The Impact of Coconut Oil and Epigallocatechin Gallate on the Levels of IL-6, Anxiety and Disability in Multiple Sclerosis Patients.

BACKGROUND: Due to the inflammatory nature of multiple sclerosis (MS), interleukin 6 (IL-6) is high in blood levels, and it also increases the levels of anxiety related to functional disability. Epigallocatechin gallate (EGCG) decreases IL-6, which could be enhanced by the anti-inflammatory effect of high ketone bodies after administering coconut oil (both of which are an anxiolytic). Therefore, the aim of this study was to assess the impact of coconut oil and EGCG on the levels of IL-6, anxiety and functional disability in patients with MS. METHODS: A pilot study was conducted for four months with 51 MS patients who were randomly divided into an intervention group and a control group. The intervention group received 800 mg of EGCG and 60 mL of coconut oil, and the control group was prescribed a placebo. Both groups followed the same isocaloric Mediterranean diet. State and trait anxiety were determined before and after the study by means of the State-Trait Anxiety Inventory (STAI). In addition, IL-6 in serum was measured using the ELISA technique and functional capacity was determined with the Expanded Disability Status Scale (EDSS) and the body mass index (BMI). RESULTS: State anxiety and functional capacity decreased in the intervention group and IL-6 decreased in both groups. CONCLUSIONS: EGCG and coconut oil improve state anxiety and functional capacity. In addition, a decrease in IL-6 is observed in patients with MS, possibly due to the antioxidant capacity of the Mediterranean diet and its impact on improving BMI.

Sleep assessment devices: types, market analysis, and a critical view on accuracy and validation.

Introduction: Sleep assessment devices are essential for the detection, diagnosis, and monitoring of sleep disorders. This paper provides a state-of-the-art review and comparison of sleep assessment devices and a market analysis.Areas covered: Hardware devices are classified into contact and contactless devices. For each group, the underlying technologies are presented, paying special attention to their limitations. A systematic literature review has been carried out by comparing the most important validation studies of sleep tracking devices in terms of sensitivity and specificity. A market analysis has also been carried out in order to list the most used, best-selling, and most highly-valued devices. Software apps have also been compared with regards to the market.Expert opinion: Thanks to technological advances, the reliability and accuracy of sensors has been significantly increased in recent years. According to validation studies, some actigraphs present a sensibility higher than 90%. However, the market analysis reveals that many hardware devices have not been validated, and especially software devices should be studied before their clinical use.

A survey on sleep assessment methods.

PURPOSE: A literature review is presented that aims to summarize and compare current methods to evaluate sleep. METHODS: Current sleep assessment methods have been classified according to different criteria; e.g., objective (polysomnography, actigraphy…) vs. subjective (sleep questionnaires, diaries…), contact vs. contactless devices, and need for medical assistance vs. self-assessment. A comparison of validation studies is carried out for each method, identifying their sensitivity and specificity reported in the literature. Finally, the state of the market has also been reviewed with respect to customers' opinions about current sleep apps. RESULTS: A taxonomy that classifies the sleep detection methods. A description of each method that includes the tendencies of their underlying technologies analyzed in accordance with the literature. A comparison in terms of precision of existing validation studies and reports. DISCUSSION: In order of accuracy, sleep detection methods may be arranged as follows: Questionnaire < Sleep diary < Contactless devices < Contact devices < PolysomnographyA literature review suggests that current subjective methods present a sensitivity between 73% and 97.7%, while their specificity ranges in the interval 50%-96%. Objective methods such as actigraphy present a sensibility higher than 90%. However, their specificity is low compared to their sensitivity, being one of the limitations of such technology. Moreover, there are other factors, such as the patient's perception of her or his sleep, that can be provided only by subjective methods. Therefore, sleep detection methods should be combined to produce a synergy between objective and subjective methods. The review of the market indicates the most valued sleep apps, but it also identifies problems and gaps, e.g., many hardware devices have not been validated and (especially software apps) should be studied before their clinical use.

A survey on sleep questionnaires and diaries.

Sleep assessment is a fundamental part of health evaluation. In fact, many diseases (such as obesity, diabetes, or hypertension, as well as psychiatric, neurological, and cardiovascular diseases) produce sleep disorders that are often used as indicators, diagnosis (symptoms), or even as predictors (eg, for depression) of health. For this reason, many efforts have been devoted to designing methods to control and report on sleep quality. Two of the most used sleep assessment tools are sleep questionnaires and sleep diaries. Both methods have a very low cost are easy to administer do not require a sleep centre (unlike, eg, polysomnography), and can be self-administered. Most important, as it has been shown in recent studies, their accuracy is relatively high. In this survey, we systematically review and compare these tools. We examine the evolution of sleep questionnaires and diaries over time, and compare their structure and usage. We also review the validation studies and comparatives performed in previous studies. This allows us to compare the relative sensitivities and specificities of these methods. Modern sleep diaries come in the form of an app. Therefore, we also present the most advanced and used apps, and discuss their advantages over classical paper diaries.