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Suicide, Social Interactions, and Sleep: What Wearable Technology Can Teach Us

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by Fiona Brown, Research Assistant 

Wearable technology is providing us with an unprecedented amount of information about our health, activity, and our habits. Now they may help answer some pressing questions about the links among social interactions, the quality of our sleep, and suicide risk. Austen Riggs Center Research Assistant Fiona Brown explains some of what may be possible and what it is like to wear one particular device being used in a newly-funded NIMH study. 

Recently, Katie Lewis, PhD, of the Erikson Institute of the Austen Riggs Center obtained a grant from the National Institute of Mental Health (NIMH), in collaboration with Rutgers University in New Jersey and Long Island University in Brooklyn, to study the effects of disturbed sleep and impaired interpersonal functioning on suicidal thoughts and behaviors. The study will be conducted over the course of two years, recruiting participants from each of the three institutions. I am fortunate enough to be Dr. Lewis’ research assistant for this project. 

The intention of the study is to gain a clearer insight into suicide risk factors using in-the-moment data collection, known as EMA (ecological momentary assessment), to assess feelings associated with social interactions, as well as collecting physiological data to assess sleep duration and quality. In this way, researchers will be able to collect information in real time in order to determine how risk factors interact to predict suicidal thought and behaviors. We will be collecting this data for a total of two weeks for each participant. 

In order to collect the physiological data related to sleep, the study will be using a device called the “Actiwatch.” Something like a Fitbit, this device is worn on the wrist and tracks activity throughout the day. When worn at night, it can be used to determine when someone has fallen asleep, how much they move around during the night, and when they wake up. This will give researchers insight into how much quality sleep an individual is getting, and how restless they are during the night. 

Wearable technology is providing us with data on our health.

In preparation for the study, Dr. Lewis and I each wore the Actiwatch for a week to get a feel for the user experience. While the device is rather clunky, you get used to it quickly. You wear it as you would your regular wrist watch, and it gives you the time and date. I actually found it to be a good conversation starter when people asked about what I called my “back to the future” watch; it provided an opportunity to engage with people around the topic of suicide, which is so often tip-toed around and stigmatized.  

Unlike a regular wrist watch, however, you do not take the Actiwatch off as you get ready for bed. Rather, this is when it begins its most important job. Once you are in bed, lights off, and ready to attempt to sleep (not when you are going to continue scrolling Facebook for 20 minutes), you hit a little silver button on the side to indicate the beginning of your rest period. This helps the researchers to know that the lack of activity can be attributed to sleep, rather than a Netflix binge. Then you sleep as normal and press the little button again as soon as you wake up (or at least as soon as you think of it). I found that, initially, knowing that my movements were being recorded made me hyper vigilant of how often I was moving, and made it harder to fall asleep. However, this effect went away after a few nights, and it is partly why participants are required to wear it for two weeks.   

In addition to Dr. Lewis and I piloting the devices, we decided to have our partners try them out as well in order to gather more feedback about the user experience. I was particularly interested in the data my fiancé would give, as he is a consummate sleep talker and actor. Unsurprisingly, he indicated many more bouts of wakefulness on an average night than I did, and I averaged more sleep than he did. Looking at the difference between Dr. Lewis and her husband’s sleep patterns was also interesting. They have two young daughters, a five-year-old and a one-year-old. Notably, Katie’s data showed much more activity during the night, which matched up with her self-report of getting up to tend to the baby. Interesting indeed! 

Overall, trying out the Actiwatch was a very interesting and exciting experience, at least for us research nerds. We hope participants will find this method of data collection fascinating as well, as they will receive a report of their data over the course of the two weeks, as well as an interpretation from the researcher as to what it means. This is an exciting time for us as we put all the pieces of the research puzzle together, and I hope you enjoyed getting a glimpse into the process! 

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