Consumer-facing Diagnostic Sensors in a Patient with Implantable Cardioverter-Defibrillator.

Since its introduction in 2015, the Apple Watch (Apple Inc., Cupertino, CA, USA) has been purchased by an estimated 60 million consumers and boasts algorithms cleared by the United States Food and Drug Administration able to detect bradycardia, tachycardia, and atrial fibrillation, with the newest version of the device also allowing for real-time electrocardiogram acquisition. This case offers potentially the first demonstration of an Apple Watch correctly detecting atrial fibrillation with an implantable cardioverter-defibrillator confirming the accuracy of the detection from stored electrograms.

Minimal Effect of Daytime Napping Behavior on Nocturnal Sleep in Pregnant Women.

STUDY OBJECTIVES: To assess whether daytime naps negatively impact nocturnal sleep. DESIGN: Longitudinal, prospective cohort design. PARTICIPANTS: 161 pregnant women recruited and evaluated in early gestation (10-20 weeks). MEASUREMENTS AND RESULTS: Daily sleep information was collected in three 2-week periods (10-12, 14-16, and 18-20 weeks gestation) with a daily sleep diary and an actigraph. The average number of naps, as well as the average length of each nap, were calculated from sleep diaries. Women were categorized first as non nappers (0 naps/2-week period), moderate nappers (1-3 naps/2-week period), or frequent nappers (≥ 4 naps/2-week period). Then, based on the average nap length, they were categorized as short (< 90 min) or long (≥ 90 min) nappers. Nocturnal sleep parameters included SOL, WASO, SE, and TST. SAS procedure MIXED was used for modeling the main effects of nap group and time, and time by nap group interactions. Women who took naps had a decrease in diary-assessed nocturnal TST, but not actigraphy-assessed TST. This observation was group- and time-specific. There were no other group differences. Women who napped ≥ 90 min had poorer diary-assessed SE and lower diary-assessed TST than those who took shorter naps. Length of nap was not associated with any other sleep measures. CONCLUSIONS: The number of daytime naps have minimal impact on nocturnal sleep parameters; however, long nappers did exhibit modestly impaired sleep continuity and sleep quality. Overall, we propose that daytime naps provide a beneficial countermeasure to the sleep disruption commonly reported by pregnant women. This may be clinically beneficial given that sleep continuity and quality are important correlates of pregnancy outcomes. COMMENTARY: A commentary on this article appears in this issue on page 593.