Insights into endometriosis symptom trajectories and assessment of surgical intervention outcomes using longitudinal actigraphy

Endometriosis is a common, chronic condition associated with debilitating pain, fatigue, and heterogeneous symptom presentation. In this exploratory study, 68 participants with confirmed endometriosis were monitored for up to three 4-6-week smartwatch cycles. We collected daily self-reports of pain and fatigue as well as retrospective questionnaires assessing quality of life, and we extracted daily measures of physical activity (PA), sleep, and diurnal rhythms from wrist-worn actigraphy data. We found that daily PA was strongly negatively correlated with self-reported fatigue (repeated measures correlations <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:mi>R</mml:mi> <mml:mo><</mml:mo> <mml:mo>-</mml:mo> <mml:mn>0.3</mml:mn></mml:mrow> </mml:math> ) and that participants with more severe or variable symptom trajectories displayed lower levels of PA, greater sleep disturbance, and more disrupted sleep and activity rhythms (Spearman's <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:mi>|R|</mml:mi> <mml:mo>></mml:mo> <mml:mn>0.3</mml:mn></mml:mrow> </mml:math> ). Lastly, we found evidence of sleep and PA changes following surgery for endometriosis that reflected change in self-reported symptoms. Collectively, our findings suggest that passive data collection using wrist-worn wearables in endometriosis could facilitate individualized objective insights into symptom trajectories.