Exploring the Association Between Self-Reported Asthma Impact and Fitbit-Derived Sleep Quality and Physical Activity Measures in Adolescents

Abstract

BackgroundSmart wearables such as the Fitbit wristband provide the opportunity to monitor patients more comprehensively, to track patients in a fashion that more closely follows the contours of their lives, and to derive a more complete dataset that enables precision medicine. However, the utility and efficacy of using wearable devices to monitor adolescent patients’ asthma outcomes have not been established.ObjectiveThe objective of this study was to explore the association between self‑reported sleep data, Fitbit sleep and physical activity data, and pediatric asthma impact (PAI).MethodsWe conducted an 8‑week pilot study with 22 adolescent asthma patients to collect: (1) weekly or biweekly patient‑reported data using the Patient-Reported Outcomes Measurement Information System (PROMIS) measures of PAI, sleep disturbance (SD), and sleep‑related impairment (SRI) and (2) real-time Fitbit (ie, Fitbit Charge HR) data on physical activity (F-AM) and sleep quality (F‑SQ). To explore the relationship among the self-reported and Fitbit measures, we computed weekly Pearson correlations among these variables of interest.ResultsWe have shown that the Fitbit-derived sleep quality F-SQ measure has a moderate correlation with the PROMIS SD score (average r=−.31, P=.01) and a weak but significant correlation with the PROMIS PAI score (average r=−.18, P=.02). The Fitbit physical activity measure has a negligible correlation with PAI (average r=.04, P=.62).ConclusionsOur findings support the potential of using wrist-worn devices to continuously monitor two important factors—physical activity and sleep—associated with patients’ asthma outcomes and to develop a personalized asthma management platform.

Migraine Burden of Disease: From the Patient's Experience to a Socio‐Economic View

“…Examples of such approaches are arising in other disease areas. In asthma, a study was conducted which assessed self‐reported physical activity and sleep quality via a patient smart wearable (wrist‐worn device) …”

Psychometric properties of the Patient‐Reported Outcomes Measurement Information System (PROMIS) Sleep Disturbance and Sleep‐Related Impairment item banks in adolescents

“…We previously started validation of the PROMIS adult sleep item banks for adolescents (van Kooten, Litsenburg, Yoder, Kaspers, & Terwee, 2018;van Kooten, Terwee, Kaspers, & Litsenburg, 2016), because sleep item banks for children (Bevans et al, 2018;Forrest et al, 2018) were not yet developed. Since then, multiple studies have used the PROMIS adult sleep item banks in young adults and adolescents (Bian et al, 2017;Hanish, Lin-Dyken, & Han, 2017;Levenson et al, 2017).…”

Wearable Technology and How This Can Be Implemented into Clinical Practice

“…The Fitbit device tended to overestimate sleep efficiency and underestimate wake counts compared with actigraphy. Two additional studies were conducted in pediatric populations and focused on correlating Fitbit-derived sleep measures to patient-reported outcomes such as asthma control and asthma impact [21,22]. Bian and colleagues assessed the association between self-reported asthma impact and Fitbit-derived sleep quality (the ratio of minutes asleep to minutes in bed) and physical activity measures (daily minutes of moderate and vigorous activity) in adolescents with asthma [21].…”

“…Two additional studies were conducted in pediatric populations and focused on correlating Fitbit-derived sleep measures to patient-reported outcomes such as asthma control and asthma impact [21,22]. Bian and colleagues assessed the association between self-reported asthma impact and Fitbit-derived sleep quality (the ratio of minutes asleep to minutes in bed) and physical activity measures (daily minutes of moderate and vigorous activity) in adolescents with asthma [21]. Fitbit-derived sleep quality was moderately correlated with Patient-Reported Outcomes Measurement Information System (PROMIS) sleep disturbance score (r = − 0.31, P = 0.01) and had a weak but significant correlation with the PROMIS pediatric asthma impact score (average r = − 0.18, P = 0.02).…”