Severity of Depression and Anxiety Symptoms Manifest in Physiological and Behavioral Metrics Collected from a Consumer-Grade Wearable Ring

Background Modern wearable devices generate a multitude of digital metrics, which can be used to measure human function in health and disease. This study investigated whether and how digital metrics generated from a consumer-grade smart ring were different in individuals with varying severity of depression and anxiety symptoms in a large population-based cohort. Methods Data were obtained from the Northern Finland Birth Cohort 1986 when participants were 33–35 years of age. Participants were asked to wear the Oura Ring for two weeks, which provided digital measures of sleep architecture, nocturnal heart rate (HR), nocturnal heart rate variability (HRV), and minute-by-minute movement intensity. Participants with at least one weekday and a weekend day with no less than 15 hours wear time were included. Depression and anxiety symptoms were assessed using the Generalized Anxiety Disorder 7-item scale (GAD-7) and the Hopkins Symptom Checklist-25 (HSCL-25). Participants were grouped into no, mild, and moderate-to-severe anxiety symptom groups based on GAD-7, and with and without depression and anxiety symptoms based on HSCL-25. Time-series data were visualized, and statistical differences between groups were assessed using one-way ANCOVA followed by Tukey’s post hoc test. Results A total of 1,290 participants provided enough valid data and were included. The metrics generated by Oura ring were different across symptom severity groups. Participants with moderate-to-severe anxiety assessed by GAD-7 and with depression and anxiety symptoms assessed by HSCL-25 exhibited lower proportions of rapid eye movement (REM) and deep sleep, and increased light sleep compared with the group without depression and anxiety. These two groups also showed elevated HR, reduced HRV during sleep, and lower levels of moderate-to-vigorous physical activity during the day. The differences between mild anxiety group with no and moderate-to-severe anxiety groups were overall less apparent. Conclusions Findings suggest that severity of depression and anxiety are manifested in physical and physiological metrics generated by a consumer-grade wearable ring. These findings suggest that they may be a promising tool for large-scale monitoring and early detection of mental health risks.