Sunday, March 24, 2013

Better Sleep - Part II


The industrial revolution has made many changes in our life style. For example, one profound change is the abundant food supply that presented an enormous challenge on our genetic code of building up and storing energy for survival. The genetic evolution that built over millions of years could not adapt fast enough for the food revolution happened over a few hundred years --- this underlies the widespread obesity issue facing the world today.

Our eight to five work schedule has made similar impact on at least two other schedules of our daily life --- eat and sleep.

In trying to get to work before nine, I usually get up around 7. Breakfast is an abbreviated meal that I try to finish in 15 minutes. My wife makes an effort of packing lunch with leftover from last night, not ideal, but at least usually with plenty of vegetables. For dinner, as this is the only meal we enjoy as a family, by the usual dinner time of 7:30 PM, I am so starved that you have to yell at me to stop. In trying to keep with the new year resolution for better sleep, I go to bed around 11.

Overall, a pretty healthy lifestyle for a contemporary working man. Or is it?

I have been looking for answers for two questions:

One, is it better to eat three meals a day or eat four or five smaller meals a day? Two, is it better to have one consolidated sleep period from 11 to 7 or a couple of shorter periods, or is there a better schedule for each of us individually.

The sleep period is an interesting one. Eleven to 7 could be the best choice we have, given our work schedule, but it certainly is not for the longest living people on earth. Dan Beuttner in his book "Blue Zone" documented that the 80-, 90- or 100-year olds from the Greek island of Ikaria often party well into late night, sometimes mid-night. Then they get up whenever they wake up, eight, nine or ten in the morning. They often take naps in the afternoon, which is often a controversial topics among sleep experts. Some studies showed naps can improve neurocognitive function, and other experts consider any unconsolidated sleep --- sleeping during the day or in bursts is unsound.

Matthew Wolf-Meyer in his book "The Slumbering Masses" claims that our current model of consolidated sleep is not rooted in biology, but resulted from the relentless pressure for productivity in a capitalist society. He noted that American used to sleep in two or more periods throughout the day. They went out to bed not long after the sunset. Four or five hours later, they woke up --- praying, chatting, making love, and went back to a second sleep.

The biologic clock regulate sleep can be very different among us. Early birds and night owls are not only self claims but supported by models of sleepiness and wakefulness. Perhaps there could be another mobile health device to help figure out what is the best sleep schedule for each of us. You could measure sleep efficiency (for example, percent of sleep in the period of time in bed) when trying out different sleep patterns. After you have figured out when to take that best nap in the afternoon, you just have to get the carpenter who designed the desk for George Costanza.

I am still looking for answers on three meals a day...

Sunday, March 17, 2013

Mobile Health Revolution - Understand Health Risks

Listening to the news on my drive to work every morning, the world is full of risks. This past week, it was the nuclear threat from North Korea. The biggest risk at the time of listening to this news, however, was in a moment of attention slip, I could hit someone's car, or similarly, someone else could hit me. Given the statistics from US census of 11 million car accidents in 2009, which resulted 36,000 deaths, it is a far bigger risk than dying from a nuclear war (0 death in the US history) or from a mass shooting (88 deaths in 2012), headlines of recent news.

Similar to the daily risk on the road, understand the daily health risk is also quite fascinating.


Jared Diamond wrote an interesting piece about our misperception about spectacular risks from events that are out of our control versus frequent small risks that we can control. The largest health risk facing by seniors may not be the mired of diseases associated with aging, it is that 1 in a 1,000 chance of a fall in the shower. For the 75 yr old professor Diamond, he figured that he needs to reduce that chance to be much smaller to survive from 5,475 showers to live to 90.


The mobile health revolution can help us be watchful to small daily risks that may become real dangers.


Bradycardia, or a very slow heart rate, is a condition common in seniors. It is often the cause for passing out momentarily or loss of consciousness. The occurrence of bradycardia is often intermittent and hard to diagnose. Just as dangerous of a slip in the shower, a fall due to a bradycardiac event is also the debilitating event for many seniors. A mobile health solution could monitor the event much more accurately than the clinic setting, and improve the ability to diagnose and provide appropriate treatment options.


Sleep apnea is another condition that occurs frequently, but varies night to night. The current diagnostic standard is to spend one night in the sleep lab or a one night home sleep test. A mobile health solution can help monitor the daily condition and tailor treatment accordingly.

The combination of these solutions may help us understand the overall health risk, be attentive to small daily risks, and be preventive to large events that send us into the hospital.


I am excited to see what Samsung’s new ‘S Health’ feature may offer.