Usability of Wearable Devices to Remotely Monitor Sleep Patterns Among Patients With Ischemic Heart Disease: Observational Study

Michael Fortunato, Srinath Adusumalli, Neel Chokshi, Joseph Harrison, Charles Rareshide, Mitesh Patel, Michael Fortunato, Srinath Adusumalli, Neel Chokshi, Joseph Harrison, Charles Rareshide, Mitesh Patel

Abstract

Background: There is growing interest in using wearable devices to remotely monitor patient behaviors. However, there has been little evaluation of how often these technologies are used to monitor sleep patterns over longer term periods, particularly among more high-risk patients.

Objective: The goal of the research was to evaluate the proportion of time that patients with ischemic heart disease used wearable devices to monitor their sleep and identify differences in characteristics of patients with higher versus lower use.

Methods: We evaluated wearable device data from a previously conducted clinical trial testing the use of wearable devices with personalized goal-setting and financial incentives. Patients with ischemic heart disease established a sleep baseline and were then followed for 24 weeks. The proportion of days that sleep data was collected was compared over the 24 weeks and by study arm. Characteristics of patients were compared to groups with high, low, or no sleep data.

Results: The sample comprised 99 patients with ischemic heart disease, among which 79% (78/99) used the wearable device to track their sleep. During the 6-month trial, sleep data were collected on 60% (10,024/16,632) of patient-days. These rates declined over time from 77% (4292/5544) in months 1 and 2 to 58% (3188/5544) in months 3 and 4 to 46% (2544/5544) in months 5 and 6. Sleep data were collected at higher rates among the intervention group compared with control (67% vs 55%, P<.001). In the main intervention period (months 3 and 4), patients with higher rates of sleep data were on average older (P=.03), had a history of smoking (P=.007), and had higher rates of commercial health insurance (P=.03).

Conclusions: Among patients with ischemic heart disease in a physical activity trial, a high proportion used wearable devices to track their sleep; however, rates declined over time. Future research should consider larger evaluations coupled with behavioral interventions.

Trial registration: ClinicalTrials.gov NCT02531022; https://ichgcp.net/clinical-trials-registry/NCT02531022.

Keywords: ischemic heart disease; sleep; wearable devices.

Conflict of interest statement

Conflicts of Interest: MP is supported by career development awards from the Department of Veterans Affairs Health Services Research and Development and the Doris Duke Charitable Foundation. MP is founder of Catalyst Health, a technology and behavior change consulting firm. MP also has received research funding from Deloitte, which is not related to the work described in this manuscript. The remaining authors declare no conflict of interest.

©Michael Fortunato, Srinath Adusumalli, Neel Chokshi, Joseph Harrison, Charles Rareshide, Mitesh Patel. Originally published in JMIR Formative Research (http://formative.jmir.org), 07.04.2020.

References

    1. Itani O, Jike M, Watanabe N, Kaneita Y. Short sleep duration and health outcomes: a systematic review, meta-analysis, and meta-regression. Sleep Med. 2017 Apr;32:246–256. doi: 10.1016/j.sleep.2016.08.006.
    1. Domínguez F, Fuster V, Fernández-Alvira J, Fernández-Friera L, López-Melgar B, Blanco-Rojo R, Fernández-Ortiz A, García-Pavía P, Sanz J, Mendiguren JM, Ibañez B, Bueno H, Lara-Pezzi E, Ordovás J. Association of sleep duration and quality with subclinical atherosclerosis. J Am Coll Cardiol. 2019 Jan 22;73(2):134–144. doi: 10.1016/j.jacc.2018.10.060.
    1. Patel MS, Asch DA, Volpp KG. Wearable devices as facilitators, not drivers, of health behavior change. JAMA. 2015 Feb 03;313(5):459–460. doi: 10.1001/jama.2014.14781.
    1. Patel MS, Foschini L, Kurtzman GW, Zhu J, Wang W, Rareshide CA, Zbikowski SM. Using wearable devices and smartphones to track physical activity: initial activation, sustained use, and step counts across sociodemographic characteristics in a national sample. Ann Intern Med. 2017 Nov 21;167(10):755–757. doi: 10.7326/M17-1495.
    1. Shelgikar AV, Anderson PF, Stephens MR. Sleep tracking, wearable technology, and opportunities for research and clinical care. Chest. 2016 Sep;150(3):732–743. doi: 10.1016/j.chest.2016.04.016.
    1. Baron KG, Duffecy J, Berendsen MA, Cheung Mason I, Lattie EG, Manalo NC. Feeling validated yet? A scoping review of the use of consumer-targeted wearable and mobile technology to measure and improve sleep. Sleep Med Rev. 2018 Aug;40:151–159. doi: 10.1016/j.smrv.2017.12.002.
    1. Kroll RR, McKenzie ED, Boyd JG, Sheth P, Howes D, Wood M, Maslove DM, WEARable Information Technology for hospital INpatients (WEARIT-IN) study group Use of wearable devices for post-discharge monitoring of ICU patients: a feasibility study. J Intensive Care. 2017;5:64. doi: 10.1186/s40560-017-0261-9.
    1. Rosenberger M, Buman M, Haskell W, McConnell M, Carstensen L. Twenty-four hours of sleep, sedentary behavior, and physical activity with nine wearable devices. Med Sci Sports Exerc. 2016 Mar;48(3):457–465. doi: 10.1249/MSS.0000000000000778.
    1. Melton BF, Buman MP, Vogel RL, Harris BS, Bigham LE. Wearable devices to improve physical activity and sleep. J Black Studies. 2016 Jul 27;47(6):610–625. doi: 10.1177/0021934716653349.
    1. Chokshi NP, Adusumalli S, Small DS, Morris A, Feingold J, Ha YP, Lynch MD, Rareshide CA, Hilbert V, Patel MS. Loss-framed financial incentives and personalized goal-setting to increase physical activity among ischemic heart disease patients using wearable devices: the ACTIVE REWARD randomized trial. J Am Heart Assoc. 2018 Jun 13;7(12) doi: 10.1161/JAHA.118.009173.
    1. Mantua J, Gravel N, Spencer R. Reliability of sleep measures from four personal health monitoring devices compared to research-based actigraphy and polysomnography. Sensors (Basel) 2016 May 05;16(5) doi: 10.3390/s16050646.

Source: PubMed

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