Presentation (CTI)

OBJECTIVES: To map and synthesize existing evidence on digital biomarkers derived from wearable devices, particularly the Oura Ring, for monitoring sleep, stress, heart rate variability (HRV), and mental health-related indicators among adolescents and young adults. This review aimed to describe the physiological and behavioral markers captured by wearables and explore their potential for real-time mental health assessment.
METHODS: This scoping review followed PRISMA-ScR guidelines. Searches were conducted in PubMed, Embase, Scopus, and Web of Science for studies published from January 2015 to November 2025. We included studies that used wearable devices to measure digital biomarkers such as HRV (changes in the time interval between heartbeats), sleep duration and sleep efficiency (how long and how well a person sleeps), nighttime physiology (resting heart rate during sleep), and activity and circadian patterns (movement levels and regularity of sleep-wake cycles). Studies were eligible if they examined links between these measures and stress, mood, anxiety, depressive symptoms, or emotional well-being. Study designs included observational studies, ecological momentary assessment (EMA) studies, validation studies, and feasibility studies. In total, 284 records were screened, 47 full texts reviewed, and 10 studies included.
RESULTS: Lower HRV and higher nighttime heart rate were consistently associated with higher stress, worse mood, and more anxiety symptoms. Poor sleep patterns, including shorter sleep duration, lower sleep efficiency, and irregular sleep timing, were linked with lower daily well-being. Studies combining wearable data with mood check-ins found that changes in HRV and sleep measures could predict next-day mood. Oura Ring studies showed acceptable accuracy and high user acceptability.
CONCLUSIONS: Wearable devices like the Oura Ring can provide continuous, noninvasive information about stress and emotional health in adolescents and young adults. HRV and sleep measures appear useful for early identification of emotional changes. More research is needed to validate these tools and address privacy considerations for youth.