Lifestyle Modification Using a Wearable Biometric Ring and Guided Feedback Improve Sleep and Exercise Behaviors: A 12-Month Randomized, Placebo-Controlled Study

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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The Impact of Sleep Timing, Sleep Duration, and Sleep Quality on Depressive Symptoms and Suicidal Ideation amongst Japanese Freshmen: The EQUSITE Study

Sleep Disorders ◽

10.1155/2016/8737654 ◽

2016 ◽

Vol 2016 ◽

pp. 1-10 ◽

Cited By ~ 17

Author(s):

Atin Supartini ◽

Takanori Honda ◽

Nadzirah A. Basri ◽

Yuka Haeuchi ◽

Sanmei Chen ◽

...

Keyword(s):

Depressive Symptoms ◽

Suicidal Ideation ◽

Sleep Quality ◽

Sleep Duration ◽

Sleep Onset ◽

Poor Sleep ◽

Sleep Onset Latency ◽

Onset Latency ◽

Poor Sleep Quality ◽

The Impact

Aim. The aim of this study was to identify the impact of bedtime, wake time, sleep duration, sleep-onset latency, and sleep quality on depressive symptoms and suicidal ideation amongst Japanese freshmen.Methods. This cross-sectional data was derived from the baseline survey of the Enhancement of Q-University Students Intelligence (EQUSITE) study conducted from May to June, 2010. A total of 2,631 participants were recruited and completed the following self-reported questionnaires: the Pittsburgh Sleep Quality Index (PSQI), the Center for Epidemiologic Studies Depression Scale (CES-D), and the original Health Support Questionnaires developed by the EQUSITE study research team.Results. Of 1,992 participants eligible for analysis, 25.5% (n=507) reported depressive symptoms (CES-D total score ≥ 16), and 5.8% (n=115) reported suicidal ideation. The present study showed that late bedtime (later than 01:30), sleep-onset latency (≥30 minutes), and poor sleep quality showed a marginally significant association with depressive symptoms. Poor sleep quality was seen to predict suicidal ideation even after adjusting for depressive symptoms.Conclusion. The current study has important implications for the role of bedtime in the prevention of depressive symptoms. Improving sleep quality may prevent the development of depressive symptoms and reduce the likelihood of suicidal ideation.

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No Compromise of Competition Sleep Compared With Habitual Sleep in Elite Australian Footballers

International Journal of Sports Physiology and Performance ◽

10.1123/ijspp.2016-0776 ◽

2018 ◽

Vol 13 (1) ◽

pp. 29-36 ◽

Cited By ~ 12

Author(s):

Benita J. Lalor ◽

Shona L. Halson ◽

Jacqueline Tran ◽

Justin G. Kemp ◽

Stuart J. Cormack

Keyword(s):

Sleep Quality ◽

Sleep Onset ◽

Well Being ◽

Subjective Rating ◽

Sleep Onset Latency ◽

Onset Latency ◽

Start Time ◽

Australian Football ◽

Post Hoc ◽

The Impact

Purpose: To assess the impact of match-start time and days relative to match compared with the habitual sleep characteristics of elite Australian Football (AF) players. Methods: 45 elite male AF players were assessed during the preseason (habitual) and across 4 home matches during the season. Players wore an activity monitor the night before (−1), night of (0), 1 night after (+1), and 2 nights (+2) after each match and completed a self-reported rating of sleep quality. A 2-way ANOVA with Tukey post hoc was used to determine differences in sleep characteristics between match-start times and days relative to the match. Two-way nested ANOVA was conducted to examine differences between competition and habitual phases. Effect size ± 90% confidence interval (ES ± 90% CI) was calculated to quantify the magnitude of pairwise differences. Results: Differences observed in sleep-onset latency (ES = 0.11 ± 0.16), sleep rating (ES = 0.08 ± 0.14), and sleep duration (ES = 0.08 ± 0.01) between competition and habitual periods were trivial. Sleep efficiency was almost certainly higher during competition than habitual, but this was not reflected in the subjective rating of sleep quality. Conclusions: Elite AF competition does not cause substantial disruption to sleep characteristics compared with habitual sleep. While match-start time has some impact on sleep variables, it appears that the match itself is more of a disruption than the start time. Subjective ratings of sleep from well-being questionnaires appear limited in their ability to accurately provide an indication of sleep quality.

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Abstract 037: History Of Weight Cycling Is Prospectively Associated With Shorter And Poorer Quality Sleep, And Higher Sleep Apnea Risk In Diverse Us Women: Results From The AHA Go Red For Women Strategically Focused Research Network

Circulation ◽

10.1161/circ.143.suppl_1.037 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Vivian Cao ◽

Nour Makarem ◽

Moorea Maguire ◽

Ivan Samayoa ◽

Huaqing Xi ◽

...

Keyword(s):

Sleep Quality ◽

Sleep Onset ◽

Research Network ◽

Poor Sleep ◽

Sleep Onset Latency ◽

Weight Cycling ◽

Onset Latency ◽

Cross Sectional ◽

History Of ◽

Insomnia Severity

Introduction: Poor sleep and history of weight cycling (HWC) are associated with worse cardiovascular health, yet limited research has evaluated the association between HWC and poor sleep patterns. Hypothesis: We hypothesized that HWC would be associated with poor sleep in US women. Methods: The AHA Go Red for Women Strategically Focused Research Network cohort at Columbia University (n=506, mean age 37 ± 15.7y, 61% racial/ethnic minority) was used to evaluate cross-sectional associations of HWC and sleep characteristics at baseline, and prospective associations of HWC from baseline with sleep measures at 1-yr. HWC, defined as losing and gaining ≥ 10 lbs at least once (excluding pregnancy), and number of WC episodes were self-reported. Sleep duration, measures of sleep quality, insomnia severity, and obstructive sleep apnea (OSA) risk were assessed using the validated Pittsburgh Sleep Quality Index, Insomnia Severity Index, and Berlin questionnaire. Linear and logistic regression models, adjusted for age, race/ethnicity, education, health insurance status, pregnancy history, and menopausal status, were used to evaluate the relation of HWC with sleep. Results: Most women reported ≥1episode of weight cycling (72%). In linear models of cross-sectional and prospective data, each additional weight cycling episode was related to shorter sleep duration, poorer sleep quality, longer sleep onset latency, greater insomnia severity, more sleep disturbances and daytime dysfunction, lower sleep efficiency, and higher sleep medication use frequency. In logistic models, HWC (≥1 vs. 0 episodes) was associated with greater odds for short sleep, poor sleep quality, long sleep onset latency ≥26 min, high OSA risk, and sleep efficiency<85% ( Table ). Conclusion: HWC predicted poor sleep among women, suggesting that weight maintenance may represent an important strategy to promote sleep health. Long-term studies are needed to disentangle the complex relations between weight fluctuations and sleep across the life course.

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Utility of Activity Monitors and Thermometry in Assessing Sleep Stages and Sleep Quality

Journal for the Measurement of Physical Behaviour ◽

10.1123/jmpb.2018-0012 ◽

2018 ◽

Vol 1 (3) ◽

pp. 108-121

Author(s):

Natashia Swalve ◽

Brianna Harfmann ◽

John Mitrzyk ◽

Alexander H. K. Montoye

Keyword(s):

Sleep Quality ◽

Skin Temperature ◽

Sleep Stage ◽

Sleep Onset ◽

Sleep Efficiency ◽

Sleep Stages ◽

Sleep Onset Latency ◽

Onset Latency ◽

Activity Monitors ◽

Research Grade

Activity monitors provide an inexpensive and convenient way to measure sleep, yet relatively few studies have been conducted to validate the use of these devices in examining measures of sleep quality or sleep stages and if other measures, such as thermometry, could inform their accuracy. The purpose of this study was to compare one research-grade and four consumer-grade activity monitors on measures of sleep quality (sleep efficiency, sleep onset latency, and wake after sleep onset) and sleep stages (awake, sleep, light, deep, REM) against an electroencephalography criterion. The use of a skin temperature device was also explored to ascertain whether skin temperature monitoring may provide additional data to increase the accuracy of sleep determination. Twenty adults stayed overnight in a sleep laboratory during which sleep was assessed using electroencephalography and compared to data concurrently collected by five activity monitors (research-grade: ActiGraph GT9X Link; consumer-grade: Fitbit Charge HR, Fitbit Flex, Jawbone UP4, Misfit Flash) and a skin temperature sensor (iButton). The majority of the consumer-grade devices overestimated total sleep time and sleep efficiency while underestimating sleep onset latency, wake after sleep onset, and number of awakenings during the night, with similar results being seen in the research-grade device. The Jawbone UP4 performed better than both the consumer- and research-grade devices, having high levels of agreement overall and in epoch-by-epoch sleep stage data. Changes in temperature were moderately correlated with sleep stages, suggesting that addition of skin temperature could increase the validity of activity monitors in sleep measurement.

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Adding team-based financial incentives to the Carrot Rewards physical activity app increases daily step count on a population scale: a 24-week matched case control study

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-020-01043-1 ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Emma Pearson ◽

Harry Prapavessis ◽

Christopher Higgins ◽

Robert Petrella ◽

Lauren White ◽

...

Keyword(s):

Physical Activity ◽

Financial Incentives ◽

Step Count ◽

Daily Step ◽

Individual Level ◽

Significant Difference ◽

Daily Step Count ◽

Steps Per Day ◽

The Impact ◽

Experimental Group

Abstract Background Mobile health applications (mHealth apps) targeting physical inactivity have increased in popularity yet are usually limited by low engagement. This study examined the impact of adding team-based incentives (Step Together Challenges, STCs) to an existing mHealth app (Carrot Rewards) that rewarded individual physical activity achievements. Methods A 24-week quasi-experimental study (retrospective matched pairs design) was conducted in three Canadian provinces (pre-intervention: weeks 1–12; intervention: weeks 13–24). Participants who used Carrot Rewards and STCs (experimental group) were matched with those who used Carrot Rewards only (controls) on age, gender, province and baseline mean daily step count (±500 steps/d). Carrot Rewards users earned individual-level incentives (worth $0.04 CAD) each day they reached a personalized daily step goal. With a single partner, STC users could earn team incentives ($0.40 CAD) for collaboratively reaching individual daily step goals 10 times in seven days (e.g., Partner A completes four goals and Partner B completes six goals in a week). Results The main analysis included 61,170 users (mean age = 32 yrs.; % female = 64). Controlling for pre-intervention mean daily step count, a significant difference in intervention mean daily step count favoured the experimental group (p < 0.0001; ηp2 = 0.024). The estimated marginal mean group difference was 537 steps per day, or 3759 steps per week (about 40 walking min/wk). Linear regression suggested a dose-response relationship between the number of STCs completed (app engagement) and intervention mean daily step count (adjusted R2 = 0.699) with each new STC corresponding to approximately 200 more steps per day. Conclusion Despite an explosion of physical activity app interest, low engagement leading to small or no effects remains an industry hallmark. In this paper, we found that adding modest team-based incentives to the Carrot Rewards app increased mean daily step count, and importantly, app engagement moderated this effect. Others should consider novel small-teams based approaches to boost engagement and effects.

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Microclimate Thermal Management Using Thermoelectric Air-Cooling Duct System Operated at Five Incremental Powers and its Effect on Sleep Adaptation of the Occupants

Energies ◽

10.3390/en12193695 ◽

2019 ◽

Vol 12 (19) ◽

pp. 3695 ◽

Cited By ~ 1

Author(s):

Kashif Irshad ◽

Salem Algarni ◽

Mohammad Tauheed Ahmad ◽

Sayed Ameenuddin Irfan ◽

Khairul Habib ◽

...

Keyword(s):

Sleep Quality ◽

Cooling System ◽

Sleep Onset ◽

Air Cooling ◽

Sleep Onset Latency ◽

Onset Latency ◽

Test Room ◽

Environmentally Sustainable ◽

Highly Sensitive ◽

The Mean

In this study, the microclimate of the test room was regulated using thermoelectric air duct cooling system (TE-AD) operated at input powers-240 W, 360 W, 480 W, 600 W, 720 W, and 840 W, on subsequent nights. Fifteen (15) healthy male volunteers were recruited to sleep under these test conditions and their sleep quality was assessed by studying objective measures such as sleep onset latency (SOL), mean skin temperature and heart rate as well as subjective parameters like predicted mean vote (PMV) and predicted percentage of dissatisfied (PPD). There was a consistent improvement on all studied parameters when the power of the system was increased from 240 W to 720 W. The mean sleep onset latency time was reduced from (M = 40.7 +/− 0.98 min) to (M = 18.33 +/− 1.18 min) when the operating power was increased from 240 W to 720 W, denoting an improvement in sleep quality. However, increasing the power further to 840 W resulted in deteriorating cooling performance of the TE-AD system leading to an increase in temperature of the test room and reduction in sleep comfort. Analysis of subjective indices of thermal comfort viz. PMV and PPD revealed that subjects are highly sensitive towards variations in microclimate achieved by changing the operating power of the TE-AD. This device was also found to be environmentally sustainable, with estimated reduction in CO2 emission calculated to be around 38% as compared to the conventional air-conditioning.

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Examining the impact of physical activity on sleep quality and executive functions in children with autism spectrum disorder: A randomized controlled trial

Autism ◽

10.1177/1362361318823910 ◽

2019 ◽

Vol 23 (7) ◽

pp. 1699-1710 ◽

Cited By ~ 12

Author(s):

Choi Yeung Andy Tse ◽

Hong Paul Lee ◽

Ka Shing Kevin Chan ◽

Veronica Bordes Edgar ◽

Alison Wilkinson-Smith ◽

...

Keyword(s):

Physical Activity ◽

Autism Spectrum Disorder ◽

Sleep Quality ◽

Executive Functions ◽

Sleep Onset ◽

Children With Autism ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Sleep Onset Latency ◽

The Impact

Sleep disturbance and executive dysfunction have been widely reported in children with autism spectrum disorder. While the positive impacts of physical activity on sleep quality and cognition are documented in children with typical development, similar studies in children with autism spectrum disorder are scarce. The objective of this study was to examine the impact of physical activity on sleep quality and cognition in children with autism spectrum disorder. A total of 40 children diagnosed with autism spectrum disorder (mean age = 9.95 years) were randomly assigned into two groups: physical activity intervention and control. Four sleep parameters (sleep efficiency, sleep onset latency, sleep duration, and wake after sleep onset) and two executive functions (inhibition control and working memory) were assessed. Results revealed a significant improvement in sleep efficiency, sleep onset latency, and sleep duration in the intervention group but not in the control group during weekdays. Moreover, a significant improvement in inhibitory control was shown in the intervention group but not in the control group. No significant improvement in working memory capacity was documented in either group ( ps > 0.05). Our findings highlight the value of physical activity in improving sleep quality and cognition among children with autism spectrum disorder, but specific physical activity may be required to benefit individual executive functions.

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The MIPAM trial – motivational interviewing and physical activity monitoring to enhance the daily level of physical activity among older adults – a randomized controlled trial

European Review of Aging and Physical Activity ◽

10.1186/s11556-021-00269-7 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Rasmus Tolstrup Larsen ◽

Christoffer Bruun Korfitsen ◽

Camilla Keller ◽

Jan Christensen ◽

Henning Boje Andersen ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Motivational Interviewing ◽

Community Dwelling ◽

Step Count ◽

World Health ◽

Controlled Study ◽

Daily Step ◽

Randomized Controlled ◽

Daily Step Count

Abstract Background One in four older adults in Denmark and almost half of the very old above 75 do not meet the World Health Organization’s recommendations for a minimum of physical activity (PA). A cost-efficient and effective way to increase focus on and motivation for daily walking might be to use Physical Activity Monitors (PAMs) in combination with behavioural change intervention. Thus, the objective of this randomized controlled study was to investigate the effect of Motivational Interviewing (MI) as an add-on intervention to a PAM-based intervention measured in community-dwelling older adults. Methods This two-arm parallel group randomized controlled effectiveness trial compared a 12-weeks PAM-based intervention with additional MI (PAM+MI group) with a PAM-based intervention alone (PAM group). The primary outcome, average daily step count, was analysed with a linear regression model, adjusted for sex and baseline daily step count. Following the intention-to-treat principle, multiple imputation based on baseline step count, sex and age was performed. Results In total, 38 participants were randomized to the PAM intervention and 32 to the PAM+MI intervention arm. During the intervention period, PAM+MI participants walked on average 909 more steps per day than PAM participants, however insignificant (95%CI: − 71; 1889) and reported 2.3 points less on the UCLA Loneliness Scale (95%CI: − 4.5; − 1.24). Conclusion The use of MI, in addition to a PAM-based intervention among older adults in PA promoting interventions hold a potential clinically relevant effect on physical activity and should thus be investigated further with adequately powered RCTs. Trial registration This study was pre-registered in the clinicaltrials.gov database with identifier: NCT03906162.

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Adding Team-Based Financial Incentives to the Carrot Rewards App Increases Daily Step Count on a Population Scale: A 24-Week Matched Pairs Study

10.21203/rs.3.rs-54028/v1 ◽

2020 ◽

Author(s):

Emma Pearson ◽

Harry Prapavessis ◽

Christopher Higgins ◽

Robert Petrella ◽

Lauren White ◽

...

Keyword(s):

Physical Activity ◽

Financial Incentives ◽

Step Count ◽

Matched Pairs ◽

Daily Step ◽

Significant Difference ◽

Daily Step Count ◽

Steps Per Day ◽

The Impact ◽

Experimental Group

Abstract Background Mobile health applications (mHealth apps) targeting physical inactivity have increased in popularity yet are usually limited by low engagement. This study examined the impact of adding team-based incentives (Step Together Challenges, STCs) to an existing mHealth app (Carrot Rewards) that rewarded individual physical activity achievements. Methods A 24-week quasi-experimental study (retrospective matched pairs design) was conducted in three Canadian provinces (pre-intervention: weeks 1–12; intervention: weeks 13–24). Participants who used Carrot Rewards and STCs (experimental group) were matched with those who used Carrot Rewards only (controls) on age, gender, province and baseline mean daily step count (± 500 steps/d). Carrot Rewards users earned individual-level incentives (worth $0.04 CAD) each day they reached a personalized daily step goal. With a single partner, STC users could earn team incentives ($0.40 CAD) for collaboratively reaching individual daily step goals 10 times in seven days (e.g., Partner A completes four goals and Partner B completes six goals in a week). Results The main analysis included 61,170 users (mean age = 32yrs; % female = 64). Controlling for pre-intervention mean daily step count, a significant difference in intervention mean daily step count favoured the experimental group (p < 0.0001; ηp2 = 0.024). The estimated marginal mean group difference was 537 steps per day, or 3759 steps per week (about 40 walking min/wk). Linear regression suggested a dose-response relationship between the number of STCs completed (app engagement) and intervention mean daily step count (adjusted R2 = 0.699) with each new STC corresponding to approximately 200 more steps per day. Conclusion Despite an explosion of physical activity app interest (100,000 + published apps), low engagement leading to small or no effects remains an industry hallmark. In this paper, we found that adding modest team-based incentives to the Carrot Rewards app increased mean daily step count, and importantly, app engagement moderated this effect. Others should consider novel small-teams based approaches to boost engagement and effects.

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IMPACT OF PHYSICIAN LED LIFE STYLE MODIFICATIONS (DIET AND DAILY STEP COUNT BY USING PEDOMETER) ON GLYCEMIC CONTROL OF PATIENTS WITH TYPE II DIABETIC

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i2.2788 ◽

2021 ◽

Vol 71 (2) ◽

pp. 478-81

Author(s):

Rimsha Azhar ◽

Khurshid Uttra ◽

Andaleeb Khan ◽

Marriam Hussain Awan ◽

Ayesha Anwer ◽

...

Keyword(s):

Glycemic Control ◽

Life Style ◽

Step Count ◽

Diabetic Patients ◽

Care Hospital ◽

Type Ii ◽

Daily Step ◽

Significant Difference ◽

Daily Step Count ◽

The Impact

Objective: To determine the impact of physician led life style modifications (diet and daily step count by using pedometer) on glycemic control of type II diabetic patients Study Design: Quasi experimental study. Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi, Aug 2018 to Feb 2019. Methodology: The sample population comprised of 200 diabetic patients reporting for the routine follow-up at a tertiary care hospital in Rawalpindi. Patients were divided into two groups by random method. Group A had the patients with continuation of the routine anti-diabetic medication while group received the physician led life style modifications in addition to the routine anti diabetic medication. Values of HBA1c among the groups were compared three months after the start of study. Results: Mean age of the patients was 42.19 ± 6.175 years. Mean duration of DM in the study participants was 4.52 ± 4.166 years. Out of 115 patients were male while 85 were female. HBA1c in the intervention group was 7.96% ± 0.39 while in the control group was 7.04% ± 0.81. Difference between the two groups was statistically significant (p-value<0.01). Conclusion: This study showed a significant difference in glycemic control of patients who received physician led life style modification in addition to conventional biological treatment than those who only received the routine anti-diabetic medication. Physicians should be trained to impart this sort of education to the diabetic patients in routine diabetic clinics.

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