Feasibility of one-month home-based HRV monitoring in ASD: a case study using smart clothing technology

Background: Sleep disturbances and autonomic dysregulation are common in autism spectrum disorder (ASD), yet few studies have examined long-term nocturnal heart rate variability (HRV) in home settings. Objective: This study evaluated the feasibility of one-month home-based HRV monitoring using smart clothing in a preschooler with ASD, and explored whether nocturnal HRV predicts next-day problem behaviors. Methods: HRV was recorded nightly for 25 valid days using a garment-type wearable ECG. Problem behaviors were reported daily by caregivers. HRV indices were compared between nights preceding days with and without problem behaviors using Wilcoxon signed-rank tests. Results: No significant differences in total sleep time or HRV indices were found between the two day types. Conclusion: Although HRV did not predict next-day behavior, the study demonstrates the feasibility and methodological transparency of long-term home-based physiological monitoring in young children with ASD.