the new era self-care and democratization of sleep medicine5db5ef8f-83f1-437e...optical (oximeter,...
TRANSCRIPT
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Health monitoring in insuranceUnlocking the power of your customers' data
The New Era Self-care and Democratization of Sleep Medicine
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A Sleepless SocietyBrightness map indicates light pollution
Insufficient sleep Insomnia Circadian rhythm problems
Social jet lag Obstructive sleep apnea
99% of Europeans and people in the US, live under skies nearly 10% brighter than their natural starry state
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Allan Rechtschaffen, 1970
“If sleep does not serve an absolutely vital function, then it is the biggest mistake the evolutionaryprocess has ever made.”
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Why we sleep?
Through an explosion of discoveries over the past
twenty years, we have come to realize that
evolution did not make a spectacular blunder in
conceiving of sleep. Sleep dispenses a multitude
of health-ensuring benefits, yours to pick up in
repeat prescription every twenty-four hours, should
you choose. (Many don’t.)“
Matthew Walker; 2017
“
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General Organization of the Autonomic Nervous Function
Endocrine (Glands Secrete
Circulating Factors)
Autonomic Nerves (organs)
Environment (sensory)
Endocrine (Glands Secrete
Circulating Factors)
Autonomic Nerves (organs)
Motor and Pain Control
CentralAutonomic
Network
Behavioral State Control (attention, sleep-wake cycle,
motivation…)
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Sleep Drive (needs)
Circadian Rhythm (clock)
Age
Individual/Genetic Differences
Determinants of Sleep
Waketime
Function
& HealthStress/Mood
Health/Pain
Motivation
Ambient Conditions
Social Time
Light-dark Cycle
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The Sleep-Life Balance is Broken
Technology Brought Fast Changes In Human Life:
Computers
TV and Media
Smartphones
Social media
Industrial revolution
Artificial light
Transportation
Communication
Half of the population of the U.S.A, Europe, and China
suffers from sleep deficit & sleep disorders
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Sleep DeficiencyPoor or Insufficient Sleep
Cardiovascular Diseases, Obesity & Metabolic
Syndrome, Cancer, Degenerative Disorders &
Dementia, Infectious Diseases, Mood
Disorders, Work and Traffic Accidents,
Absenteeism, Presenteeism….
Lower Quality of Life
Decreased Performance
Decreased Life Expectancy
Causes:
Leading to increase in:
Resulting in:
Lower Immunity
Increased Inflammation
Increased Stress
Endocrine Dysfunction
Memory Impairment
Increased Reaction Time
Emotional Imbalance
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Economic cost of insufficient sleep in 5 OECD countries
Source: Jess Plumridge/RAND Europe
The Impact of Sleep Loss
$63 B - Cost to employers$1,500 vs $300 - Cost to insurance company for person with poor sleep vs good sleep
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Use Technology to Repair the Very Damage it Caused
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Give Sleepa Chance
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Assess
SolveMonitor
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SleepRate Solutionat a Glance
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Heart Rate Measurement
Electrical (ECG, Chest Strap)
Optical (Oximeter, PPG)
Ballistical
Integration of Signals to Improve Results
Heart Rate
Actigraphy
Breathing
Oxygen Saturation
Ambient factors
Sound (noise & snoring)
Light
Temperature
Weather
Light-Dark
SleepRate Supports a Variety of Sensors
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BIO
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“ Wearable apps help Olympic athletes train at their best” Special for USA TODAY Sports; July 29, 2016
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Assessment
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Assessment Algorithm Flow
Raw Data Data Analysis Results
Sleep times and alarms as measured (GTB,WU,Alarm)
IBI
Accelerometer
Ambient sound & snoring
Daytime sleepiness, stress and naps (reported)
Daytime behaviors & habits
Questionnaires and demographics
Perceived sleep times
Sleep disturbances connected to ambient factors
Measured stress, HR and recovery
Perceived sleep measures & discrepancies from objective variables
Sleep Architecture (HRV and/or Actigraphy)
Correlates with daytime habits
Insomnia
DSPS
DSPS & Insomnia
ASPS
Insufficient sleep
Poor sleep related habits
Normal sleep
Referral to expert
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Global Sleep Fix
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Global Sleep Fix participation map
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Global Sleep Fix
50.0%
23.2%
7.5%
6.5%
12.5%0.2%
AssessmentOutcome
Insomnia Insomnia and Circadian Circadian Insufficient Sleep Habits Only Normal Sleep
7904 completed assessment
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50
51
52
53
54
55
56
57
Alcohol No Alcohol
Subjective Sleep Satisfaction
0
2
4
6
8
10
12
14
Alcohol No Alcohol
min
ute
s
Subjective WASO
error bars are standard errors
**
**
** p<0.0001
Alcohol and Sleep Parameters
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Pain and Sleep
• Pain – 586 Users • No Pain – 4437 Users
For which conditions have you been diagnosed or treated? • Arthritis or pain: Yes / No
40
50
60
70
80
90
100
Active Insomnia Insomnia - Not Active Short Sleep Duration Poor Sleep Habits
% o
f U
se
rs
Pain No Pain
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Therapy
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Historical Wisdom
The day and night [together] are twenty-four hours long. It is sufficient to
sleep for a third of this, i.e. eight hours, which should be at the end of the
night, so that there will be eight hours from when one goes to sleep to
sunrise. One should get up before sunrise.
One should not sleep on one's front or on one's back, but on one's side; at the
beginning of the night one should sleep on one's left side, and at the end of
the night on one's right side. One should not sleep close to having eaten, but
one should first wait three or four hours. One should not sleep during the day.
Maimonides, The Book of Knowledge, Regimen of Health, 1170-1180
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Increases sleep drive
Stabilizes circadian rhythm
Synchronizes sleep drive with
circadian rhythm
Reduces conditioned arousals
Lowers sleep related anxiety
Targets sleep damaging behaviors
Provides adequate individual guidance to reduce
conditioned arousals and negative emotions
Provides sleep education
Supports adherence with challenging behavioral
changes
Provides biofeedback or relaxation guidance
Provides detection of disturbing ambient noise
Therapy Phase corrects detected abnormalities Improves Sleep
How Does CBT+ Work
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Aetna Validation Study (RCT)
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Subjective-ObjectiveDiscrepancies (mean and SEM)
* for p<0.05 two-tailed paired t-test
CONFIDENTIAL AND PROPRIETARY
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619 subjects with insomnia symptoms
Each subject’s sleep parameters were compared:
last goal in therapy versus assessment
Insomnia Improvement
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0
10
20
30
40
50
60
Assessment Last Goal
min
ute
s
Subjective Sleep Onset
0
5
10
15
20
25
30
35
40
Assessment Last Goal
min
ute
s
Subjective WASO
76
78
80
82
84
86
88
90
Assessment Last Goal
%
Subjective Sleep Efficiency
40
42
44
46
48
50
52
Assessment Last Goal
Subjective Sleep Satisfaction
0
2
4
6
8
10
12
Assessment Last Goal
SSS Rank
**
**
**
**
**
error bars are standard errors
** p<0.0001
Insomnia Improvement
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Users’ engagement
0%
10%
20%
30%
40%
50%
60%
70%
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
# nights in therapy
With Device Without Device
% o
f u
se
rsw
ith
co
mp
lete
d a
ss
es
sm
en
t
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Assess
Solve
Prevent
Monitor
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Sleep Deficiency is SolvableRedeem your natural rights to sleep and undo the damage:
Cardiovascular Diseases, Obesity & Metabolic
Syndrome, Cancer, Degenerative Disorders &
Dementia, Infectious Diseases, Mood
Disorders, Work and Traffic Accidents,
Absenteeism, Presenteeism….
Better Quality of Life
Better Performance
Increased Life Expectancy
Normalize:
Reduce risk of:
Get:
Immunity
Inflammation
Stress
Endocrine function
Memory
Reaction time
Emotional Imbalance
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> 70,000 - # of users > 3,000 - # of therapy customers > 400,000 - # of nights recorded
As users’ s data accumulates Therapy improves and Prevention becomes possible
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> 70,000 - # of users > 3,000 - # of therapy customers > 400,000 - # of nights recorded
Sleep Well
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This presentation is for information purposes only and contains non-binding indications. Any opinions or views expressed are of the author and do not necessarily represent those of Swiss Re. Swiss Re makes no warranties or representations as to the accuracy, comprehensiveness, timeliness or suitability of this presentation for a particular purpose. Anyone shall at its own risk interpret and employ this presentation without relying on it in isolation. In no event will Swiss Re be liable for any loss or damages of any kind, including any direct, indirect or consequential damages, arising out of or in connection with the use of this presentation.