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Toward scalable biomarkers: the promise of sleep wearables in neurodevelopmental research

Neuropsychopharmacology (2025)Cite this article

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While the relationship between sleep and neurodevelopment has long been established, recent studies utilizing traditional in-lab sleep EEGs have identified differences in aspects of sleep neurophysiology (i.e., sleep spindles and slow wave activity; Fig. 1), which were associated with daytime outcomes (e.g., cognition [1], symptoms, resting-state functional connectivity [2]), in both children and adults with NDDs, suggesting the existence of sleep-related biomarkers of NDDs. Extending beyond biomarker identification, these aspects of sleep neurophysiology have been shown to be manipulable through both non-pharmacological (e.g., closed-loop auditory stimulation [3]) and pharmacological methods (e.g., Zolpidem [4]), providing multiple avenues for potential therapeutic interventions. However, further investigation of these biomarkers has been limited by the high burden of traditional sleep EEG methods (i.e., polysomnography), particularly for individuals with NDDs, resulting in small samples that were biased towards less affected patients, yielding inconsistent results.

Wearable sleep headbands, which typically include a low-density montage of wet or dry EEG electrodes, facilitate remote monitoring of sleep physiology for several consecutive nights, providing hours of data in a naturalistic setting. The lower burden of wearable sleep EEG headbands for both participants and researchers allows scalability to cultivate larger, more representative research samples and eventually better translation to a clinical setting. Wearable sleep EEG headbands perform similarly to in-lab sleep EEG recordings [5] and have even been used to modulate aspects of sleep neurophysiology in typically developing adolescents (mean age: 16.1 years) using closed-loop auditory stimulation [6].

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Fig. 1: Summary of traditional (green) and wearable (blue) sleep EEG methods for indexing sleep neurophysiology.

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Funding

This work was supported by Autism Speaks grant #13530, UCLA Center for Autism Research and Treatment (CART), and the National Institutes of Health R37MH085953.

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Authors and Affiliations

  1. Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA

    Kathleen P. O’Hora & Carrie E. Bearden

  2. Neuroscience Interdepartmental Program, University of California, Los Angeles, CA, USA

    Kathleen P. O’Hora

  3. Department of Psychology, University of California, Los Angeles, CA, USA

    Carrie E. Bearden

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  1. Kathleen P. O’Hora
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  2. Carrie E. Bearden
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KPO and CEB wrote the paper.

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Correspondence to Kathleen P. O’Hora.

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O’Hora, K.P., Bearden, C.E. Toward scalable biomarkers: the promise of sleep wearables in neurodevelopmental research. Neuropsychopharmacol. (2025). https://doi.org/10.1038/s41386-025-02185-1

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