A wearable device could help detect and monitor patients struggling with poor sleep, pain and anxiety after a traumatic event, according to research published in JAMA Psychiatry.

The study tracked more than 2,000 participants for eight weeks after they reported to an emergency department following a traumatic stress exposure, like a car crash, physical assault, sexual assault, serious fall or mass casualty incident. Most people in the study were recovering from a car crash.

Participants were equipped with Verily Life Sciences' Study Watch and instructed to wear it at least 21 hours a day. Researchers found eight significant biomarkers for symptoms of adverse posttraumatic neuropsychiatric sequelae, like pain, depression, anxiety and sleep disruption. 

Reduced 24-hour activity variance was associated with greater pain severity, and six rest-activity measures were associated with changes in pain over time. They also found one sleep biomarker, the number of times a participant woke up during sleep, was associated with changes in pain, sleep and anxiety.

"Simple biomarker or symptom change cutoffs suggest that these biomarkers might have utility as initial screening tools to identify individuals with potential good recovery in these domains who might not need further evaluation. In clinical practice, they could serve as ancillary data to help patients and physicians identify whether symptoms are improving or worsening after trauma," the study's authors wrote.

"Notably, the magnitude of associations between individual rest-activity biomarkers and APNS outcomes were small, and no single biomarker achieved both high positive and negative predictive value for APNS symptom change. Given this, these biomarkers would likely have the most utility if used to augment other measures, such as self-report."

WHY IT MATTERS

Researchers noted some limitations in the study, such as that all participants reported to the emergency department and most were survivors of car crashes, so the data might not be generalizable to other trauma patients.

The study was limited to eight weeks following a traumatic event, and the analysis required both wearable and self-reported data. 

They also noted that their study included a more socioeconomically disadvantaged group. Most of the participants were female, while half of the study was Black, 34% were white and 11% were Hispanic. Nearly 80% of the study did not have a college degree, while 64% earned $35,000 per year or less.

"Most individuals experience traumatic events, and many individuals who come to the ED for care after traumatic stress struggle with one or more persistent APNS. This is particularly true for individuals from socioeconomically disadvantaged populations," the researchers wrote.

"Wrist-wearable devices with accelerometry are common, and 24-hour rest-activity characteristics obtained from wearable devices might identify those who will recover from trauma in high-risk populations."