JMIR Publications

ABSTRACT

Background:

Emergency department (ED) boarding is associated with increased morbidity and delirium, with exacerbation of sleep challenges proposed as a causal pathway. Wearable technologies offer a promising approach for objective sleep investigation among older adults admitted from the ED, yet their feasibility and acceptability are unexplored.

Objective:

This study investigated the feasibility and acceptability of the Oura Ring Gen 3 for measuring sleep in older adults admitted to the hospital from the ED.

Methods:

We performed a single-site, prospective cohort study enrolling ED patients aged ≥ 65 years to wear the Oura ring for up to four days or until hospital discharge. Participants completed the Montreal Cognitive Assessment, daily delirium assessments using 3D-CAM, daily sleep questionnaires, and a study exit survey. Feasibility was assessed by analyzing the proportion of approached patients who enrolled and the proportion of enrolled patients who wore the device for >75% of the study period. Acceptability was assessed using an exit survey question “This ring bothered me while participating in this study”, measured on a 5-point Likert scale from strongly disagree to strongly agree, where any disagreement (1 or 2) was considered acceptable. Sleep duration (hours slept per 24 hours) was calculated from Oura sleep tracking data.

Results:

Of 29 patients approached, 15 enrolled (51.7%). Fourteen (93%) wore the Oura ring for >75% of their enrolled period. Ten patients responded to the exit survey, and of these eight (80%) found the Oura ring acceptable. Participants had a device-estimated median 4.3 hours of sleep per 24 hours during the study (IQR: 2.9-7.0) and reported good or very good sleep during 47% of hospital nights with a positive correlation between device measurement and patient-reported sleep (Kendall’s τ = 0.54).

Conclusions:

The Oura Ring was feasible and acceptable for estimating sleep among older adults admitted from the ED. These findings support further use of wearable devices to characterize sleep in this high-risk population and inform interventions to mitigate hospital sleep disturbance.