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A Community-based Stress Management Program: Using Wearable Devices to Assess Whole Body Physiological Responses in Non-laboratory Settings
Published on: January 22, 2018
Sighing Dynamics as a Candidate Digital Biomarker for Anxiety in Daily Life Using Wearable Respiratory Monitoring:
Xinying Zhao1,2, Yue Li1, Lizhu Zhang1
1Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, School of Medicine, Zhejiang University, Tianmushan Road No.305, Hangzhou, Zhejiang, 310013, China, 86 13484036877.
JMIR Formative Research
|August 7, 2026
Summary
Daily sighing patterns may serve as a digital biomarker for anxiety disorders. This study found reduced sighing in individuals with anxiety disorders, differing from healthy controls in real-world settings.
Area of Science:
- Psychophysiology
- Digital Health
- Respiratory Medicine
Background:
- Sighing is linked to emotional regulation, but its role in anxiety lacks real-world validation.
- Existing evidence on sighing and anxiety primarily comes from lab studies, limiting ecological validity.
- It's unclear if daily sighing reflects temporary anxiety or long-term pathology.
Purpose of the Study:
- To assess daily-life sighing dynamics as a digital biomarker for anxiety.
- To differentiate between state (momentary) and trait (enduring) anxiety-sigh associations.
- To compare sighing patterns in individuals with anxiety disorders (ADs) versus healthy controls (HCs).
Main Methods:
- An intensive longitudinal study combining smartphone-based ecological momentary assessment (EMA) with continuous respiratory inductance plethysmography (RIP).
- 38 adults (15 with ADs, 23 HCs) underwent four 36-hour monitoring blocks over 1-2 weeks.
- Sighs were defined by tidal volume; multilevel models analyzed sigh proportion in relation to state and trait anxiety.
Main Results:
- A total of 1279 synchronized windows from 33 participants were analyzed.
- Higher trait anxiety correlated with lower overall sigh proportion (OR 0.80).
- Individuals with ADs had lower baseline sigh probability than HCs (OR 0.78).
- A significant interaction showed sighing increased with momentary anxiety in HCs but not in ADs.
Conclusions:
- Daily sighing dynamics exhibit a state-trait dissociation, with diminished state-dependent coupling in ADs.
- Sighing shows potential as a candidate digital biomarker for anxiety.
- The synchronized EMA-RIP protocol is feasible and provides high-integrity real-world data.
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