Beyond the Clinic: Continuous Nighttime Symptom Monitoring as the New Gold Standard
Mikesh Udani
Updated: 27th August 2026
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Clinical trials have advanced in what they measure, yet a large proportion of disease activity still occurs outside of the clinic and outside traditional measurement windows. Nighttime symptoms, sleep-related biomarkers and overnight deterioration are central to many conditions but remain challenging to capture with diaries due to poor perception and recall bias, or with wearables due to patient compliance challenges.
In this International Clinical Trials article, CEO Mikesh Udani examines how continuous, passive monitoring is beginning to change that. He describes the longstanding gap between when treatment response is most evident and when trials typically measure it, and how contactless technologies are now making it possible to capture objective nighttime physiology at scale everyday, without adding burden to patients or sites.
The piece explores the evidence behind these approaches, including validation against clinical reference standards, long-term usability data, and applications across asthma, COPD, heart failure, neurological conditions and safety monitoring. It also outlines the implications for trial design, from more sensitive endpoints to earlier detection of deterioration.
Continuous monitoring is moving upstream from exploratory pilots into protocol planning, and reshaping how the industry understands treatment response, risk and disease biology, particularly in the domains that matter most to patients.
Download the full article below to explore the data, validation studies and operational considerations.