A Descriptive Comparative Pilot Study: Association Between Use of a Self-monitoring Device and Sleep and Stress Outcomes in Pregnancy

Abstract

Pregnancy is a challenging time for maintaining quality sleep and managing stress. Digital self-monitoring technologies are popular because of assumed increased patient engagement leading to an impact on health outcomes. However, the actual association between wear time of such devices and improved sleep/stress outcomes remains untested. Here, a descriptive comparative pilot study of 20 pregnant women was conducted to examine associations between wear time (behavioral engagement) of self-monitoring devices and sleep/stress pregnancy outcomes. Women used a ring fitted to their finger to monitor sleep/stress data, with access to a self-monitoring program for an average of 9½ weeks. Based on wear time, participants were split into two engagement groups. Using a linear mixed-effects model, the high engagement group showed higher levels of stress and a negative trend in sleep duration and quality. The low engagement group showed positive changes in sleep duration, and quality and experienced below-normal sleep onset latency at the start of the pilot but trended toward normal levels. Engagement according to device wear time was not associated with improved outcomes. Further research should aim to understand how engagement with self-monitoring technologies impacts sleep/stress outcomes in pregnancy.

Exploring Access as a Process of Adaptation in a Self-Monitoring Perinatal eHealth System: Mixed Methods Study From a Sociomaterial Perspective

“…In total, 20 pregnant women monitored themselves in either a high (n=14, 70%) or a low (n=6, 30%) amount ( Table 2 ) based on the kernel density estimate conducted in our previous study [ 18 ]. Women described that the eHealth system’s mediating activities and their own adaptive activities of self-monitoring enacted a process of cocreation for eHealth system use.…”

“…What is lacking in many studies on evaluating perinatal self-monitoring systems is a clear definition and examination of patient engagement and associated health outcomes [ 24 ]. A descriptive comparative analysis conducted as part of our larger feasibility study revealed the limitations of only examining the physical use of self-monitoring technology [ 18 ]. The process characteristics will be missed if we do not look beyond physical use as an indicator of engagement [ 18 ].…”

“…A descriptive comparative analysis conducted as part of our larger feasibility study revealed the limitations of only examining the physical use of self-monitoring technology [ 18 ]. The process characteristics will be missed if we do not look beyond physical use as an indicator of engagement [ 18 ]. Here, women cocreated their use patterns aided by the mediation of the eHealth system.…”

“…Pregnant users were recruited from early antenatal visits during their second trimester by the PHNs. Refer to Auxier et al [ 18 ] for details regarding recruitment and informed consent.…”

“…Participants were stratified according to the distribution of individual means of nonwear time of the smart ring. See further details of stratification reported previously [ 18 ]. Convergence of data sources was then conducted by organizing qualitative data according to user group.…”