F094 Longitudinal analysis of sleep and physical activity in Huntington’s disease – results from the DOMINO-HD study

<h3>Background</h3> Reduced sleep quality and physical activity (PA) are features of Huntington’s Disease (HD).^{1 2} Wearable devices offer a method to monitor these potentially modifiable features, and to track disease progression or treatment response. Aim: To examine sleep and PA over time using wearable devices in HD. <h3>Methods</h3> Participants wore a Fitbit Charge 4^{3 4} during a 12-month observational study. Clinical measures at baseline and 12-months included the Unified HD Rating Scale total motor score (UHDRS-TMS) and composite UHDRS (cUHDRS). Daily/nightly Fitbit metrics included total sleep time, percentage rapid eye movement (%REM) and deep (%Deep) sleep, REM latency, awakenings, step count and mean heart rate. Baseline and follow-up were defined as the initial and final four weeks. Data were analysed for 64 participants at baseline (32 male; pre-manifest/manifest=15/49; age=51.5±12.4 years; TMS=26.5±19.5; cUHDRS=10.3±4.9), and 55 participants at follow-up (29 male; pre-manifest/manifest=12/43). For each feature, correlations with cUHDRS and UHDRS-TMS were examined at baseline, and the effect of time was examined using paired t-tests. <h3>Results</h3> Significant moderate correlations were observed between cUHDRS and%REM (R=0.26) and REM Latency (R=-0.29), and between UHDRS-TMS and awakenings (R=-0.26). No significant differences in UHDRS-TMS, cUHDRS, or any sleep metric were observed between baseline and follow-up (289.2±74.4 days), however daily step count decreased (p&lt;0.001). <h3>Conclusions</h3> Longitudinal monitoring using a wrist-worn wearable revealed reduced physical activity, with no change in sleep or clinical scores. Sleep features estimated using Fitbit at home were correlated with clinical scores. Longer monitoring periods may reveal new digital biomarkers to monitor clinical progression in HD. <h3>References</h3> Herzog-Krzywoszanska, Krzywoszanski. <i>Frontiers in Psychiatry</i> 2019. McLaren, <i>et al</i>. <i>Neuropsychology</i> 2021. Doheny, <i>et al. J. Clinical Sleep Medicine</i> 2024. Lozano-Garcia, <i>et al. IEEE Transactions Neural Systems Rehab Eng</i>, 2024.