Using objective measures of physical activity, sleep, and breathing for disease profiling of patients with systemic lupus erythematosus and Sjögren’s disease

BackgroundPatients with Systemic Lupus Erythematosus (SLE) and Sjögren’s disease (SjD) often report disrupted sleep, excessive fatigue, and decreased physical activity. Symptom assessment and their impact on daily life relies heavily on subjective measures, which are limited. Investigating novel digital biomarkers could facilitate continuous monitoring of symptoms such as sleep disturbances and reduced physical capacity to better capture disease impact and therapy effects.ObjectiveTo evaluate passive sensing for identifying activity, sleep, and breathing patterns that distinguish SLE and SjD phenotypes in the home environment.Methods29 SLE, 29 SjD and 37 demographic-matched healthy participants were recruited in a 6-month in-home study. We investigated a set of digital measures collected from a wrist worn actigraphy device (ActiGraph CentrePoint Insight Watch) to measure physical activity and a wall mounted non-contact radio wave device (Emerald) to measure sleep staging and breathing signals during sleep. In addition, self-reported eDiaries and clinical assessments of disease activity were administered. We performed a disease profiling analysis by exploring how eDiary and digital data differ by cohort. We also investigated how ActiGraph and Emerald data correlate with eDiary and disease activity.ResultsResults from ActiGraph and Emerald data suggest that SLE participants exhibited lower physical activity, poorer sleep quality, and higher breathing rate and breathing variability when compared to healthy participants. Similarly to SLE participants, SjD participants showed a reduction in physical activity with an earlier peak activity time, but no differences were recorded in sleep and breathing. Overall, many of the digital measurements of physical activity, sleep, and breathing had weak correlation with self-reported symptoms captured via eDiary and both higher breathing rate and breathing variability were associated with higher SLE disease activity.ConclusionsData obtained from digital health devices indicates that physical activity is disrupted in patients with SLE and SjD, while sleep and breathing patterns are also impaired in those with SLE. These results align with the known SLE and SJD symptoms that affect physical activity and sleep and provide initial support for the importance of using passive sensing to understand quality of life in individuals living with chronic autoimmune diseases.