Combating fatigue in IBD patients: The promise of wearables & HRV
Wearable technology, such as the Fitbit Inspire 2.0, offers a way to monitor heart rate variability (HRV), which could help manage IBD-related fatigue.
Inflammatory bowel disease (IBD) patients often experience fatigue as one of their most debilitating symptoms. A recent study presented at the 2023 Crohn’s and Colitis Congress found a correlation between lower HRV and fatigue in IBD patients.
Wearables typically utilize HRV as a tool to assess the user’s overall well-being, fitness level, and recovery. By measuring the variability between heartbeats, they provide insights into the balance between the sympathetic and parasympathetic nervous systems. This balance can indicate the user’s stress levels, readiness for exercise, and recovery status after a workout.
But lower HRV has also been associated with an increased risk for cardiovascular events and greater vulnerability to psychological stress (Curr Cardiol Rev 2021;17[5]:e160721189770; Neurosci Biobehav Rev 2012;36[2]:747-756). Factors like vitamin and mineral deficiencies, depression, poor sleep, and inflammation can contribute to fatigue. But IBD patients often still struggle with this symptom when these other factors are under control.
The study
Researchers at Northwestern Medicine in Chicago monitored sleep and HRV in adult IBD patients using the Fitbit Inspire 2 for a period of 14 days. Participants also completed the IBD Fatigue Scale and disease activity indices (HBI or SCCAI) at baseline, week 1, and week 2. The researchers conducted baseline laboratory testing for C-reactive protein (CRP), vitamins B12 and D, and ferritin.
The interim analysis revealed that the average patient HRV was below the published normative average. The results showed no differences based on sex or IBD type. Although 75% of the participants were in remission, all reported fatigue, and 44% met criteria for severe fatigue. The study therefore found a correlation between lower HRV and increased fatigue. This suggests that HRV could be a potential intervention point for IBD-related fatigue.
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One possible way to increase HRV is through deep diaphragmatic breathing techniques. This could be through resonance frequency breathing or a yoga breathing practice. These methods are known to improve vagal tone, which in turn, increases HRV. Physicians can recommend such practices to their patients as safe and effective ways to manage fatigue symptoms without medication or other medical interventions. Other ways of increasing include getting enough sleep and rest, healthy eathing and more.
Changes in HRV have also been linked to IBD flares ( (Inflamm Bowel Dis 2021;27[10]:1576-1584; Neurogastroenterol Motil 2016;28[11]:1655-1662). However, the study’s lead investigator, Josie McGarva, MA, noted that a significant percentage of patients in their study were in remission. She added that improving HRV can help expand the body’s tolerance to stress and trauma, making it beneficial in various ways.
Convergence of technology and healthcare
The Northwestern Medicine study shows that wearable technology has far-reaching applications beyond fitness tracking and everyday health monitoring. By incorporating HRV measurements and other physiological data, such devices have the potential to play an important role in medical research. This convergence of technology and healthcare not only provides valuable insights for researchers and clinicians but also empowers patients to take a more active role in their own health management.
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