Sleep Review: The Journal for Sleep Specialists is dedicated to helping its 20,000 readers stay on top of changes in the rapidly growing field of diagnosing and treating sleep disorders. Each issue covers case reports, innovative research findings, business news, and product and service introductions, as well as offering inspiring stories of leading sleep centers and useful ideas for improving..
The great minds at Gravity Blankets have come up with the Gravity Blanket, a weighted blanket that is scientifically engineered to help you fall asleep peacefully and comfortably, according to Men’s Health.
Weighted blankets are as heavy as 7-12 percent of your body weight. Their weight relaxes the nervous system by simulating the feeling of being held or hugged, which then increases serotonin and melatonin levels and decreases cortisol levels. These chemicals improve your mood and foster restful, consistent sleep.
To put it simply, weighted blankets basically feel like the best cuddle of your life, but without any weird sweat, annoying snoring, or awkward midnight bumping and poking. If you’re not much of a hugger, they’re less painful and/or weird than human contact.
The color cyan – between green and blue – is a hidden factor in encouraging or preventing sleep according to biologists, reports BBC.
University of Manchester researchers say higher levels of cyan keep people awake, while reducing cyan is associated with helping sleep. The impact was felt even if color changes were not visible to the eye.
The researchers want to produce devices for computer screens and phones that could increase or decrease cyan levels. Sleep researchers have already established links between colors and sleep – with blue light having been identified as more likely to delay sleep.
Dr. Kyran Quinlan and colleagues at Rush issue an urgent call for prevention strategies for sleep-related infant deaths in his viewpoint, “Protecting Infants From Sleep-Related Deaths” published in JAMA Pediatrics, reports News Medical.
“Approximately 3,700 sudden unexpected infant deaths occur each year,” said Quinlan, associate professor and division director of general pediatrics at Rush University Medical Center. “These infant deaths all occur before the child’s first birthday, with 90 percent occurring within six months.”
While infant deaths from sudden infant death syndrome and suffocation significantly declined following the 1992 American Academy of Pediatrics recommendation regarding sleep position and the National Institutes of Health-led Back to Sleep campaign, the number of sleep-related deaths has now plateaued for nearly 20 years. Leading to a decrease in infant deaths, the campaign included safe sleep practices such as place the baby on his or her back to sleep, use a firm and flat sleep surface separate designed for infants, and not to place soft objects or loose bedding in the infant’s sleep area.
People with sleep apnea, especially those over 60, could decrease their risk of heart failure by using CPAP masks at night to help with breathing, according to new research, reports Medical Xpress.
The study, published Friday in the Journal of the American Heart Association, explored the connection between heart failure and sleep apnea, a condition that goes beyond plain snoring. It’s when a person pauses in breathing five to 30 times or more per hour while sleeping.
Previous studies have tied sleep apnea to heart attacks and strokes, but researchers of the new study focused on the possible link between sleep apnea and heart failure, when the heart isn’t pumping as well as it should be, causing the body to receive less oxygen.
Napping benefits cognitive function in older adults, according to findings presented at SLEEP 2018, reports Healio.
“This study aimed to synthesize the current evidence on the association between daytime napping and cognition in older adults,” Fang FangFan, of the University of Pennsylvania, and colleagues wrote in the abstract.
To analyze the association between daytime napping and cognition in older adults, researchers conducted a systematic search of PubMed, Google Scholar and PsycInfo, using keywords, such as nap, daytime sleep or siesta and cognition, cognitive function, memory, executive function, visual spatial, reaction time or attention and older adults, elderly, seniors or aging.
Amazon, Berkshire Hathaway, and JPMorgan Chase announced the next step in their partnership on US employee healthcare with the appointment of Atul Gawande, MD, as its CEO, effective July 9. The new company will be headquartered in Boston and will operate as an independent entity that is free from profit-making incentives and constraints.
Gawande is a surgeon, writer, and public health innovator. He practices general and endocrine surgery at Brigham and Women’s Hospital and is professor at the Harvard T.H. Chan School of Public Health and Harvard Medical School. He is founding executive director of the health systems innovation center, Ariadne Labs. He also is a staff writer for The New Yorker magazine, has written four New York Times bestsellers: Complications, Better, The Checklist Manifesto, and Being Mortal, and has received numerous awards for his contributions to science and healthcare.
“I’m thrilled to be named CEO of this healthcare initiative,”Gawande says in a release. “I have devoted my public health career to building scalable solutions for better healthcare delivery that are saving lives, reducing suffering, and eliminating wasteful spending both in the US and across the world. Now I have the backing of these remarkable organizations to pursue this mission with even greater impact for more than a million people, and in doing so incubate better models of care for all. This work will take time but must be done. The system is broken, and better is possible.”
Jamie Dimon, chairman and CEO of JPMorgan Chase, says, “As employers and as leaders, addressing healthcare is one of the most important things we can do for our employees and their families, as well as for the communities where we all work and live. Together, we have the talent and resources to make things better, and it is our responsibility to do so. We’re so grateful for the countless statements of support and offers to help and participate, and we’re so fortunate to have attracted such an extraordinary leader and innovator as Atul.
Jeff Bezos, founder and CEO of Amazon, says, “We said at the outset that the degree of difficulty is high and success is going to require an expert’s knowledge, a beginner’s mind, and a long-term orientation. Atul embodies all three, and we’re starting strong as we move forward in this challenging and worthwhile endeavor.”
Berkshire Hathaway Chairman and CEO, Warren Buffett, says, “Talent and dedication were manifest among the many professionals we interviewed. All felt that better care can be delivered and that rising costs can be checked. Jamie, Jeff and I are confident that we have found in Atul the leader who will get this important job done.”
Some patients struggle with how to navigate CPAP in their dating lives or marriages, reports Vice.
Paul Hokemeyer, a family therapist in New York City, says that the best way to mitigate feelings of shame or awkwardness is to take charge of the situation and be completely up front about it. “You don’t have a machine because you needed another expensive accessory, you need it because you can’t breathe at night. It’s a physiological condition, not an issue of a personal weakness,” he says.
It’s a lot of daylight, which reduces production of the hormone melatonin that regulates sleep, reports CBS Philly.
“Light antagonizes melatonin”, says Dr. Karl Doghramji, medical director of the Jefferson Sleep Disorders Center. He says stress and other things can also interfere with sleep, but the extra dose of sunlight that comes with the solstice can make insomnia even worse.
Visual displays that inadvertently suppress the release of melatonin, such as in smartphones, televisions, and computer screens, can be redesigned to give us all a well-earned rest, say scientists from the Universities of Manchester and Basel.
The team led by Rob Lucas, BSc, PhD, and Annette Allen, BSc, MRes, PhD, from The University of Manchester recently unveil technology that could impact displays in televisions, smartphones, projectors, computer screens, and tablets.
The researchers, who published their European Research Council-funded study in the journal Sleep, say the technology could also mean that night workers are less likely to fall asleep at a computer.
The device—which the researchers call a “melanopic display”—allows users to control the alerting effects of screen use and can also enhance the visual appearance of screens, say the team.
The technology allows the amount of cyan light in images to be altered while keeping colors true.
Conventional display is made up of red green and blue primary colurs, which match up with three types of photoreceptors in our eyes. The team added a fourth “primary color” (cyan), which controls melanopsin cells in the eye that detect light, normally in the daytime. When the cyan light was turned up, the 11 participants in the trial felt more alert; when turned down, they felt more sleepy.
They watched a movie produced with or without the cyan primary, rating how sleepy they felt afterwards and producing saliva samples for the team to measure levels of melatonin.
Participants felt more alert when exposed to cyan light and sleepier when the cyan was dimmed even though colours looked the same. Melatonin levels in their saliva were also higher when cyan was turned down.
“This outcome is exciting because it that tells us that regulating exposure to cyan light alone, without changing color, can influence how sleepy we feel,” Lucas says in a release. “Our study also shows how we can use that knowledge to provide a next generation of visual displays. We built our melanopic display by adapting a data projector, but we would expect that this design could be applied to any type of display. Such displays could, for example, help phone obsessed teenagers to fall asleep or support alertness in people who need to use a computer at night.
Allen says, “The new display design could actually have a wider benefit, as it seems that this technology also improves image appearance. Like adding salt to food, we aren’t necessarily aware that it’s been done though we appreciate the effect.”
With the launch of a new ultraviolet light-based disinfecting device, Sleep Review takes a look at the pros and cons of ozone versus UV light versus plain water and soap, as well as the impact of travel CPAPs on the device cleaners market.
By Dillon Stickle
As CPAP technology continues to advance, so does that of accessories like CPAP cleaners. Cleaners help patients keep their devices free of bacteria and other buildup, and some find the convenience of cleaner devices to be an integral part of their therapy experience. This article discusses the advantages and disadvantages of ozone versus ultraviolet (UV) light versus soap and water to clean CPAPs, as well as the impact of the increase of travel CPAPs on the CPAP cleaners market.
UV Light, Ozone, or Soap and Water?
3B Medical recently launched the Lumin, which uses UV light to disinfect CPAP masks, water chambers, and hoses. Incorporating UV is a new technology in the CPAP cleaners market, though it has been previously utilized for other types of medical disinfection. Alex Lucio, CEO of 3B Medical, says, “We planned a 90-day initial production run and went on backorder within the first week of sales. We raised production levels and still went on backorder.”
Lucio thinks the higher-than-3B-anticipated order volume is due to pulmonary physician concerns over respiratory patients using CPAP cleaners that rely on ozone—traditionally the disinfecting mechanism employed in CPAP cleaning devices. Though using ozone does have its own advantages, which are discussed later in this article, Lucio says a concern is: “When ozone is handled correctly (i.e., not vented into a room with humans or pets and a 2 to 3 hour waiting period before use), it is an effective disinfectant,” he says. “But if used incorrectly, or with products that don’t have safety warnings or labeling, it can result in pulmonary edema and lung irritation. For that reason, I think the market was primed for an ozone-free alternative to disinfection.”
Ozone (O3) is the disinfectant that most sleep clinicians think of when it comes to CPAP cleaners. SoClean, maker of the SoClean cleaner, uses ozone for its devices for several reasons, according to Jess Cormier, director of marketing at SoClean. “Ozone has the ability to permeate into areas that are difficult to reach by other processes, such as the inside of a CPAP hose, water in the reservoir, and crevices of the reservoir and mask,” she says. “CPAP hoses, for instance, are a breeding ground for germs and bacteria and are often constructed with ridges throughout, making it very difficult to thoroughly disinfect a hose.
SoClean’s technology floods the inside of the hose with ozone, cleaning the inside of the hose and its crevices. “SoClean connects directly to a CPAP device via adapter to automatically sanitize the CPAP reservoir, hose, and mask between uses without any additional work on behalf of the user,” Cormier says, adding that it’s an automated and fully closed system that will even sanitize residual water left in the humidifier chamber.
The downside with UV light as a CPAP cleaner, according to SoClean is that it’s, “only effective on the surface that it touches,” according to Cormier. “Any shadows cast on any piece of equipment can impede the effectiveness of the UV light process. For example, a mask in a compartment will not be completely sanitized by UV light if the surfaces are pressed against a wall of a compartment.”
Lucio, however, counters by saying the Lumin solves this potential problem with light-based disinfection. He says the Lumin chamber is constructed of highly polished aluminum that reflects UVC light 360 degrees. “Additionally,” he says, “most thin polymers and silicones are semi-transparent to UVC allowing UVC to penetrate sufficiently for additional coverage into crevices of a soft plastic or silicone. For example, with a CPAP hose, sufficient UVC penetrates the interior of the hose to disinfect and stop growth of a biofilm. 3B Medical does not make a marketing claim on disinfecting the interior of the hose because the wide variety of hoses on the market makes it difficult to design a study to support the claim, but the company does advise using Lumin twice a week on a CPAP hose for general sanitization.” Lucio adds that in a few months, 3B will be launching a companion accessory called the Lumin Bullet, specifically designed to disinfect the interior of a CPAP hose.
So what about regular soap and water? This is the most accessible and affordable CPAP cleaner available and many CPAP device and mask makers recommend it as the default choice.
CPAP cleaner companies concede that soap and water is effective, but point out there are downsides, particularly related to the amount of time needed and the lack of convenience.
SoClean’s Cormier says soap and water can be an effective sanitization method if done correctly. “However, it is nearly impossible to reach the inside of a hose and the crevices in a hose, the inside of a reservoir, and the crevices of a mask with soap and water alone,” she says. “This method of cleaning is a time-consuming process for users that requires taking apart CPAP machines and a scrubbing process.”
Daniel Labi, vice president of product sales at VirtuOx, maker of the VirtuClean CPAP cleaner, which uses ozone, says, “Cleaning with soap and water is a very time consuming, tedious process that cannot ensure all of the necessary germs and bacteria are sanitized at the same rate that you can with ozone.”
Lucio says, “Soap is a surfactant, which means it can loosen bacteria. But when hands are rubbed together or fingers rub a surface, bacteria are typically just moved and relocated,” he says. “We generally recommend use of a CPAP wipe to remove oil and residue (or soap and water) followed by disinfection or sanitization.”
The Impact of Travel CPAPs on the CPAP Cleaners Market
Consumers have more awareness today ever than before about the need to travel with their sleep apnea therapy, in part due to the launches of the Philips DreamStation Go and ResMed’s AirMini in 2017.
Soap and water remain accessible while traveling, but the drying time for this cleaning method may not be available, particularly when hotel checkout times are 11 am or noon.
CPAP cleaner companies weigh in on whether the increased awareness of traveling with CPAP has made an impact on their businesses.
3B’s Lucio says there hasn’t been much of an impact and that users will make their own decisions when it comes to how they use or clean their device. “Our view of this is that disinfection is education and awareness,” he says. “A patient with a travel PAP [device] is either going to respond—or not—based on their own awareness, but not because of owning a travel device.”
SoClean sees it differently. “The increase of travel CPAPs has been beneficial for the CPAP cleaners market as a CPAP user’s investment in travel devices confirms the importance of adhering to daily CPAP therapy,” says Cormier, adding that the company markets its SoClean 2 Go as a lightweight wireless device for travel CPAPs.
VirtuOx’s Labi says travel CPAPs have given VirtuOx an opportunity to meet a demand. “We see it as a large opportunity for our specific device, which can easily be used for at home or traveling use,” he says. “With the growth of travel CPAPs in the market, typically this same market will grow hand-in-hand with a portable CPAP sanitizer.”
CPAP cleaners are one tool for patients to keep their device clean and free of potentially harmful bacteria. When deciding what option is best, clinicians and patients must weigh the pros and cons and figure out which option would work best for them.
Dillon Stickle is associate editor of Sleep Review.
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