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Papers of the Week


Papers: 27 Feb 2021 - 5 Mar 2021

RESEARCH TYPE:
Psychology


Human Studies

PAIN TYPE:
Itch


2021 Mar 03


NPJ Digit Med


4


1

Development of digital measures for nighttime scratch and sleep using wrist-worn wearable devices.

Authors

Mahadevan N, Christakis Y, Di J, Bruno J, Zhang Y, Dorsey RE, Pigeon WR, Beck LA, Thomas K, Liu Y, Wicker M, Brooks C, Kabiri N S, Bhangu J, Northcott C, Patel S
NPJ Digit Med. 2021 Mar 03; 4(1):42.
PMID: 33658610.

Abstract

Patients with atopic dermatitis experience increased nocturnal pruritus which leads to scratching and sleep disturbances that significantly contribute to poor quality of life. Objective measurements of nighttime scratching and sleep quantity can help assess the efficacy of an intervention. Wearable sensors can provide novel, objective measures of nighttime scratching and sleep; however, many current approaches were not designed for passive, unsupervised monitoring during daily life. In this work, we present the development and analytical validation of a method that sequentially processes epochs of sample-level accelerometer data from a wrist-worn device to provide continuous digital measures of nighttime scratching and sleep quantity. This approach uses heuristic and machine learning algorithms in a hierarchical paradigm by first determining when the patient intends to sleep, then detecting sleep-wake states along with scratching episodes, and lastly deriving objective measures of both sleep and scratch. Leveraging reference data collected in a sleep laboratory (NCT ID: NCT03490877), results show that sensor-derived measures of total sleep opportunity (TSO; time when patient intends to sleep) and total sleep time (TST) correlate well with reference polysomnography data (TSO: r = 0.72, p < 0.001; TST: r = 0.76, p < 0.001; N = 32). Log transformed sensor derived measures of total scratching duration achieve strong agreement with reference annotated video recordings (r = 0.82, p < 0.001; N = 25). These results support the use of wearable sensors for objective, continuous measurement of nighttime scratching and sleep during daily life.