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

Jens Acker; Olga Golubnitschaja; Antje Büttner-Teleaga; Kneginja Richter

doi:10.1007/s13167-021-00250-5

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

EPMA J. 2021 Aug 6;12(3):349-363. doi: 10.1007/s13167-021-00250-5. eCollection 2021 Sep.

Authors

Jens Acker¹, Olga Golubnitschaja², Antje Büttner-Teleaga^{3

4}, Kneginja Richter^{5

6

7}

Affiliations

¹ Clinic for Sleep Medicine, Zurzach Care, Badstrasse 33, 5330 Bad Zurzach, Switzerland.
² Predictive, Preventive and Personalised (3P) Medicine, Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
³ Institute of Cognitive Science, Woosuk University, Samnye-up, South Korea.
⁴ Department of Psychiatry, University Witten-Herdecke, Witten, Germany.
⁵ Sleep Ambulance, University Clinic for Psychiatry and Psychotherapy, Paracelsus Medical University, Nuremberg, Germany.
⁶ Institute for E-Counselling, Technical University for Applied Sciences Nuremberg Georg Simon Ohm, Nuremberg, Germany.
⁷ Faculty for Medical Sciences, University Goce Delcev, Stip, Macedonia.

Abstract

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.

Keywords: Actigraphy; Behavioural patterns; COVID-19 pandemic; Cancer; Chronobiology; Circadian rhythm; Dementia; Depression; Exposition to light; Fatigue; Health policy; ICU; Individual outcomes; Individualised patient profiling; Insomnia; Mental health; Military; Mood; Motor activity; Pain; Patient stratification; Performance enhancement; Personalised medication; Post-traumatic stress disorder; Predictive preventive personalised medicine (PPPM/3PM); Primary secondary tertiary care; Recommendations; Sleep disorder; Sleep disturbance; Sleep quality tool; Sleep–wake rhythm; Sport medicine; Tailored treatment; Targeted prevention; Traffic safety.