FT Health: The silent epidemic of sleep loss

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Sleep has dominated health news this week. A leading neuroscientist brought out a hard-hitting book urging us to sleep more; the Nobel medicine prize went to scientists who discovered how our body clock controls the circadian rhythm of sleep and wakefulness; and an important finding was published on how the sleeping brain stores memories.

Matthew Walker's Why We Sleep  is an angry attempt to awaken consciousness about a public health disaster caused by “the decimation of sleep throughout industrialised nations”.

He maintains that a silent sleep-loss epidemic, resulting from changing social and employment patterns together with sleep-disrupting consumer products, “is having a catastrophic impact on our health, our life expectancy, our safety, our productivity and the education of our children”. Walker advocates eight hours a night and argues that getting consistently less than seven raises your risk of suffering ailments including Alzheimer’s, cancer, diabetes, heart disease and stroke.

The Nobel Prize went to Jeffrey Hall, Michael Rosbash and Michael Young, who worked out that a biochemical oscillation, involving a feedback loop between two genes and their protein products, keeps our body clocks ticking.

Juleen Zierath of the Nobel Assembly said their research helped to “raise awareness of the proper importance of sleep hygiene and the importance of really making certain we allow ourselves to go to bed at an hour that’s suitable”.

A key function of sleep is processing and consolidating memories. By observing people asleep in an MRI scanner, researchers have watched the transfer of a memory trace from one region of the brain to another. It is the first time memories have been observed being filed away in humans during sleep.

Three Questions

We interview Janet Hemingway, who is retiring as director of the Liverpool School of Tropical Medicine but has plenty of plans for the future.

Are we winning the battle against mosquito-borne diseases?

For malaria, it’s certainly a lot better than it was with deaths down from 2m to 600,000. But the curve has started to flatten out, because we have had many of the early gains and we now really need to concentrate on the real heartlands and where it is hardest to get. Other diseases like dengue have gone the other way — the mosquitoes that transmit have moved into populations which don’t have immunity.

What are the most exciting developments you have seen at the LSTM?

Developing new antibiotics and using old ones, and working out we could cure the disease and reverse the symptoms with lymphatic filariasis. The link between HIV, TB and malaria, and how to reach rural populations and take the stigma away from testing — an awful lot of social science is going on which is very exciting. And a lot of what we are learning in the tropics is relevant to the UK and the developed world as well.

What are your future plans?

I’m certainly not retiring. I’ll be having more fun with the science, with my existing work and new areas. There are a lot of consumer products out there that people buy to stop themselves getting bitten by mosquitoes, but we have no idea what impact that has on stopping transmission. I’d love to see products — that consumers want — that impact transmission, and a means of measuring it. It’s a huge untapped market.

Listen to her full interview with the FT.

Chartwatch

Diet and health A report from food and agricultural experts blamed supermarkets for an obesity crisis in Africa as the middle classes move away from homegrown food. Fast food-chains such as KFC are increasing their presence and diabetes is rising. In the US, obesity is driving a rise in cancer. The WHO issued new guidelines on childhood obesity. (Guardian, Malabo Montpellier Panel, NYT, CDC, WHO)

News round-up

Health leadership World Health Organization chief Tedros Adhanom Ghebreyesus announced his new leadership team with 60 per cent women. The UN appointed Dr Natalia Kanem — a pioneer in women's reproductive health — as head of the United Nations Population Fund. (WHO, The Wire, Devex)

Brexit bargaining Jockeying between EU members to host the post-Brexit European Medicines Agency after it leaves London is intensifying and morale among EMA staff is low, with many unhappy at the prospect of moving. The medical device industry also has Brexit worries. (FT)

Puerto Rico misery US officials are racing to cope with national shortages of drugs and medical devices manufactured at 80 plants in hurricane-hit Puerto Rico, while the island's residents are lacking care supplies and clean water. (NYT, WSJ)

Plague fears The UN and WHO are scaling up responses to plague in Madagascar. The country is regularly affected by the disease but this year's situation looks worse than usual, with 30 deaths since August. (NPR)

Casualties of war The New Barbarism  is a documentary on how healthcare workers have become targets in Syria, Yemen and Afghanistan. (CSIS)

HIV hopes Rates of new HIV diagnoses in gay and bisexual men in the UK dropped 21 per cent over the past year — the first decline since the 1980s, when effective treatment first became available. (Public Health England)

Drug prices A pharma industry legal challenge to UK policy on drug prices has been defeated. Here's the FT scoop first reporting the action. In the US, Scott Gottlieb, new head of the Food and Drug Administration, said high prices were a "public health concern". Here are five reasons why. (FT, WSJ, Stat) 

Big pharma and consumer drugs Merck's possible sale of its consumer healthcare unit raises wider questions about how best to serve the retail market. The $107bn global over-the-counter sector has been growing at 5 per cent a year for the past five years. (FT)

Vaccination vigilance Endemic measles was eliminated in the US in 2000 but outbreaks are still occurring with failure to vaccinate the likely cause. The WHO discusses the best way to combat the scaremongering of anti-vaccination campaigners. (Jama, WHO)

Organ opt-out Clinicians and campaigners welcomed the move from Theresa May, the UK prime minister to switch the law in England to an "opt-out" approach to organ donation. Mrs May told her party conference that at least 500 people died last year for want of a suitable organ. (Huffington Post)

Trump tracker An interactive guide to the US president's health policies, from Obamacare repeal to opioids to drug prices. Eric Hargan was confirmed as Health and Human Services secretary after Tom Price's resignation over the use of a government jet. (Reuters, The Hill) 

Smoke signals US media are set to run court-mandated ads from Altria and British American Tobacco with texts such as "Altria, R.J. Reynolds Tobacco, Lorillard, and Philip Morris USA intentionally designed cigarettes to make them more addictive". The WHO has poured scorn on Philip Morris' new "Foundation for a Smoke-free World". (WSJ, WHO) 

Commercialising science Former BP boss John Browne, now chairman of London's Francis Crick Institute, London's new biomedical science centre, says he is determined to speed medical discoveries into the marketplace. New methods for pairing up scientists with business include "speed dating" at London Zoo. (FT)

History lessons 1. A look at the US opioid crisis — of 1908 — and its lessons for today's problems. 2. A BBC doc on the big business deals that transformed the way we deal with mental health — from ADHD to depression screening. 3. How stress was "democratised" in Britain. (Washington Post, BBC, The Conversation)

Best from the Journals

Cancer drugs Most cancer drugs approved by the EMA are not proven to extend life. "Individual patients can be harmed, important societal resources wasted, and the delivery of equitable and affordable care undermined." (BMJ)

Zika hopes An experimental method for fighting the virus with neutralising antibodies has proved successful in monkeys. (Science Translational Medicine)

Hepatitis Should hepatitis B virus be treated as a neglected tropical disease? There are many parallels with NTDs and a reclassification could speed the move towards eventual elimination. (PLoS)

Urban planning Green space provides positive effects for city dwellers such as improved air quality, increased physical activity, stress reduction, and greater social cohesion and can also help against allergies. (The Lancet)

The cost of guns Firearms accounted for more than 36,000 deaths in the US in 2015 — the third leading cause of injury-related death after poisoning and car crashes. (Health Affairs).

Podcast of the week

Michel Kazatchkine, a UN special envoy for Aids, talks about Russia’s health system and struggles with HIV/Aids in the context of its history. (The Lancet, 13m)

In case you missed it

Previous edition: Ending unsafe abortions

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Final thought

Awareness campaigns Breast cancer campaigners have been phenomenally successful in raising awareness of the condition. What can other campaigns learn from their experience? (Stat)