Modern technology ends sleepless nights

The team has just released 2breathe - a device connects with an app on a smartphone to coordinate music with the user’s breathing to help him/her fall asleep quickly.

The 2breathe device and app records and modifies breathing rates for better sleep (photo credit: 2BREATHE)
The 2breathe device and app records and modifies breathing rates for better sleep
(photo credit: 2BREATHE)
Insomnia has been in existence at least since the description of King Ahasuerus’s sleep disturbance in the Book of Esther, perhaps because of his political woes. Difficulty falling asleep, staying asleep and sleeping enough are still major issues today, whether due to health problems, overuse of technology or demanding work schedules.
To learn more about sleep and insomnia, In Jerusalem spoke with father-and-son team Benny and Erez Gavish at the recent health and life sciences industry event IATI-BIOMED in Tel Aviv. The team has just released 2breathe, their second product in the digital therapeutic device category. The device connects with an app on a smartphone to coordinate music with the user’s breathing to help him/her fall asleep quickly.
2breathe has partnered with Japanese company Teijin, with all the interface in Japanese. They recently opened sales to the US and Israeli markets.
“The adventure began 25 years ago with my mother, who had a headache,” recalls Erez. Benny, a biophysicist, invited his wife to his laboratory.
“I attached a monitor to her finger to measure the constriction and dilation of her blood vessels,” says Benny. “Then I turned on the sound generator. That’s how I realized that by deliberately changing someone’s breathing, we could affect other systems in the body.”
This breakthrough led to the development of the Gavishes’ first product, RESPeRATE, a device designed to lower blood pressure by promoting slow, deep breathing.
“They told me it would take 20 years to be an accepted treatment,” says Benny.
“They were right. Only recently, a decade after the US Food and Drug Administration cleared RESPeRATE as a hypertension treatment device, the American Heart Association listed RESPeRATE second on its recommended list of nonpharmacological treatments for high blood pres sure, after aerobic exercise.
And now doctors and clinics are recommending the device to their patients.
The team has sold about a quarter of a million units.
Erez, now t he CEO, joined the team almost by accident.
“I’m a n electrical engineer with a degree from the Technion [Israel Institute of Technology],” he says. “I came in 1997 for six months to help my father raise money. But I didn’t know that it takes at least a decade and that I had to stay.”
“Our instructions for RESPeRATE were to use it three to four times a we e k for 15 minutes each,” explains Benny.
“Those who did found that t heir blood pressure decreased significantly within several weeks. But there was a side effect – they slept really well. We actually had to change the instructions, asking users not to use it when t hey w ere resting because they had to stay awake and actively breathe for about 15 minutes.”
The Gavishes realized that the side effect of the blood pressure device could become the main feature of a new product.
Medical professionals are increasingly recognizing the importance of sufficient sleep for health. Approximately 50 million to 70 million adults in the US have some type of sleep or wakefulness disorder.
According to the Centers for Disease Control and Prevention, people who sleep fewer than seven hours a night are more likely to suffer from hypertension, diabetes, depression and obesity, as well as cancer and reduced quality of life and productivity.
Current estimates suggest that 30 percent of the adult population suffers from insomnia some of the time, with 6% to 10% experiencing chronic insomnia, defined as trouble falling or staying asleep that lasts longer than one month.
Using Bluetooth technology, a small electronic device strapped around the abdomen records the user’s breathing to an iOs app on a smartphone. An electronic synthesizer composes music in real time, based on the user’s breathing rate.
“A dancer’s movements follow the timing of the orchestra, but here, the orchestra follows the dancer,” notes Benny.
The sensors set a baseline, with the device playing tones in rhythm with the user’s breathing. Gradually, the tones slow down, encouraging the user to slow down his or her breathing as well. If the user’s breathing speeds up again, so will the music, until the user falls asleep and the device automatically shuts off.
Techniques like meditation also focus on breathing to help the body relax. But unlike 2breathe, these techniques require instruction.
“Instructions activate the cognitive part of the brain,” Benny says, “making it harder to fall asleep.”
Erez explains how the device helps users with two types of sleeping difficulty.
“Some people take a long time to fall asleep,” he says. “Others fall asleep easily but wake up in the night and can’t fall back to sleep. We’ve found that for the second group, using the device at bedtime also helps them fall back to sleep in the middle of the night without reactivating the device.”
In the morning, users can check their breathing rates, how long it took to fall asleep and how closely their breathing matched the rhythm of the tones. Writing in the app’s diary helps them keep track of their progress. The 2breathe team receives the data and can check in with the user.
“If we see that users have not worked with the device or if it doesn’t seem to be helping them, we contact them to find out why. They appreciate this,” says Erez.
Benny addresses a common misconception about sleep: “People think that by sleeping they become relaxed; but people who are not relaxed will not sleep for enough time. Deep, relaxed sleep is essential in order for the brain to correct damage to it that occurs throughout the day.”
According to Benny, 80% of the problem is fear of not being able to fall asleep.
“Just knowing that the device is there means that users will not resort to alcohol or medication,” he says.
Adi Gewirtzman, a Tel Aviv mother of three, is a friend of Erez’s. Her son Liam, now 10, was one of the earliest users of the device.
“About two years ago, he began having difficulty falling asleep,” recalls Gewirtzman.
“He would go to bed early but get out of bed and back in over and over. Usually he fell asleep at around midnight or 1 a.m. and sometimes later. Of course, we didn’t sleep either. Liam was frustrated, too. He had trouble waking up for school and felt tired throughout the day.”
About six months ago, Erez offered Gewirtzman a chance to try the new device. Until then, the Gavishes hadn’t considered that the device might help children as well as adults.
“From the very first night of using 2breathe, Liam began falling asleep within two to 10 minutes,” Gewirtzman remembers. “Once in a while, he needs to activate it a second time.”
Liam can operate the device by himself after setting his smartphone to airplane mode to minimize radiation levels.
Gewirtzman concludes, “We are so grateful to Erez. The whole family sleeps better now.” 
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