The role of 24-hour wearable sensors in early evaluation of adolescent orthostatic dysregulation

PCN Rep. 2025 Nov 18;4(4):e70246. doi: 10.1002/pcn5.70246. eCollection 2025 Dec.

Abstract

Aim: We investigated orthostatic dysregulation using wearable sensors capable of monitoring electrocardiograms (ECGs) and motion via accelerometers.

Methods: Study 1: Thirty-three healthy students participated in the study. Wearable sensors recorded continuous 24-h ECGs, and a triaxial accelerometer was fixed to the participants' waist for three consecutive weekdays. Clinical psychiatric ratings involved assessments using the internet addiction test, the depression self-rating scale, the state-trait anxiety inventory, and the autism spectrum quotient. In Study 2, 19 patients diagnosed with orthostatic dysregulation were compared with healthy controls.

Results: No significant correlation was found between depressive symptoms and heart rate variability. A standing test revealed a strong correlation between heart rate changes immediately after changing the position and average 24-h heart rate variability. The orthostatic dysregulation group exhibited a significantly lower high-frequency ratio than the control group. This group also had longer sleep durations, lower sleep efficiency, and lower energy consumption.

Conclusion: Wearable sensors proved valuable in evaluating autonomic function. Significant differences in accelerometer-based sleep ratings were observed between normal subjects and patients with orthostatic dysregulation.

Keywords: adolescent; heart rate variability; orthostatic dysregulation; wearable sensor.