There is a growing body of research showing that increasing slow-wave activity during sleep can improve outcomes, including sleep quality[1], memory, and correlations with amyloid response[2].
Sadly, our latest grant application did not receive funding, but we are supporting other clinical researchers with our technology. Our technology is based on more than a decade of research with 50+ published, peer reviewed studies.
We focus on sleep directly rather than the disease, which means people do not have to wait years for regulatory approvals before they can feel day-to-day benefits.
For those curious about learning more, our approach and links to additional research are on our website https://affectablesleep.com
.
Getting better sleep has been a bit of a personal quest for me. Having said that, much as I would love to get the device, having been bitten by a bunch of subscription locked devices by startups, I have (reluctantly) settled on a policy of not purchasing hardware that can't work independently of the company.
Startups are hard at the best of times, hardware startups are harder. When the company making the hardware inevitably goes under, you are left with a useless piece of plastic that you paid a ton of money upfront for, and then paid a hefty sum every month on top.
The reason we use a subscription is to keep the upfront cost much lower. It's important to us that we make better sleep as accessible as possible. A one-time payment makes that more challenging at this stage.
We also wanted to keep things simple at checkout. Too many options can be confusing, and at this early stage our priority is making it straightforward for people who want to try the technology.
Fair point. To be clear, time in deep sleep does not increase. What increases is delta power, the primary measure researchers use for how restorative deep sleep is. This has been shown in the research, and our technology has been validated by an independent laboratory so that they could use it in their own clinical trial.
On our site we simplify the language. That is partly because of the regulations do not allow us to make clinical claims prior to approval, and partly because explaining the neuroscience in detail would overwhelm most visitors.
I link to the research so those interested can dive in deeper, and that is allowed.
really cool Im sorry to hear you didnt get funding. I dont know much but isnt the problem related to what causes the build up in teh first place? wasnt it scarring or something?
Thanks. We're used to not getting funding. It's part of the journey as a start-up and in research.
The build-up isn't scarring.
It's misfolded proteins in the brain which stick in places they shouldn't and the glymphatic system which flushes cerebrospinal fluid through the brain removes the build-up of these protiens.
If you have poor sleep or lack of sleep, these proteins don't get removed and that build-up interferes and disrupts the firing of neurons.
Alzheimer's drugs are able to help remove the build-up, but unfortunately are not able to repair the damage. That's why they only slow progression of the disease, not treat it.
If slow-wave enhancement lives up to the potential, it would likely also only be preventative. It would be surprising if it was able to treat AD.
yes, poor sleep quality leads to bad days, bad days lead to more bad sleep, it is a downward spiral and may impact many of us in our prime years, too.
All the best on your research and funding. Quality sleep has been undervalued, especially among work cultures that value overachieving at the expense of personal health.
Thanks. A researcher we work with has postulated that build-up of metabolic waste (amyloid and tau, among others) directly impairs the glymphatic system, leading to more build-up. A viscous cycle.
I don't think she's the first to postulate this, but I believe she is researching this relationship now.
Though work culture is an important one, we're somewhat more focused on the less self-imposed sleep challenges related to maternity and perimenopause/menopause.
that's a cute Freudian slip (or deliberate joke) - viscous cycle - sure, amyloid and tau are probably very viscous when you poke at them with the laboratory utensil of your choice. And accumulation of them is like a viscious cycle of plaque accumulation and even worse clearance. It seems exponetial
I have narcolepsy and it's hard to describe what an absolute fog I was in for years before diagnosis. The current best treatment is a powerful depressant taken at bed time and again middle of the night to induce deep sleep.
Is that gabapentin? Or is there something else that is the go to these days?
There was a comment on reddit a few days ago from someone with narcolepsy who was looking for a sleep tracker.
Sadly, our technology does not "induce" deep sleep.
It is suspected that the reason the Alzheimer's study showed such an increase in deep sleep was due to decreased cortisol as a result of stimulation, but that is just a theory at this point.
Sodium oxybate. And yeah most commercial sleep trackers are not going to work for someone with such disordered sleep. There have been retail EEGs available but they never catch on.
We don’t sell or share EEG data with third parties.
The data is encrypted on the device and in storage.
Our system processes it to show the user how they respond to stimulation, but company staff do not have direct access to individual user data.
Internally we only look at anonymized or aggregated data to improve the technology.
Is that what you meant? I assumed you meant from a privacy perspective.
Almost everyone on our team is on Android, but we wanted to iterate on the platform that most users are on and focus on getting that experience right.
Sales will somewhat depend on when we bring on someone to pick up the Android front-end.
We're a really small team, and with hardware, firmware, services, and apps, the engineering footprint becomes quite large.
What often doesn't get factored in is manufacturing test rigs, plus we have software to support clinical research.
I'm not complaining about it, but holding off on Android seemed to be the right move, as we can't remove any of the other functions. We've had quite a few requests for Android.
The standard statistical caution for these kinds of screening tests is especially important here, because while Alzheimers drugs may be more effective earlier in the disease course, none of them are "effective" in the sense of meaningfully staving the disease off; the upside to early detection is not very strong.
Meanwhile: the big challenge for screening tests is base rate confounding: the test needs to be drastically more specific the lower the percentage of the cohort that truly has the condition is. Relatively low rates of false positives can pile up quickly against true positives for conditions that are rare in the population.
The bad thing here is: you get a test suggestive of early-onset Alzheimers. It could realistically be the case that the test positive indicates in reality a coin-flip chance you have it. But that doesn't matter, because it will take years for the diagnosis to settle, and your mental health is materially injured in the meantime.
while Alzheimers drugs may be more effective earlier in the disease course, none of them are "effective" in the sense of meaningfully staving the disease off; the upside to early detection is not very strong.
One correction here: the amyloid antibodies that successfully clear out a large amount of plaque have yet to report data from intervention trials prior to symptom onset, so we can’t say this with confidence and in fact we have good reason to suspect they would be more effective at this disease stage.
Edited to add: the sort of test discussed in the OP wouldn’t be relevant to presymptomatic treatment, however, since it’s a test of symptoms rather than biomarkers for preclinical disease.
That is an amazing breakdown of AD, and I think it will be my go-to for sharing in the future.
Have you seen the research in phase-targeted auditory stimulation, memory, amyloid, and sleep? Do you have thoughts on that?
Acoustic stimulation during sleep predicts long-lasting increases in memory performance and beneficial amyloid response in older adults - https://doi.org/10.1093/ageing/afad228
I hadn’t seen that research, thanks for passing it along. It seems like an interesting approach to improve slow wave sleep, which is known to help with amyloid clearance.
Exercise significant skepticism with neuroscience. People are credulous — and many studies are honestly shams. Like that “MIT study shows that ChatGPT reduces brain activity.”
I tend to agree with you, and many sleep studies are even worse. I work in the space.
I believe replication is key.
It was amazing when the room temperature superconductor paper came out about 18 months ago, the immediate response was to share the news, and then replicate.
I am not understanding this: "It can’t directly predict who will develop Alzheimer’s, but it does identify who could be at a higher risk." I get the part that it can't "directly predict", but what does it mean to "identify who could be at a higher risk"? How was "higher risk" independently diagnosed in the study in order to show a correlation between higher risk according to this test, and higher risk according to some other test?
"Patients with amnestic MCI—who have memory loss as their main symptom and are more likely to develop Alzheimer’s compared to people with non-amnestic MCI—had lower responses to the test, reports the Guardian’s Ian Sample. It can’t directly predict who will develop Alzheimer’s, but it does identify who could be at a higher risk."
It's correlated eith amnestic MCI, ehich itself correlated with higher risk of alzheimers(edit0:typo) (that's what I'm reading from the begining of the paragraph you quoted)
There is a growing body of research showing that increasing slow-wave activity during sleep can improve outcomes, including sleep quality[1], memory, and correlations with amyloid response[2].
Sadly, our latest grant application did not receive funding, but we are supporting other clinical researchers with our technology. Our technology is based on more than a decade of research with 50+ published, peer reviewed studies.
We focus on sleep directly rather than the disease, which means people do not have to wait years for regulatory approvals before they can feel day-to-day benefits.
For those curious about learning more, our approach and links to additional research are on our website https://affectablesleep.com .
Mild-to-moderate Alzheimer’s changes in sleep https://doi.org/10.1016/j.jagp.2024.07.002
Slow-wave activity, memory, and amyloid response https://doi.org/10.1093/ageing/afad228
Was really interested in this until I saw it was another static hardware product with a subscription as if it were a service.
If the toilet was invented today, plumbers would all be telling us how $1/shit is a steal.
Then I could theoretically use a shit coin to pay for an actual shit...
Great incentive to hack it open (like people did with eight sleep) or use prior art for an open source version.
That’s… actually a good way to have premium services on a bidet
Here I sit, broken-hearted...
Consumer Poop Index, used to be a dime
Getting better sleep has been a bit of a personal quest for me. Having said that, much as I would love to get the device, having been bitten by a bunch of subscription locked devices by startups, I have (reluctantly) settled on a policy of not purchasing hardware that can't work independently of the company.
Startups are hard at the best of times, hardware startups are harder. When the company making the hardware inevitably goes under, you are left with a useless piece of plastic that you paid a ton of money upfront for, and then paid a hefty sum every month on top.
Thanks for this thoughtful response.
The reason we use a subscription is to keep the upfront cost much lower. It's important to us that we make better sleep as accessible as possible. A one-time payment makes that more challenging at this stage.
We also wanted to keep things simple at checkout. Too many options can be confusing, and at this early stage our priority is making it straightforward for people who want to try the technology.
It's a delicate balance.
Does it back up that it increases deep sleep? Just see word salads on the web page and: ”dont ask how it sounds, if it where a pill you wouldnt!”
Just red flags everywhere.
Fair point. To be clear, time in deep sleep does not increase. What increases is delta power, the primary measure researchers use for how restorative deep sleep is. This has been shown in the research, and our technology has been validated by an independent laboratory so that they could use it in their own clinical trial.
On our site we simplify the language. That is partly because of the regulations do not allow us to make clinical claims prior to approval, and partly because explaining the neuroscience in detail would overwhelm most visitors.
I link to the research so those interested can dive in deeper, and that is allowed.
really cool Im sorry to hear you didnt get funding. I dont know much but isnt the problem related to what causes the build up in teh first place? wasnt it scarring or something?
Thanks. We're used to not getting funding. It's part of the journey as a start-up and in research.
The build-up isn't scarring. It's misfolded proteins in the brain which stick in places they shouldn't and the glymphatic system which flushes cerebrospinal fluid through the brain removes the build-up of these protiens.
If you have poor sleep or lack of sleep, these proteins don't get removed and that build-up interferes and disrupts the firing of neurons.
Alzheimer's drugs are able to help remove the build-up, but unfortunately are not able to repair the damage. That's why they only slow progression of the disease, not treat it.
If slow-wave enhancement lives up to the potential, it would likely also only be preventative. It would be surprising if it was able to treat AD.
If you want to know more, a comment in this post has what I think may be the most thorough breakdown of AD. https://www.astralcodexten.com/p/in-defense-of-the-amyloid-h...
Great stuff thank you!
yes, poor sleep quality leads to bad days, bad days lead to more bad sleep, it is a downward spiral and may impact many of us in our prime years, too.
All the best on your research and funding. Quality sleep has been undervalued, especially among work cultures that value overachieving at the expense of personal health.
Thanks. A researcher we work with has postulated that build-up of metabolic waste (amyloid and tau, among others) directly impairs the glymphatic system, leading to more build-up. A viscous cycle.
I don't think she's the first to postulate this, but I believe she is researching this relationship now.
Though work culture is an important one, we're somewhat more focused on the less self-imposed sleep challenges related to maternity and perimenopause/menopause.
that's a cute Freudian slip (or deliberate joke) - viscous cycle - sure, amyloid and tau are probably very viscous when you poke at them with the laboratory utensil of your choice. And accumulation of them is like a viscious cycle of plaque accumulation and even worse clearance. It seems exponetial
Came here to say this. Also lol:
> And accumulation of them is like a viscious cycle
I don’t know what this slip meant though ;-)
LOL :)
Unintentional, but I like it!
I have narcolepsy and it's hard to describe what an absolute fog I was in for years before diagnosis. The current best treatment is a powerful depressant taken at bed time and again middle of the night to induce deep sleep.
Is that gabapentin? Or is there something else that is the go to these days?
There was a comment on reddit a few days ago from someone with narcolepsy who was looking for a sleep tracker.
Sadly, our technology does not "induce" deep sleep.
It is suspected that the reason the Alzheimer's study showed such an increase in deep sleep was due to decreased cortisol as a result of stimulation, but that is just a theory at this point.
Studies do show a decrease in night-time cortisol (https://doi.org/10.1038/s41467-017-02170-3) early in the night during stimulation.
Sodium oxybate. And yeah most commercial sleep trackers are not going to work for someone with such disordered sleep. There have been retail EEGs available but they never catch on.
What do you do with user data?
We don’t sell or share EEG data with third parties. The data is encrypted on the device and in storage. Our system processes it to show the user how they respond to stimulation, but company staff do not have direct access to individual user data. Internally we only look at anonymized or aggregated data to improve the technology.
Is that what you meant? I assumed you meant from a privacy perspective.
Are you planning on allowing this device to work with Android? I'm asking because I can see on your website that it requires an iphone currently.
Yeah, we definitely will have Android.
Almost everyone on our team is on Android, but we wanted to iterate on the platform that most users are on and focus on getting that experience right.
Sales will somewhat depend on when we bring on someone to pick up the Android front-end.
We're a really small team, and with hardware, firmware, services, and apps, the engineering footprint becomes quite large.
What often doesn't get factored in is manufacturing test rigs, plus we have software to support clinical research.
I'm not complaining about it, but holding off on Android seemed to be the right move, as we can't remove any of the other functions. We've had quite a few requests for Android.
The standard statistical caution for these kinds of screening tests is especially important here, because while Alzheimers drugs may be more effective earlier in the disease course, none of them are "effective" in the sense of meaningfully staving the disease off; the upside to early detection is not very strong.
Meanwhile: the big challenge for screening tests is base rate confounding: the test needs to be drastically more specific the lower the percentage of the cohort that truly has the condition is. Relatively low rates of false positives can pile up quickly against true positives for conditions that are rare in the population.
The bad thing here is: you get a test suggestive of early-onset Alzheimers. It could realistically be the case that the test positive indicates in reality a coin-flip chance you have it. But that doesn't matter, because it will take years for the diagnosis to settle, and your mental health is materially injured in the meantime.
while Alzheimers drugs may be more effective earlier in the disease course, none of them are "effective" in the sense of meaningfully staving the disease off; the upside to early detection is not very strong.
One correction here: the amyloid antibodies that successfully clear out a large amount of plaque have yet to report data from intervention trials prior to symptom onset, so we can’t say this with confidence and in fact we have good reason to suspect they would be more effective at this disease stage.
I wrote about this and related topics here: https://www.astralcodexten.com/p/in-defense-of-the-amyloid-h...
Edited to add: the sort of test discussed in the OP wouldn’t be relevant to presymptomatic treatment, however, since it’s a test of symptoms rather than biomarkers for preclinical disease.
That is an amazing breakdown of AD, and I think it will be my go-to for sharing in the future.
Have you seen the research in phase-targeted auditory stimulation, memory, amyloid, and sleep? Do you have thoughts on that?
Acoustic stimulation during sleep predicts long-lasting increases in memory performance and beneficial amyloid response in older adults - https://doi.org/10.1093/ageing/afad228
Acoustic Stimulation to Improve Slow-Wave Sleep in Alzheimer's Disease: A Multiple Night At-Home Intervention https://doi.org/10.1016/j.jagp.2024.07.002
Thank you for your kind words.
I hadn’t seen that research, thanks for passing it along. It seems like an interesting approach to improve slow wave sleep, which is known to help with amyloid clearance.
If you're looking into this space further, I've posted the majority of the research on our website https://www.affectablesleep.com/how-it-works (bottom of the page)
What about Alpha Cognition’s Zunveyl?
Your first sentence seems to imply that an effective intervention or treatment for AD would need to be a drug.
Exercise significant skepticism with neuroscience. People are credulous — and many studies are honestly shams. Like that “MIT study shows that ChatGPT reduces brain activity.”
Why is this pilot study in the Smithsonian?
I tend to agree with you, and many sleep studies are even worse. I work in the space.
I believe replication is key.
It was amazing when the room temperature superconductor paper came out about 18 months ago, the immediate response was to share the news, and then replicate.
In fairness, as I understand it room temperature superconducting would change everything. Small wonder people were excited.
I am not understanding this: "It can’t directly predict who will develop Alzheimer’s, but it does identify who could be at a higher risk." I get the part that it can't "directly predict", but what does it mean to "identify who could be at a higher risk"? How was "higher risk" independently diagnosed in the study in order to show a correlation between higher risk according to this test, and higher risk according to some other test?
"Patients with amnestic MCI—who have memory loss as their main symptom and are more likely to develop Alzheimer’s compared to people with non-amnestic MCI—had lower responses to the test, reports the Guardian’s Ian Sample. It can’t directly predict who will develop Alzheimer’s, but it does identify who could be at a higher risk."
It's correlated eith amnestic MCI, ehich itself correlated with higher risk of alzheimers(edit0:typo) (that's what I'm reading from the begining of the paragraph you quoted)
> may identify
> linked to
Really putting their necks on the chopping block and making with the bold opinions, here.
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