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Do Wearable Stress-Reduction Devices Work?

Testing the Apollo Neuro

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Apollo Neuro

It’s 4 PM, and I’m about to interview Dr. Dave Rabin, co-creator of the Apollo Neuro device, a small wearable designed to “improve your body’s resilience to stress, so you can focus, get to sleep, and stay energized,” as their site says.

I’ve just opened the box for the loaner device he sent me, strapped it on my wrist–it’s about the size of an Apple Watch. Through its iPhone app, I set the device to the “Energy and Wake-Up” setting. This the time of day I–and most people–could sure use some Energy and Wake-Up.

When I get Rabin on the phone, I tell him I’ve got the Apollo running already on the high-energy setting. Fast, painless, staccato silent vibrating pulses are shooting through my wrist.

“You might want to turn it to a more relaxing setting,” Rabin says. “We recommend people use Energy and Wake-Up only in the morning. Otherwise, you might not be able to sleep.”

Inside my mind, I laugh at this. “Might not be able to sleep! Lol.” At 4 PM each day, I could take an intravenous amphetamine shot, and I’d still probably yawn. My afternoon slump is one of my major remaining health concerns. I either give into my overwhelming temptation to nap (facilitated by my desk’s proximity to my bed). Then I can’t get to sleep at night, then wake up the next morning groggy, and the cycle continues. 

Or I muster every bit of strength in me, and resist the urge to nap. But then I’m a miserable zombie for several hours right towards the end of the workday when I need high productivity.

Defiantly, I keep the Apollo on the high-energy mode, doubting that it will make much of a difference, where nothing else (not even espresso shots) has.

But then, as Rabin explains the method of action of the device to me–it is supposed to increase something called “heart rate variability,” more on which soon–I notice something:

I’m talking fast–interrupting Rabin with rapid-fire questions, almost impatient that he was not speaking faster himself. This behavior is not normal for me at 4 PM.

And then I realize:

“Wow, I think this thing is working!” I announce to Rabin. It’s a minor miracle. I feel wide awake, something I have not felt at this time of the day for as long as I can remember.

“OK, you’ve had it on Energy and Wake-Up for 5 minutes now. Why don’t you try another setting?”

I adjust the device via the app to the “Social and Open” setting. The vibrating pulses slow down and take on a more mellow, rounded feel to them.

Rabin tells me about heart rate variability (HRV). “At any given time, your heart rate responds to cues and signals within your environment, and within your body, about how fast it needs to be beating. The heart rate variability is the speed with which your heart rate responds appropriately to these changing cues. For example, if someone yells at you, your heart rate will increase, to give you a burst of energy to deal with a potential threat or confrontation. But then, once the threat has passed, ideally your heart rate will go back down soon enough.”

He continues, “The problem is, in people with chronic stress–which is most of us now, especially during COVID–and particularly in people with PTSD, the heart rate does not go back down quickly after the threat is gone. This persistence puts you in a state of chronic sympathetic (fight or flight) nervous system activation. It works by mimicking the soothing effects of human touch, such as cuddling or a massage, calming your nervous system down, and letting you know it’s safe to be relaxed again. ”

While I’m listening, I notice another thing:

I feel like I’m not on the phone with Rabin, but rather, standing next to him at maybe a cocktail party, and I’ve had perhaps a glass of champagne. I feel chill, bubbly, and, um…. Social and Open. 

OK, at this point, I’m sold. I’m sold because I really really doubted that sending some vibrations through my wrist could change my mood or energy. I usually need some… ah… more potent stuff to do that.

But it seems doubtful that it’s just a placebo effect. After all, a placebo effect is based on your hopes that the treatment will work. “If I felt certain it would not work, could it still be a placebo?” I ask Rabin.

“It’s not a placebo,” he replies. “We’ve run double-blind, randomized placebo-controlled studies now, at the University of Pittsburgh.” (Rabin did his residency in psychiatry at the University of Pittsburgh Medical Center. He received his M.D. and his Ph.D. in neuroscience from Albany Medical College.)

“In our first study, we tested many different vibration patterns on 38 healthy adults. The subjects were asked to perform a very stressful cognitive task that NASA gives to astronauts before they go into space, to test their ability to perform tasks accurately under extreme frustration. All subjects, who performed this task 12 times, randomly received placebo vibrations akin to a cell phone buzzing. Another group received no vibration. And one group received the actual vibration patterns we engineered, that you can find now on the app.”

It turned out the study showed that subjects’ experienced cognitive performance improvements on this task of up to 25% within 3 minutes, similar to the results observed with amphetamines, and much higher than the control groups. The performance improvement correlated directly with the amount of improvement in heart rate variability, showing that the more recovered our bodies from stress, the better we perform. 

The Wife-Husband Team on a Mission to Change Mental Health Care

We’re in the midst of a wearable wellness device boom–but the vast majority of these devices simply monitor various health metrics. While increased knowledge of metrics can be helpful, Rabin was interested in a device that could change the metrics positively–without the wearer having to do anything. 

In 2014, while still in residency at the University of Pittsburgh Medical Center, Rabin had just started researching the science behind Apollo. In 2016, the University’s Innovation Institute was interested in the idea and suggested he and his colleague and co-inventor Dr. Greg Siegle Ph.D. apply for one of their competitions to win funding. 

Rabin’s fiancé at the time (now his wife) Kathryn Fantauzzi, is an expert in tech transfer–basically, how to get scientific breakthroughs out of the lab and into people’s hands faster. 

She tells me: “Dave came home one night and said, ‘The university approached us about their competition. I’ve gone to a couple of meetings, and honestly, they’re starting to talk about things I don’t know about. This isn’t an NIH grant. It’s all about pitch decks and channels. Can you check it out?”

This was a highly opportune time for Rabin to be in a relationship with a tech transfer specialist. Soon enough, Fantauzzi was leading the business side of the fledgling Apollo company. With the help of the pitches she created, Apollo won or placed in all the competitions they entered, raising an initial $500,000 for the clinical trials. 

One of Fantauzzi’s early contributions to the concept was to move the strategy away from electricity and towards sound wave patterns. “When I first heard they were going to run electricity through people, I was like, ‘You want to what? Excuse me?’ I knew that wouldn’t fly as a consumer product, as having electricity run through you doesn’t seem very fun.” Fantauzzi suggested they run some tests and see if they could get the same results with sound patterns rather than electricity. 

This was not a random suggestion. Rabin and the other neuroscientists on the team happen to be what Rabin calls “serious amateur” musicians; he has studied piano and trumpet since childhood. He and Fantauzzi used to hold First Friday concerts in their home, open to the public, featuring bands spanning multiple genres from jazz to hip-hop to spoken word to folk music. 

After a review of the scientific literature on the effects of sound on the body,  Rabin and his team came up with several sound patterns that they theorized might induce the intended states–from the staccato bursts of “Energy and Wake Up” to the long, smooth, flowing undulations of “Social and Open.” Their initial basement lab prototypes of devices using sound forms involved lots of subwoofers. 

That turned out to be the right approach, and now the device has numerous successful academic trials supporting its efficacy, including a double-blind randomized placebo-controlled trial at the University of Pittsburgh. 

“I felt the technology worked for me,” Fantauzzi said, “but I’m a New Yorker, so I’m naturally skeptical. I thought, ‘Yeah sure, it worked on me, but I wanted to see the data from the double-blind clinical trials.’ The results came back, showing up to 25% improvement in cognitive performance and improved HRV within 3 minutes when subjects had no idea if they were getting a placebo or Apollo frequencies, and I was astounded. ‘We have something here. This could change a lot of people’s lives,’ I realized.”

They conducted another pilot trial using the Apollo with children who suffer from the difficult cluster of ADHD, autism, and anxiety at the same time with the Children’s Integrated Center for Success in Allentown, PA. “The children’s engagement with their therapy sessions while wearing the Apollo went way up, and their anxiety scores went down by 50%,” Fantauzzi said. 

“We did a trial with nurses at a skilled nursing facility in Pennsylvania, and saw similar results–an over 40% reduction in stress scores within just two weeks.” 

Rabin adds: “My colleagues at the University of Pittsburgh are conducting a trial in collaboration with the New School in New York. In the first cohort, they gave Apollo to 14 people struggling with benzodiazepine or opioid addiction, related to their treatment-resistant PTSD. Within two weeks, 13/14 reported it as “life-changing.” These are people for whom nothing else had worked on their PTSD over years. Most impressively, many had voluntarily tapered down on benzodiazepine or opioid use. We hadn’t asked them to taper anything. They just did it naturally, as they were beginning to feel better.”

Stress-Reduction in the Age of COVID

Apollo launched officially in January and immediately sold out its first run. Then COVID hit–not exactly any entrepreneur’s ideal situation for a launch years in the making.

But COVID strangely turned out to be just the right time to launch a stay-at-home consumer product that delivers immediate stress relief. Millions of people were faced with the double-whammy of much higher stress due to the pandemic–yet far fewer options to relieve that stress, as gyms, social gatherings, and in-person therapy (let alone in-person sex) shut down.

Actually, it’s a triple-whammy, because many doctors and researchers believe that all this increased stress might also increase susceptibility to COVID infection, and/or to worse outcomes once infected

There’s a desperate need for easy stress-reduction means. Many people have started looking to wearable devices. Apollo’s second batch sold out instantly in May, and their third run is now selling briskly. 

Apollo is now initiating programs to get devices to frontline COVID workers. There are few people in the nation who need instant stress reduction more urgently than those keeping us protected from COVID. 

Rabin and Fantauzzi want everyone who needs one to have access to an Apollo. To that end, they are gearing up to go through FDA trials and get it approved, “so that it can be a reimbursable medical technology less expensive than most medicines,” Rabin said. 

“It has the potential to be a first-line treatment for a host of conditions worsened by stress, starting with ADHD, and reaching other conditions like PTSD, chronic intractable pain, traumatic brain injury, concussion, and many mental illnesses–use-cases which are currently or soon to be in trials.” 

It’s not just mental health patients who are benefitting it. After sending it out to therapists for their patients to try, the therapists reported that they were using the Apollo devices in sessions too, to stay more calm, present, and focused for their clients. Since then, the range of people using Apollo continues to expand, including professional athletes, fighter pilots, veterans, children, and their parents, and the list goes on. 

“It’s harmless and has no side-effects. It does the work for you. It feels good, and people enjoy it. Who ever enjoys anything that makes you healthier?” Fantauzzi laughs. 

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