Monash develops app that could revolutionise shift workers’ sleep cycles

Monash University researchers have developed a world-first app that could dramatically improve the sleep and mood of vital shift workers.

It’s no secret that shift work can be extremely taxing, effecting workers’ sleep cycles, and their mental and physical health. Researchers from the Turner Institute for Brain and Mental Health have developed app called SleepSync to tackle this problem.

SleepSync is the world’s first app that personalises sleep-wake cycles for shift workers to improve their sleep and overall mood.

The research, led by Dr Jade Murray, saw 27 shift workers trial the app over a two-week period. The participants were mainly intensive care and emergency department nurses at high risk of shift work disorder, commonly experienced as insomnia and excessive sleepiness.

SleepSync improved these workers’ total sleep time, ability to fall asleep, sleep quality and perception of recovery on days off. With the app considering each individual’s daily routine, 70 per cent reported it was easier to fall asleep, and more than 80 per cent reported better quality sleep. Participants slept an average of 29 minutes longer each night.

“SleepSync aims to aid behavioural change and provide practical advice to shift workers by providing personalised sleep scheduling recommendations and education,” Dr Murray said.

“This has the potential to improve shift workers’ health and wellbeing and how they function day to day. It also has the potential for development and integration with wearable devices, such as smartwatches, and further helps to minimise the health costs associated with shift work to society.”

The mobile phone app is unique because it is entirely tailored to the individual user by:

  • incorporating a calendar for work and personal commitments
  • providing biologically viable recommendations for sleep timing that account for work and social obligations based on the information users enter into the calendar, such as work shifts and important personal activities
  • daily logging of actual sleep/wake times and mood

Users receive a ‘recovery score’ based on their level of adherence with the recommended sleep times.

Dr Murray said work hours outside the 9 to 5 regime play havoc with the body’s circadian clock. “Shift workers report an increased functional impact of sleep disturbance and misalignment, including impaired alertness and increased sleepiness during wakefulness compared to the general population,” she said.

“Shift workers are also at greater risk of a range of long-term adverse health consequences such as gastrointestinal problems, cardiovascular disease, mood disorders and cancer, as well as the short term increase in the risk of errors, accidents and injuries.”

To date, helping a shift worker to sleep well has largely relied on workplace interventions such as adjusting workplace lighting, scheduled workplace napping, sleep hygiene programs, wellness programs and workplace fatigue management programs.

Co-author Dr Tracey Sletten, of the Turner Institute, said individual workers need evidence-backed ways to optimise their sleep around their work schedule.

“Each person has different underlying biology and specific work patterns, which need to be accommodated in a personalised schedule to help them sleep better,” Dr Sletten said.

Dr Sletten said 67 percent of participants reported that SleepSync was influential in modifying their behaviour and habits, while 82 per cent found the app easy to incorporate into their daily lives.

“They also reported improvements in mood (depression, anxiety and stress), insomnia symptom severity, sleep hygiene and sleep-related daytime impairments.”

The Turner Institute’s research was published in the journal, Digital Health.

Feature image: Pixel-shot via Shutterstock.

New study explains why you can’t get some songs out of your head

If you listen to music for long enough, you’re bound to come across a tune that gets stuck in your head. Sometimes you don’t even like the song, but you find the beat incredibly hard to shake off.

This experience is known as an earworm – when a catchy piece of music is wriggling around inside your head.

Earworms are quite common and may be a universal phenomenon. Some research suggests up to 98 per cent of us have experienced an earworm – or involuntary musical imagery (INMI) as it’s known in music terms.

A study by Music researchers from the University of New South Wales (UNSW) may now have uncovered the reason why.

The UNSW research team conducted a systematic review of all the major studies on earworms to date, synthesising their findings on catchy music, tempos and pitches.

According to UNSW’s lead researcher, Professor Emery Schubert, the key ingredient is repetition.

“Drawing together the literature, it appears there’s an essential characteristic necessary for a song to roll out the earworms – the music itself must have some repetition in it,” Professor Schubert said.

Most reported earworms are the chorus of songs, which are inevitably the pieces of the music repeated the most.

“Research on earworms to date analyses what’s in the hook – the short riff or passage to catch the ear of the listener,” Professor Schubert said.

“But what hasn’t been considered is that the hook is invariably repeated in the music, most commonly in the chorus.

“The implication is that earworms might not have anything to do with the musical features at all. It largely doesn’t matter what the music is, as long as repetition is part of the music structure.”

But the repetition in a song is only one part of the equation. There are several preconditions for an earworm to occur, including recency and familiarity with the music. To activate an earworm, we must also be in what’s called a low-attentional state, according to the study.

“It’s sometimes referred to as mind wandering, which is a state of relaxation. In other words, if you’re deeply engaged with the environment you are in, really concentrating on a task, then you won’t get an earworm,” Professor Schubert said.

“Inside your relaxed mind, you don’t have to follow the exact structure of the music. Your mind is free to wander wherever it likes, and the easiest place to go is the repeated fragment and to simply repeat it.”

While earworms can be an unwelcome distraction at times, many people find them enjoyable.

“It’s a bit of a misconception that they’re a problem,” Prof. Schubert said. “We’re starting to see more research suggesting many find getting an earworm to be quite pleasant and it is not an issue that needs solving.”

Professor Schubert explained that the cases where earworms are dreaded is usually when the music itself is not liked.

“The earworm doesn’t care about enjoyment; it cares about how familiar the music is, how recently something similar was heard, and whether the music contains repetition.”

Although an earworm is not a medical condition, or considered a danger in most cases, for those hoping to expel an unwelcome tune, there are many theories for how to get rid of them.

“You may be able to wrap up an earworm by either finishing off the music, consciously thinking of another piece of music, or by removing yourself from the triggers, such as words or memories that relate to the music or lyrics,” Professor Schubert said.

“We don’t go out to find earworms, but earworms find us… There are still several puzzles we need to solve to understand not only their nature but what it might mean for cognition and memory.”

Feature Image: Kashirin Nickolai. Wiki Creative Commons Attribution 2.0.

A very sunburnt country: Skin cancer rising in Australia

Ciaran O’Mahony

Australia’s sunny weather may be the envy of the world, but it is proving to be both a blessing and a curse.

While we soak up more sun in a month than many countries do in a year, we also have one of the highest rates of skin cancer in the world.

New research has shown that this problem is increasing, with non-melanoma skin cancers rising at an estimated rate of 2-6% per year for the last 30 years.

The study, which was published in the Public Health Research & Practice journal last week, estimates that 69% of Australians will have at least one keratinocyte cancer (or non-melanoma) removed from their body in a lifetime.

This group comprises 73% of Australia’s male population and 65% of the female population.

Although numerous “sun smart” campaigns have been implemented over the last decade, many Australians who did not grow up with the familiar “Slip Slop Slap” messaging, are now at high risk.

Associate Professor Catherine Olsen and her colleagues highlighted that the greatest increase in skin cancer was amongst people aged 55 or older.

Photo: kali9 via Getty Images

Professor David Whiteman, a co-author of the study, explained to Guardian Australia that “as our population is living longer and more people move into those age groups that manifest in cancer, they’re now showing the effects of their sun exposure from years and decades before.”

The findings are based on the most recent population-based estimates of keratinocyte cancer incidence in Australia between 2001-2021. The researchers examined data trends over time and calculated the lifetime risk of developing these cancers whilst accounting for competing risks of death.

They also noted that their findings could be an underestimate, given that data on keratinocyte cancers is not recorded in state or territory registries (with the except of Tasmania).

While keratinocyte cancers are less deadly than melanoma, Professor Whiteman urges Australians not to be complacent.

Photo: Carol Yepes via Getty Images

“Keratinocyte cancers kill about 500 people a year, and if not treated they can borrow into nerves on the face and into the head and track back into the brain. People may need to have massive surgery and radiotherapy. So it is a dreadful disease.”

Royal Australian College of General Practitioners (RACGP) Specific Interests Dermatology Chair Dr Jeremy Hudson, told NewsGP that GPs across the country have a pivotal role to play as we manage this threat.

“GPs have an absolutely key role and continue to diagnose and manage the vast majority of skin cancers in Australia, particularly in rural, remote and low [socio-economic] areas,” he said.

“Generation X is coming of age,” Dr Hudson said. “We are planning to see a spike of skin cancers in 10 years’ time unless very robust education and preventive action is taken.”

As doctors across the country prepare for this spike, the Federal Government is set to implement Australia’s first national skin cancer campaign in over a decade.

In the meantime, Professor Whiteman says people of all ages should remain vigilant against the sun.

“The good news is that it’s never too late to use sun protection, and that even people in their 40s and beyond who start using sun protection every single day can reduce their risk of skin cancer and reduce the incidence of new skin cancers forming if they’ve already had it.”

Medical societies speak out against Queensland pharmacy pilot

Ciaran O’Mahony

Two medical societies have warned Queensland Health that its Urinary Tract Infection (UTI) Pharmacy Pilot will have serious health implications.

The pilot, which was recently extended until June 30 2022, allows pharmacists to prescribe antibiotics to women for UTIs, without any medical review or investigations.

The Urological Society of Australia and New Zealand (USANZ) and the Royal Australian College of GPs (RACGP) have cautioned that this approach poses numerous health risks, including delayed diagnosis of cancer.

President of USANZ, Associate Professor Prem Rashid, says UTIs are very common, but must be diagnosed through microbiological confirmation on urine testing.

“The importance of the mid-stream urine test in recurrent and chronic UTIs cannot be underestimated,” according to Rashid.

“This defines whether the patient has a bacterial UTI as opposed to other potential causes of similar symptoms and is also fundamental to ensure optimal and accurate treatment with the appropriate antibiotic,” he says.

USANZ President, Associate Professor Prem Rashid. Photo: Twitter.

Vice President of USANZ, Professor Helen O’Connell AO, shares Rashid’s concerns.

“Tracking of urinary white cells and epithelial cells is critical to assessment of patient progress and exclusion of a chronic state,” O’Connell says.

“It does not represent best practice for women to simply attend a pharmacist with symptoms which may or may not be due to bacteria and receive antibiotics which may not treat the bacteria present due to resistance,” she says.

UTI symptoms are similar to those experienced in a wide range of health issues, including bladder cancer.

It is therefore imperative that UTIs are correctly diagnosed to rule out other life-threatening conditions.

Photo: Science Photo Library via Getty Images.

“The symptoms of a UTI are common to a number of serious health issues, including bladder cancer, which is why a correct diagnosis of an UTI is necessary to rule out other potential health serious issues,” says Professor O’Connell.

“Blood in the urine and a burning feeling while passing urine are just two of the symptoms common to both bladder cancer and UTIs. More than 3000 people are diagnosed with bladder cancer each year, a significant number of these are women. This cancer is treatable if detected early but delayed diagnosis and treatment can compromise outcomes, and at worst may mean someone cannot be cured,” she says.

“Why should a common condition in women be redirected from medical care without long term proof of its safety?”

The RACGP says it welcomes an overhaul of the management of UTIs, but argues that the pilot is not supported by evidence and risks doing more harm than good.

RACGP President Dr Karen Price has “deep concerns about moves by the retail pharmacy sector to push through policy changes that put financial gains ahead of patient care and safety.”

“The trial in Queensland of pharmacists prescribing antibiotics for urinary tract infections is concerning,” says Price.

“One of the main problems here is that this trial is effectively an implementation trial. It’s not research on best practice and the results of the trial should be made publicly available.”

RACGP President Dr Karen Price. Photo: Twitter.

The pilot has been extended despite growing concerns around antimicrobial resistance resulting from the misuse or overuse of antibiotics.

While GPs have begun reducing unnecessary prescriptions of antibiotics, this Queensland Health initiative is seen as a threat to their efforts to tackle the problem.

Over 6,300 women have accessed this service to date.