Apps to Track Exercise, Sleep Help Patients Participate in Clinical Trials

Smartphone data is used for crowdsourcing studies of diabetes, asthma, cardiovascular disease

http://www.wsj.com/video/apple-researchkit-links-users-to-researchers/324CA4EA-1B65-4318-A3C3-3A2E5EDE2B30.html


By RON WINSLOW / April 13, 2015 4:11 p.m. ET

Steven DeMello, like many people, uses a smartphone to keep a calendar, take notes, create artful photographs and listen to music.

Recently, he began using it for a new purpose: to participate in a clinical trial. Three times a day, the retired health-care executive, who is 60 years old and has Parkinson’s disease, performs four tests using an app on his iPhone that records his results and provides feedback to researchers—and to him—on how his Parkinson’s symptoms affect his daily life.

“If I know more about my condition, the better and smarter I will be in managing my own care,” he says.

The app, called mPower, is one of five disease-related apps for clinical trials released in March in connection with Apple Inc.’s introduction of ResearchKit, a platform where users can track personal health data and participate in health studies. Other apps include My Heart Counts for cardiovascular disease, Asthma Health, GlucoSuccess for diabetes, and Share the Journey, for a study of the after effects of treatment for breast cancer.

Together the apps—and patients like Mr. DeMello—offer a glimpse of how the ubiquitous smartphone has the potential to transform medical research. Taking advantage of smartphone features such as accelerometers, gyroscopes and GPS locators, the apps track real-time daily activity and supplement other information on a patient’s condition.

ENLARGE

Three times a day, Steven DeMello, a retired health-care executive who has Parkinson’s disease, uses an app on his iPhone to perform four tests that record results and provide feedback to researchers—and to him. PHOTO:STEVEN DEMELLO

Since the apps were launched March 9, some 60,000 patients have enrolled in five studies just by downloading the apps from the app store, answering a few questions about the disease and clicking through a consent form. None of the patients had to see a doctor to sign up.

Academic researchers doing similar trials might need several years to enroll only a few hundred patients. Pharmaceutical companies need scores of research sites and hundreds of millions of dollars to find 20,000 patients for a major drug trial.

“This is a whole new way of going forward with medical research that makes it quick, scalable and efficient,” says Eric Topol, director of the Scripps Translational Science Institute in La Jolla, Calif., who is familiar with the apps but isn’t involved with developing them.

The apps all were developed by researchers at academic medical institutions leading the studies. Apps for more diseases are planned. The scientists aren’t testing new drugs, but rather hoping to learn more about the long-term effects of chronic disease on participants, including whether the use of a smartphone might help individual patients deal more effectively with their symptoms.

“The phone can be a powerful way to engage participants and make participating in a clinical study more of a two-way information exchange,” said Stanley Shaw, co-director of the Center for Assessment Technology and Continuous Health at Massachusetts General Hospital, Boston, where the diabetes app was developed.

ENLARGE

Apple's Parkinson’s disease app includes a finger-tapping test to determine the patient’s speed of movement. Other apps include My Heart Counts for cardiovascular disease, Asthma Health, GlucoSuccess for diabetes, and Share the Journey, for a study of the aftereffects of treatment for breast cancer. PHOTO: APPLE

For now, the apps work only on the iPhone 5, 5s, 6 and 6 Plus. Although tens of millions of Americans own an iPhone, the cost puts them out of reach of many lower-income earners. That raises questions about how relevant data from iPhone-based studies would be for the broader population.

Apple plans to make the ResearchKit available soon on an open-source basis. That would enable development of apps for Android-based phones, which are often cheaper than iPhones, and potentially extend use of the apps to a broader population.

Apple said it doesn’t collect or see any of the patient information researchers gather. Study participants have full control over when and whether their data, after it is uncoupled from their identity, can be shared with other researchers. Still, some worry a privacy risk remains. A significant privacy breach from app-based studies would be a “serious hit” to their use in clinical research, said Dr. Topol, of the Scripps institute.

Researchers are intrigued by the transformative potential of smartphone apps. Kathryn Schmitz, an epidemiologist at University of Pennsylvania and an investigator on the Share the Journey study, said it recently took her team three years, including the sending of 60,000 notices, to recruit just 351 patients for a separate conventional study about the impact of exercise on breast-cancer survivors.

In the first month of recruiting for Share the Journey—which she said has less stringent enrollment criteria—nearly 2,000 patients have signed up.

The apps also enable easy enrollment of patients no matter where they live in the U.S. (Apple plans international study launches.)

With Parkinson’s disease patients, mobility is a main concern. For patients who live, say, in New Jersey or on Long Island, “the idea of getting into the city to an academic center is way too overwhelming,” said Todd Sherer, head of the Michael J. Fox Foundation for Parkinson’s Research in New York, which is involved with several online research initiatives. “But if you can bring the technology to their house, they are very excited to participate.”

Smartphones also offer the capability to track people’s symptoms and activities continuously in their daily lives. In many conventional studies, patients might have just a few clinic visits a year for tests and symptom updates, and those snapshots may not provide a detailed picture.

“Patients say symptoms fluctuate over the course of a day, but we’ve never had a way of measuring that,” said Ray Dorsey, a University of Rochester researcher who heads the Parkinson’s app study. With a smartphone, patients and researchers can observe symptoms that may change hourly and see how the changes correlate with factors such as exercise, meal times and medication dose. The phone also objectively records measurements of activities—minutes of exercise, steps walked, hours of sleep—which in conventional studies are typically obtained from less-reliable patient recall.

Mr. DeMello, who lives in Oakland, Calif., says he has 20-minute visits with his neurologist about once a quarter. Yet, he lives with the disease 365 days a year.

Each day, he uses his iPhone to take a finger-tapping test to determine his speed of movement, a walking test to check his gait and balance, a voice test and a memory test. Results measure the effect of his disease.

So far, he says, he has learned his symptoms don’t move in lock step, contrary to what he used to think. “I have weeks when balance is an issue and weeks when it’s not,” he said. “Then I have weeks when I’m slower cognitively than others.”

The app, he said, “is a huge step in giving patients a chance to contribute data that is otherwise completely lost.” Now, he says, “what I mostly want to do is learn how things come together in my body and what do I have to do to make them better.”

Snoring could be an early warning sign for memory loss.

CBS NEWS     April 16, 2015, 12:43 PM

There's new evidence suggesting just how important sleep is for the brain.

A study, published Wednesday in the journal Neurology, finds that people who snore heavily and have breathing problems during sleep may develop memory loss and cognitive decline at a much younger age than average.

"This study might be keeping some people up at night," Dr. Carol Ash, director of sleep medicine at Meridian Health, told "CBS This Morning."

http://www.cbsnews.com/pictures/sleep-hacking-tips-7-ways-to-maximize-your-zzzzzs/

Snoring and sleep apnea -- a condition where breathing is repeatedly interrupted during sleep -- are common among older people, affecting about half of men and a quarter of women, according to the researchers from NYU Langone Medical Center.

They studied the medical histories of nearly 2,500 people ages 55 to 90. Participants were categorized as having either normal brain function, mild cognitive impairment (MCI), or early stages of Alzheimer's disease.

The study found that people with sleep apnea were diagnosed with mild cognitive impairment an average of nearly 10 years earlier than people without sleep apnea.

"That's significant," Ash said. Even though the study did not prove cause and effect, she said it adds to a growing body of evidence that links sleep to brain health.

• How to protect your aging brain
• New clue about what causes Alzheimer's disease

Fortunately, she said, there are things you can do to lower the risk. "When you have symptoms of snoring or symptoms that suggest you have sleep-disordered breathing, you really want to take it seriously. There's simple screening that can be done to identify somebody that has a problem. There's a home sleep test to make the diagnosis. Then there's treatment options."

For people with sleep apnea, a device called a CPAP mask, worn over the nose and mouth, can help keep the airways open at night. It may look uncomfortable, but Ash said, "When you have a patient who truly has this problem, it can change and save their life. You have to coax them through and get them comfortable, but once they're using it, they won't go back."

Losing a few pounds can also be effective, since excess weight often contributes to snoring and breathing problems. In other cases, dental work or surgery can make a difference.

The NYU researchers found that patients whose sleep issues were treated were able to ward off cognitive decline. "The age of onset of MCI for people whose breathing problems were treated was almost identical to that of people who did not have any breathing problems at all," study author Ricardo Osorio, MD, said in a press statement. "Given that so many older adults have sleep breathing problems, these results are exciting --we need to examine whether using CPAP could possibly help prevent or delay memory and thinking problems."

Ash stressed the importance of getting diagnosed and dealing with sleep problems, since in addition to memory decline, snoring and sleep apnea have also been linked to an increased risk of stroke, heart attack, and other life-threatening conditions.

"Sometimes you can't undo all of the damage, but I've seen significant improvements," she said. "It's worth looking into."

Kids Sleep Doctor: App That Improves Your Kid’s Sleep Better Than A Doctor

By Nida I Zamir on April 6, 2015

So parents are about to sigh with relief as a free app to improve children’s sleep has been launched by doctors at the Evelina Children’s Hospital in London. The app, Kids Sleep Doctor, gives parents custom advice, based on the sleeping patterns of their children, like night terrors or teens staying up all night long.

Paul Gringras, a professor of children’s sleep medicine at the hospital, said that the doctors only skim through a patient, seeing “only the tip of the iceberg” due to the “massive” waiting lists. That is why the hospital decided to develop an app which could focus on the patients more closely and give advice along the way as different problems would pop up during the life cycle of the children aged 0 – 16.

The app initially requires details about the children, like bedtimes, where the child falls asleep, how much screen time they have, and consumption of caffeinated drinks.

After five days of collecting the data on the child’s sleep habits, like night-waking and bedtimes, the actual tailored service of advice begins.

“Hopefully they are sleeping in the normal range, but if they’re outside that then it advises parents,” Prof Gringras said.

“Take a five-year-old who suddenly is waking up every night screaming, doesn’t recognize parents and pushes them away. The app would say it is like a night terror and will happen in 10% of children in this age range and they will grow out of it, but they can also try a technique called scheduled waking half an hour after they have gone to bed.”

For teenagers who are unable to sleep until really late into the night, the app would advise parents that the child needs exercise in the afternoon as it promotes healthy sleep.

“These are not annoying daily tips, it’s tailored advice,” he added.

Considering how the doctors are actually letting their waiting lists shorten for an app, it points at the hospital’s ethical responsibility which is to reduce pressure on the overburdened service, and does not focus on making a few extra dollars.

“I think there’s a lot of people it could prevent needing to see a GP. Parents can do a brilliant job,” added Prof Gringras.

However, the 200,000 children diagnosed with serious sleep disorders such as narcolepsy or obstructive sleep apnoea would still require proper doctor consultation.

Moreover, the app has a dark and orange palette to minimize the amount of blue light emission, which is the wavelength of light that disrupts sleep.

Psychologist and child therapist Professor Tanya Byron commented:

“Many children are affected by sleep problems which can have a major effect on the whole family. Getting a good night’s sleep is so important for a child’s physical and mental development, behaviour and concentration – to name but a few. We know parents know their children better than anyone, and I’m confident that the ‘Kids Sleep Dr’ app will help parents to understand and better manage their child’s sleep problems.”

Kids Sleep Doctor is currently available free on iOS. Android and Windows versions are in the pipeline.

In Resistant Hypertension, Sleep Apnea Results in Greater Blood Pressure and Treatment Lowers It.

Published on April 6, 2015

A new meta-analysis published in the Journal of Hypertension suggests that untreated sleep apnea may be a major factor in why medications appear to be less effective in reducing high blood pressure in some people. Further, the study shows that CPAP therapy may be the key to helping those with difficult to treat hypertension get their blood pressure under control.

As many as 10 million people in the United States have “resistant hypertension” which either doesn’t respond to or requires multi-drug therapy. Most people with resistant hypertension also have obstructive sleep apnea (OSA). It’s a deadly combination that exponentially increases the risk of death or disability from a stroke or heart attack, but one that researchers say may have a relatively simple solution.

“Our study indicated that the patients with resistant hypertension and the very highest blood pressure experienced the greatest reduction in blood pressure after using CPAP therapy,” says Ulysses Magalang, MD, the study’s principal investigator and director of the Sleep Disorders Center at The Ohio State University Wexner Medical Center, in a release. “This response suggests that untreated sleep apnea may be why these people haven’t seen improvement in their blood pressure despite the concurrent use of three or four medications.”

Previous studies have shown that CPAP therapy offers patients with hypertension a significant, yet modest two to three point reduction in blood pressure. Magalang and the research team found that when they honed in on the specific results for those with resistant hypertension, the benefits of CPAP use looked quite different.
In their study, patients experienced an average reduction of 7.21 millimeters of mercury (mmHg) in ambulatory systolic blood pressure (SBP), and 4.99mmHg in ambulatory diastolic blood pressure (DBP) from baseline after using CPAP therapy. Ambulatory blood pressure (measured over a 24 hour period) is considered a good predictor of future organ damage and cardiovascular problems.

“We know that small changes in blood pressure translate into big benefits in terms of protecting the heart and reducing stroke risk,” says co-author Christopher Valentine, MD, a nephrologist at Ohio State’s Wexner Medical Center. “These findings suggest that physicians may need to be more aggressive with screening for sleep apnea and ensuring CPAP therapy compliance in patients with resistant hypertension.”

Systematic Analysis of Resistant Hypertension and CPAP Use

Despite the fact that millions of people suffer from resistant hypertension, and that its cardiac comorbidities carry a significant public health burden, studies looking at CPAP use and hypertension historically haven’t focused on this difficult to treat population.

“We have a lot of evidence about the benefits of CPAP in people with hypertension and OSA, but ours is the first analysis to systematically review CPAP use in people with difficult to treat hypertension and apnea,” Valentine says. “The results are clinically relevant because the effects that we found are significantly higher than what’s been previously observed in a more general hypertensive population. CPAP use could offer this subset of patients a new chance to reach a healthier blood pressure goal, or even to reduce their medication burden.”

From an initial scan of 157 articles, the researchers narrowed the data from 6 different studies, looking at pre- and post-CPAP blood pressure measurements from more than 300 patients with resistant hypertension. The duration of CPAP use ranged from 3 weeks to 6 months. In addition to measuring ambulatory blood pressure, investigators also looked at CPAP therapy and its impact on nighttime blood pressure—another predictor of future cardiac events.

While the researchers found significant improvement in ambulatory and nocturnal blood pressure measurements after CPAP use in some of the studies, other cuts of the data showed that CPAP therapy delivered about the same nocturnal blood pressure benefit as observed in previous studies.

“More studies are needed to further define CPAP influence on blood pressure, but overall, we think that the longer the CPAP is used during the night, the greater the impact,” Magalan says.

The authors also acknowledge other limitations of their analysis, including small sample size, and potentially confounding factors such as the concomitant use of the antihypertensive medications, obesity, and other life-style factors such as the use of alcohol and smoking.

Sleep Apnea, High Blood Pressure: Shared Genetic Origins?

Magalang and Valentine say their findings also support the idea that resistant hypertension and OSA represent an “extreme phenotype” of those who have OSA, but never develop hypertension. A phenotype describes how an individual’s characteristics are influenced by the interaction of their genes with their environment. The researchers further suggest that resistant hypertension in those with sleep apnea may be caused by a less common gene variant that nonetheless has significant impact.

It’s a hypothesis that will likely be put to the test over the next decade. The researchers who collaborated on the paper all belong to the Sleep Apnea Genetics International Consortium (SAGIC), a partnership of scientists from five continents who are building the first-ever international biomedical database to uncover the genetic causes of sleep apnea. By collecting biological material from thousands of patients with sleep disorders, the group hopes to amass enough data to start identifying underlying genetic causes of different conditions.

“We’re only just now beginning to appreciate the link between sleep apnea and disease,” says Magalang. “We hope that one day we will find common genes shared between people who have uncontrollable blood pressure and sleep apnea, and that will open up a whole new world of interventions and treatment strategies.”

The research was supported by the National Heart, Lung and Blood Institute. Ohio State’s Center for Clinical and Translational Science (CCTS) also provided biomedical informatics support for the study and provides ongoing informatics support for SAGIC.

Sleep Apnea May Reduce Antidepressant Response, Increase Dementia Risk

Published on April 7, 2015

Studies suggest sleep apnea may have a strong influence on antidepressant response and increase the risk for mild cognitive impairment in older patients with major depressive disorder, reports Medscape.

“This shows that clinicians should definitely screen for sleep apnea when patients are presenting with late-life depression,” lead author Lauren Waterman, from the University of Pittsburgh School of Medicine, Pennsylvania, told Medscape Medical News.

6 Things That Are Keeping You Fat.

K. Aleisha Fetters, U.S. News & World Report
MARCH 30, 2015  11:23 AM

You're filling up on healthy foods, exercising daily and still, the scale isn't budging. It's mind-numbingly frustrating. Luckily, it's also fixable. Here are six common things that could be standing between you and your weight-loss goals – plus easy ways to bust through each.


1. You Aren't Tracking What You Eat

"Most of the time, when someone comes into my office saying they aren't losing weight, the problem is that they are eating a lot more than they think they are," says Holly Herrington, a registered dietitian and clinical nutritionist with the Center for Lifestyle Medicine at Northwestern Medical Faculty Foundation. "Almost every single person underestimates how much they are eating." You can blame oversized restaurant portions, mindless munching and "health halos" for that, she says.

After all, French fries and ice cream aren't the only things that are calorie-packed. So are healthy foods, including olive oil, avocado and nuts. For instance, 1 cup of almonds contains about 750 calories. If you're snacking on them (a great idea), but without measuring and tracking those calories (a bad idea), you could easily end up gaining weight, Herrington says.

She recommends tracking everything you eat, at least for a couple months, with apps like My FitnessPal, which will help you learn proper portion sizes and how your favorite health foods measure up calorie-wise. In one American Journal of Preventive Medicine study, people who kept daily food records lost double the weight of those who didn't track their food intake.

2. You're Not Sleeping Enough

A bad night's sleep can wreck your weight-loss efforts through a two-pronged approach. For one, it makes you hungry and likely to overeat. "When you don't get enough sleep, your levels of cortisol and also ghrelin, a hormone that increases the sensation of hunger, rise," explains board-certified internist Dr. Patricia Salber.

For example, in one University of Chicago study, healthy young men who got just four hours of sleep two nights in a row (compared to their usual seven to nine hours) reported a 24 percent increase in appetite, along with cravings for candy, cookies, chips, bread and pasta. They also experienced an 18 percent decrease in leptin, which promotes fullness, and a 28 percent increase in the hunger-hormone ghrelin.

Second of all, not getting enough sleep could make your body store what you do eat as fat. For instance, a 2011 study in the American Journal of Clinical Nutrition found that just one night's bad sleep caused healthy men's resting energy expenditure – the number of calories they burned by simply being alive – to drop by 5 percent. The number of calories they burned after each meal also dropped by 20 percent.

"Sleep deprivation and sleep apnea may affect blood sugar levels and increase insulin resistance," says endocrinologist Dr. Michael Bergman, clinical professor of medicine at the NYU Langone Medical Center. "Sleep disorders, namely obstructive sleep apnea, [have] been associated with the development of Type 2 diabetes."

If clean-sleep habits – such as keeping your bedtimes consistent and not playing on electric devices in the hour before bed – don't help you get eight solid hours a night, talk to your doctor about how you can sleep better and longer, he says.

3. You're Eating the Same Number of Calories You Did on Day One of Your Diet

Oh, the weight-loss plateau: At the beginning of your diet, you were losing weight and feeling great. But now, you're doing the exact same thing, but with zero results. That might be the problem. "As you lose weight, your caloric needs will change," Herrington says. "The smaller you get, the fewer calories your body needs, so the fewer calories you'll need to eat to continue losing weight."

If your weight-loss results have plateaued for one to two months, she recommends gradually cutting back on calories. Start by eating 100 fewer calories a day and see how the scale shifts in a couple weeks' time. Don't cut back too much, though. Most women shouldn't eat any fewer than 1,200 calories a day and men shouldn't eat any fewer that 1,700 a day. Meanwhile, you should never feel famished or low on energy, she says.

4. You're Constantly Stressed

Acute stress – say from a looming work deadline or relationship drama – can cause your appetite to go MIA. But if the stress keeps up and becomes chronic, too-high levels of the stress hormone cortisol can increase your appetite, particularly for high-carbohydrate foods, according to Salber.

"When stressed, people seek to comfort themselves and relieve the tension," she says. "All too often, that means turning to sugar or starchy foods." High-carb foods can cause a quick spike in blood sugar and feel-good serotonin levels. But both crash quickly, and put you in a vicious cycle of stress and overeating.

Meanwhile, by stimulating the production of insulin, cortisol also increases your body's tendency to store calories as visceral fat. A type of fat that hangs out in the abdominal cavity and likes to hug your vital organs, visceral fat is associated with the development of insulin resistance and, in some cases, diabetes, Salber says.

If you can't remember the last time you weren't stressed, consider visiting your doctor or a therapist to help you manage your stress levels and get healthy. Mental health issues, including stress, are no different than physical health issues, she says. They deserve professional help.

5. You're Using Artificial Sweeteners

Artificial sweeteners, whether you stir them into your coffee, get them from diet sodas or spoon them from your yogurt container, are an easy way to cut calories and sugar in the short term, but they could harm your long-term weight-loss efforts. Case in point: Research from the University of Texas found that over the course of 9.5 years, the average two-a-day diet-soda drinker puts on five times more belly fat than do people who abstain.

That could be because your brain responds to artificial sweeteners by telling you to eat more sweet stuff, according to the Harvard School of Public Health. Meanwhile, they may also throw off the balance of healthy bacteria in the gut, Salber says.

A 2014 study from the Israel-based Weizmann Institute of Science's immunology department found a significant correlation between the consumption of artificial sweeteners, gut bacterial configuration and a tendency to develop glucose intolerance, which contributes to the development of obesity and Type 2 diabetes.

Eliminate any artificial sweeteners in your diet and replace them with sweeteners that also contain vitamins and minerals, such as honey and maple syrup. Just make sure to count their calories.

6. You Have a Medical Condition

While rare, underlying health conditions can make weight-loss difficult to achieve on your own. For instance, Cushing's disease, marked by excess cortisol levels, and polycystic ovary syndrome, a common endocrine disorder in women, can both contribute to glucose disorders, Bergman says.

Meanwhile, hypothyroidism, a condition in which the thyroid gland doesn't produce enough hormones, can also contribute to weight-management issues. About half of thyroid disorder cases in America are undiagnosed, according to the American Association of Clinical Endocrinologists.

If you aren't losing weight, but feel like you are following your body's caloric needs and are exercising between two and five hours a week, Herrington recommends talking to your doctor about your weight-loss concerns. He or she may be able to run some simple tests to make sure a health condition isn't behind your frustrations. If something is amiss, treating it will do more than help you lose weight.

Obesity In Children Linked to Lack of Sleep and Breathing Problems

March 7, 2015

A child’s difficulty to sleep and breathing problems can influence the risk of your child from getting obese. The recent research study published in The Journal of Pediatrics revealed that these two conditions may double the risk for obesity of a child as he reaches the age of 15. The lead researcher, Prof. Karen Bonuck, indicated that sleep and breathing problems are correctable conditions, but when not treated accordingly can increase the risk of the child to become obese.

Sleep disordered breathing

Sleep disordered breathing is considered to be a risk factor to child obesity. The condition includes sleep apnea and snoring. Parents of children in the study were asked to provide information involving their child’s sleep duration and sleep disordered breathing symptoms since birth until the child reaches the age of 6 years. Data on body mass index(BMI) were also obtained. The study showed that those with a higher BMI and with severe sleep disordered breathing symptoms are at the greatest risk of getting obese. Their chance to become obese as they reach the age of 7 to 15 years old is twice as much as those who are symptomatic with sleep disordered breathing condition. A study made in Hong Kong revealed that children with an excess weight tend to have a breathing problem because it causes the narrowing or congestion of the child’s airway while sleeping. Children with sleep disorders also tend to have enlarged tissues at the back of their throat, increasing their chance to getting obese later on.

Sleep duration symptoms

Children with a shorter sleep duration at the age of five or six have about 60 to 100 percent of getting obese upon reaching the age of 15. This finding, however, is interestingly not consistent among children of other age group. Short sleep duration in children refers to sleep that is less than 90% than the other children of their age. Parents are advised to help their children get enough sleep at an ideal duration, considering that about 25 to 50 percent of preschoolers suffer from lack of sufficient sleep.

In a research study published in Pediatrics that was conducted by the University of Chicago researchers, the sleeping patterns of about 308 children between the age of 4 and 10 were tracked down using a special wrist device. These children were categorized with normal, overweight and obese according to their respective body mass index. The study revealed that obese children in the group have variable sleep patterns and they tend to have short duration sleep as the other children. They were also identified to have the unhealthiest blood profile during blood extraction.

Additional findings of the researchers show that those children having the tendency to become obese are more protected when they get adequate sleep. Additional observation was added by Dr. Phyllis Zee, a sleep researcher, where he agreed there is a correlating link between sleep and obesity, but also signifies that the variability of sleep-wake timing in children can also be a contributing factor in regulating weight.

Other researches were also focusing on the resulting interrupted or disordered activity of the body’s metabolism and endocrine system caused by the lack of sleep. This is especially significant among children whose body are still growing. Another relation to sleep and obesity are the changes in the levels  of two hormones named leptin and gherlin, which are responsible for appetite and hunger regulation. The body often misinterprets sleep cravings as a hunger that causes an increase in the activities of these hormones that makes a child overeat.

Israeli Researchers Develop Groundbreaking Approach To Evaluate Sleep Disorders.

Mon, Mar 16th, 2015

Ben-Gurion University of the Negev (BGU) researchers have developed a groundbreaking approach to determine sleep quality using their new breath sound analysis (BSA). This is less expensive and invasive than current polysomnography (PSG) technology, according to a new study published on PLOS Online.

“One of the main goals of sleep medicine today is to improve early diagnosis and treatment of the ’flood” of subjects presenting with sleep disorders,” says Prof. Yaniv Zigel Ph.D., head of the Biomedical Signal Processing Research Lab in BGU’s Department of Biomedical Engineering.

“We’ve developed a non-contact ‘breathing sound analysis’ algorithm that provides a reliable estimation of whole-night sleep evaluation for detection of sleep quality, snoring severity and Obstructive Sleep Apnea (OSA). It has the potential to reduce the cost and management of sleep disorders compared to PSG, the current standard of treatment, and could be used at home.”

PSG requires a full night sleep center stay and subjects are connected to numerous electrodes and sensors that are attached to the patient to acquire signals and data from electroencephalography (EEG), electrooculography (EOG), electromyography (EMG), and electrocardiography (ECG) tests. The data is processed and visually examined or mathematically transformed manually in order to reveal insights about sleep/wake states and many aspects of physiology. “This procedure is time-consuming, tedious and costly due to complexity and the need for technical expertise; the market is begging for a better solution,” says Eliran Dafna who conducted this study as part of his Ph.D. research.

In the study, the researchers measured whole-night breathing sounds from 150 patients using both ambient microphones and PSG simultaneously at a sleep laboratory. The system was trained on 80 subjects and a validation study was blindly performed on the additional 70 subjects. A set of acoustic features quantifying breathing patterns was developed to distinguish between sleep and wake segments. Sleep quality parameters were calculated based on the sleep/wake classifications and compared with PSG for validity.

When comparing sleep quality parameters, there were only minor average differences in the measurements between PSG and BSA. Measuring 150,000 individual time segments (epochs), the BSA epoch-by-epoch accuracy rate for the validation study was 83.3 percent with 92.2 percent sensitivity measuring sleep as sleep.

“The results showed that sleep/wake activity and sleep quality parameters can be reliably estimated solely using breathing sound analysis,” says Prof. Ariel Tarasiuk of BGU’s Department of Physiology and head of the Sleep-Wake Disorders Unit, at Soroka University Medical Center. “This study highlights the potential of this innovative approach to measure sleep in research and clinical circumstances. Clearly, the transition of this technology to at-home sleep evaluation depends on third party reimbursements for the use of home study equipment.”

The Biomedical Signal Processing Research Laboratory was established in 2007 by Prof. Yaniv Zigel. The lab’s team are experts in physiological signal processing and pattern recognition.

The for the Study and Diagnosis of Sleep Disorders was established in 1994 by Prof. Ariel Tarasiuk. The unit’s team of experts evaluate sleep disorders in children and adults and operates in conjunction with specialists in respiratory diseases, neurology, ENT, and gastrointestinal diseases.

Sleep Apnea More Than Doubles Risk For Car Accidents: The Dangers Of Drowsy Driving

Mar 11, 2015 11:57 AM By Chris Weller

New evidence adds to the already compelling case that driving a car while not properly rested produces similar risks as driving drunk.

The recent study was published in the journal Sleep and found people with obstructive sleep apnea were 2.5 times more likely to be the driver in an accident than people without the sleep disorder. Fortunately, the study also found continuous positive airway pressure, or CPAP, therapy was effective at reducing the rates by up to 70 percent if the person used the technique for an average of four hours every night.

"Excessive daytime sleepiness is a common symptom of obstructive sleep apnea, which can cause you to awaken in the morning feeling tired and unrefreshed despite a full night of sleep," said Dr. Timothy Morgenthale, president of the American Academy of Sleep Medicine, in a statement.

Insufficient sleep has been officially classified as a public health epidemic by the Centers for Disease Control and Prevention, as nearly 40 percent of people report unintentionally falling asleep at least once in the past month. On their own, the dangers of sleep deprivation include a suppressed immune system and moderate cognitive impairment. But the risks increase even further when those setbacks are applied to a complex activity, like driving a car. In 2010, a study found 20 to 25 hours of sleep loss resulted in the same levels of depleted brainpower as a blood-alcohol concentration of 0.10.

Obstructive sleep apnea, a condition in which the body’s airway gets blocked and results in difficulty breathing, may produce many of the same effects. In the latest study, Swedish researchers used data from the long-term data collection project STRADA, the Swedish Traffic Accident Registry. The team looked at 1,478 sleep apnea patients with an average age of 54 years. Comparing accident rates among a control population of more than 635,000, they found drivers in accidents were significantly more likely to suffer from sleep apnea. People who got only five hours of sleep, experienced daytime sleepiness, and regularly took sleeping pills also faced greater accident risks.

"Effective identification and treatment of sleep apnea is essential to reduce avoidable, life-threatening accidents caused by drowsy driving," Morgenthale said.

Obstructive sleep apnea is decidedly less common than general sleep deprivation. Roughlyone in five American adults has a mild case, while one in 15 has a moderate to severe case. Meanwhile, a recent Gallup poll found 40 percent of the country gets less than the recommended amount of sleep each night. Collectively, these missed hours account for 6,400 traffic-related deaths, which make up 21 percent of the U.S. total, according to a 2014 report. This is an increase from the 16.5 percent of deaths a previous 2010 study found.

For the dangers of drowsy driving, drunk driving still remains the greatest danger to motorists. The CDC reports that in 2012, alcohol-impaired drivers led to 10,322 deaths, which accounted for nearly a third of all traffic-related deaths in the U.S. Drunk driving’s annual cost is roughly $59 billion.

Drowsy driving, however, seldom receives a proportional amount of attention as drunk driving, which only adds to the risks. A deepening culture of casual sleepiness may account for Americans’ reluctance to sit passenger just because they feel a little groggy. For people with legitimate sleep disorders like obstructive sleep apnea, the latest research suggests people can dramatically cut their chances of an accident if they can identify their symptoms and take action.

For everyone else, the prescription is as simple as investing an extra hour or two of sleep each night. Given that 90 percent of the U.S. population drives a car to and from work, it’s a quick fix that can end up keeping everyone safe.

Snoring can lead to glaucoma: Experts

T Ramavarman,TNN | Mar 8, 2015, 06.15 AM IST

Snoring cuts off oxygen supply to your lungs and vital organs including the eyes. In glaucoma, already the opticval nerve cells are dying due to the increased pressure. Lack of oxygen accelerates the decay.

THRISSUR: Besides creating nuisance to those around you, snoring can aggravate glaucoma-optic nerve damage associated with the buildup of pressure in the eye-leading to loss of vision, experts said.

Studies reinforced the belief that those who snore were at the risk of developing glaucoma, ophthalmic surgeon Dr Rani Menon said.

"Snoring cuts off oxygen supply to your lungs and vital organs including the eyes. In glaucoma, already the opticval nerve cells are dying due to the increased pressure. Lack of oxygen accelerates the decay. So snoring is a very serious risk as far as glaucoma is concerned,'' she said.

When pressure builds up, the nerve cells inside the eye get strangulated and they start dying. There are about five million nerve cells in the human eye, and vision would be affected when about 30% cent of them are lost.

According to statistics, one in 200 of those aged above 40 stand the risk of getting glaucoma affected, while one in 100 aged above 65 were at risk. In India, about 11.9 million people are glaucoma-affected.

Though early detection is critical in treating glaucoma, patients seldom perceive any clear symptom, said Dr Babu Krishnakumar, secretary of the Kerala society of ophthalmic surgeons.

'Glaucoma Week' is being organized across the world from March 8.

Snooze and lose: Getting more sleep may be the key to weight loss

Registered dietitian Caryn Alter talks to her "Lighten Up Weight Loss" class in Freehold. Alter is one of a growing number of health professionals who agree that sleep deprivation can hinder weight loss. (Noah K. Murray | For NJ Advance Media)

By Susan Bloom | For The Star-Ledger 
on March 05, 2015 at 3:57 PM

Frustrated about that extra weight you've put on or those few pounds you just can't seem to lose? Put down that iPad and plump up your pillow instead -- a growing body of research has shown a strong connection between sleep duration and weight in adults and children, and suggests that a little more sleep might be just what you need to kick your body into natural weight loss or weight management mode.

With the hustle and bustle of 21st century life leading the average American to get up to two hours less sleep per night while tipping the scales at over 20 pounds more than they did 50 years ago, a variety of studies have explored the powerful correlation between sleep and weight. Among their findings, a Mayo Clinic study recently found that women who slept less than six hours or more than nine hours per night were more likely to gain 11 pounds than women who slept seven hours per night, while researchers at the Harvard-affiliated General Hospital for Children determined that, of the 1,000 children they tracked from the age of six months to seven years old, those who were the most sleep-deprived were about 2 1/2 times as likely to be obese as the children who consistently got enough sleep.

The average American requires 7-9 hours of sleep each night to function optimally, according to the National Sleep Foundation in Arlington, Va.

"But an estimated one-third of Americans are sleep-deprived in some way, which is an issue because a lot of important things happen as we sleep, " said Dr. Priyanka Yadav pediatrics and sleep medicine specialist at Robert Wood Johnson University Hospital's Comprehensive Sleep Disorders Center in Hillsborough.

State of Check

In addition to providing the body with critical restorative time and supporting focus, retention, and memory consolidation of what we learned during the day, she said, the process of sleep keeps the body in an important state of check and balance and sleep deprivation can absolutely affect metabolism and appetite.

That's because sleep-deprived individuals have been found to possess both higher levels of ghrelin, a hormone which drives feelings of hunger, as well as lower levels of leptin, a hormone which triggers feelings of fullness and satisfaction after we eat - a dangerous double whammy for weight gain.

"Many patients I treat for sleep issues also have weight management issues - these seem to go hand in hand because sleep deprivation can cause glucose intolerance, hormonal imbalances, and other metabolic conditions, " Yadav said. "In addition, when you're sleep-deprived, the frontal cortex of the brain - which controls our ability to plan, problem-solve, and make decisions and naturally blunts the impulse to eat more fatty, carbohydrate-heavy, and caloric foods - is less active, " she said.

Caryn Alter, a registered dietitian at CentraState Medical Center's Health Awareness Center in Freehold, agrees that sleep-deprived individuals can gain weight because of poor dietary choices they make - consciously or unconsciously.

"Carbohydrates tend to raise the body's levels of the neurotransmitter serotonin, which makes people feel sleepier and calmer, " Alter explained. "So when they're tired or stressed out, people often eat with less self-control and reach for carb-laden foods like ice cream, cookies and potato chips. The hitch is that these 'comfort foods, ' in large portions, can cause weight gain."

Her message for the tens of millions of Americans struggling with weight issues? "It's not necessarily that you don't have willpower or mindfulness, but rather that there may be a chemical event in the brain causing you to feel hungrier because you're simply tired, " she said.

"If you seem to have more of an appetite or find yourself nibbling more, it could be stemming from a physiological cause - too little sleep - rather than a psychological one."

At the "Lighten Up"weight-loss classes that she conducts weekly at CentraState, Alter instructs attendees on nutrition, exercise, and body chemistry but is also quick to advise on the importance of sleep to an overall healthy lifestyle and recommends a few extra hours of sleep each week for those getting less than six hours per night.

When it comes to weight loss, "getting more sleep and/or regulating your sleep pattern, in addition to mindful eating and exercising, may just be the missing link, " said Alter, who noted that it can be difficult to motivate yourself to exercise if you're tired, another factor increasing the likelihood for sleep-deprived individuals to pack on pounds.

Don't go too far

Yadav agreed that for many people, getting more sleep can be an easy way to feel better and start losing weight - to a point.

"Too much sleep causes people to burn fewer calories and is associated with an increased risk of mortality, " she said.

Colts Neck resident and former nurse Kathie Nolte, 64, said she experienced some of the diminishing returns of too much sleep following her retirement two years ago.

"When I was working a 7 a.m.-3 p.m. shift, I was waking up at 5:30 a.m. and going to bed at 9:30 p.m. and I was able to maintain my weight, " she said.

"But after retiring, I found myself going to bed later, reaching for a lot of carbs late at night, and waking up late after sleeping for 10 hours. I didn't have the same energy level as I did when I was working and it made me get down on myself, " she said of the way her new sleep pattern threw off her eating schedule, made her less productive throughout the day, negatively impacted her mood, and ultimately contributed to a 30-pound weight gain.

Sleep and slimming down

Nolte said she is already several pounds down since changing her sleep schedule and joining Alter's "Lighten Up" class in January.

"I feel much better about myself now - more put together and organized," Nolte said. "And I learned that getting good-quality sleep and the right amount is as important to your health as eating a proper diet or exercising."

"Most people know that diet and exercise are important to health, but many forget that sleep is the missing, third component of a healthy life cycle, " agreed Natalie Dautovich, National Sleep Foundation Environmental Scholar.

"Not only is adequate sleep necessary for healthy cognitive functioning, but because sleep is rejuvenating, a good night's sleep can help you slim down and maintain an ideal body weight. This rejuvenation can lead to more enthusiastic and longer workouts, which in turn can also lead to increased weight loss and better quality sleep. Sufficient, high-quality sleep also leads to a greater ability to self-regulate and select healthy food choices, which in turn helps with maintaining a healthy weight, " she said.

"It's great to see more awareness of the importance of sleep to our overall health and to our weight in particular, " said Yadav, who advises people to tap into the body's natural rhythm and enjoy the benefits of even an hour more sleep a night if they've been getting short-changed.

"The body is intuitive and is designed to survive. So we should just let it do what it needs to do and stop getting in the way of ourselves."