Seattle in Deep Sleep This Week

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Seattle wasn't sleepless this week. Not after more than 4,000 sleep experts from around the world descended upon the Emerald City for SLEEP 2015, an annual conference sponsored by the American Academy of Sleep Medicine and the Sleep Research Society.

Topics and research on all things related to sleep -- how much we need, how much we don't get, how much is disrupted by undiagnosed sleep disorders and how a better, cheaper, less obtrusive way to detect sleep apnea is needed -- were discussed.

"Right now we don't have enough sleep clinics, sleep laboratories and sleep specialists in the country to address all the sleep apnea that is out there," said Dr. Nathaniel F. Watson, University of Washington professor of neurology and co-director of the UW Medicine Sleep Center.

Sleep deficiency is linked to many chronic health problems, including heart disease, kidney disease, high blood pressure, diabetes and obesity and it's associated with serious non-alcohol-related car crash injuries and death, according to the National Heart Lung and Blood Institute.

Pharmacy Times cites several more studies attributing higher rates of depression, stroke and other health conditions to untreated sleep apnea.

While specialized overnight clinics using polysomnography are regarded as the gold standard for sleep apnea diagnosis, they are expensive, inconvenient and invasive. Sleep labs may also not replicate a person's normal sleep pattern because of the unfamiliar setting and the feeling that someone is watching you sleep. Which they are -- in the next room where they are recording your every snore, sniffle, whiffle and waking moment. Searching for a more natural way to record sleep cycles, scientists are turning to bioengineering and cell phone technology.

A smart phone application called ApenaApp, developed at the University of Washington in Seattle, uses inaudible sound waves emanating from the phone's speakers to a track a sleeper's breathing patterns without needing sensors or other special equipment.

ApneaApp captured sleep apnea events as accurately as a hospital polysomnography test 98 percent of the time, a clinical study found.

Think bats, or at least how bats fly around in the dark, to understand how it works.

"It's similar to the way bats navigate," said Rajalakshmi Nandakumar, lead author of the study and a doctoral candidate in the UW's department of computer science and engineering. "They send out sound signals that hit a target, and when those signals bounce back they know something is there."

The phone's speaker sends out inaudible sound waves, which bounce off a sleeping person's body and are picked back up by the phone's microphone. Designed for an Android phone, the app even has the ability to zone out a bed partner and key in on one sleeper. "It can distinguish because the distance from the individual to the phone is different," Watson explained.

UW researchers plan to seek FDA approval; ApneaApp could be available to consumers with one to two years.

While fitness trackers are becoming the rage to record a person's every step, sweat, heart beat, calories in and out, the trackers don't measure sleep as accurately as manufacturers claim, sleep experts say. These devices measure movement of a sleeping person, not breathing sounds or sleep patterns. On average, wearable fitness devices overestimate sleep by about one hour, Watson said.

According to the World Health Organization, an estimated 100 million individuals worldwide have some degree of obstructive sleep apnea. The American Sleep Apnea Association reports that sleep apnea affects 22 million Americans but about 80 percent are undiagnosed.

"Millions of people globally have poor sleep quality, and most of them, 80 percent, are unaware of it," Yaniv Zigel, an Israeli professor and researcher at Ben-Guiron University of the Negev, said in an interview. Its lab has also developed a new, easier way diagnose sleep apnea.

One of the main reasons sleep disorders go undetected, Zigel says, is because polysomnography involves sleeping over at a hospital sleep lab with tangles of wires attached to your head and body. "We're trying to make it less invasive," he said.

The system developed at Ben-Gurion University's Department of Biomedical Engineering places a microphone in the ceiling above a person's bed and records breathing to detect whether a person is awake or asleep. Called breath sound analyasis, the sounds are analyzed using an algorithm. In a study published in PLOS ONE, the audio device was found to be about 83 percent as as accurate as polysomnography sensors that detect brain waves, heart signals and muscle activity.
"We see this as another tool in the arsenal of tools to help detect sleep disorders," Zigel said.

Watson, the University of Washington sleep expert, says these new approaches and apps won't replace polysomnography, which can detect many problems, such as heart arrhythmias, restless leg syndrome and rapid pulse. "It's important to acknowledge that apps don't diagnose people, doctors do," he said, adding that the new technology could be used as an initial screen for a person concerned about their sleep, who could then consult a physician.

Snoring, according to the National Sleep Foundation, is the primary cause of sleep disruption for approximately 90 million American adults. But whose snoring is it, yours or your partner's? Apparently, that's a question asked the world over.

As Prof. Ariel Tarasivk, head of the Sleep-Wake Disorders Unit at Soroka University Medical Center in Beer-Sheva, Israel puts it:

"Snoring is in the ear of the beholder."