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Sleeping disorders: the changing face of health and care

Sleeping disorders: the changing face of health and care
Hello! I am going to talk about the changing face of health and care with the focus on health information technology. My name is Yu-Chuan (Jack) Li. I’m from the Taipei medical university graduate institute of biomedical informatics. I’m a professor in medical informatics. Most of the dean of the college medical science and technology.
Well, there are a lot of shifting happen in the recent years in health care. On the disease side, we’re now more focusing on chronic diseases than acute diseases. On the care side, it used to be short and it is hit and skip because you go to the hospital when you are sick or visit a clinic or GP’s office when you are sick but then you come back home and things don’t get taken care of and then you have to go back. Now we’re more focusing on long term care and continuously monitor the health status. On the health behavior part, usually we rely on drugs. Traditional, we rely more on drugs.
Now we rely more on food and behavior change or lifestyle change. In terms of technology, most medical technology were used in hospital and they were designed for general purpose and they were usually quite expensive. Now the technology has shifted more on the homefront and these devices are smaller and more personalized so that we can actually do monitoring no matter whether you’re in the hospital or back home. Now I’m going to use sleep disorder to illustrate out the point of this change.
As many of you know, that sleep disorder is a worldwide problem. In the US, more than 32% of the people and in Paris 30%, Japan 20%, UK is a little bit lower 14%, of the people responded that they have suffered from sleep disorder. This is a survey from some European country and as you can see, the numbers are also around 20% to 30%. And about Insomnia or sleeping disorder, there are several different categories. Today we are going to focus only on primary Insomnia because if you are suffering from secondary Insomnia, you probably need to find the primary reason before you can resolve this problem. But sleeping, you know…sleeping well is very tricky thing.
It’s not easy to identify the real sleep quality. Although you can probably find some apps or some tools that claims to monitor sleep quality or give you irrelative number for deep sleep, shallow sleep and REM but when you look at the real progress of sleep, EEG or Encephalo Electrogram, you will find out that it’s not there’s not a single pattern that you can seen that indicates the quality. Generally, you need to have several REM or Rapid Eye Movement stage. But if you have too many REM, and the REM is not long enough, then it’s not good. And also you need more deep sleep, but it doesn’t mean that you have to have a very long deep sleep.
So it’s really difficult to determine sleep quality even just by looking at EEG. And sleeps are actually affected by many different factors. As you can see, mood and comorbidity, medication all affect Circadian clock which is the biological clock that control sleeping time. And as you can see, aging is a also a very major factor that will affect Circadian clock and the sleep wake cycle. Aging and insomnia, we all know, that when people age, we…our melatonin, start to decrease and the decrease seems to be more prevalent…more prominent on female than male. It takes long time to fall asleep and you wake up multiple times.
You wake up early..and you wake up feeling tired so these are signs of sleeping disorder or low quality sleep. There is a way, called Cognitive Behavioral Therapy for Insomnia or (CBTi) for short. That using the behavior science that would actually in cognitive techniques that could actually help reduce Insomnia. However, the CBTi, the traditional CBTi requires a lot of consultation session. You have to go to your sleep counselor like 3 times a week and you have to several hours going back and forth. And the whole process can last several months. In this project, we are trying to help you do the sleep preparation through mobile technology like smart phone with some wearable devices.
So we try to collect all the risk factors, all the factors that could affect your sleep quality and we use machine learning to predict whether you are going to sleep well or not today. There are many factors that could affect sleep, like your age, gender, personality, environment, and the sleep related records and variables, and the APP that you use. So we collect a lot of data we use wearable devices or so called bio-patch, to collect vital signs. We also use questionnaire to determine personality and determine the personal scenario and belief and the environment and lifestyle. We use APP to track your daily behavior and your sleep diary. And we evaluate a lot of wearables.
We end up determine that we use EPSON for this purpose, for this project. Because it’s the best across heartrate accuracy, the screen size and the battery life. And we also use a biopatch that could check your ECG, your electronic-cardiogram. That include the heart rate, the heart rate variability, activity, and body service temperature. So using all this wearable device provided all this information, plus the app, called “Night Sleep” and we will use this app to predict because we build this sleep preparation… prediction model. That would actually remind you several hours before your bedtime whether you are going to sleep or not.
And if the model predict you will sleep well, then you don’t have to worry about it, you just go on your daily work and go to sleep. If the model predict that you will not sleep well, then it will tell you that you should do some sleep preparation. And there is a setup CPTi work that would actually tell you how to get a good sleep, how to prepare for a good sleep. So that’s just one example of how technology could help problems that often aging people would often face.
So in the end, we could know we would actually see more HIT or Health Information Technology that will be invested into disorders related to aging population because that’s where we’re going, like it or not. And wearable sensors with wireless connections, these devices now we call them “IOT” or Internet of Things will be a key enabling technology that would include all the wearable devices as well as your smart phone. And eventually human behavior will co-evolve with the technology that we have and change the landscape of health and care. That’s I think, the topic of today about the changing face of health and care. Thank you!.

Sleeping disorders, especially insomnia, are common in older age. In this video, Professor Jack Li looks at how wearable technology can help to track and analyse sleep problems.


Prof. Yu-Chuan (Jack) Li

Prof. Li is the Dean of College of Medical Science and Technology in Taipei Medical University, and a Distinguished Professor of the Graduate Institute of Biomedical Informatics. Professor Li has been a pioneer of Medical Informatics research and a board-certified dermatologist in Taiwan. From 2006 to 2009, he was the President of Asia Pacific Association for Medical Informatics (APAMI). He has been the Principle Investigators of many national projects in Electronic Health Record, Patient Safety Informatics and Medical e-learning. He is also author of 140 scientific papers and 3 college-level textbooks.

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