Abstract
Abstract
Background
Emergency department (ED) boarding exposes admitted older adults to a high-disruption environment. Sleep loss during acute hospitalization is associated with adverse outcomes and may contribute to delirium, yet objective sleep measurement in this setting is difficult. Consumer multisensor wearables may permit low-burden, longitudinal measurement, but the feasibility and acceptability of ring-based monitoring among acutely ill older adults is unknown.
Objective
This study aimed to estimate the feasibility and acceptability of Oura Ring Gen 3 sleep monitoring in older adults admitted to the hospital from the ED, and to describe exploratory device-measured and patient-reported sleep outcomes.
Methods
We conducted a single-site prospective cohort study from February through March 2025. Patients aged 65 years or older with an inpatient medical bed request were recruited in the ED and asked to wear the ring continuously for up to 4 days or until discharge; monitoring continued after transfer to an inpatient unit from the ED. Participants underwent daily 3-Minute Diagnostic Interview for Confusion Assessment Method-Defined Delirium (3D-CAM) assessments, cognitive testing when not delirious, daily sleep surveys, and an exit survey. Feasibility outcomes were the approached-to-enrolled proportion and the proportion of study completers with wear for more than 75% of the analyzed period. Acceptability was the proportion of exit respondents who disagreed or strongly disagreed that the ring bothered them. Device-estimated sleep duration was normalized to hours per 24 hours, and its association with mean patient-reported sleep quality was assessed using Kendall τ.
Results
Of 29 patients approached for consent, 15 enrolled (51.7%, 95% CI 32.5%‐70.6%); 1 withdrew immediately, leaving 14 who completed study procedures. Of these 14 patients, 13 wore the ring for ≥75% of their enrollment period (92.9%, 95% CI 66.1%‐99.8%). Eleven participants completed the exit survey, and 9 reported that the ring was not bothersome (81.8%, 95% CI 48.2%‐97.7%). Among the 13 participants who wore the ring for ≥75% of the analyzed period, median device-estimated sleep was 4.3 (IQR 2.6-7.0) hours per 24 hours. Participants reported good or very good sleep on 9 of 19 surveyed nights (47.4%). Mean sleep quality and device-estimated sleep duration were positively associated among 10 participants with complete paired data (Kendall τ=0.54;
P
=.04).
Conclusions
In this pilot study, we found that sleep monitoring with the Oura Ring Gen 3 was feasible and acceptable to older adults admitted from the ED. These findings support larger studies validating the Oura Ring against polysomnography in hospitalized older adults.