Rhythms of Health
Listen carefully.....Can you hear the clock ticking inside each cell in your body? Probably not, but our health actually revolves around the many clocks inside of us and how well they are aligned with one another. In fact, the most recent Nobel Prize for Medicine was awarded to three scientists who studied our circadian roughly 24-hour) rhythms precisely because they understood how central these rhythms are to our health.
Much of healthcare and, surprisingly even digital approaches to healthcare are ignorant of how critical our body’s clock or clocks are to the optimal timing of medication, surgery, chemotherapy and a host of other interventions. Nor, is there clear recognition of the role of that the timing of sleep, meals, activity, rest and a host of other behaviors play in determining the course of the chronic medical conditions that account for the majority of disease burden in the developed world.
At HealthRhythms we are taking a scientifically validated approach to improving the mental and physical wellbeing of all individuals by leveraging the passive sensing capabilities of commercial smartphones to identify behavioral health patterns and to further demonstrate the importance of physiological and behavioral rhythms and their role across disease.
We are all born with certain genetic vulnerabilities and resiliencies that play out across our lifespan and interact with our environment to produce health or disease. Recent data shows that we have clocks in virtually every cell of our bodies and that the function or malfunction of those clocks is directly related to our health and functioning.
So, we argue that one of the best ways to measure health is to think about rhythmicity. If we measure rhythms, we can understand health. If we measure changes in rhythms, we can understand the progression into (and out of) disease. Human behavior is not separate from, but simply a reflection of, physiology. Measuring behavioral rhythms can thus provide a biologically-grounded indication of health and disease. There is strong evidence that changes in behavioral rhythms are a reliable indicator of mental health and we have shown how these measurements correlate with, and predict, clinically-validated self-report and clinician-administered measures. The smartphone measurement approach is especially useful because genetic and biological markers are costly and difficult to measure continuously and it is the rare individual who sticks with a wearable device for more than a few months, whereas most individuals keep with them 24 hours a day, 7 days a week for months and years on end.
At HealthRhythms we bring to bear a selected group of behavioral rhythms measures related to sleep, activity, mobility, speech, and technology use by (i) continuously measuring these rhythmic parameters (ii) detecting changes in rhythms and health early and then (iii) providing the opportunity for patients themselves and/or their clinicians to help patients lead lives characterized by more regular, health supporting routines.
The real world is continuous and non-linear. Most conventional scales that measure health are cross-sectional and linear and that is true whether we are talking about depression or blood pressure. The enormous advantage of HealthRhythms’ sensing approach is that it provides a continuous and comprehensive assessment of changes in rhythms over time. By looking at behavior continuously and dimensionally (rather than dichotomously e.g. depressed/not depressed) we see things as they really are. HealthRhythms is continuing to gather more evidence of the key role of rhythms across more populations and creating tools that providers and patients can use to provide feedback and stabilize behavioral rhythms.
About the Authors
Tanzeem Choudhury is associate professor of Computing and Information Sciences at Cornell University where she is working on inventing the future of technology-assisted wellbeing. Her interests include building novel wearables and mobile systems for capturing and influencing everyday human behaviors. Tanzeem has a Ph.D and M.S. from MIT Media Laboratory and a B.S. from University of Rochester. She is the CEO of HealthRhythms.
Ellen Frank is the Chief Scientific Officer at HealthRhythms. She is a Distinguished Emeritus Professor of Psychiatry at the University of Pittsburgh School of Medicine. Considered a classic in the mental health field, her research focused on interventions for mood disorders, emphasizing sleep and circadian rhythms as predictors of treatment response. Ellen has been awarded and honored with numerous awards for her contribution to the science of psychiatry. She was on the U.S. FDA Psychopharmacologic Drugs Advisory Panel and in 1999, Ellen was elected to the National Academy Medicine (formerly the Institute of Medicine). She received her PhD from University of Pittsburgh.