Assessment of psychological stress during sleep using digital devices and its clinical relevance to future occupational health practice

Abstract

Psychophysiological decompensation as a result of occupational stress leads to impairment of occupational performance. Adequate recovery from psychological stress is necessary to maintain occupational performance. It is possible to measure the psychophysiological status and recovery during sleep with health data streamed from biomedical digital devices. Such data, with reference to heart and sleep parameters, could be processed to reflect health status and whether there is a risk of psychophysiological decompensation. This article describes the interpretation of resting heart rate measures, heart rate variability, and actigraphy measures during regular sleep in relation to psychological stress. Interpretation of the health data should be done by informed health-care professionals in combination with clinical history taking. The article does not cover digital measurements while awake and active. The aim of this review article is to provide an evidence-based rationale to health professionals how to interpret digital health data profiles from biomedical devices in appraising psychological stress and recovery. The objective is to prevent the adverse impact of psychological stress on health. Specific lifestyle measures and therapy to manage psychological stress, such as exercise, diet, and cognitive behavioral therapy for insomnia, are not discussed in this article. Applications are especially relevant in the field of occupational health in preventing occupational burnout, achieving a healthy work–life balance, and sustaining a healthy working life. There are future implications with regard to disease prevention as a large proportion of chronic diseases, for example, hypertension, diabetes depression, and ischemic heart disease, are related to chronic psychological stress. Stress monitoring with biomedical devices should occur over periods of work and nonwork days.