Changes in Continuous, Long-Term Heart Rate Variability and Individualized Physiological Responses to Wellness and Vacation Interventions Using a Wearable Sensor

Abhishek Pratap; Steve Steinhubl; Elias Chaibub Neto; Stephan W Wegerich; Christine Tara Peterson; Lizzy Weiss; Sheila Patel; Deepak Chopra; Paul J Mills

doi:10.3389/fcvm.2020.00120

Changes in Continuous, Long-Term Heart Rate Variability and Individualized Physiological Responses to Wellness and Vacation Interventions Using a Wearable Sensor

Front Cardiovasc Med. 2020 Jul 31:7:120. doi: 10.3389/fcvm.2020.00120. eCollection 2020.

Authors

Abhishek Pratap^{1

2}, Steve Steinhubl³, Elias Chaibub Neto¹, Stephan W Wegerich⁴, Christine Tara Peterson⁵, Lizzy Weiss⁶, Sheila Patel^{5

7}, Deepak Chopra^{5

6}, Paul J Mills⁵

Affiliations

¹ Sage Bionetworks, Seattle, WA, United States.
² Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, United States.
³ Scripps Translational Science Institute, La Jolla, CA, United States.
⁴ PhysIQ, Chicago, IL, United States.
⁵ Department of Family Medicine and Public Health, University of California, San Diego, San Diego, CA, United States.
⁶ The Chopra Foundation, Carlsbad, CA, United States.
⁷ Chopra Global, New York, NY, United States.

Abstract

There are many approaches to maintaining wellness, including taking a simple vacation to attending highly structured wellness retreats, which typically regulate the attendee's personal time and activities. In a healthy English-speaking cohort of 112 women and men (aged 30-80 years), this study examined the effects of participating in either a 6-days intensive wellness retreat based on Ayurvedic medicine principles or unstructured 6-days vacation at the same wellness center setting. Heart rate variability (HRV) was monitored continuously using a wearable ECG sensor patch for up to 7 days prior to, during, and 1-month following participation in the interventions. Additionally, salivary cortisol levels were assessed for all participants at multiple times during the day. Continual HRV monitoring data in the real-world setting was seen to be associated with demographic [HRV_ALF: β_Age = 0.98 (95% CI = 0.96-0.98), false discovery rate (FDR) < 0.001] and physiological characteristics [HRV_PLF: β = 0.98 (95% CI = 0.98-1), FDR =0.005] of participants. HRV features were also able to quantify known diurnal variations [HRV_LF/HF: β_{ACT:night vs. early-morning} = 2.69 (SE = 1.26), FDR < 0.001] along with notable inter- and intraperson heterogeneity in response to intervention. A statistically significant increase in HRV_ALF [β = 1.48 (SE = 1.1), FDR < 0.001] was observed for all participants during the resort visit. Personalized HRV analysis at an individual level showed a distinct individualized response to intervention, further supporting the utility of using continuous real-world tracking of HRV at an individual level to objectively measure responses to potentially stressful or relaxing settings.

Keywords: cardiovascular medicine; digital health; intervention; remote monitoring; stress; wearable; wellness.