2022/12/29

Discussion on Digital Health

Online Roundtable Discussion Among Clinical Doctors 【Part 5】

Digital Therapeutics (DTx), Clinical Doctor, Telemedicine, Japan, Sleep disorder, Disease management and Patient monitoring, Wearable

The Second Part: Sleep and Sleep Tech 

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For the fifth part of the Online Roundtable Discussion Among Clinical Doctors, continuing from the previous meeting, doctors interested in “sleep tech” will discuss “Sleep and Sleep Tech” frankly. In the first part of this issue, doctors talked about their problems with sleep and measures against them. This time, they will discuss topics such as smart rings and mindfulness. 
(Although the names of specific products and services appear in the text, these are personal impressions and are not intended to guarantee efficacy or endorse specific products. We have no vested interest in any particular company or organization in connection with this article.)

Participants: 

Facilitator: LSMIP Editorial Office

Source: Shutterstock

Features and Improvements to be Expected in Sleep Tech

Facilitator:     Thank you for telling us in the previous session about the Sleep Techs and sleep measures that doctors use. The first question of this time is, what additional functions would you like to be expected in the devices you are currently using, or what would you like to see improved?

Dr. Nemuruko: I would like the SpO2 measurement on the Apple Watch to be more accurate. It would be nice if something with accuracy, like a simple PSG, could be incorporated as an app.

Facilitator:     By improving the accuracy, I expect the Apple Watch to utilize it more in the medical field.

Dr. Slowly EP:  It would be great if it could provide detailed lifestyle guidance like a personal trainer based on one’s sleep data.

Facilitator:     This is a big challenge. We need monitoring plus support to hope for effectiveness. If it’s like a chatbot-like service where you can consult with them about various things, it could be done quickly.

Dr. Nemuruko: In a diet app called “Asken Diet*1,” it reads the daily calories and nutritional balance from the ingredients entered by the user and gives advice on what foods are lacking and what foods are good. It would be nice to have such an app (for sleep apps as well). I suppose many people use sleep apps but don’t make the most of them.

Facilitator:     Yes, that’s right. It isn’t easy to continue if people don’t know how to improve or are motivated by monitoring only.

Dr. Reina:    This is a little off the mark regarding desired improvements in device functionality, but it would be easier to recommend the device if it were cheaper. I often receive advice on sleep-related problems and am often told that Fitbit and Apple Watch are too expensive for people who want to try them for the first time. Then I tend to recommend the “JUKUSUI” app. I don’t say anything too complicated in my sleep counseling, but timely praise greatly motivates the consulter. The same is valid for diet support. Cognitive-behavioral therapy is expected to be effective. Also, my clients suffer from insomnia and shallow sleep, so they don’t like to sleep with something on their arms.

Facilitator:     Cognitive-behavioral therapy should be introduced more in the future, but some parts cannot be supported by apps and devices alone, and human support is necessary. Will it be a matter of combining them well?

Dr. Reina:    I think so, too, and although there are some aspects that a bot could handle, it would be easier to understand if a person intervenes to provide a starting point. In the diet support I provide (for people aiming for general weight loss), we talk to each other, and I grasp their cooking skills and favorite trends, suggest recipes, and when they get into the swing of things, I introduce them to the app, and that’s it. By the way, the “Asken Diet” app is great. It seems easier to receive nutritional guidance than the outpatient nutritional guidance offered at hospitals. Since it is self-funded, I thought it would be suitable for those who want to receive support voluntarily.

Facilitator:     Personally, the diet support by a doctor was a good service.

Source: Shutterstock

Oura Ring

Facilitator:     I don’t think the Oura Ring we mentioned last time is sold in stores in Japan (as of Oct-2022) *2 but is it available directly from the official website? Also, it looks heavy, but won’t it get in the way while working? Is it inconvenient? Is the accuracy good? Can you explain the advantages, disadvantages, etc.?

Dr. Slowly EP:  I bought Oura through the official website. It is in English. You can also buy it in Japanese on Amazon.
The advantages of the official site are free sizing kits and free 6-month membership ($6.99/month). The disadvantage is that the price has been raised. 
Amazon’s advantages are cheaper than the official ones, but they do not always have colors and sizes, no memberships, and sizing kits must be purchased separately. Membership is required to receive satisfactory service.
Also, weight is not a concern. It is pretty light. But it might be too lumpy for women. I don’t wear it while working for hygiene reasons. 
The accuracy is ◎, and I am satisfied with the functionality. It fits in with my life.
Oura’s strength is that it scores your sleep and life. What can I do to improve this score? It motivates me to do so. I don’t know how good or bad my physical condition is, even though I thought I knew. Therefore, using the score as an orientation to improve your lifestyle is good. Although it is unclear whether this score is a surrogate marker of my physical condition, I believe it is. I’ve been exposed because my score goes down with my heart rate and other factors when I eat a night meal. And I guess I should stop eating at night.
The cons are that I can’t put it on while I’m working (due to work commitments) and that service is highly diminished without membership.    

Facilitator:     For those who are not confident in their English, it is a hurdle to purchase from the official website.

Dr. Slowly EP:  That’s right. Private importing seems quite a hurdle for those who have never done it. It could be more of a psychological burden than a work hurdle.

Dr. Nemuruko: It’s pretty painful to know that service is diminished without membership. And there seems to be a bit of resistance from everyone to the subscriber thing. And it’s hard when it fluctuates with the exchange rate.

Dr. Reina:    How do you feel about the charge? Also, can you tell us about the service life?

Dr. Slowly EP:  Oura, even if you don’t charge it for a few days, the battery never runs out. It’s enough to charge it in 10-minute increments during gaps in time. Officially it says it can be recharged in 20-80 minutes and used for about seven days. I have no trouble with the batteries at all. There are no malfunctions, and it runs very smoothly. There are no unusual outliers, etc., and use is non-stressful.
The instructions said the warranty is 1-2 years (depending on region and generation). The service life seems to work on a year-to-year basis.

Source: Shutterstock

Mindfulness

Facilitator:     Apart from monitoring, there was a news story about this robot development at ANA a while ago. I heard that it is a meditation communication robot. Excuse me, and this is a little far from sleep.    “Using Mindfulness to Recharge Inflight” |What’s up? ANA|https://www.anahd.co.jp/ana_news/archives/en/2017/09/26/20170926-1.html

Dr. Slowly EP:  I have never heard of this kind of service. I am not very good at flying, so it is good news that I will be more energetic than before the flight. I try mindfulness apps, but I can never get them right. It’s fascinating to have a robot like this to help me. Is there anyone good at mindfulness?

(Continue to the next) 


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