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Wrist-wearable Device Biomarkers May Help Predict Adverse Posttraumatic Neuropsychiatric Symptoms
In high-risk populations, wrist-wearable device biomarkers may be useful screening tools for pain, sleep, and anxiety symptom treatment outcomes after trauma exposure, according to a cohort study recently published in JAMA Psychiatry.
Wrist-wearable devices with accelerometry capabilities are common, “thus, a proportion of the population may be using devices capable of yielding useful information to help screen for trauma survivors with high pain levels at a point in time and/or poor pain, sleep, and/or anxiety recovery over time,” researchers said in the study.
Study data were obtained from the Advancing Understanding of Recovery After Trauma (AURORA) study that began enrollment in September 2017. Included patients (N = 2021) who had completed a follow-up assessment at 8 weeks by January 2020 and were seen in one of 27 included emergency departments (ED) up to 72 hours after experiencing a traumatic event were included in this analysis. Included participants also provided baseline assessments and provided data from wrist-wearable devices. Qualifying traumatic events included motor vehicle collision, physical assault, sexual assault, a fall more than 10 ft, and mass casualty incidents, with motor vehicle collision being the most common.
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Participants, 62.2% of which were female with a mean age of 35.8 years, were instructed to wear a research watch for at least 21 hours a day throughout the 8-week study period and were sent home with a charging dock and a connectivity hub with 4G LTE for data upload.
Researchers randomly divided the collected data into 2 equal parts (n = 1010) for biomarker identification and validation. Data were collected from September 2017 to January 2020 and analyzed from May 2020 to November 2022.
Over time, changes in 6 rest-activity measures were associated with changes in pain and changes in the number of transitions between sleep and wake were linked with changes in pain, sleep, and anxiety. Simple cutoffs for these biomarkers identified individuals with good recovery for pain (positive predictive value [PPV], 0.85; 95% CI, 0.82-0.88), sleep (PPV, 0.63; 95% CI, 0.59-0.67, and anxiety (PPV, 0.76; 95% CI, 0.72-0.80) with high predictive value.
“Individuals with more severe pain at a point in time demonstrated diminished daily activity variance, indicating less movement during the day and greater sleep disruption during the night,” researchers said. “This finding is consistent with prior research suggesting pain conditions are associated with blunted rest-activity rhythms.”
Improving sleep consolidation was associated with improving self-reported anxiety symptoms. This indicates that it may be effective to implement interventions to improve sleep consolidation soon after trauma to improve other long-term mental health outcomes. Researchers suggest clinicians deliver brief behavioral interventions for sleep via telehealth.
“In the future, [the studied] biomarkers might be useful to identify trauma survivors who merit further evaluation for adverse trauma outcomes, particularly in vulnerable populations,” researchers wrote. “Such biomarkers might also be useful to help clinicians and patients evaluate their responses to treatment interventions for pain, sleep, or anxiety and to help patients understand how their activity, rest, and sleep affect their health.”
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