with sleep data collected by a wearable ring. On average, the participants used their smartphones in bed for 322.8 s (5 min and 22.8 s), with an IQR of 43.7-456. Participants spent an average of 42% of their time in bed using their smartphones (IQR of 5.87-55.5%). Our findings indicate that smartphone use in bed has significant adverse effects on sleep latency, awake time, average heart rate, and HR variability. We also find that smartphone use does not decrease sleep quality when used outside of bed. Our results indicate that intense smartphone use alone does not negatively affect well-being. Since all smartphone users do not use their phones in the same way, extending the investigation to different smartphone use types might yield more information than general smartphone use. In conclusion, this paper presents the first investigation of the association between smartphone application use logs and detailed sleep metrics. Our work also validates previous research results and highlights emerging future work.
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Gabinet NM, Portnov BA. Investigating the combined effect of ALAN and noise on sleep by simultaneous real-time monitoring using low-cost smartphone devices. ENVIRONMENTAL RESEARCH 2022; 214:113941. [PMID: 35931188 DOI: 10.1016/j.envres.2022.113941] [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: 05/25/2022] [Revised: 07/05/2022] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Abstract
The association between artificial light at night (ALAN) and noise, on the one hand, and sleep, on the other, is well established. Yet studies investigating these associations have been infrequent and mostly conducted in controlled laboratory conditions. As a result, little is known about the applicability of their results to real-world settings. In this paper, we attempt to bridge this knowledge gap by carrying out an individual-level real-world study, involving 72 volunteers from different urban localities in Israel. The survey participants were asked to use their personal smartphones and smartwatches to monitor sleep patterns for 30 consecutive days, while ALAN and noise exposures were monitored in parallel, with inputs reported each second. The volunteers were also asked to fill in a questionnaire about their individual attributes, daily habits, room settings, and personal health, to serve as individual-level controls. Upon cointegration, the assembled data were co-analyzed using bivariate and multivariate statistical tools. As the study reveals, the effect of ALAN and noise on sleep largely depends on when the exposure occurred, that is, before sleep or during sleep. In particular, the effect of ALAN exposure was found to be most pronounced if it occurred before sleep, while exposure to noise mattered most if it occurred during the sleep phase. As the study also reveals, the effects of ALAN and noise appear to amplify each other, with a 14-15.3% reduction in sleep duration and an 8-9% reduction in sleep efficiency observed at high levels of ALAN-noise exposures. The study helped to assemble a massive amount of real-time observations, enabling a robust individual-level analysis.
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Affiliation(s)
- Nahum M Gabinet
- Department of Natural Resources and Environmental Management, Faculty of Social Sciences, University of Haifa, Mt. Carmel, Haifa, 3498838, Israel.
| | - Boris A Portnov
- Department of Natural Resources and Environmental Management, Faculty of Social Sciences, University of Haifa, Mt. Carmel, Haifa, 3498838, Israel.
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Shama H, Gabinet N, Tzischinsky O, Portnov B. Monitoring sleep in real-world conditions using low-cost technology tools. BIOL RHYTHM RES 2022. [DOI: 10.1080/09291016.2022.2131990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Hassan Shama
- Department of Natural Resources and Environmental Management, University of Haifa, Haifa Israel
| | - Nahum Gabinet
- Department of Natural Resources and Environmental Management, University of Haifa, Haifa Israel
| | - Orna Tzischinsky
- Department of Behavioral Science, Max Stern Yezreel Valley College, Israel
| | - Boris Portnov
- Department of Natural Resources and Environmental Management, University of Haifa, Haifa Israel
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Rafl J, Bachman TE, Rafl-Huttova V, Walzel S, Rozanek M. Commercial smartwatch with pulse oximeter detects short-time hypoxemia as well as standard medical-grade device: Validation study. Digit Health 2022; 8:20552076221132127. [PMID: 36249475 PMCID: PMC9554125 DOI: 10.1177/20552076221132127] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 09/22/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE We investigated how a commercially available smartwatch that measures peripheral blood oxygen saturation (SpO2) can detect hypoxemia compared to a medical-grade pulse oximeter. METHODS We recruited 24 healthy participants. Each participant wore a smartwatch (Apple Watch Series 6) on the left wrist and a pulse oximeter sensor (Masimo Radical-7) on the left middle finger. The participants breathed via a breathing circuit with a three-way non-rebreathing valve in three phases. First, in the 2-minute initial stabilization phase, the participants inhaled the ambient air. Then in the 5-minute desaturation phase, the participants breathed the oxygen-reduced gas mixture (12% O2), which temporarily reduced their blood oxygen saturation. In the final stabilization phase, the participants inhaled the ambient air again until SpO2 returned to normal values. Measurements of SpO2 were taken from the smartwatch and the pulse oximeter simultaneously in 30-s intervals. RESULTS There were 642 individual pairs of SpO2 measurements. The bias in SpO2 between the smartwatch and the oximeter was 0.0% for all the data points. The bias for SpO2 less than 90% was 1.2%. The differences in individual measurements between the smartwatch and oximeter within 6% SpO2 can be expected for SpO2 readings 90%-100% and up to 8% for SpO2 readings less than 90%. CONCLUSIONS Apple Watch Series 6 can reliably detect states of reduced blood oxygen saturation with SpO2 below 90% when compared to a medical-grade pulse oximeter. The technology used in this smartwatch is sufficiently advanced for the indicative measurement of SpO2 outside the clinic. TRIAL REGISTRATION ClinicalTrials.gov NCT04780724.
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Affiliation(s)
- Jakub Rafl
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic,Jakub Rafl, Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, nam. Sitna 3105, CZ-272 01 Kladno, Czech Republic.
| | - Thomas E Bachman
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic
| | - Veronika Rafl-Huttova
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic
| | - Simon Walzel
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic
| | - Martin Rozanek
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic
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Smart Consumer Wearables as Digital Diagnostic Tools: A Review. Diagnostics (Basel) 2022; 12:diagnostics12092110. [PMID: 36140511 PMCID: PMC9498278 DOI: 10.3390/diagnostics12092110] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/26/2022] [Accepted: 08/29/2022] [Indexed: 11/17/2022] Open
Abstract
The increasing usage of smart wearable devices has made an impact not only on the lifestyle of the users, but also on biological research and personalized healthcare services. These devices, which carry different types of sensors, have emerged as personalized digital diagnostic tools. Data from such devices have enabled the prediction and detection of various physiological as well as psychological conditions and diseases. In this review, we have focused on the diagnostic applications of wrist-worn wearables to detect multiple diseases such as cardiovascular diseases, neurological disorders, fatty liver diseases, and metabolic disorders, including diabetes, sleep quality, and psychological illnesses. The fruitful usage of wearables requires fast and insightful data analysis, which is feasible through machine learning. In this review, we have also discussed various machine-learning applications and outcomes for wearable data analyses. Finally, we have discussed the current challenges with wearable usage and data, and the future perspectives of wearable devices as diagnostic tools for research and personalized healthcare domains.
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Kazemi K, Laitala J, Azimi I, Liljeberg P, Rahmani AM. Robust PPG Peak Detection Using Dilated Convolutional Neural Networks. SENSORS (BASEL, SWITZERLAND) 2022; 22:6054. [PMID: 36015816 PMCID: PMC9414657 DOI: 10.3390/s22166054] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
Accurate peak determination from noise-corrupted photoplethysmogram (PPG) signal is the basis for further analysis of physiological quantities such as heart rate. Conventional methods are designed for noise-free PPG signals and are insufficient for PPG signals with low signal-to-noise ratio (SNR). This paper focuses on enhancing PPG noise-resiliency and proposes a robust peak detection algorithm for PPG signals distorted due to noise and motion artifact. Our algorithm is based on convolutional neural networks (CNNs) with dilated convolutions. We train and evaluate the proposed method using a dataset collected via smartwatches under free-living conditions in a home-based health monitoring application. A data generator is also developed to produce noisy PPG data used for model training and evaluation. The method performance is compared against other state-of-the-art methods and is tested with SNRs ranging from 0 to 45 dB. Our method outperforms the existing adaptive threshold, transform-based, and machine learning methods. The proposed method shows overall precision, recall, and F1-score of 82%, 80%, and 81% in all the SNR ranges. In contrast, the best results obtained by the existing methods are 78%, 80%, and 79%. The proposed method proves to be accurate for detecting PPG peaks even in the presence of noise.
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Affiliation(s)
- Kianoosh Kazemi
- Department of Computing, Faculty of Technology, University of Turku, 20014 Turku, Finland
| | - Juho Laitala
- Department of Computing, Faculty of Technology, University of Turku, 20014 Turku, Finland
| | - Iman Azimi
- Department of Computing, Faculty of Technology, University of Turku, 20014 Turku, Finland
- Department of Computer Science, University of California, Irvine, CA 92697-3435, USA
- Institute for Future Health, University of California, Irvine, CA 92697, USA
| | - Pasi Liljeberg
- Department of Computing, Faculty of Technology, University of Turku, 20014 Turku, Finland
| | - Amir M. Rahmani
- Department of Computer Science, University of California, Irvine, CA 92697-3435, USA
- Institute for Future Health, University of California, Irvine, CA 92697, USA
- School of Nursing, University of California, Irvine, CA 92697, USA
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Mousavi ZA, Lai J, Simon K, Rivera AP, Yunusova A, Hu S, Labbaf S, Jafarlou S, Dutt ND, Jain RC, Rahmani AM, Borelli JL. Sleep Patterns and Affect Dynamics Among College Students During the COVID-19 Pandemic: Intensive Longitudinal Study. JMIR Form Res 2022; 6:e33964. [PMID: 35816447 PMCID: PMC9359303 DOI: 10.2196/33964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 05/24/2022] [Accepted: 06/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Sleep disturbance is a transdiagnostic risk factor that is so prevalent among young adults that it is considered a public health epidemic, which has been exacerbated by the COVID-19 pandemic. Sleep may contribute to mental health via affect dynamics. Prior literature on the contribution of sleep to affect is largely based on correlational studies or experiments that do not generalize to the daily lives of young adults. Furthermore, the literature examining the associations between sleep variability and affect dynamics remains scant.
Objective
In an ecologically valid context, using an intensive longitudinal design, we aimed to assess the daily and long-term associations between sleep patterns and affect dynamics among young adults during the COVID-19 pandemic.
Methods
College student participants (N=20; female: 13/20, 65%) wore an Oura ring (Ōura Health Ltd) continuously for 3 months to measure sleep patterns, such as average and variability in total sleep time (TST), wake after sleep onset (WASO), sleep efficiency, and sleep onset latency (SOL), resulting in 1173 unique observations. We administered a daily ecological momentary assessment by using a mobile health app to evaluate positive affect (PA), negative affect (NA), and COVID-19 worry once per day.
Results
Participants with a higher sleep onset latency (b=−1.09, SE 0.36; P=.006) and TST (b=−0.15, SE 0.05; P=.008) on the prior day had lower PA on the next day. Further, higher average TST across the 3-month period predicted lower average PA (b=−0.36, SE 0.12; P=.009). TST variability predicted higher affect variability across all affect domains. Specifically, higher variability in TST was associated higher PA variability (b=0.09, SE 0.03; P=.007), higher negative affect variability (b=0.12, SE 0.05; P=.03), and higher COVID-19 worry variability (b=0.16, SE 0.07; P=.04).
Conclusions
Fluctuating sleep patterns are associated with affect dynamics at the daily and long-term scales. Low PA and affect variability may be potential pathways through which sleep has implications for mental health.
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Affiliation(s)
- Zahra Avah Mousavi
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
| | - Jocelyn Lai
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
| | - Katharine Simon
- Department of Cognitive Sciences, University of California, Irvine, Irvine, CA, United States
| | - Alexander P Rivera
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
| | - Asal Yunusova
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
| | - Sirui Hu
- Department of Economics, University of California, Irvine, Irvine, CA, United States
| | - Sina Labbaf
- Department of Computer Science, University of California, Irvine, Irvine, CA, United States
| | - Salar Jafarlou
- Department of Computer Science, University of California, Irvine, Irvine, CA, United States
| | - Nikil D Dutt
- Department of Cognitive Sciences, University of California, Irvine, Irvine, CA, United States
- Department of Computer Science, University of California, Irvine, Irvine, CA, United States
| | - Ramesh C Jain
- Department of Computer Science, University of California, Irvine, Irvine, CA, United States
| | - Amir M Rahmani
- Department of Computer Science, University of California, Irvine, Irvine, CA, United States
- School of Nursing, University of California, Irvine, Irvine, CA, United States
| | - Jessica L Borelli
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
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Wang Y, Azimi I, Kazemi K, Rahmani AM, Liljeberg P. PPG Signal Reconstruction Using Deep Convolutional Generative Adversarial Network. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:3387-3391. [PMID: 36086184 DOI: 10.1109/embc48229.2022.9871678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Photoplethysmography (PPG) is a non-invasive technique used in wearable devices to collect various vital signs, including heart rate and heart rate variability. The signal is highly susceptible to motion artifacts, which is inevitable in health monitoring and may lead to inaccurate decision-making. Studies in the literature proposed time series analysis, signal decomposition, and machine learning methods to reconstruct PPG signals or reduce noise. However, they are limited to short-term noisy signals or to noise caused by certain physical activities. In this paper, we propose a deep convolutional generative adversarial network (GAN) method to reconstruct distorted PPG signals. Our method exploits the temporal information extracted from the corrupted signal and preceding data to perform PPG reconstruction. The model is trained and tested using data collected by smartwatches in a home-based health monitoring application. We evaluate the proposed GAN method in comparison to three state-of-the-art PPG reconstruction methods. The evaluation includes noisy PPG signals with different durations and SNR values. The proposed method outperforms the other methods by obtaining the least error rates. The results indicate that the proposed method is effective for improving PPG signal quality to produce reliable heart rate and heart rate variability.
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38
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Hsu J. Personalized Digital Health Beyond the Pandemic. J Nurse Pract 2022; 18:709-714. [PMID: 35645634 PMCID: PMC9130337 DOI: 10.1016/j.nurpra.2022.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The effectiveness of telehealth and personalized digital health became evident during the coronavirus disease 2019 pandemic. This article defines what personalized digital health is and provides selected examples of the various personalized digital health devices patients may be using. The article also delves into how to implement and incorporate these personalized digital health devices in practice and presents suggestions on political actions that nurse practitioners need to advocate for with regard to telehealth and personalized digital health policy.
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Emognition dataset: emotion recognition with self-reports, facial expressions, and physiology using wearables. Sci Data 2022; 9:158. [PMID: 35393434 PMCID: PMC8989970 DOI: 10.1038/s41597-022-01262-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 03/18/2022] [Indexed: 11/30/2022] Open
Abstract
The Emognition dataset is dedicated to testing methods for emotion recognition (ER) from physiological responses and facial expressions. We collected data from 43 participants who watched short film clips eliciting nine discrete emotions: amusement, awe, enthusiasm, liking, surprise, anger, disgust, fear, and sadness. Three wearables were used to record physiological data: EEG, BVP (2x), HR, EDA, SKT, ACC (3x), and GYRO (2x); in parallel with the upper-body videos. After each film clip, participants completed two types of self-reports: (1) related to nine discrete emotions and (2) three affective dimensions: valence, arousal, and motivation. The obtained data facilitates various ER approaches, e.g., multimodal ER, EEG- vs. cardiovascular-based ER, discrete to dimensional representation transitions. The technical validation indicated that watching film clips elicited the targeted emotions. It also supported signals’ high quality. Measurement(s) | cardiac output measurement • Electroencephalography • Galvanic Skin Response • Temperature • acceleration • facial expressions | Technology Type(s) | photoplethysmogram • electroencephalogram (5 electrodes) • electrodermal activity measurement • Sensor • Accelerometer • Video Recording | Sample Characteristic - Organism | Homo sapiens | Sample Characteristic - Environment | laboratory environment |
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Martenstyn JA, Jeacocke NA, Pittman J, Touyz S, Maguire S. Treatment Considerations for Compulsive Exercise in High-Performance Athletes with an Eating Disorder. SPORTS MEDICINE - OPEN 2022; 8:30. [PMID: 35239063 PMCID: PMC8894522 DOI: 10.1186/s40798-022-00425-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 02/13/2022] [Indexed: 01/11/2023]
Abstract
Compulsive exercise is linked with poorer treatment outcomes in people with eating disorder (EDs). High-performance athletes represent a growing and complex subcomponent of the broader ED population, and emergent evidence indicates that different conceptualisations of compulsive exercise are needed in this population. Existing randomised controlled trials in ED populations have demonstrated small treatment effects on compulsive exercise compared with control groups; however, athletes were sparsely sampled across these studies. Thus, the extent to which current treatments for compulsive exercise in EDs are also effective in high-performance athletes is unknown. For this opinion paper, we sought representation from high-performance sports leadership, someone with lived experience of both an ED and high-performance athletics, and ED clinical experts. We discuss the utility of recommending exercise abstinence in ED treatment with athletes, as well as a number of other treatment strategies with some evidence in other contexts for further consideration and research in this population. These include using mindfulness-based interventions as an adjunct to cognitive-behavioural therapies, using wearable technologies and self-reported fatigue to inform training decisions, and incorporating greater exercise variation into training programs. We also offer practical considerations for clinicians seeking to apply foundational elements of cognitive-behavioural interventions (e.g., exposure and response prevention, cognitive restructuring, behavioural experiments) into an ED treatment program for a high-performance athlete. Future research is needed to examine characteristics of pathological compulsive exercise in athletes and whether available treatments are both feasible and effective in the treatment of compulsive exercise in athletes with an ED.
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Affiliation(s)
- Jordan A Martenstyn
- Clinical Psychology Unit, School of Psychology, The University of Sydney, Sydney, NSW, Australia. .,InsideOut Institute for Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.
| | | | - Jana Pittman
- School of Medicine, Blacktown Hospital, Western Sydney University, Sydney, NSW, Australia
| | - Stephen Touyz
- InsideOut Institute for Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.,Sydney Local Health District, NSW Health, St Leonards, Sydney, NSW, Australia
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Cao R, Azimi I, Sarhaddi F, Niela-Vilen H, Axelin A, Liljeberg P, Rahmani AM. Accuracy Assessment of Oura Ring Nocturnal Heart Rate and Heart Rate Variability in Comparison With Electrocardiography in Time and Frequency Domains: Comprehensive Analysis. J Med Internet Res 2022; 24:e27487. [PMID: 35040799 PMCID: PMC8808342 DOI: 10.2196/27487] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 06/08/2021] [Accepted: 11/08/2021] [Indexed: 01/24/2023] Open
Abstract
Background Photoplethysmography is a noninvasive and low-cost method to remotely and continuously track vital signs. The Oura Ring is a compact photoplethysmography-based smart ring, which has recently drawn attention to remote health monitoring and wellness applications. The ring is used to acquire nocturnal heart rate (HR) and HR variability (HRV) parameters ubiquitously. However, these parameters are highly susceptible to motion artifacts and environmental noise. Therefore, a validity assessment of the parameters is required in everyday settings. Objective This study aims to evaluate the accuracy of HR and time domain and frequency domain HRV parameters collected by the Oura Ring against a medical grade chest electrocardiogram monitor. Methods We conducted overnight home-based monitoring using an Oura Ring and a Shimmer3 electrocardiogram device. The nocturnal HR and HRV parameters of 35 healthy individuals were collected and assessed. We evaluated the parameters within 2 tests, that is, values collected from 5-minute recordings (ie, short-term HRV analysis) and the average values per night sleep. A linear regression method, the Pearson correlation coefficient, and the Bland–Altman plot were used to compare the measurements of the 2 devices. Results Our findings showed low mean biases of the HR and HRV parameters collected by the Oura Ring in both the 5-minute and average-per-night tests. In the 5-minute test, the error variances of the parameters were different. The parameters provided by the Oura Ring dashboard (ie, HR and root mean square of successive differences [RMSSD]) showed relatively low error variance compared with the HRV parameters extracted from the normal interbeat interval signals. The Pearson correlation coefficient tests (P<.001) indicated that HR, RMSSD, average of normal heart beat intervals (AVNN), and percentage of successive normal beat-to-beat intervals that differ by more than 50 ms (pNN50) had high positive correlations with the baseline values; SD of normal beat-to-beat intervals (SDNN) and high frequency (HF) had moderate positive correlations, and low frequency (LF) and LF:HF ratio had low positive correlations. The HR, RMSSD, AVNN, and pNN50 had narrow 95% CIs; however, SDNN, LF, HF, and LF:HF ratio had relatively wider 95% CIs. In contrast, the average-per-night test showed that the HR, RMSSD, SDNN, AVNN, pNN50, LF, and HF had high positive relationships (P<.001), and the LF:HF ratio had a moderate positive relationship (P<.001). The average-per-night test also indicated considerably lower error variances than the 5-minute test for the parameters. Conclusions The Oura Ring could accurately measure nocturnal HR and RMSSD in both the 5-minute and average-per-night tests. It provided acceptable nocturnal AVNN, pNN50, HF, and SDNN accuracy in the average-per-night test but not in the 5-minute test. In contrast, the LF and LF:HF ratio of the ring had high error rates in both tests.
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Affiliation(s)
- Rui Cao
- Department of Electrical Engineering and Computer Science, University of California, Irvine, CA, United States
| | - Iman Azimi
- Department of Computing, University of Turku, Turku, Finland
| | | | | | - Anna Axelin
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Pasi Liljeberg
- Department of Computing, University of Turku, Turku, Finland
| | - Amir M Rahmani
- Department of Electrical Engineering and Computer Science, University of California, Irvine, CA, United States.,Department of Computer Science, University of California, Irvine, CA, United States.,School of Nursing, University of California, Irvine, CA, United States
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Browne JD, Boland DM, Baum JT, Ikemiya K, Harris Q, Phillips M, Neufeld EV, Gomez D, Goldman P, Dolezal BA. Lifestyle Modification Using a Wearable Biometric Ring and Guided Feedback Improve Sleep and Exercise Behaviors: A 12-Month Randomized, Placebo-Controlled Study. Front Physiol 2021; 12:777874. [PMID: 34899398 PMCID: PMC8656237 DOI: 10.3389/fphys.2021.777874] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 10/29/2021] [Indexed: 11/20/2022] Open
Abstract
Purpose: Wearable biometric monitoring devices (WBMD) show promise as a cutting edge means to improve health and prevent disease through increasing accountability. By regularly providing real-time quantitative data regarding activity, sleep quality, and recovery, users may become more aware of the impact that their lifestyle has on their health. The purpose of this study was to examine the efficacy of a biometric tracking ring on improving sleep quality and increasing physical fitness over a one-year period. Methods: Fifty-six participants received a biometric tracking ring and were placed in one of two groups. One group received a 3-month interactive behavioral modification intervention (INT) that was delivered virtually via a smartphone app with guided text message feedback (GTF). The other received a 3-month non-directive wellness education control (CON). After three months, the INT group was divided into a long-term feedback group (LT-GTF) that continued to receive GTF for another nine months or short-term feedback group (ST-GTF) that stopped receiving GTF. Weight, body composition, and VO2max were assessed at baseline, 3months, and 12months for all participants and additionally at 6 and 9months for the ST-GTF and LT-GTF groups. To establish baseline measurements, sleep and physical activity data were collected daily over a 30-day period. Daily measurements were also conducted throughout the 12-month duration of the study. Results: Over the first 3months, the INT group had significant (p<0.001) improvements in sleep onset latency, daily step count, % time jogging, VO2max, body fat percentage, and heart rate variability (rMSSD HRV) compared to the CON group. Over the next 9months, the LT-GTF group continued to improve significantly (p<0.001) in sleep onset latency, daily step count, % time jogging, VO2max, and rMSSD HRV. The ST-GTF group neither improved nor regressed over the latter 9months except for a small increase in sleep latency. Conclusion: Using a WBMD concomitantly with personalized education, encouragement, and feedback, elicits greater change than using a WBMD alone. Additionally, the improvements achieved from a short duration of personalized coaching are largely maintained with the continued use of a WBMD.
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Affiliation(s)
- Jonathan D. Browne
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
- School of Medicine, California University of Science and Medicine, Colton, CA, United States
| | - David M. Boland
- Army-Baylor University Doctoral Program in Physical Therapy, San Antonio, TX, United States
| | - Jaxon T. Baum
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, United States
| | - Kayla Ikemiya
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Quincy Harris
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Marin Phillips
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Eric V. Neufeld
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, NY, United States
| | - David Gomez
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Phillip Goldman
- College of Arts and Sciences, University of Colorado Boulder, Boulder, CO, United States
| | - Brett A. Dolezal
- Airway & Exercise Physiology Research Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
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43
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Jimah T, Borg H, Kehoe P, Pimentel P, Turner A, Labbaf S, Asgari Mehrabadi M, Rahmani AM, Dutt N, Guo Y. A Technology-Based Pregnancy Health and Wellness Intervention (Two Happy Hearts): Case Study. JMIR Form Res 2021; 5:e30991. [PMID: 34787576 PMCID: PMC8663690 DOI: 10.2196/30991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 09/11/2021] [Accepted: 09/18/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The physical and emotional well-being of women is critical for healthy pregnancy and birth outcomes. The Two Happy Hearts intervention is a personalized mind-body program coached by community health workers that includes monitoring and reflecting on personal health, as well as practicing stress management strategies such as mindful breathing and movement. OBJECTIVE The aims of this study are to (1) test the daily use of a wearable device to objectively measure physical and emotional well-being along with subjective assessments during pregnancy, and (2) explore the user's engagement with the Two Happy Hearts intervention prototype, as well as understand their experiences with various intervention components. METHODS A case study with a mixed design was used. We recruited a 29-year-old woman at 33 weeks of gestation with a singleton pregnancy. She had no medical complications or physical restrictions, and she was enrolled in the Medi-Cal public health insurance plan. The participant engaged in the Two Happy Hearts intervention prototype from her third trimester until delivery. The Oura smart ring was used to continuously monitor objective physical and emotional states, such as resting heart rate, resting heart rate variability, sleep, and physical activity. In addition, the participant self-reported her physical and emotional health using the Two Happy Hearts mobile app-based 24-hour recall surveys (sleep quality and level of physical activity) and ecological momentary assessment (positive and negative emotions), as well as the Perceived Stress Scale, Center for Epidemiologic Studies Depression Scale, and State-Trait Anxiety Inventory. Engagement with the Two Happy Hearts intervention was recorded via both the smart ring and phone app, and user experiences were collected via Research Electronic Data Capture satisfaction surveys. Objective data from the Oura ring and subjective data on physical and emotional health were described. Regression plots and Pearson correlations between the objective and subjective data were presented, and content analysis was performed for the qualitative data. RESULTS Decreased resting heart rate was significantly correlated with increased heart rate variability (r=-0.92, P<.001). We found significant associations between self-reported responses and Oura ring measures: (1) positive emotions and heart rate variability (r=0.54, P<.001), (2) sleep quality and sleep score (r=0.52, P<.001), and (3) physical activity and step count (r=0.77, P<.001). In addition, deep sleep appeared to increase as light and rapid eye movement sleep decreased. The psychological measures of stress, depression, and anxiety appeared to decrease from baseline to post intervention. Furthermore, the participant had a high completion rate of the components of the Two Happy Hearts intervention prototype and shared several positive experiences, such as an increased self-efficacy and a normal delivery. CONCLUSIONS The Two Happy Hearts intervention prototype shows promise for potential use by underserved pregnant women.
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Affiliation(s)
- Tamara Jimah
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, United States
| | - Holly Borg
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, United States
| | - Priscilla Kehoe
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, United States
| | - Pamela Pimentel
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, United States
| | - Arlene Turner
- First 5 Orange County Children & Families Commission, Santa Ana, CA, United States
| | - Sina Labbaf
- Department of Computer Science, University of California, Irvine, Irvine, CA, United States
| | - Milad Asgari Mehrabadi
- Department of Electrical Engineering and Computer Science, University of California, Irvine, Irvine, CA, United States
| | - Amir M Rahmani
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, United States
- Department of Computer Science, University of California, Irvine, Irvine, CA, United States
- Institute for Future Health, University of California, Irvine, Irvine, CA, United States
| | - Nikil Dutt
- Department of Computer Science, University of California, Irvine, Irvine, CA, United States
- Department of Electrical Engineering and Computer Science, University of California, Irvine, Irvine, CA, United States
| | - Yuqing Guo
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, United States
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44
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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: 21] [Impact Index Per Article: 7.0] [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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45
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Patel V, Chesmore A, Legner CM, Pandey S. Trends in Workplace Wearable Technologies and Connected‐Worker Solutions for Next‐Generation Occupational Safety, Health, and Productivity. ADVANCED INTELLIGENT SYSTEMS 2021. [DOI: 10.1002/aisy.202100099] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Vishal Patel
- Department of Electrical & Computer Engineering Iowa State University 2126 Coover Hall Ames IA 50011 USA
| | - Austin Chesmore
- Department of Electrical & Computer Engineering Iowa State University 2126 Coover Hall Ames IA 50011 USA
| | - Christopher M. Legner
- Department of Electrical & Computer Engineering Iowa State University 2126 Coover Hall Ames IA 50011 USA
| | - Santosh Pandey
- Department of Electrical & Computer Engineering Iowa State University 2126 Coover Hall Ames IA 50011 USA
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46
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Bartholomew J, Gilligan C, Spence A. Contemporary Variables that Impact Sleep and Development in Female Adolescent Swimmers and Gymnasts. SPORTS MEDICINE - OPEN 2021; 7:57. [PMID: 34373962 PMCID: PMC8353044 DOI: 10.1186/s40798-021-00331-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 05/24/2021] [Indexed: 11/10/2022]
Abstract
The effects of sleep on elite athletes in late adolescence and early adulthood have been well documented in a myriad of sports. However, there is underrepresentation of pre-pubertal and young female adolescent athlete research between the ages of 11-17, and specifically female gymnast and swimmers. Neglecting to understand how high energy demand at a young age relates to sleep and restoration may lead to developmental ramifications for this group, as they display physiological dysfunctions like delayed puberty, amenorrhea and are at risk for the female athlete triad or components of the triad. This review aims to summarize the contemporary variables of blue light emitting screens, social media, and caffeine on quality and quantity of sleep in young athletes while identifying gaps in the literature on how these factors impact the target group of young female swimmers and gymnasts. The implications of this work include sleep hygiene recommendations for increasing duration and quality of sleep, as well as future research with respect to electronic device usage, social media participation, caffeine consumption, and sport engagement in female early adolescent athletes.
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Affiliation(s)
- Janine Bartholomew
- Department of Biology, Portage Learning, 2521 Darlington Road, Beaver Falls, PA, 15010, USA
| | - Carrie Gilligan
- Carlow University, 3333 Fifth Ave, Pittsburgh, PA, 15237, USA
| | - Ann Spence
- Department of Nursing, Carlow University, 3333 Fifth Ave, Pittsburgh, PA, 15237, USA.
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Baka T, Simko F. Monitoring Non-dipping Heart Rate by Consumer-Grade Wrist-Worn Devices: An Avenue for Cardiovascular Risk Assessment in Hypertension. Front Cardiovasc Med 2021; 8:711417. [PMID: 34368261 PMCID: PMC8342801 DOI: 10.3389/fcvm.2021.711417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 06/30/2021] [Indexed: 12/23/2022] Open
Affiliation(s)
- Tomas Baka
- Institute of Pathophysiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Fedor Simko
- Institute of Pathophysiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia.,3rd Department of Internal Medicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia.,Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
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48
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Ong JL, Lau T, Karsikas M, Kinnunen H, Chee MWL. A longitudinal analysis of COVID-19 lockdown stringency on sleep and resting heart rate measures across 20 countries. Sci Rep 2021; 11:14413. [PMID: 34257380 PMCID: PMC8277902 DOI: 10.1038/s41598-021-93924-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 07/01/2021] [Indexed: 12/20/2022] Open
Abstract
Lockdowns imposed to stem the spread of COVID-19 massively disrupted the daily routines of many worldwide, but studies to date have been mostly confined to observations within a limited number of countries, based on subjective reports and surveys from specific time periods during the pandemic. We investigated associations between lockdown stringency and objective sleep and resting-heart rate measures in ~ 113,000 users of a consumer sleep tracker across 20 countries from Jan to Jul 2020, compared to an equivalent period in 2019. With stricter lockdown measures, midsleep times were universally delayed, particularly on weekdays, while midsleep variability and resting heart rate declined. These shifts (midsleep: + 0.09 to + 0.58 h; midsleep variability: − 0.12 to − 0.26 h; resting heart rate: − 0.35 to − 2.08 bpm) correlated with the severity of lockdown across different countries (all Ps < 0.001) and highlight the graded influence of stringency lockdowns on human physiology.
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Affiliation(s)
- Ju Lynn Ong
- Centre for Sleep and Cognition, Human Potential Program, Yong Loo Lin School of Medicine, National University of Singapore, 12 Science Drive 2, Singapore, 117549, Singapore
| | - TeYang Lau
- Centre for Sleep and Cognition, Human Potential Program, Yong Loo Lin School of Medicine, National University of Singapore, 12 Science Drive 2, Singapore, 117549, Singapore
| | - Mari Karsikas
- Oura Health, Oulu, Finland.,Centre for Life Course Health Research, University of Oulu, Oulu, Finland
| | | | - Michael W L Chee
- Centre for Sleep and Cognition, Human Potential Program, Yong Loo Lin School of Medicine, National University of Singapore, 12 Science Drive 2, Singapore, 117549, Singapore.
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49
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Micarelli A, Viziano A, Pistillo R, Granito I, Micarelli B, Alessandrini M. Sleep Performance and Chronotype Behavior in Unilateral Vestibular Hypofunction. Laryngoscope 2021; 131:2341-2347. [PMID: 34191310 DOI: 10.1002/lary.29719] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/20/2021] [Accepted: 06/21/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To evaluate sleep behavior and its relation to otoneurological parameters in a group of patients with chronic unilateral vestibular hypofunction (UVH) without self-reported sleep disturbances when compared with healthy subjects serving as a control group (CG). METHODS Fifty-one patients affected by UVH underwent a retrospective clinical and instrumental otoneurological examination, a 1-week actigraphy sleep analysis, and a series of self-report and performance measures (SRM/PM). A CG of 60 gender- and age-matched healthy subjects was also enrolled. A between-group analysis of variance was performed for each variable, while correlation analysis was performed in UVH patients between otoneurological, SRM/PM, and actigraphy measure scores. RESULTS When compared with CG subjects, UVH patients were found to be spending less time sleeping and taking more time to go from being fully awake to asleep, based on actigraphy-based sleep analysis. Also, SRM/PM depicted UVH patients to have poor sleep quality and to be more prone to an evening-type behavior. Correlations were found between vestibular-related functionality indexes and subjective sleep quality, as well as between longer disease duration and reduced sleep time. CONCLUSION For the first time, a multiparametric sleep analysis was performed on a large population-based sample of chronic UVH patients. While a different pattern in sleep behavior was found, the cause is still unclear. Further research is needed to expand the extent of knowledge about sleep disruption in vestibular disorders. LEVEL OF EVIDENCE Level 3 Laryngoscope, 2021.
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Affiliation(s)
- Alessandro Micarelli
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy.,ITER Center for Balance and Rehabilitation Research (ICBRR), Rome, Italy
| | - Andrea Viziano
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Rossella Pistillo
- ITER Center for Balance and Rehabilitation Research (ICBRR), Rome, Italy
| | - Ivan Granito
- ITER Center for Balance and Rehabilitation Research (ICBRR), Rome, Italy
| | - Beatrice Micarelli
- ITER Center for Balance and Rehabilitation Research (ICBRR), Rome, Italy
| | - Marco Alessandrini
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
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50
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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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