Three ongoing studies at the University of Miami’s Miller School of Medicine explore how environmental determinants affect a person’s sleep, specifically among at-risk and underrepresented Black and Latino populations in the U.S.

The research team, led by Drs. Girardin Jean-Louis and Azizi Seixas, hopes to better comprehend how the quantity and quality of sleep impact the brain and heart health of individuals in this population.

“People of color who live in urban and rural areas are disproportionately burdened by poor heart and brain health outcomes,” Dr. Seixas relates. “Our studies tackle a very vexing public health and clinical and scientific issue amongst an underserved community.”

Air quality is one of the pieces to the puzzle. Evidence suggests that particulate pollution, temperature, and humidity can significantly affect sleep environments. Dr. Seixas explains further that “if not dealt with over a period of time, these environmental problems can add up to someone who is sleep deprived.”

As part of their study, the team is gathering a “360-degree perspective” of health data, to fully understand biology, behavioral lifestyle, clinical risks, psychosocial risks, and environmental risks, including air quality. This conglomeration of data presents an unprecedented picture of health.

IQAir’s AirVisual air quality monitors play an integral role in this groundbreaking research, by providing air quality data for these studies.

Measuring the air with the AirVisual

To correlate how participants’ health and sleep is impacted by air quality, each participant was given an AirVisual Pro air quality monitor to install next to their beds.

It was crucial for the team to have access to the participants’ air quality data in real time, using reliable technology. “We didn't just want to rely on very aggregated types of data you get from NASA,” emphasizes Dr. Seixas. “We wanted to be able to look at the proximal and acute effects of dwelling and what air quality factors have on health outcomes.”

AirVisual Pros were selected over other air quality monitors. The fact that the World Health Organization uses IQAir’s data boosted the research team’s confidence in their choice.

A distinct methodology

When the studies were originally designed, standard observational methods were anticipated, in which the subjects would travel to nearby health centers and interact with the research team. COVID-19 changed all that. The team had to devise a plan for remote health monitoring.

Potential participants wanted to avoid traveling to separate locations and did not want researchers coming to their houses, so the team had to devise a plan for remote health monitoring. The researchers provided each participant with a kit that included a Fitbit watch to measure heart rate and other health metrics, an ActiGraph watch to measure sleep/wake behavior, a smart ring to measure cardiac pulmonary coupling, a smart scale, and an ambulatory blood pressure monitor. These devices, along with the AirVisual monitors, allowed for continuous monitoring of the participants' vital signs, sleep quality, and quantity for 7 days.

AirVisual upgrades participant experience

The AirVisual’s user-friendly display became an impressive tool amongst other groups. Study participants could easily digest the air quality data provided.

“We like the fact that the AirVisual included recommendations like if the carbon levels rose to a certain level, it would say turn on the fan or put on a mask,” Dr. Seixas says. “We're trying to make health care more tangible and accessible for participants and patients. The AirVisual maximized interactivity and was helpful for what we were trying to achieve.”

AirVisual’s user-friendly interface helped. “We’ve had good feedback,” adds Malik Ellington, a research associate on the team. “Participants like seeing the numbers and icons on the screen.”

Jesse Moore, a Clinical Research Coordinator at the university, agrees. “It's a nice consumer-oriented design. It’s great how they can see an up-to-date picture of their air quality.”

Tracking the data made easier

IQAir also provided the research team with an Enterprise Dashboard, part of IQAir’s AirVisual Platform. The Enterprise Dashboard was designed to help large, decentralized projects like the University of Miami to manage multiple devices, data, and locations, making the process painless.

“The dashboard is a one-stop shop that allows us to access the data to each of the devices all from one screen,” Ellington explains. “Before, we did it individually, which is a very laborious process.”

The dashboard enables the team to see all the active devices and download data remotely, so they can quickly add it to the larger pool of data at the click of a button. The team then manage devices across hundreds of locations and users. Beyond this, the data on the Dashboard can be exported to other platforms (like Excel or Airtable) for further data parsing and analysis.

Screenshot of the AirVisual Enterprise dashboard. Source: IQAir.

Dr. Seixas sums it up: "IQAir's AirVisual enterprise dashboard has instantaneously improved our operations management and troubleshooting. We can pull vast amounts of unprocessed data under one umbrella."

“This kind of device management is necessary,” Moore adds, “because of the logistics of having 1,500 participants across many locations. We can’t do this without the dashboard.”

Moving forward

These studies are still in the data acquisition phase. Analyzing all the collected data is the next step.

The analyzed data will be used to build an agent-based geospatial model by ZIP codes, develop different sleep/health scenarios, and create computer-based profiles of at-risk individuals.

“From there, we can start to simulate what levers we need to pull to effectuate the changes at a public health standpoint that can improve sleep outcomes and will improve health outcomes as well,” Dr. Seixas explains.

There are several points of pride in the study so far. “We are one of the first to do this type of work,” Dr. Seixas says. “We are taking a 360-degree perspective and our team does a great job prepping and educating folks.”

Long term, Dr. Seixas states that they “would love to be able to take the average of air quality and correlate that with some target variables, whether it be sleep or heart health or brain health outcomes.”

The takeaway

The University of Miami team is proud to have developed a remote health monitoring system that studies air quality’s relation to health outcomes. Their unique decentralized approach allowed them to gather new insights in ways that weren’t previously possible.

In the future, Dr. Seixas and his team hope that accessible air quality and other health data collection will benefit the general population. “There shouldn’t be a barrier for people to access healthcare or health trials like ours,” he says. “We want to make the process less restrictive while, at the same time, adhering to the highest integrity of science. We're trying to make healthcare cooler.”