Translator: David DeRuwe Reviewer: Maurício Kakuei Tanaka I'm a sleep medicine expert. We know that body temperature fluctuates throughout the day. A little after lunch, there's a drop in temperature, which corresponds to the moment that we're the sleepiest.
So feel free to sleep. "Teacher, I was practicing. " No problem at all.
(Laughter) Now, I think they already said that technology itself is merely allowing us to see things differently. If we look for the definitions of health and sickness, according to WHO, the World Health Organization, health is physical, mental, and spiritual well-being, plus another thing. If I ask you here who has all this at the same time, nobody's going to raise their hand.
Since we have such an idealized vision of health, what are we all? Sick. So we have a naturally mistaken vision.
Everybody's sick; everybody's depressed; everybody has high blood pressure, reflux. If you add up all the illnesses we have, they won't fit on Earth because everybody's sick. Technology is allowing us to see this situation differently.
The truth is that the English, who like thinking about this issue, have argued that . . .
health is your ability to deal with new challenges. It's a total paradigm shift that can only happen if we manage to monitor things differently because if I go to a doctor to take my blood pressure, my first question is, "Doctor, is my blood pressure normal? " So I'm either healthy or sick.
There's no other option. Now, if I can measure something over time, I'll realize that things fluctuate throughout the day, and we'll be able to say, "Can I handle this situation right now? " Because saying that stress is a bad thing isn't true.
I'm stressed about being here, but at the same time, this gives me an energy and a desire to share with you this idea that is, in fact, a radical paradigm shift, that has absolutely nothing to do with the technology itself. If we're talking about sleep, for example, if you take your cellphone, you can download a hundred applications that measure the right time to go to bed, how many hours you sleep, the quality of your sleep, the phases of your sleep, and even the time you wake up. The problem is that nobody has validated these applications, and we have a technology that serves for something, but we don't know for what.
At least, it makes us realize that we're a sleep-deprived society. We sleep less and less, and this is the newest sleep thief. We turn out the light but continue connected, and in the morning, the alarm goes off.
And everything we say goes down the drain because when you're tired, none of this works. Now, who here already - Can I ask for a show of hands? Who here has tried to sleep and suddenly, by your side, someone is snoring loudly, and you can't get to sleep?
Raise your hands, please. It's an incredible quantity, but I'm worried about those who didn't raise their hands. (Laughter) Because it's not us who snores; it's someone else.
I don't snore. My wife, here in the second row, says I snore, but I don't believe it. (Laughter) And it's a curious disease.
Now, let's take a look at these people who snore. There are snores and "snores. " No problem if you lie face-up and snore once in a while.
Women know that. They nudge the guy, he turns on his side, and it's OK. But he keeps on snoring.
What happened? He's a professional. (Laughter) He snores in any position.
You're laughing, but this can indicate a highly serious and common illness: obstructive sleep apnea. And what is apnea? So I'll ask you to do something now.
I'll count to three, and you do an apnea: you stop breathing. Let's go. You, at home, too.
One, two, three. Stop breathing. Hold on, while I tell the story of sleep apnea.
The person who stops breathing during sleep has to stop, each time, for at least 10 seconds for it to be considered a sleep apnea event. Now you can breathe. Most of you didn't do it, but those who did it will realize that before you stopped breathing, you inflated your lungs and filled your chest with air.
It's a natural response for an animal that dives. It doesn't happen for sleep apnea patients, because they're snoring, and the snore means partial obstruction of air while they're breathing. Human throats are very narrow.
We've made a terrible mistake. If you believe in the theory of evolution, our monkey cousins have their chins here. We dominated fire, then our maxillas and mandibles were projected backward, and we came out of the tree.
Now the airway makes a curve, and our throats are narrow, and there's nothing we can do about it. And that person who's snoring suddenly lets out the air, and when they want to breathe again, they find their throat closed. Then you say, "Now I'll sleep because they quit snoring.
" Well, that's when they quit breathing as well. They're trying to breathe and can't. So what do they do?
They have a micro-awakening. (Snore) They have that loud resuscitative snore. (Laughter) You're laughing, but it's a serious illness.
(Laughter) I usually joke that this person can sleep and breathe. They just don't know how to do both at the same time. When sleeping, their throat closes, and this picture keeps repeating itself, which causes tiredness and sleepiness.
At InCor heart institute, we have studied the relationship between sleep apnea, mainly due to cyclical oxygen drops, and high blood pressure, cardiac arrhythmia, increased risk of stroke, and acute myocardial infarction. The diagnosis is made through polysomnography. You spend a night in the laboratory.
"Poly" means many, and "somnography" is the recording of multiple signals while asleep. Something drawing attention to this disease is a study made three years ago and published by Professor Sérgio Tufik. More than 1,000 representatives of the city of São Paulo between 20 and 80 years old were chosen by Datafolha polling institute to undergo polysomnography, and the occurrence of sleep apnea is 33%.
It means that if you're sitting there, if the person on your right doesn't have apnea - look at them - and if the person on your left doesn't have apnea, you probably have it. (Laughter) We know that's not how statistics work, but you probably know someone very close to your family who has an undiagnosed sleep apnea. This illness is a worldwide problem.
According to the AASM, American Academy of Sleep Medicine, in a study published two years ago, annually, there is a 260 billion dollar loss on account of sleep apnea underdiagnosis. The person has diminished productivity, a higher risk of accident, and a growing number of simultaneous chronic diseases. The good news is there is treatment.
In the most severe cases, you can put on a mask hooked to a compressor called CPAP. "Wow, but I can't sleep with that! " Yes, you can, because CPAP greatly improves the quality of sleep.
It throws out a little air and opens your throat. A mandibular advancement plate done by the dentist, sleeping on your side, losing weight, and muscle exercises are among an infinite number of possible treatments - but first we need to make the diagnosis. I'm proud to participate in a multidisciplinary work coordinated by an engineer, Tácito Almeida, who is here in the second row.
We're working together to solve this problem. We've been working for more than three years. The entire sleep laboratory is now in my hands.
Since we all have cellphones at our bedsides, we put together a little device, newly approved by ANVISA health regulatory agency. So this isn't just a gadget out there. It's being validated.
You put it on your finger, and you can do it many times during the week, for example. We know there is variability: one day, we sleep better or worse. You keep this little device at home.
The information goes by cellphone to the cloud, returns, and is quickly analyzed. We believe that we can change the underdiagnosis paradigm of sleep apnea not only in Brazil - of course, we want to do this here - but this solution will work all over the world. To finish, I would like to wish you all that was said before: peace, love, success, fulfillment, and all these things.
But none of this makes sense without a good night's sleep. So I would like to wish you all a great night's sleep. Thank you for your attention.
