Using consumer-wearable technology for remote assessment of physiological response to stress in the naturalistic environment

Abstract

Psychosocial stress is a major risk factor for morbidity and mortality related to a wide range of health conditions and has a significant negative impact on public health. Quantifying exposure to stress in the naturalistic environment can help to better understand its health effects and identify strategies for timely intervention. The objective of the current project was to develop and test the infrastructure and methods necessary for using wearable technology to quantify individual response to stressful situations and to determine if popular and accessible fitness trackers such as Fitbit® equipped with an optical heart rate (HR) monitor could be used to detect physiological response to psychosocial stress in everyday life. The participants in this study were University of Minnesota students (n = 18) that owned a Fitbit® tracker and had at least one upcoming examination. Continuous HR and activity measurements were obtained during a 7-day observation period containing examinations selfreported by the participants. Participants responded to six ecological momentary assessment surveys per day (~2 hour intervals) to indicate occurrence of stressful events. We compared HR during stressful events (e.g., exams) to baseline HR during periods indicated as non-stressful using mixed effects modeling. Our results show that HR was elevated by 8.9 beats per minute during exams and by 3.2 beats per minute during non-exam stressors. These results are consistent with prior laboratory findings and indicate that consumer wearable fitness trackers could serve as a valuable source of information on exposure to psychosocial stressors encountered in the naturalistic environment.

Smart Devices and Wearable Technologies to Detect and Monitor Mental Health Conditions and Stress: A Systematic Review

“…A total of 15 studies were identified for inclusion in this review based on the search term “stress”. Similar to anxiety, the use of cardiac metrics, namely heart rate and heart rate variability, were the predominant physiological markers of stress detection in 10 of the 15 studies which detected stress [ 9 , 12 , 14 , 17 , 18 , 20 , 22 , 23 , 26 , 28 ]. It has been reported that altered HRV measurements are related to ANS dysregulation associated with many cardiovascular diseases including cardiac ischemia, myocardial infarction and heart failure, diabetes, and obesity, as well as mental health conditions including anxiety and depression [ 9 , 46 ].…”

“…In studies that only examined HR [ 20 , 22 ] it was found that there was a significant difference between genders, with females having significantly higher average HR than males when exposed to occupational stress, when measured using an Apple Watch (Series 1, Apple Inc., Cupertino, CA, USA) [ 20 ]. Interestingly, Lucas et al (2019) also commented that baseline cardiovascular fitness, determined by survey, had no significant impact on HR, which is the inverse of what is physiologically expected [ 20 ].…”

“…Interestingly, Lucas et al (2019) also commented that baseline cardiovascular fitness, determined by survey, had no significant impact on HR, which is the inverse of what is physiologically expected [ 20 ]. Further, in the study by Pakhomov et al (2020), which used the Fitbit ® (no model specifics provided) to detect HR at baseline and during exposure to stressors, it was found that the Fitbit ® is capable of detecting stressors, with HR increasing an average of nine beats per minute [ 22 ]. Whilst the findings by Lucas et al (2019) and Pakhomov et al (2020) suggest HR may be useful in detecting stress, both studies were limited by the young age of their subjects; thus, the impact of comorbidities on HR, and therefore stress detection, may not be reflective of the general population [ 20 , 22 ].…”

“…Further, in the study by Pakhomov et al (2020), which used the Fitbit ® (no model specifics provided) to detect HR at baseline and during exposure to stressors, it was found that the Fitbit ® is capable of detecting stressors, with HR increasing an average of nine beats per minute [ 22 ]. Whilst the findings by Lucas et al (2019) and Pakhomov et al (2020) suggest HR may be useful in detecting stress, both studies were limited by the young age of their subjects; thus, the impact of comorbidities on HR, and therefore stress detection, may not be reflective of the general population [ 20 , 22 ]. The study by van Kraajj et al (2020) supports this, using two separate wearables: an unspecified chest patch for HR measurement and a wristband (Chillband) for detecting activity, with the study reporting that there was a significant relationship between HR and the three-way interaction between chronic stress, gender, and circadian rhythm [ 28 ].…”

Let’s Focus on Solutions to Entrepreneurial Ill-Being! Recovery Interventions to Enhance Entrepreneurial Well-Being

“…A recent study using smart-watches to deliver and monitor a breathing intervention, for example, reported one sixth fewer stress instances among participants randomly assigned to the smart-watches group compared to the waiting list group (Smith et al, 2020). Smart-watches and associated health apps allow users to share information on their current levels of activity, physical exercise, and sleep (Pakhomov et al, 2020). Therefore, the same indicators may be used to deliver or assess intervention effects.…”