Having a strong social network of family and friends has long been associated with an individual’s happiness and ability to bounce back from life’s setbacks. Now, a team of researchers at the Mount Sinai Health System has used the Apple Watch to capture the effect of such networks on the body, as well, by connecting resilience and support with an individual’s heart rate variability (HRV)—a primary component of the body’s autonomic nervous system (ANS) and a keen indicator of the effect of stress on the body.
Zahi A. Fayad, PhD
In a preliminary study of 361 Mount Sinai health care workers conducted between April and September 2020—a period that included the height of the COVID-19 pandemic in New York City—the researchers identified characteristics that indicate whether a health care worker is prone to worsening stress from the pandemic. They found that individuals with high resilience or emotional support were protected against the effects of stress and had different ANS stress patterns compared with those who had medium or low emotional support or resilience.
The physiological measurements were captured on Apple Watches worn by the participants, who downloaded a customized app. The researchers found that the participants’ physiological results aligned with their self-reported surveys.
“Individuals may tell us about their feelings or symptoms, which is subjective, but HRV is how your body speaks and reveals itself,” says the study’s senior author, Zahi A. Fayad, PhD, Director of the BioMedical Engineering and Imaging Institute, and Professor of Radiology, and Medicine (Cardiology), at the Icahn School of Medicine at Mount Sinai. HRV, which is influenced by the parasympathetic and sympathetic nervous systems, is a measure of the variation in the heart’s beat-to-beat intervals.
According to the study’s corresponding author, Robert P. Hirten, MD, Assistant Professor of Medicine (Gastroenterology), there was a range of emotional support and resilience across health care occupations.
Robert P. Hirten, MD
“One of our goals with this study was to see how the pandemic was affecting the psychological well-being of health care workers and whether we could identify features that would allow us to see which workers would be at risk from these psychological effects over time,” says Dr. Hirten. “If you’re a large health system, you want to make sure your employees have the psychological support they need so they don’t develop long-term effects from the pandemic. Measuring resilience and emotional support may be one way to identify at-risk health care workers.”
The study was initiated at the same time the Mount Sinai Center for Stress, Resilience, and Personal Growth was launched by the Mount Sinai Health System. This comprehensive, first-of-its-kind initiative was designed to help front-line workers manage the ongoing psychosocial effects of the COVID-19 pandemic through workshops, counseling, and wellness apps.
Drs. Fayad and Hirten say that going forward, combining their study with the interventions available through the Center for Stress, Resilience, and Personal Growth will allow Mount Sinai’s most vulnerable health care workers to build resilience and feel they are part of a supportive network.
“COVID-19 disrupted many lives, not only from a health point of view but from routines and social interactions,” says Dr. Fayad. “Many people will recover and that’s resilience. But some other people may not and that’s why we need to offer interventions. That is the power of this technology. It provides us with information you wouldn’t capture in a visit to the doctor or the hospital, but it would be helpful to integrate into our daily life.”
Dr. Hirten says the team’s next steps will be to “study the effects of resilience-building interventions on HRV, the ANS, and on improving the well-being of health care workers.”
In December, Drs. Fayad and Hirten published the results of a separate study among health care workers that showed an Apple Watch detected subtle changes in an individual’s heartbeat that signaled the onset of COVID-19 up to seven days before they were diagnosed with the infection.
These charts below show differences in the nervous system over 24 hours in those with high, medium, and low resilience and emotional support.
