Wrist actigraphic approach in primary, secondary and tertiary care based on the principles of predictive, preventive and personalised (3P) medicine

Abstract

Sleep quality and duration as well as activity-rest-cycles at individual level are crucial for maintaining physical and mental health. Although several methods do exist to monitor these parameters, optimal approaches are still under consideration and technological development. Wrist actigraphy is a non-invasive electro-physical method validated in the field of chronobiology to record movements and to allow for monitoring human activity-rest-cycles. Based on the continuous recording of motor activity and light exposure, actigraphy provides valuable information about the quality and quantity of the sleep–wake rhythm and about the amount of motor activity at day and night that is highly relevant for predicting a potential disease and its targeted prevention as well as personalisation of medical services provided to individuals in suboptimal health conditions and patients. Being generally used in the field of sleep medicine, actigraphy demonstrates a great potential to be successfully implemented in primary, secondary and tertiary care, psychiatry, oncology, and intensive care, military and sports medicines as well as epidemiological monitoring of behavioural habits as well as well-being medical support, amongst others. Prediction of disease development and individual outcomes Activity-rest-cycles have been demonstrated to be an important predictor for many diseases including but not restricted to the development of metabolic, psychiatric and malignant pathologies. Moreover, activity-rest-cycles directly impact individual outcomes in corresponding patient cohorts. Targeted prevention Data acquired by actigraphy are instrumental for the evidence-based targeted prevention by analysing individualised patient profiles including light exposure, sleep duration and quality, activity-rest-cycles, intensity and structure of motion pattern. Personalised therapy Wrist actigraphic approach is increasingly used in clinical care. Personalised measurements of sedation/agitation rhythms are useful for ICU patients, for evaluation of motor fatigue in oncologic patients, for an individual enhancement of performance in military and sport medicine. In the framework of personalised therapy intervention, patients can be encouraged to optimise their behavioural habits improving recovery and activity patterns. This opens excellent perspectives for the sleep-inducing medication and stimulants replacement as well as for increasing the role of participatory medicine by visualising and encouraging optimal behavioural patterns of the individual.

Sleep Disorders in Cancer—A Systematic Review

“…For the research of sleep and quality of sleep, the easy-to-use actigraphy is commonly used [ 89 , 90 ]. Actigraphy data from various studies have shown that there is a strong correlation between the changes in subjectively experienced CrF and sleep quality [ 2 , 10 , 16 ].…”

Physiological Rhythms and Biological Variation of Biomolecules: The Road to Personalized Laboratory Medicine

“…Besides, circadian rhythms are useful for the treatment, prediction, and prevention of several physical and mental diseases including cardiovascular disease, myocardial ischemia, neurodegenerative disease, body microbiota, sleep–wake disorder, etc. [ 210 , 211 , 212 , 213 ].…”

Hair cortisol level might be indicative for a 3PM approach towards suicide risk assessment in depression: comparative analysis of mentally stable and depressed individuals versus individuals after completing suicide

“…Even worse, for each completed suicide, twenty other non-fatal suicide attempts can be considered statistically [8]. This unacceptable high number of cases further accentuates the utmost urgent need to promote and establish the principles of 3PM (for example see [9][10][11] also in psychiatric healthcare (see [12] for pharmacogenomics in the treatment of mood disorders)), especially predictive and preventive strategies in those associated with suicidality. In contrast to the risk for MDD, both suicidal risk and fatal suicide attempts are more strongly associated with the male sex [13].…”