Everybody talks about preventive medicine, but nobody puts it in clear words, just how far he wants to go with it. Not smoking in restaurants? OK. No alcohol on the streets? Getting more difficult. Additional insurance for skiers? Controversial. Annual full-body MRT on the health funds? Uuuuaaaaaahh. But the options do not get less, they get more. Another utensil might join the preventive doctor's armentarium soon: the cuspidor.
Brain to Salivary gland: I'm tired.
But let's start from the beginning: Scientists at the Washington University Sleep Medicine Center report in the latest edition of the journal PNAS about an exceptional research project. Namely they have been looking for biomarks helping them with the diagnosis of sleep related diseases. What they found in the end, was an enzyme. Actually it did not show, whether someone sleeps well or not. But it clearly signals, if someone did not sleep enough. It is not a new enzyme, but the well-known amylase, a digestion enzyme for carbon hydrates. So far, only gastroenterologists were interested in the amylase, or rather the one in serum. It took a neuron scientist to discover, that exactly this amylase, measured in the saliva, tells tales about how much of a sleep deficit a person has. The original experiments by head of studies Paul Shaw and his colleagues were made with the saliva of fruit flies, which were deprived of sleep. The saliva was interesting because the according brain region responsible for the regulation of sleep is closely connected to those providing the salivary glands. With those flies the scientists were able to prove that the amylase contents in the saliva increased the more the flies were deprived of sleep.
What's next? A chip to test a lack of sleep?
The increase of amylase was independent from the type of sleep withdrawal. "With the help of mutated flies we were able to show also, that the observation of higher amylase factors did have nothing to do with the animals simply being longer awake. "We were very pleased with the correlation between the amylase level and the duration of the sleep withdrawal", says Shaw. In further examinations, he was also able to prove an interrelation between sleep withdrawal and amylase level in the saliva of the human being. Despite the surprising accuracy of the amylase measurements, the neurobiologist has come to the conclusion, that, in the long run, tests covering several different biomarkers in the saliva, are better for a diagnosis of the sleep status than mere amylase tests. We are now moving into the domain of biochip-diagnostics, which might have certain practical advantages for a later deployment in preventive medicine. What exactly Shaw is targeting at with a test for sleep withdrawal remains nebulous though. "I hope that people will start to think more about the dangers of chronic sleep withdrawal" he says. He mainly thinks about drivers falling into the dreaded microsleep, thus causing accidents – a scenario popular with German sleep therapists as well and on a regular basis. But: how do you get drivers and an amylase test together? Or in other words: Would a tired driver, still going behind the wheel, be impressed enough by an amylase test and not drive?
Extra offer: the biochip cuspidor for 1,000 Euro
There certainly are other scenarios. For example the famous mouth tube dished out by the patrol police could be complemented by the obligatory cuspidor. Not only drunks, but also sleep delinquents could be caught by the police and get the punishment, they deserve. Similar to certain tools for alcoholics, repeat offenders could get an engine immobilizer and blocking system linked up with a cuspidor with amylase measuring unit. And all this – depending on the work of preventive medicine lobbyists – as an obligatory extra analogous to the soot filter. Also possible would be a continuous amylase measurement with alert function, for example with sensor dental braces. The results could either be transmitted online to a sleep therapist or, as a closed feedback loop, transmitted to the end device. Whether it is the cell phone, that starts ringing, the iPod switching to Heavy Metal or the GPS navigator spitting out the details of the closest hotel room – that would be up to individual preferences.