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Wearable Devices for your Mental Health 

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Anshu Bahanda: This is Anshu Bahanda on Wellness Curated. Thanks for joining me on this podcast. My mission is to empower you with health and wellness so that you can then go and empower others.

I have joining me today, Kathryn Fantauzzi, who’s the co-founder and CEO of Apollo Neuroscience. It’s a company that developed and launched a scientifically validated device, a wearable technology that actively improves energy, focus, and sleep. So, it sounds very, very interesting. 

Tell me about wearable devices in general that can help with mental health and other issues. 

Kathryn Fantauzzi: Everyone’s kind of familiar, right, with wearable devices. So, probably a lot of people have an Apple watch or an aura ring or one of these other wearables. I think the way to think about it is that there are multiple kinds of wearables in the market. One primary one that most people are familiar with is a tracker. A tracker started off with like a Fitbit. We’re all familiar, right? We were tracking steps that kind of evolved into more sophisticated devices in terms of sensing that would detect things like cardiovascular metrics or your sleep. And people often use them in an aspirational way. They may have a problem or they may be trying to solve something to make it better. And so, they purchase a wearable device in order to track something about themselves. So, sleep, recovery one of those things might be. But those are really information providers, so they track some information about yourself. So, like, you have to do something with that information. A lot of people in your ecosystem might know about the Muse, which is a brain-sensing headband. You have an EEG, and it’s telling you how your meditation is going. Apollo Neuro is a different kind of wearable technology. Apollo Neuro uses touch therapy. So, rather than being a technology there, it tracks you and tells you what to change or you have to do something or give feedback. Apollo is a wearable that uses touch technology to augment your day-to-day life.

AB: Okay. 

KF: And so, it uses touch to change how you feel in terms of helping you with these, basically to restore balance to your body so that you can have more control over how you feel. Because the world is really chaotic with all those pings and dings, your calendar, everything. People have a lot of aspirations about balancing their sleep and helping reduce their anxiety and their stress throughout the day.

AB: Okay. And tell me, is there anything else like this available? Like Apollo Neuro.

KF: In general, other products don’t do what we do. They generally either help you with one thing, like stress, for instance. Apollo is kind of like an accompaniment for your whole day. You can wake up with it in the morning. You can use it at night to help you fall asleep. You can use it during the day to help you focus.

Song Playing: When I wake up in the morning, love

And the sunlight hurts my eyes

And something without warning, love

Bears heavy on my mind. 

KF: I’d liken it to the right song, right? If you wake up in the morning and listen to music that you really enjoy, it helps your body transition and Apollo works in a very similar way.

Song continues: Just one look at you.

KF: …by stimulating your body to get into the state that you’re looking to get into, very much like breath work.

Song continues: A lovely day, lovely day, lovely day

A lovely day, lovely day, lovely day

A lovely day, lovely day, lovely day

A lovely day, lovely day, lovely day.

AB: Apollo Neuro is a pioneer in terms of wearable devices based on touch therapy.

KF: I mean, Apollo is wearable because we had to build hardware to deliver our therapy. But Apollo is really a new kind of technology, right? Apollo uses our sense of touch to change how we feel and we all know that touch changes how we feel, but a lot of us are disconnected from that. And so, where this came from was research at the University of Pittsburgh. So, my co-founder and I my co-founder is Dr. David Raven. He’s a psychiatrist and a neuroscientist, he has been studying chronic stress for over 15 years, and he works with patients who have stress-related conditions. While you can teach someone biofeedback and meditation, what he noticed is that when people went home, they had a really hard time continuing those practices. And we know behavior change is hard. And we know that learning how to meditate and learning how to do breathing exercises is challenging in general, particularly if you’re coming at it as an adult. 

Learning a foreign language as an adult is hard. Learning how to meditate as an adult is hard if that was not part of your culture growing up, right? The real challenge there is that if you are stressed, it’s even harder to change behavior and it’s even harder to learn new things. Because when you’re under chronic stress from whatever that might be, being over scheduled, not sleeping enough, having a very stressful job, having a lot to juggle, many of those things tax your nervous system, and then your body is in the state of fight or flight where you can’t necessarily or it is more difficult to have that cognitive control. There’s a reason that going for ice cream and Netflix is easier. Your body is looking for relief. And so, we thought to ourselves, why are we getting patients up for failure? Why are we setting people up for failure? They want to take on this wellness practice, but they’re having a hard time doing it. Why would we make people feel bad? We don’t want people to feel bad. And so, then we looked at, okay, well, so what are the other mechanisms that help people feel calmer?

AB: Right.

KF: So, we looked at brain work and we looked at biofeedback. So, something where you’re getting feedback from your body to tell you how to change practice. And we looked at how all of those patterns exist in the body and we said, okay, but how about when you’re trying to fall asleep? And how about when your kids are screaming in the back of the car? And how about when you have to give a presentation? Where are you going to stop and meditate? Then maybe, but it’s really hard to do. And so, we mapped out the whole sensory pathway of how we could engender safety in the body without anyone having to do anything. And that’s how we came to Apollo. With Apollo, we developed a new type of technology that actually uses sound waves, so gentle vibrations that you can feel but you can’t hear to actually help the body transition into the states that people want to be in.

AB: Wow!

KF: And that’s what we found.

AB: Can you tell us how this works? How does sound therapy work?

KF: Very simply, Apollo has a wearable device and a mobile app. So, you choose how you want to feel in the same way that you’d pick a playlist for a particular mood. So, let’s say that you’re at work and you have a bazillion tasks on your list of things to do and you need to just focus your attention. You need to settle down and get in the zone and focus. You put on clear and focus mode. And the way that it works is it sends these waves to your body so they feel very gentle. This doesn’t feel like a cell phone buzzing. This doesn’t feel like a massager. It’s barely perceptible. You put it on and these gentle waves start coming to your body and it’s like white noise for your brain. What it does is it sends a signal to your brain that says, hey, that email isn’t going to kill you. And that computer, it’s not a bear. And in the same way that meditation helps to retrain the nervous system to do that, so you turn that on and it helps stimulate recovery in your nervous system. Likewise, when you get home and you’re kind of wired and tired, you can put on relax, unwind, or sleep mode to help the body transition into that sleep state. I think, the most important thing to know about this, though, is that Apollo isn’t just used for the moment. You can use it in the moment that you need it. You’re given a presentation, now you have a really hard day today, and you want to recover and feel calmer, you can use it that way. You can use it to help you sleep.

AB: Okay.

KF: Consistency of use is how you get the best results. So, just like you can work out one time, you can meditate one time, it doesn’t do it right. The nice thing is what we’ve learned about Apollo is we did a study with our users who also wear an aura ring, and so we tracked people’s biometrics for about a year and over 500 people for about a year to get their baseline and then watched how their biometrics changed in correlation with their usage of Apollo. And what we found is that the people who used Apollo consistently, so used it three plus hours a day, five plus days a week. They had these tremendous changes, right? 19% improvement in their deep sleep, and 12% improvement in their heart rate variability, which is this key metric of resilience to stress. And the reason that that’s important is that it’s helping the body recover during the day. 

So, using it during the day for focus, right? Just putting on the mode and then it play while you’re doing something helps the body recover from stress. And then using it again at night helps you fall asleep more quickly, get more deep sleep, get more REM sleep because your body’s calmer. And when your body is balanced and in a calm state, you can enter sleep more quickly, but you can also get deeper, restorative sleep because the body feels safe and it has this positive reinforcement loop, right? You feel calmer during the day, you get better sleep. You get more sleep. You feel calmer during the day. And it’s this nice reinforcing cycle in the same way that a regular meditation practice or a regular movement routine helps to restore balance to the nervous system. Apollo works through the same pathways.

AB: So, you’ve talked about focus, you’ve talked about sleep. What are the different areas that it can help with?

KF: The Apollo helps you recover during your daily activities. So, the way that we set this up is you can use it to wake you up in the morning, you can use it for focusing during the day, but you can also use it on social mode. So, for instance, right now, I have it on social and open, which is a mode that gives you a little bit of energy and helps you stay present with people. And then there are other modes for recovering from stress: meditating, relaxing, and sleeping.

AB: What does it look like? Where should people wear it? Do you want to explain that to people?

KF: Sure, yeah. So, Apollo can be worn on the wrist or the ankle and set the volume, the intensity right around where you can feel it, but it doesn’t need to be up all the way. I think, that’s a really important thing for people to know. A lot of people think more is more, right? You turn Apollo right where you notice it, right where it works for your environment, and then it should fade into the background. After a minute or two, you should barely notice it. And then the other thing I think I know is that there’s a feature to schedule it, which I love, so I use it to help me wake up so I don’t snooze the alarm. It helps to stimulate my body to wake up and gets my brain going, and then I use it throughout the day for work and focus, and then again at night to help me sleep. But you can schedule it. So, for instance, if you know that you have, like, a 02:00 p. m. coffee slump, rather than going for the cup of coffee that’s going to disrupt your sleep later, the Apollo can turn on to help you stay awake and keep your energy up and stay focused through the end of the day.

AB: The one question that I’ve actually been thinking about is, it is Bluetooth, right?

KF: Well, so you can run Apollo completely in airplane mode. So, the Apollo only connects, it’s not like a device that’s constantly communicating back and forth. You can set it right now, you set the mode, and the only time it connects via Bluetooth is when you’re actually going into the app to turn it on. So, it’s a very low EMF. But also, you can turn on scheduling so that it automatically turns on and run the device completely in airplane mode if you want to.

AB: Okay, that’s wonderful. How did you actually get the idea to create Apollo Neuro? Did the University of Pittsburgh come to you?

KF: This was my co-founder’s idea. Right. So, David was looking at his patients. He works with patients who have PTSD or chronic stress-related conditions, and he noticed that they were looking for a solution. He was trying to teach them new skills, and they worked really well in the clinic, but then when they went home, they had a hard time maintaining those practices, and we can all kind of relate to that, right? Everyone sometimes lapses, and it’s hard to learn new things when you’re stressed. And so, David mapped out this whole pathway around how touch can engender safety in the body to help the body. Because basically, when the body feels safe, your mind is clear and you have control over how you feel. If you had a good night’s sleep and you get cut off in traffic on the way to the farmers market, you’re going to have more of a likelihood of saying, “hey, that guy must be having a rough day” than if you’re totally exhausted. So, David wanted to induce safety in the body. The way we came to Apollo being a wearable device is that we know that there because it could have been in so many different ways like it’s a touch therapy. It could have been in so many different modalities. The reason we went with a wearable device is because Apollo can be used throughout the day to help you transition throughout the day. So, it can help with so many different activities of daily life that making it a wearable, makes it accessible so that people can use it at the moment that they need it, whenever it is that they need it.

AB: Tell me about the scientific research that you’ve done.

KF: So, Apollo, again, was a nexus of research at the University of Pittsburgh. The way I came to be part of Apollo is that my background is technology transfer.

AB: Okay.

KF: So, it’s how to get things out of labs faster, because on average, it takes 17 years from something to go from bench to bedside in the US. And so, my job is to get those things done faster. And so, I got brought in. David asked me basically if I would be part of this to help, really, from the early-stage development, to make sure that whatever was developed would be really effective for folks using it in their day-to-day lives. And so, I joined the team and we did three clinical trials while at the University of Pittsburgh, the first of which was a double-blind, randomized, placebo-controlled, crossover trial. Since then, we’ve completed three more trials that are academic in-lab trials, and we continue to do research. I think, we have 13 trials currently underway with academic partners across the United States.

AB: Okay so tell me about the trials where it’s helped with mental health and how it has helped people with mental health, because I know that David works with mental health patients as well.

KF: So, the first trial that we did with a double-blind, randomized, placebo-controlled, crossover trial was actually in healthy people. And in this trial that we did with our current users, who are wearing an aura ring, they’re also healthy, right? And what is really important in both those trials, none of those people are coming to that trial because they’re trying to solve a specific condition. But what we saw in the first trial, the double-blind trial in the lab, is that we give healthy people a cognitive stress task. So, we asked them to do what’s called the PASAT, which is a task where we have to listen to single digit numbers and add the last two you heard every 2 seconds for 3 minutes. It’s a really hard task. It’s a task to get astronauts before they go into space, to make sure that they have a high tolerance for futility. And it basically creates the experience of running out of time on a standardized test or being late in traffic and not being able to find a parking spot. And so, what normally happens is that people’s heart rate goes up their heart rate variability, which is this metric of how well they’re responding to stress, how quickly they’re able to, how resilient they are to stress goes down, and their performance goes down. Because we’ve all been there where you got so many things going on and you lose your keys, right? Or you take the wrong turn or whatever it is because you don’t have that control anymore. What we found is that when we did this with Apollo vibrations, or what would become Apollo vibrations, no vibrations, and then controlled vibrations, so something more akin to a cell phone buzz or slow tapping. And what we found is that when you used Apollo frequencies, we improved heart rate variability, and for everyone whose HRV goes up, their cognitive performance went up, some up to 25%. And so, what we essentially did was we induced a flow state, we calmed the body down so people could think more clearly and had more cognitive control, so they did better on the task, and this was extremely compelling to me. We really did something, we really changed cardiovascular metrics and metrics of cognitive performance through this touch therapy. But that’s an in the moment, right? So, we helped clear someone’s mind by calming their body down and restoring balance to the body so that they had more control and could do better and be more focused. But what was really interesting about this study that we did with the users who are using an aura ring, is we tracked their biometrics and how they changed over time, as a result of just incorporating Apollo into their day-to-day life. And that was the most interesting for me because what it showed is that by using the Apollo during the day and by using the Apollo at night, we actually helped change the balance of the nervous system as measured by people’s cardiovascular metrics and their sleep metrics. So, we saw again, like a 4% reduction in average heart rate and resting heart rate, 12% improvement in their heart rate variability, 19% improvement in their deep sleep, increased how long people are sleeping. It was incredible, right? Incredible to see that, and incredible to see that in the real world, right? You can do a trial in the lab, but you don’t necessarily know that things are going to be consistent in the real world. And before we ever launched Apollo, we did the three clinical trials at the University of Pittsburgh, and we saw those results coming in. We tested Apollo in beta for 18 months across 3000 people to make sure that we would get consistency of results in the real world. And when we saw that, that’s when we launched the product. We do have studies ongoing now for various conditions that are worsened by stress and those results will come out. So, folks who have issues with attention, folks that have pain and other stress relate, traumatic stress related conditions, and those studies are ongoing, and we’ll publish the results when completed. And all those studies are being conducted actually, by academic partners across the US.

AB: Oh, fabulous. Tell me more about sleep and Apollo Neuro. I know, you talked about the aura ring and people went into REM faster and things like that. So, talk to me more about the sleep aspect of it, because, as you know, a lot of people are struggling with sleep these days.

KF: Yeah, so 30% of Americans said they had trouble sleeping pre-pandemic, and now it’s 50%. But a lot of it is that we lead these really hectic lives right. Stress makes sleep harder, and stress makes sleep harder for two primary reasons-one, it makes it harder for you to fall asleep because your body thinks there’s a threat. If you think about us from an evolutionary standpoint, if stress used to be that there was a bear outside the cave, it is advantageous to the human for survival not to fall asleep if there’s a bear outside, because you’re vulnerable when you sleep. So, in order to sleep well, you have to feel safe. Your body has to know that it’s okay. 

And so how Apollo works is you use it during the day to help with stress management, so, to help you focus. And stress management doesn’t necessarily mean that something bad is happening. It just could mean that you have a lot to do that day, because when you think about it, being on Zooms, having lots of meetings, having to travel back and forth, having to get dinner on the table, all these different things are tiring. It’s sometimes a lot to do. And a lot of folks that use Apollo are actually really active, engaged, overachievers. We put a lot on our plate. And so, people use Apollo during the day to help them with focus and energy and staying social and all that, then they use it at night to help them kind of unwind and do that reset from the rest of the day and transition into sleep. And so, the way that that works is by stimulating the body to be in a recovery straight during the day. Your resting heart rate is lower, your resiliency is up, you feel calmer, and so that when you go to transition to bedtime, you’re not wired and tired anymore. You’re able to just relax and get sleepy. Not exhausted, but sleepy, and then transition into a sleep state more easily. It kind of just softens the edges. It’s like a nice accompaniment to the day, and then it helps transition into sleep. And that compounding effect is that by helping the body relax into sleep more quickly and being in a calmer state when you fall asleep allows you to get deep sleep. A lot of us are sleeping, but it might be a lot of light sleep, and you need deep sleep, and REM sleep, for memory consolidation, for improved cognitive performance, and to feel well rested and energized the next day. And so, Apollo works by helping the body feel safe and calm, helping you sleep as a result. And if you sleep well, a lot of things are resolved.

AB: Absolutely. And tell me, how long do people typically have to use it before they begin to notice the benefits?

KF: It kind of depends on your baseline. So, when you think about that and the way I liken this is we saw that in the lab, people’s bodies were changing within 3 minutes. And you could measure it and you could see that their cognitive performance improved, but they were all under stress. So, they were going to definitely notice. In the same way that when you have a headache and you take something for your headache, you notice that your headache went away. Right? And so, the way I would say it is that if you are feeling stressed out, overwhelmed, tired, or you’re having trouble sleeping, people notice the effects very quickly, right? It could be immediately, or it could be within a few days. But when you really get the benefit is when you use Apollo consistently, you need to use Apollo for at least 30 days to start to really see these benefits, because it’s a retraining of the nervous system to be in a calmer state. And so, for instance, when you start meditating, you might feel that meditating is actually frustrating. But if you don’t, you may notice a little bit of benefit, but you don’t notice these big changes in your life until it’s been a long time. So, the nice thing about Apollo Is that it’s really easy. All you have to do is put it on and press a button. In the same way that an exercise routine or a meditation practice takes a little while for you to notice these bigger changes in your life, like feeling more settled, calmer, having more focus, staying in a state of flow more easily, sleeping better, that sort of thing.

AB: Are there any disadvantages to using this device?

KF: So, we actually spent a long time looking at that because we never came to Apollo with the perspective of starting a company. We started Apollo and what would become Apollo, because we were looking to develop a solution to a problem. We wanted people to have more balance. We wanted people to feel more in control of their day-to-day lives. Stress makes you feel out of control. And when people feel in control, when people are calmer, they make better decisions, they feel better, they have better control over their mood, and they have more control over how they pay attention to things, which is our most important skill. What you pay attention to makes a tremendous amount of difference in your mindset. And so, when we developed Apollo, we first tested in the lab, but part of that testing after the lab testing, before we went to market in 2020. We wanted to test it in the real world because we wanted to make sure that using Apollo wouldn’t be habit-forming, that it wouldn’t change something negatively, and that we also wanted to make sure it would keep working because what’s the point of buying something or using something and then it works for a little bit and then stops working? That happens to people all the time. And so, we wanted to make sure that Apollo would consistently work. We wanted to see that it wasn’t habit-forming. We wanted to see that it would not become something that people need more and more of just to feel calm. And what we found was incredible, which was that actually using it more made you more sensitive to its effects, which means that by using it consistently, you start to notice getting into that state, feeling calmer, getting to sleep quicker, because it’s like a meditation practice. 

When you first start learning to meditate or first start doing breathwork, it takes a little while for your body to get into that state. But after you’ve done it consistently, you can do what people call drop-in. It remembers how the feeling of being in a meditative state feels. It remembers what feeling a calmed, balanced state feels like. When you use it consistently, it does a similar thing. You use it and your body goes, “oh, hey, the Apollo’s on”, and it just goes with that stimulation. It enters that zone in the same way that when your favorite song comes on, you can’t help but dance, because your body remembers all of the things associated with that song, right? It’s the move, it’s the energy, it’s the whole environment that you created yourself with a song. And so, Apollo kind of works in a similar way. It’s kind of like a playlist for your body. The most important thing to understand is that all of us, I think that commonality is this growth mindset, right? Wanting to be better, wanting to have more control over our health, wanting to have longevity, and not just the years of longevity, but feeling well for as long as you can feel well, right? I think, what’s important to understand is that when you restore that balance, when you nurture your nervous system, you have so much more agency and control, and you have so much more power. And so, you can do that with Apollo, you can do that with exercise, you can do that with meditation, you can do that with establishing daily practices that support your sleep. The most important thing that you can do is take care of yourself and take care of that balance in your body. Because when you do, you are more for yourself, you are more powerful in yourself, but you’re also better for everyone else that you interact with. Our energy is contagious. If we feel well, the people around us feel well too.

AB: Absolutely. And on that note thank you so much, that was such an enlightening chat. Thanks for joining us. Hope you enjoyed the Wellness Curated podcast. Please subscribe and tell your friends and family about it and here’s to you, leading your best life.