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 R < - 0.3 ) 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 |R| > 0.3 ). 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.