There are numerous things to dislike about going to the doctor: Paying a copay, sitting in the waiting room, out-of-date magazines, sick people coughing without covering their mouths. For many, though, the worst thing about a doctor’s visit is getting stuck with a needle. Blood tests are a tried-and-true way of evaluating what is going on with your body, but the discomfort is unavoidable. Or maybe not, say Caltech scientists.
In a new paper published in Nature Biotechnology, researchers led by Wei Gao, assistant professor of medical engineering, describe a mass-producible wearable sensor that can monitor levels of metabolites and nutrients in a person’s blood by analyzing their sweat. Previously developed sweat sensors mostly target compounds that appear in high concentrations, such as electrolytes, glucose, and lactate. Gao’s sweat sensor is more sensitive than current devices and can detect sweat compounds of much lower concentrations, in addition to being easier to manufacture, the researchers say.
The development of such sensors would allow doctors to continuously monitor the condition of patients with illnesses like cardiovascular disease, diabetes, or kidney disease, all of which result in abnormal levels of nutrients or metabolites in the bloodstream. Patients would benefit from having their physician better informed of their condition, while also avoiding invasive and painful encounters with hypodermic needles.
“Such wearable sweat sensors have the potential to rapidly, continuously, and noninvasively capture changes in health at molecular levels,” Gao says. “They could enable personalized monitoring, early diagnosis, and timely intervention.”
Gao’s work is focused on developing devices based on microfluidics, a name for technologies that manipulate tiny amounts of liquids, usually through channels less than a quarter of a millimeter in width. Microfluidics are ideal for an application of this sort because they minimize the influence of sweat evaporation and skin contamination on the sensing accuracy. As freshly supplied sweat flows through the microchannels, the device can make more accurate measurements of sweat and can capture temporal changes in concentrations.
Until now, Gao and his colleagues say, microfluidic-based wearable sensors were mostly fabricated with a lithography-evaporation process, which requires complicated and expensive fabrication processes. His team instead opted to make their biosensors out of graphene, a sheet-like form of carbon. Both the graphene-based sensors and the tiny microfluidics channels are created by engraving the plastic sheets with a carbon dioxide laser, a device that is now so common that it is available to home hobbyists.
The research team opted to have their sensor measure respiratory rate, heart rate, and levels of uric acid and tyrosine. Tyrosine was chosen because it can be an indicator of metabolic disorders, liver disease, eating disorders, and neuropsychiatric conditions. Uric acid was chosen because, at elevated levels, it is associated with gout, a painful joint condition that is on the rise globally. Gout occurs when high levels of uric acid in the body begin crystallizing in the joints, particularly those of the feet, causing irritation and inflammation.
To see how well the sensors performed, the researchers ran a series of tests with healthy individuals and patients. To check sweat tyrosine levels, which are influenced by a person’s physical fitness, they used two groups of people: trained athletes and individuals of average fitness. As expected, the sensors showed lower levels of tyrosine in the sweat of the athletes. To check uric acid levels, they took a group of healthy individuals and monitored their sweat while they were fasting as well as after they ate a meal rich in purines, compounds in food that are metabolized into uric acid. The sensor showed uric acid levels rising after the meal. Gao’s team also performed a similar test with gout patients. Their uric acid levels, the sensor showed, were much higher than those of healthy people.
To check the accuracy of the sensors, the researchers also drew blood samples from the gout patients and healthy subjects. The sensors’ measurements of uric acid levels strongly correlated with levels of the compound in the blood.
Gao says the high sensitivity of the sensors, along with the ease with which they can be manufactured, means they could eventually be used by patients at home to monitor conditions like gout, diabetes, and cardiovascular diseases. Having accurate real-time information about their health could even allow a patient to adjust their own medication levels and diet as required.
“Considering that abnormal circulating nutrients and metabolites are related to a number of health conditions, the information collected from such wearable sensors will be invaluable for both research and medical treatment,” Gao says.
The paper describing the research, titled, “A laser-engraved wearable sensor for sensitive detection of uric acid and tyrosine in sweat,” appears in the Nov. 25 issue of Nature Biotechnology.
I fought ageing hard before deciding to go grey. It was the start of a brilliant new midlife
Casting off society’s expectations to grow old gracefully felt subversive. Ever since, I have grown bolder in body and mind
In my early 40s, it hit me that I was ageing. At first, the physical signs really bothered me. Solving the grey-hair part was easy: I embraced hair dye, rejoicing that I could cheat the grey grim reaper for ever. Next came the wrinkles and saggy bits on my body. I fought them with an array of costly, time-consuming and mostly ineffectual rituals. Seduced by a barrage of ads playing on my fears of growing older, I diligently bought and applied a cupboard full of allegedly age-defying serums and moisturisers to my face and body. But it began to take so much effort, especially the hair. Those darned roots required a fortnightly touchup. I planned my life around the emergence of that badger stripe.
One day in my late 40s, I had an epiphany. What if I just … went grey? It really shouldn’t be a big deal, but for many women it is. No silver-fox badge of honour awaits us: we are likely to be pilloried for “letting ourselves go”. I feared not only being grey, but going grey; facing not so much a bad hair day as a bad hair year. Grey hair would unequivocally position me as old, heralding to everyone that my inevitable downward slide towards invisibility, senility and death had begun. Nonetheless, I decided to try it.
I can’t pretend that I enjoyed the process to start with. My burgeoning roots looked unkempt and it took for ever for the grey to grow out, offering a life lesson in humility and patience. Going grey led me to question the narrative I had mindlessly absorbed over the years: stay young at any cost.
Then, a few months into my great grey grow-out, something unexpected happened. I realised I was starting to enjoy the process. It felt subversive to deviate from the societal diktat that says women must not visibly age. And, as I became more comfortable with my grey hair, I scrutinised the rest of my outlook more closely. Whether or not I now looked older, I realised that I cared less. Casting off society’s expectationswas curiously liberating.
Psychological research is clear: a positive outlook towards ageing is mentally and physically healthy. What’s more, there is mounting evidence (explored in books such as Bolder by Carl Honoré) that there are many upsides to growing older. Of course, there are some downsides, but the received wisdom that inevitable decline is to be expected as you age is vastly overstated. As a psychology lecturer and avid consumer of such literature, I knew this in theory, but had still succumbed to the whole anti-ageing narrative. Enough! I was ready for a midlife reboot.
My whole outlook has since shifted. If my exterior wears the patina of age a little more obviously than it used to, well, that’s OK. Fixating on the superficial signs of ageing seems less important. Rather than buying the latest face cream, I’m actively investing in my current and future health more generally because I want to enjoy this phase. Adopting a sense of agency about it all, seeing I have some choices in terms of how I age, makes me feel positively involved in the process.
I have scrutinised my lifestyle and made changes. My diet has improved. I’ve embraced regular exercise, too. If my body is to keep pace with my pro-age stance, I realised it needed serious work. I initially found the gym a scary place. Whereas others were effortlessly crunching, squatting and lunging, I was groaning, creaking and occasionally falling over. But I stuck at it and I’m fitter than I was in my 20s. And of course, it’s not just about the physical stuff. I’ve also adopted other lifestyle changes linked to ageing well, such as remaining socially engaged and challenging my brain.
Going grey was, for me, the conduit to a more spirited enjoyment of life after 50. I have grown bolder in word and deed, less afraid to stray outside my comfort zone. I’ve taken on new projects that challenge the notion that older women become invisible or matter less. I’m a founder member of Advocates for Ageing (a group of pro-age activists) and I have written a children’s book exploring the issues around growing older. Over the past year, I have started to share on social media psychological research around ageing, alongside my reflections and lived experiences. Closer to home, I’m keen that my daughters grow up aware of these issues and see that an alternative narrative is possible.
The process has also had an impact on my job as a university psychology lecturer. My teaching and research activities increasingly focus on ageism and gendered ageism. I relish spirited debates with my young students on these topics. Even at their age, they realise that anti-ageing pressures hold sway. Equipping them with tools to recognise and fight ageism matters.
What started out as an experiment in going grey has ended up being so much more. It has prompted a huge lifestyle reappraisal and a monumental mindset shift. I have learned to befriend ageing, rather than see it as my enemy. I now know that I can play an active part in how my life unfolds after 50. Bring it on.
Sometimes people just need a nudge in the right direction
To whom it may concern: writing emails is painful. It’s bad enough finding the time to write them, but once you’ve done it, checked it and removed all the excess exclamation marks, you’re still not guaranteed a reply.
There’s some good news though: psychology can help. By factoring in a bit of behavioural science, and tweaking your emails to match, you can give your recipients a little more encouragement to respond. It’s not about tricking people with mind games – that’s a bit sinister. But these psychological tactics could edge your next email into RE: territory.
First, make it easy to respond. You’ve heard that before, we know, but chances are you haven’t been taking it far enough. “The strongest effect you’ll have, in any environment, is by making things easier,” says Max Mawby, head of behavioural science at fintech startup Plum. Your words should be easy to understand, your recipient should be able to figure out what you want them to do, and what you’re asking for should be easy to accomplish.
Nobel Laureate Richard Thaler won the prize for his work that was centered around that concept. “If you want to get people to do something, make it easy. Remove the obstacles,” he wrote in his book Nudge. It sounds simple, but the best advice usually is.
Before Plum, Mawby worked on the Behavioural Insights Team, nicknamed the Nudge Unit after Thaler’s theories. The government division developed a four-part toolkit called EAST to help people use behavioural science. It’s a pneumonic: make it Easy, Attractive, Social and Timely.
“At the end of the email you just put exactly what you want the person to do,” says Mawby. “Don’t dress it up at all.” Try to incite as little thinking as possible. People often assume that someone will want to know everything there is to know about something before making a decision – but that can get overwhelming. “Information overload does not lead to people doing things,” says Mawby, “it actually reduces the likelihood that people will take action.” The easier, the better.
In the few sentences you do write, make sure your request is the bit that gets their attention. That’s the ‘attractive’ part. Our brains find it much easier to complete a task if we’ve got something to aim for. When employees at Amsterdam’s Schiphol airport wanted to get the men using its bathrooms to aim better, they painted a picture of a housefly on each urinal – right next to the drain. Spillage declined 80 per cent. Sending a marketing newsletter? Hard code in a button for someone to click – that’s the fly on your urinal.
Next, make it more social. Humans are rigged up to be influenced by what other people say and do. “We all keep very, very precise ledgers in our brains of things that people have done for us,” Mawby says. “And when someone does something for us, we feel compelled to do something for them in return.” This is the concept of reciprocity.
If you’re sending an email to a prospective employer, for example, don’t just ask for a job, give them something first. Share a marketing idea, a design suggestion or a way to improve the company’s code – at the very least, show you’ve invested some time and energy into researching the brand. “This may seem quite basic, but you’d be surprised how many people don’t bother,” says Clare O’Connor, the editorial director of dating app Bumble. “Showing you’ve done at least a modicum of research really helps ensure you’ll get a reply.”
Just being polite on a basic level also helps, says Mai-Chi Vu, a product designer at email plug-in Boomerang, which uses machine learning to calculate the likelihood you’ll get a response. The company’s algorithms factor in politeness levels. “Emails on the politer side get higher response rates,” she says.
Reciprocity comes in here too. Thanks in advance was the most effective sign-off, with a 66 per cent response rate, beating Thanks (63 per cent) and Thank you (58 per cent) by a slim margin, but totally annihilating the classics like Best (51 per cent). Perhaps we’ve subconsciously realised that no one is actually “sincerely” sending their “best wishes” or “kind regards”, but still feel obliged to complete a task we’ve already been thanked for.
Boomerang’s plug-in also lets you schedule emails – use it to keep them timely. (Google’s Gmail has also introduced its own version of the feature). “The same information sent at different times can have drastically different levels of success,” Mawby says, but the best times will be different for each situation. If you’re sending a newsletter, do an A/B test. If you’re on a tight schedule, figure out when your recipient usually gets into the office and schedule your email to arrive then, so it’s at the top of their inbox.
Think about how much of their time you’re taking. “Respecting the other person’s time is crucial,” O’Connor says. “Rather than saying you’d like to pick my brain, say that you’d like 15 minutes on the phone for your master’s project. Being forthright will help prevent a long back-and-forth.”
It all comes back to making things easy. But Mawby also let us in on a little trick. “This is one to use sparingly,” he says, or it’ll become more annoying than clever. “You can arrange your email so that if the person doesn’t do anything something good happens.”
People are intrinsically lazy, so they often just go with the default option. “But do you even need a response?” asks Mawby. “Set it so that the default, if they don’t do anything, is that you go ahead.” Email me if you aren’t convinced. If I don’t hear anything, I’ll assume you’re satisfied. Sound good? Thanks in advance.
Paging Dr. Robot: Artificial intelligence moves into care
by Tom Murphy
The next time you get sick, your care may involve a form of the technology people use to navigate road trips or pick the right vacuum cleaner online.
Artificial intelligence is spreading into health care, often as software or a computer program capable of learning from large amounts of data and making predictions to guide care or help patients.
It already detects an eye disease tied to diabetes and does other behind-the-scenes work like helping doctors interpret MRI scans and other imaging tests for some forms of cancer.
Now, parts of the health system are starting to use it directly with patients. During some clinic and telemedicine appointments, AI-powered software asks patients initial questions about their symptoms that physicians or nurses normally pose.
And an AI program featuring a talking image of the Greek philosopher Aristotle is starting to help University of Southern California students cope with stress.
Researchers say this push into medicine is at an early stage, but they expect the technology to grow by helping people stay healthy, assisting doctors with tasks and doing more behind-the-scenes work. They also think patients will get used to AI in their care just like they’ve gotten accustomed to using the technology when they travel or shop.
But they say there are limits. Even the most advanced software has yet to master important parts of care like a doctor’s ability to feel compassion or use common sense.
“Our mission isn’t to replace human beings where only human beings can do the job,” said University of Southern California research professor Albert Rizzo.
Rizzo and his team have been working on a program that uses AI and a virtual reality character named “Ellie” that was originally designed to determine whether veterans returning from a deployment might need therapy.
Ellie appears on computer monitors and leads a person through initial questions. Ellie makes eye contact, nods and uses hand gestures like a human therapist. It even pauses if the person gives a short answer, to push them to say more.
“After the first or second question, you kind of forget that it’s a robot,” said Cheyenne Quilter, a West Point cadet helping to test the program.
Ellie does not diagnose or treat. Instead, human therapists used recordings of its sessions to help determine what the patient might need.
“This is not AI trying to be your therapist,” said another researcher, Gale Lucas. “This is AI trying to predict who is most likely to be suffering.”
The team that developed Ellie also has put together a newer AI-based program to help students manage stress and stay healthy.
Ask Ari is making its debut at USC this semester to give students easy access to advice on dealing with loneliness, getting better sleep or handling other complications that crop up in college life.
Ari does not replace a therapist, but its designers say it will connect students through their phones or laptops to reliable help whenever they need it
USC senior Jason Lewis didn’t think the program would have much for him when he helped test it because he wasn’t seeking counseling. But he found that Ari covered many topics he could relate to, including information on how social media affects people.
“Everybody thinks they are alone in their thoughts and problems,” he said. “Ari definitely counters that isolation.”
Aside from addressing mental health needs, artificial intelligence also is at work in more common forms of medicine.
The tech company AdviNOW Medical and 98point6, which provides treatment through secure text messaging, both use artificial intelligence to question patients at the beginning of an appointment.
AdviNOW CEO James Bates said their AI program decides what questions to ask and what information it needs. It passes that information and a suggested diagnosis to a physician who then treats the patient remotely through telemedicine.
The company currently uses the technology in a handful of Safeway and Albertsons grocery store clinics in Arizona and Idaho. But it expects to expand to about 1,000 clinics by the end of next year.
Eventually, the company wants to have AI diagnose and treat some minor illnesses, Bates said
Researchers say much of AI’s potential for medicine lies in what it can do behind the scenes by examining large amounts of data or images to spot problems or predict how a disease will develop, sometimes quicker than a doctor.
Future uses might include programs like one that hospitals currently use to tell doctors which patients are more likely to get sepsis, said Darren Dworkin, chief information officer at California’s Cedars-Sinai medical center. Those warnings can help doctors prevent the deadly illness or treat it quickly.
“It’s basically that little tap on the shoulder that we all want to get of, ‘Hey, perhaps you should look over here,'” Dworkin said.
Dr. Eric Topol predicts in his book “Deep Medicine” that artificial intelligence will change medicine, in part by freeing doctors to spend more time with patients. But he also notes that the technology will not take over care.
Even the most advanced program cannot replicate empathy, Topol said. Patients stick to their treatment and prescriptions more and do better if they know their doctor is pulling for them.
Artificial intelligence also can’t process everything a doctor considers when deciding on treatment, noted Harvard Medical School’s Dr. Isaac Kohane. That might include a patient’s tolerance for pain or the desire to live a few more months to attend a child’s wedding or graduation.
“Good doctors are the ones who understand us and our goals as human beings,” he said.
MOTOROLA RAZR 2 COULD ARRIVE WITH A TOUCH SENSITIVE SIDES
4.1 (82.61%) 23 votes
Motorola has recently broken the delay on its first foldable smartphone, the Motorola Razr. And now, it’s time to start talking about its likely successor.
In fact, Motorola has filed a new patent at the US USPTO and WIPO for a particular foldable device. As you can see from the drafts relating to the patent that we added bellow. The smartphone would integrate a foldable display and will have sensitive sides to the user’s touch. According to what is described by the patent, the lateral touch band would consist of several sensors capable of associating 20 different functions. In correspondence with the recognition of 20 different gestures.
MOTOROLA RAZR 2: FOLDABLE PHONE WITH SIDE TOUCH SENSORS
The recognition of gestures would be available even when the device is closed. As you can see from the images attached to the patent. Motorola would also like to integrate a fingerprint sensor into the display.
Clearly, the fact that Motorola has received the publication of the patent that it has filed does not imply that it will automatically use it to make the Razr 2. This is only a hypothesis by LetsGoDigital. Currently, there is no evidence showing Motorola’s interest in making a new foldable device. For more information on the Motorola patent just described, we suggest you consult the complete document,
MOTOROLA RAZR SPECIFICATIONS
It is worth to mention that the Motorola Razr has arrived with a 6.2-inch (2142 x 876 pixels) 21:9 Cinemavision foldable pOLED screen with an external 2.7-inch (600 x 800 pixels) 4:3 gOLED screen and Corning Gorilla Glass 3 Protection. It has an Octa-Core Snapdragon 710 10nm SoC with Dual 2.2GHz Kryo 360 and Hexa 1.7GHz Kryo 360 CPUs alongside with Adreno 616 GPU. Also, it has a 6GB (LPPDDR4x) RAM and 128GB storage. It runs Android 9.0 (Pie).
Read Also:Honor Watch Magic 2 Appears in Official Teaser, It’ll be Waterproof
Regarding the photographic compartment, the phone boasts a 16MP rear camera with dual-LED FLASH, Sony IMX519 sensor with f/1.7 aperture, 1.22um pixel size, EIS, Dual Pixel autofocus (AF) and Laser AF and a 5MP front-facing camera with f/2.0 aperture.
It has a fingerprint sensor and supports Splash-proof with water-resistant nanocoating. It also has a Bottom-ported speaker, 4 mics and a 2510mAh battery with 15W TurboPower fast charging.
“I don’t think at this stage, we are 100%, or even close to 100%, sure that AI can replace a historical high-touch type of doctor-patient relationship,” said Dr. Chun Yuan Chiang, a health practitioner and founder of IHDPay Group, a health care payments firm.
Still, experts say AI — defined broadly as machines programmed to mimic human intelligence, in areas such as problem-solving and learned behavior — has reshaped the medical landscape.
Artificial intelligence is ‘enhancing’ healthcare: IHDpay Group
From detection to diagnosis, digitization is widely being accepted as the new approach to medicine.
Health care practitioners and patients are quickly embracing digital apps and advanced technology to get to the bottom of an ailment.
But can technology and artificial intelligence ever replace doctors?
“I don’t think at this stage, we are 100%, or even close to 100%, sure that AI can replace a historical high-touch type of doctor-patient relationship,” said Dr. Chun Yuan Chiang, a health practitioner and founder of IHDPay Group, a health care payments firm.
“In terms of diagnostic aid, it’s a different category. So, I would say at the end of Day 4, the patient wants recovery,” he told CNBC’s Nancy Hungerford at a panel discussionat East Tech West conference in the Nansha district of Guangzhou, China on Tuesday.
Still, experts say AI — defined broadly as machines programmed to mimic human intelligence in areas such as problem-solving and learned behavior — has reshaped the medical landscape.
“We used to use x-rays to detect lung cancer. The problem is you can only go to stage 3 or stage 4 with x-ray,” said another member of the panel Dai Ying, chief innovation officer for GE Healthcare in China.
“Now, with CT you can see all lung modules, and with AI can tell where it is and how big it is. It’s much more advanced than before,” he said referring tocomputed tomography scans used to detect medical conditions.
Diagnosis of ailments and diseases is being done remotely these days. Health care providers are connected via centralized systems that can monitor patients remotely. But can AI replace a doctor’s visit for those that are remote?
“We are building telemedicine in our apps today where you can consult a doctor from the convenience of your homes, not for emergency,” said Jai Verma, CEO and board member of insurance company Cigna DIFC, and global head of government solutions at Cigna International. “I think AI, internet of things, are going to change the way we deliver health care in the future.”
Verma also believes that along with AI, blockchain technology will make it easier for heath care companies, professionals and patients to share medical records, and that many insurance companies are already looking at integrating blockchain into their modern systems.
As health-care providers plough millions into AI-powered machines, blockchain and other expensive innovative technologies to improve the future of medicine, there are concerns that health care costs could go up.
Experts think otherwise.
“I think the technology is going to help us streamline the operations and reduce our operating costs,” said Verma, pointing out that most costs these days are associated with manual work. “AI would help you to make it automated, so the future systems are going to help reduce your costs.”
However, concerns about fraud and data privacy persist as medical records get exchanged electronically.
Verma, who works for insurer Cigna, noted that many people misuse health care identities. “We lost a lot of money on fraud with people using the (ID) card and accessing the care for someone else,” he said adding that dispersing of incorrect medicine is a big risk with digitization.
Chiang pointed out that efficiency can be brought about by preventing fraud or moral risks, and that his company is committed to safety and authentication. “We provide a platform that everybody can use … to make sure it’s the right doctor, real doctor, real pharmacists, real drug, real insured person etc.”
In comments on twitter, Tesla CEO Elon Musk shared some more information about Tesla’s recently-revealed Cybertruck and some of the reasons for its controversial design.
The Cybertruck was unveiled on Thursday to…mixed reviews. The design is certainly polarizing, and a lot of people are not a fan of how different it looks.
There’s been a lot of memes passed around comparing the truck to the Pontiac Aztek, to bad early 3D models with few polygons, to strange 1970s concept cars or outdated concepts of what the future should look like.
Others have really liked the design, calling it a refreshing take on the pickup truck, which hasn’t changed much in a century.
Today on twitter, we got a little more insight into one of the reasons the truck is so angular – because machines aren’t strong enough to make it curvy:
Reason Cybertruck is so planar is that you can’t stamp ultra-hard 30X steel, because it breaks the stamping press
As Musk and designer Franz von Holzhausen demonstrated on stage, the Cybertruck is built for abuse. Instead of using stamped aluminum or steel like Tesla’s other cars (and most other vehicles on the road), Tesla is using 30X cold-rolled steel.
Tesla’s Cybertruck design differs from traditional autos because it uses a stainless steel exoskeleton instead of a traditional body-on-frame design. In the traditional design, the car body doesn’t have as much structural integrity and is mainly used for aerodynamic and styling purposes, and to protect occupants from the elements.
In the Cybertruck’s design, the entire vehicle exterior is used as a stressed member, allowing it to do double duty as both the body and the frame. This reduces complexity, and, since Tesla is using ultra-hard steel, increases sturdiness of the vehicle exterior.
This is why the doors were able to resist a sledgehammer swing from von Holzhausen, and were shown to be bulletproof in a demonstration video shown by Tesla during the reveal event.
The problem with this hardened steel exterior is that traditional auto-body stamping machines are made to deal with much smaller, more malleable pieces of sheet metal. These machines take a flat piece of metal and then smash it against a mold, creating the curve of each body panel separately.
But since the panels of the Cybertruck are so stiff, machines aren’t strong enough to stamp them. In order to add curves to the Cybertruck’s body, Tesla would need to build a whole new type of stamping press – or just design the car without curves. They did the latter.
I know there are reasons for it, including those mentioned above. And inside the truck, it feels great. It was smooth, spacious, comfortable. My test ride was excellent.
But it’s ugly and the design won’t grow on me. If you can get over that, great. If you just straight up like it and don’t think there’s anything to get over, also great. If it ushers in a new era of automotive design which reduces costs and increases durability and changes the way the world sees automobiles, that’s all cool too. Genuinely. But I still don’t like how it looks.
Could Cognitive Behavioural Therapy be the secret to helping insomniacs get to sleep faster & stay snoozing for longer?
24 Nov 2019, 0:25
Most of us know what it’s like to have difficulty sleeping, but one in three of us – including myself – have insomnia.*
The NHS defines insomnia as regular sleeping problems, including finding it hard to go to sleep, waking throughout the night or waking up too early. According to mental health charity Mind, insomnia can also be linked to depression and difficulties in coping with daily life.
A few years ago, I suddenly started waking during the night for up to three hours at a time. I tried ear plugs, eye masks, milky drinks, playing wave sounds, brandy and lavender pillows to no avail. My periods of bad sleep came in waves of a few weeks, improving for a while but always coming back.
During an acute phase I could be snappy and bad-tempered with loved ones – it was an emotional rollercoaster. So I was intrigued when I heard that a new study from Canada’s Queen’s University has found cognitive behavioural therapy (CBT) can help insomniacs get to sleep faster and stay snoozing for longer.
The majority of participants fell asleep between nine to 30 minutes more quickly after having between four to six sessions of CBT with a therapist, compared to up to four minutes for those who didn’t have it. CBT works on the premise that the way we think about situations can affect the way we feel and behave.
CBT for insomnia is readily available from private therapists, but provision on the NHS is patchy. And although sleeping pills can sometimes provide a temporary fix, they aren’t a long-term option because of side effects (such as daytime grogginess) and the fact your body builds up a resistance to the drug.
Ideally, we’d all do CBT with a trained therapist – some forms of it, for example for people with OCD, aren’t suitable to try on your own. But for a specific issue like insomnia, many people access CBT through groups, books and apps.
I decide to give automated CBT a go using Sleepio. It been rigorously tested in clinical trials and evaluated by the National Institute for Clinical Excellence (NICE).
It’s currently only available to NHS patients in some areas of the South East, with the intention of rolling it out across the country soon. So could 20-minute online sessions once a week for six weeks really nip my insomnia in the bud?
In the first session, I learn that CBT can help overcome the negative emotions that accompany insomnia. Worrying about not getting to sleep can make us feel anxious, which creates a cycle.
The Prof – a Scottish cartoon character who narrates the Sleepio sessions – explains the aim is to improve sleep efficiency, which is the amount of time spent asleep divided by the amount of time spent in bed.
Mine was 72% as I spent eight hours in bed but slept for under six.I judge my “sleep quality” two out of 10. The program asks you to fill in a daily sleep diary, alongside a sleep quality box in which you grade your sleep, to establish a weekly score.
I learn how to check my bedroom has adequate air and the most comfortable mattress and pillows for me.
Your room must be used only for sleep, so reading, listening to music or talking on the phone can’t happen in bed (sex is an exception).
My book and phone usually sit on my bedside table, but this week I leave them in the living room.
Coffee or vigorous exercise in the evenings are forbidden, and I’m told to avoid alcohol for at least four hours before going to bed – while it can help you fall asleep, it also tends to wake you up.
I like a brisk walk at 8pm, so I move that to 6pm instead. The Prof also recommends tensing and relaxing different muscle groups and taking deep, slow breaths in bed.
I’m urged to ditch my ear plugs to acclimatise to noise rather than blocking it out, but I find night road traffic too disturbing, so I keep the ear plugs in. Eye masks are OK for those troubled by light.
I now judge my sleep quality to be three, while sleep efficiency is 77%. I’m waking up less and dropping back off quicker. I’m taught that if I wake for more than 15 minutes, I have to get up.
The Prof encourages users to have a “wake-up plan” for this, so I leave a soft lamp, a blanket and a book in the living room.
This helps to build the relationship between bed and sleep, and to break the connection between bed and tossing and turning.
The course also introduces “sleep restriction” – narrowing the window in which we attempt to sleep. If you tend to get around 6.5 hours, stay awake until midnight and rise at 6.30am.
Following the 15-minute rule, I get up twice in the night this week. I’m tired, but it feels good to stop trying to sleep and read instead.
When I feel ready to go back to bed, dropping off is easier and I feel under less pressure. I also practise sleep restriction for three nights. My sleep efficiency is now 79%.
The course encourages you to create a vivid mental moving image you can conjure to help you relax in bed – I go for a babbling brook with the wind rustling the trees.
I’m also taught to repeat a meaningless word such as “the” to block unwelcome thoughts by thinking of them like a train that I allow to speed through my mind and come out the other side. Practising these visualisations helps.
My sleep efficiency is now 82%. Quality is five out of 10 and I’m feeling more alert, energetic and focused during the day.
The Prof teaches me to “de-catastrophise” my fears around not sleeping.
When I start to panic because I can’t nod off, my mind races with thoughts such as: “I’ll be rubbish at work tomorrow if I don’t sleep now”.
I think about the last time I had a bad night’s sleep and how well I actually coped the next day.
My sleep efficiency is 85%, just 5% away from the “healthy” goal of 90%. I feel so different. My mood is better, I feel mentally lighter and more equipped to tackle difficulties.
The benefits are making a big difference to my life – and my partner’s when he stays over. I may even be able to ditch the ear plugs and sleep through his snoring one day.
The Sleepio course was great for me because my insomnia isn’t rooted in emotional issues.
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However, if yours is, it may not be appropriate for you and you should seek a face-to-face appointment with a therapist if needed.
Now, when I wake in the night, I don’t feel pressure to get back to sleep, which means I’m more likely to drop off. I just wish I’d done it sooner.