The “International Biomarkers Workshop on Wearables in Sleep and Circadian Science” was held at the 2018 SLEEP Meeting of the Associated Professional Sleep Societies. The workshop brought together experts in consumer sleep technologies and medical devices, sleep and circadian physiology, clinical translational research, and clinical practice. The goals of the workshop were: (1) characterize the term “wearable” for use in sleep and circadian science and identify relevant sleep and circadian metrics for wearables to measure; (2) assess the current use of wearables in sleep and circadian science; (3) identify current barriers for applying wearables to sleep and circadian science; and (4) identify goals and opportunities for wearables to advance sleep and circadian science. For the purposes of biomarker development in the sleep and circadian fields, the workshop included the terms “wearables,” “nearables,” and “ingestibles.” Given the state of the current science and technology, the limited validation of wearable devices against gold standard measurements is the primary factor limiting large-scale use of wearable technologies for sleep and circadian research. As such, the workshop committee proposed a set of best practices for validation studies and guidelines regarding how to choose a wearable device for research and clinical use. To complement validation studies, the workshop committee recommends the development of a public data repository for wearable data. Finally, sleep and circadian scientists must actively engage in the development and use of wearable devices to maintain the rigor of scientific findings and public health messages based on wearable technology.
Objectives
To investigate premorbid sleep reactivity as a vulnerability to incident shift work disorder and related changes in depression and anxiety following a transition to a rotating shifts work schedule.
Methods
This is a longitudinal study with two waves of data collection. The community-based sample included normal sleeping non-shift workers (N=96; 62.5% female; 47.9±13.3 yo) without a lifetime history of insomnia or baseline excessive daytime sleepiness who transitioned to rotating shift work one year later. Participants reported demographic characteristics, trait sleep reactivity on the Ford Insomnia Response to Stress Test, depression symptoms on the Quick Inventory of Depression Symptomatology, and anxiety symptoms on the Beck Anxiety Inventory. Shift work disorder was determined based on significant sleep disturbance and/or excessive sleepiness in the context of working a rotating shifts schedule.
Results
Analyses revealed that the odds were over five times greater for highly sleep reactive individuals to develop shift work disorder after transitioning to rotating shifts (OR=5.59, p=.04). Nearly 90% of shift work disorder sufferers were accurately identified as high risk at 1-y prior to disease onset. Furthermore, individuals who developed SWD reported greater increases in symptoms of depression and anxiety. Finally, analyses revealed significant indirect effects wherein high sleep reactivity increased risk for SWD, which led to greater severity of anxiety and depression symptoms.
Conclusions
The FIRST accurately identifies a focused target population in which the premorbid psychobiological processes complicit in SWD onset and progression, as well as shift work-related depression and anxiety changes, can be better investigated, thus improving future preventative efforts.
Results provide evidence that the wide dissemination of dCBT-I may effectively target both insomnia and comorbid depression across a wide spectrum of the population.
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