New Sleep-Tracking Wearables Help Solve Real Medical Problems

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Every year, nearly a million exhausted people with sleep apnea—a breathing disorder caused when throat muscles relax and block the airway during sleep—get into car accidents, causing over a thousand deaths. Apnea is linked to obesity, heart disease, diabetes, an additional $3.4 billion in medical costs, and $16 billion in auto collision costs. Even though apnea has telltale signs (loud snoring, daytime fatigue), it goes undiagnosed 75 percent of the time.

Why? It’s damned expensive and horrendously inconvenient to diagnose sleep apnea. Polysomnography, the standard medical sleep study, requires a medical technician to attach 22 wires to a person’s body and monitor them all night long. The average cost is nearly $3,000. In the world of high-deductible health plans, that payment comes right out of the patient’s pocket. Follow-up testing to measure the effectiveness of treatment is financially unthinkable. The idea of doing clinical sleep studies once a month to monitor progress is a diagnostic crack-pipe fantasy.

Enter wearables, specifically the “pro-sumer” variety with FDA clearance and clinical backing. Unlike first-generation activity trackers that measure movement and sometimes heartbeat, clinical consumer wearables like the recently released SleepImage can measure heart rhythm (ECG), breathing volume, and snoring (through tissue vibration). They can also keep tabs on body movement as well as position—whether a person is sleeping on their back, side, or belly. Algorithms calculate the second-to-second relationship between heart rate variability and breathing variability. This relationship between heart and breathing rhythms, known as cardio-pulmonary coupling, maps to the sleep stages and breathing disruptions that previously only a polysomnogram could measure.

The SleepImage is a small, oval-shaped disc that sticks to the chest near the heart. An electrode on a short wire is also attached a little lower, on the ribs. At the end of the night, a person peels off the wearable, uploads the data to a HIPPA-compliant web site, and sees a breakdown the night’s sleep: stable versus unstable sleep stages, REM sleep, snore count, position and sleep interruptions. A prescription subscription gives a person more detailed clinical data visualizations and gives their doctor enough raw biometric data to distinguish between the cardio-pulmonary patterns of obstructive sleep apnea and other sleep-related breathing disorders.

Pro-sumer wearables—consumer devices that generate clinically relevant biometric data—are not (yet) cheap. The SleepImage is $249. Its consumer-level data service is $99 a year, and its prescription-level data service is $149 per year. But it’s an order of magnitude cheaper than polysomnography, and it’s two orders of magnitude cheaper if used four nights in a row, or once a month for half a year, to see whether measures to address the problem—losing weight, sleeping with a mouthpiece that helps keep the airway open, or a continuous positive air pressure (CPAP) mask—make a measurable difference. The real shift that pro-sumer devices enable is from one-time snapshots to a continuous, long-duration series of views that allow a patient and doctor to adjust tactics and measure the results.

Pro-sumer wearables also move measurement from the lab to the actual environment where a person lives. If the devices get cheap enough, the data makes it possible to tease apart individual sleeping issues and social sleeping problems: a partner’s movements, snores and yes, cover stealing.

In a clinical case study using wearables, researchers stacked husband-and-wife time-series data to observe that the husband’s snoring wasn’t loud enough to wake up his wife. But it was loud enough to disrupt her stable sleep, leaving her wrecked the next day. After the husband was treated for apnea, his wife’s sleep quality improved even more than his did. At long last, the Quantified Self can deliver what snorers’ partners have always wanted: evidence.

Jokes aside, the hope for pro-sumer wearables is that they can transcend the “nice to have” activity data generated by movement trackers and provide the “need to have” data that indicates major medical issues. It’s one thing for a healthy person to tinker with their caffeine intake, room temperature and the thread count of their sheets to see what happens to their sleep. It’s a completely different thing for a doctor and patient to use wearables to addresses life-threatening conditions. That shift has a potentially monumental impact on patients, their sleeping partners, and everyone who shares the road with millions of drowsy drivers.

New Sleep-Tracking Wearables Help Solve Real Medical Problems

Getty Images

Every year, nearly a million exhausted people with sleep apnea—a breathing disorder caused when throat muscles relax and block the airway during sleep—get into car accidents, causing over a thousand deaths. Apnea is linked to obesity, heart disease, diabetes, an additional $3.4 billion in medical costs, and $16 billion in auto collision costs. Even though apnea has telltale signs (loud snoring, daytime fatigue), it goes undiagnosed 75 percent of the time.

Why? It’s damned expensive and horrendously inconvenient to diagnose sleep apnea. Polysomnography, the standard medical sleep study, requires a medical technician to attach 22 wires to a person’s body and monitor them all night long. The average cost is nearly $3,000. In the world of high-deductible health plans, that payment comes right out of the patient’s pocket. Follow-up testing to measure the effectiveness of treatment is financially unthinkable. The idea of doing clinical sleep studies once a month to monitor progress is a diagnostic crack-pipe fantasy.

Enter wearables, specifically the “pro-sumer” variety with FDA clearance and clinical backing. Unlike first-generation activity trackers that measure movement and sometimes heartbeat, clinical consumer wearables like the recently released SleepImage can measure heart rhythm (ECG), breathing volume, and snoring (through tissue vibration). They can also keep tabs on body movement as well as position—whether a person is sleeping on their back, side, or belly. Algorithms calculate the second-to-second relationship between heart rate variability and breathing variability. This relationship between heart and breathing rhythms, known as cardio-pulmonary coupling, maps to the sleep stages and breathing disruptions that previously only a polysomnogram could measure.

The SleepImage is a small, oval-shaped disc that sticks to the chest near the heart. An electrode on a short wire is also attached a little lower, on the ribs. At the end of the night, a person peels off the wearable, uploads the data to a HIPPA-compliant web site, and sees a breakdown the night’s sleep: stable versus unstable sleep stages, REM sleep, snore count, position and sleep interruptions. A prescription subscription gives a person more detailed clinical data visualizations and gives their doctor enough raw biometric data to distinguish between the cardio-pulmonary patterns of obstructive sleep apnea and other sleep-related breathing disorders.

Pro-sumer wearables—consumer devices that generate clinically relevant biometric data—are not (yet) cheap. The SleepImage is $249. Its consumer-level data service is $99 a year, and its prescription-level data service is $149 per year. But it’s an order of magnitude cheaper than polysomnography, and it’s two orders of magnitude cheaper if used four nights in a row, or once a month for half a year, to see whether measures to address the problem—losing weight, sleeping with a mouthpiece that helps keep the airway open, or a continuous positive air pressure (CPAP) mask—make a measurable difference. The real shift that pro-sumer devices enable is from one-time snapshots to a continuous, long-duration series of views that allow a patient and doctor to adjust tactics and measure the results.

Pro-sumer wearables also move measurement from the lab to the actual environment where a person lives. If the devices get cheap enough, the data makes it possible to tease apart individual sleeping issues and social sleeping problems: a partner’s movements, snores and yes, cover stealing.

In a clinical case study using wearables, researchers stacked husband-and-wife time-series data to observe that the husband’s snoring wasn’t loud enough to wake up his wife. But it was loud enough to disrupt her stable sleep, leaving her wrecked the next day. After the husband was treated for apnea, his wife’s sleep quality improved even more than his did. At long last, the Quantified Self can deliver what snorers’ partners have always wanted: evidence.

Jokes aside, the hope for pro-sumer wearables is that they can transcend the “nice to have” activity data generated by movement trackers and provide the “need to have” data that indicates major medical issues. It’s one thing for a healthy person to tinker with their caffeine intake, room temperature and the thread count of their sheets to see what happens to their sleep. It’s a completely different thing for a doctor and patient to use wearables to addresses life-threatening conditions. That shift has a potentially monumental impact on patients, their sleeping partners, and everyone who shares the road with millions of drowsy drivers.

This TV Does 3-D Without the Glasses, and It Doesn’t Look Half Bad

Ultra-D

A funny thing happened to me at the DICE Summit in Las Vegas last week: I glanced upward and found myself staring into a 3-D television.

I was at the gaming industry conference to try to get a glimpse of the future of videogames, and maybe this is one facet of it. I’ve used 3-D televisions before, of course, but you can’t accidentally happen upon those. You’ve got to put on the glasses, get yourself situated, the whole routine. So to look upwards at the TV mounted on the bar and realize that there was a depth illusion happening there—that was pretty weird.

What I was looking at was called Ultra-D, a glasses-free 3-D tech that’s been making the rounds at the electronics trade shows for a couple of years now. Representatives from the company at DICE told me they’re hoping to actually have some TVs using the tech in homes within this year. So who knows, maybe you’ll be trying this for yourself soon enough.

If you’re going to be in the market for a giant 4K TV this year, I mean. Stream TV Networks, the company behind Ultra-D, isn’t actually manufacturing televisions. It’s looking to spin up what it refers to as the “Intel Inside”-style business model: Licensing the technology to a range of manufacturers, who can then build it into their sets. It estimates that including its 3-D display might add around 10 percent to the retail price of the television.

Stream TV

Stream TV says that Ultra-D displays will have a 140-degree viewing angle, which means that multiple viewers should all be able to see the effect while hanging out on the couch. If you’re outside of that window, you’ll just perceive a 2-D image.

But Ultra-D is promising more than just a glasses-free 3-D display. It also includes a Qualcomm Snapdragon processor, which enables the sets to convert any 2-D content on the fly to 3-D. I didn’t actually see this in action—Stream TV’s reps showed me a snippet of the classic 1946 film It’s a Wonderful Life in 3-D, but said that had been converted by hand. (And we’ll leave for later the question as to whether anyone should be converting It’s a Wonderful Life into 3-D.)

While Ultra-D will thus add depth effects to your existing videogames—while the TV sets must be 4K to work with the tech, the content doesn’t have to be 4K resolution—Stream TV also said it would work with game developers if they wanted to add native support into their games.

If you encounter Ultra-D over the next year, perhaps it’ll be in a public venue. One of the concepts Stream TV showed in its demo was the idea of having a 3-D TV in a movie theater’s lobby to advertise gift cards or popcorn. Maybe that’s a more realistic scenario for those of us who aren’t quite into the idea of upgrading our TV again this year. (And I can vouch for the fact that having one sitting in a public place certainly got my attention.)

This TV Does 3-D Without the Glasses, and It Doesn’t Look Half Bad

Ultra-D

A funny thing happened to me at the DICE Summit in Las Vegas last week: I glanced upward and found myself staring into a 3-D television.

I was at the gaming industry conference to try to get a glimpse of the future of videogames, and maybe this is one facet of it. I’ve used 3-D televisions before, of course, but you can’t accidentally happen upon those. You’ve got to put on the glasses, get yourself situated, the whole routine. So to look upwards at the TV mounted on the bar and realize that there was a depth illusion happening there—that was pretty weird.

What I was looking at was called Ultra-D, a glasses-free 3-D tech that’s been making the rounds at the electronics trade shows for a couple of years now. Representatives from the company at DICE told me they’re hoping to actually have some TVs using the tech in homes within this year. So who knows, maybe you’ll be trying this for yourself soon enough.

If you’re going to be in the market for a giant 4K TV this year, I mean. Stream TV Networks, the company behind Ultra-D, isn’t actually manufacturing televisions. It’s looking to spin up what it refers to as the “Intel Inside”-style business model: Licensing the technology to a range of manufacturers, who can then build it into their sets. It estimates that including its 3-D display might add around 10 percent to the retail price of the television.

Stream TV

Stream TV says that Ultra-D displays will have a 140-degree viewing angle, which means that multiple viewers should all be able to see the effect while hanging out on the couch. If you’re outside of that window, you’ll just perceive a 2-D image.

But Ultra-D is promising more than just a glasses-free 3-D display. It also includes a Qualcomm Snapdragon processor, which enables the sets to convert any 2-D content on the fly to 3-D. I didn’t actually see this in action—Stream TV’s reps showed me a snippet of the classic 1946 film It’s a Wonderful Life in 3-D, but said that had been converted by hand. (And we’ll leave for later the question as to whether anyone should be converting It’s a Wonderful Life into 3-D.)

While Ultra-D will thus add depth effects to your existing videogames—while the TV sets must be 4K to work with the tech, the content doesn’t have to be 4K resolution—Stream TV also said it would work with game developers if they wanted to add native support into their games.

If you encounter Ultra-D over the next year, perhaps it’ll be in a public venue. One of the concepts Stream TV showed in its demo was the idea of having a 3-D TV in a movie theater’s lobby to advertise gift cards or popcorn. Maybe that’s a more realistic scenario for those of us who aren’t quite into the idea of upgrading our TV again this year. (And I can vouch for the fact that having one sitting in a public place certainly got my attention.)

Bacteria's hidden traffic control

Not unlike an urban restaurant, the success of a bacterial cell depends on three things: localization, localization and localization. But the complete set of controls by which bacteria control the movement of proteins and other essential biological materials globally within the confines of their membrane walls has been something of a mystery. Now, researchers at the University of Washington have parsed out the localization mechanisms that E. coli use to sort through and organize their subcellular components.

"Despite their small size and relative simplicity, bacterial cells appear to possess a robust and complex level of subcellular organization, both spatially and temporally, that was once thought to only exist in more complex organisms," said Nathan Kuwada, a postdoctoral fellow in the lab of Paul Wiggins at the University of Washington.

"We wanted to know how many mechanisms bacteria possess to localize subcellular components, and to answer this question, we set out to image the localization pattern of nearly every protein in a bacterial cell for the entire cell cycle."

Kuwada will describe the group's findings this week at the Biophysical Society's 59th annual meeting in Baltimore, Md.

E. coli localize nearly one-fifth of their proteins to specific subcellular sites, but until now, the cell-cycle localization behavior of only a small subset of proteins had been characterized in detail.

Kuwada and his colleagues sought to remedy this by imaging an existing library of green-fluorescent protein fusions in E. coli by use of a high-throughput live-cell imaging scheme. This allowed them to image close to a thousand individual protein fusions in growing cells for 6-8 hours, providing them with hundreds of complete cell cycles for each protein.

Using custom image processing software, the researchers processed and organized the thousands of images from each experiment, allowing them to quantitatively compare the localization patterns on a genomic scale. The researchers also developed a public online database with all of their raw and processed data in a browsable and searchable form at: http://ift.tt/1Ixxnms

Rather than a small number of patterns combining in various permutations determined by function, the researchers found that bacteria possess a large number of distinct patterns with subtle spatial and temporal differences.

For example, Kuwada and his colleagues also observed that the DNA-binding proteins were asymmetrically distributed towards the daughter cell during cell divisions, despite the morphological symmetry between parent and daughter cells.

"Although the asymmetry is somewhat weak, it is still statistically significant and we think it must have an exciting biological significance," Kuwada said. "This finding, which is only observable using our complete-cell-cycle approach, potentially has many biological consequences that we are currently trying to better understand."

Future work for Kuwada and his colleagues includes further exploring the specific mechanisms that drive subcellular organization, through targeting the behavior of specific groups of proteins such as transcription factors with increased precision.

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The above story is based on materials provided by Biophysical Society . Note: Materials may be edited for content and length.