The goal of this clinical trial is to learn if two stress-reduction methods can lower stress in medical students. The study compares a wearable device and a mindfulness program. The wearable device sends gentle vibrations to the body, while the mindfulness program teaches meditation and stress awareness skills.

The main questions it aims to answer are:

• Does the wearable device lower stress levels in medical students?
• Does mindfulness meditation lower stress levels in medical students?
• Is one method more effective than the other?

Researchers will compare the wearable device to the mindfulness program to see if one works better for reducing stress.

Participants are medical students from Saint James School of Medicine. Each participant will try both methods during the study. Participants will:

• Use the wearable device daily for four weeks
• Complete a four-week mindfulness meditation program
• Take a one-week break between the two methods
• Complete surveys about stress and satisfaction
• Have heart rate variability (HRV) measured to assess stress levels

This study will help researchers understand whether wearable technology or mindfulness training is more effective for managing stress in medical students. It may also show if both methods can improve how the body responds to stress over time.

This study is a randomized, unblinded, two-period crossover clinical trial designed to evaluate and compare the effects of a wearable stress-modulation device and a mindfulness-based stress reduction (MBSR) program on stress levels in medical students.

Stress is common among medical students due to academic demands and challenges with maintaining work-life balance. Chronic stress can negatively affect both mental and physical health, including cognitive performance and emotional well-being. Interventions that improve stress regulation may help support student health and academic success.

This study investigates two non-invasive approaches to stress reduction: a wearable device that delivers gentle vibratory stimulation intended to regulate the autonomic nervous system, and a structured mindfulness meditation program designed to improve stress awareness and emotional regulation.

A total of 20 medical students from Saint James School of Medicine were enrolled and randomly assigned in a 1:1 ratio to one of two sequences:

• Sequence AB: mindfulness-based stress reduction (MBSR) followed by the wearable device
• Sequence BA: wearable device followed by MBSR

Each intervention period lasted four weeks and was separated by a one-week washout period to reduce potential carryover effects.

Participants in the MBSR group completed a structured mindfulness program focused on meditation practices and stress management techniques. Participants in the wearable device group used the device regularly during daily activities.

Outcome measures included both subjective and objective assessments:

• Heart rate variability (HRV), used as a physiological marker of autonomic nervous system regulation and stress response
• Patient Satisfaction Questionnaire (PSQ), using a five-point Likert scale
• Qualitative surveys to assess participant experiences and perceived stress

The primary objective was to determine whether the wearable device is more effective than mindfulness meditation in reducing stress, as measured by HRV and self-reported outcomes.

Results showed no statistically significant difference between the two interventions in terms of HRV or patient-reported satisfaction. However, both interventions were associated with improvements in HRV over time, suggesting enhanced autonomic regulation. Mindfulness-based stress reduction demonstrated a stronger initial effect, while the wearable device showed smaller but consistent improvements. No significant carryover effects were observed between intervention periods.

These findings suggest that both interventions may support stress reduction and improved autonomic nervous system function in medical students. The wearable device offers a practical advantage, as it can be used during daily activities without requiring dedicated time for practice, unlike mindfulness training.

Future research should include larger sample sizes, consider cultural and environmental factors influencing stress, and use blinded study designs to reduce bias.

Inclusion Criteria:

• Medical Student at Saint James Medical School
• Proficient in English

Exclusion Criteria:

• Insufficient stress levels
• Already owning an Apollo Device
• Inability to provide informed consent
• Have any medical condition that precluded the use of Apollo

Individual participant data will not be shared publicly due to the small sample size (n=20), sensitive physiological and psychological measures, lack of data-sharing infrastructure, and no requirement for public IPD sharing.