Science from the Field: Unlocking the Power of Circadian Rhythms with Alexander Dimitrov

Krystal: I’m really excited to have you on the podcast because I personally find the research that’s happening in blue light therapy so interesting. I know we touched on it in the introduction, but can you share a little bit about your background and what drew you from studying business to develop a sleep health device?

Alex: Absolutely. So as you mentioned I’ve been passionate about healthy living since I was a child. I’ve been doing sports more or less on a daily basis, even in my preteens years, and I’ve been passionate about healthy food. So sleep and circadian health kind of came naturally.

But what really triggered that was me moving to the Netherlands. and experiencing firsthand what effect the lack of light can have on our energy levels, mood, sleep, and general wellbeing. Together with my co-founder Branislav, whom I met during my masters, we experienced the effect a lack of light can have because he’s from Serbia, I’m from Bulgaria, both are relatively sunny countries, even in winter. We didn’t really know how to cope with this lack of light that we experienced up in the north, and that’s what really drew us to learn more about light therapy, chronobiology and the effect of light in general for our wellbeing.

Krystal: What was the journey of actually developing AYO as a product? Where did you start and what were some of the steps you both took to actually create this device?

Alex: It’s typically people who have a problem, they do look for solutions. So we looked into the market, what solutions were out there. We learned about light therapy, and as we were in the Netherlands, the most renowned company in light therapy at that time was Philips, and they had different products on the market, such as the Philips Go Light, Philips Wake Up Light. So we bought them and we tried them.

Even though they’re great and the science is solid, and there are decades of research on the effect of light on our general wellbeing, but we found some limitations. For example, the Philips Wake Up Light is a wake up light. So it illuminates the whole room and wakes up not only you, but if you’re sharing the room with someone, a roommate, partner, then it illuminates the whole room. So it might not be perfect if you’re in different sleep wake cycles.

And if if we look into the Philips Go light, it’s a light therapy box which you need to put on a desk and you need to sit still and you need to look into a specific angle and make sure that you’re using it correctly. It was great if you get all the recommendations and guidance from, let’s say, doctors or someone helping you, but for the general public, it was not really the best. That’s why we decided to develop AYO, or the idea came about, to develop a combination wearable device that emits circadian blue light together with a mobile application that gives guidance, helping you understand what the circadian rhythm does and recommend different times to use the device for your specific case.

Krystal: It’s a much more personalised device, isn’t it? I think one of the things that we’re particularly excited about at BMedical with AYO is the personalised guidelines and the way it works with the companion app. So you can actually create your own schedule that is tailored to your circadian rhythm.

Alex: Exactly. Each one of us has a chronotype, and the chronotype is how naturally we’re inclined to being a morning type or an evening type or somewhere in the middle. So with the application, we help you on one side to understand what is your type. And based on that, and on your desired wake up goal and what you’d like to achieve using the device, we give you guidance and recommendations, not only related to using the device or light therapy, but also related to avoiding light, related to meal timing, exercise timing, caffeine intake, etc. So all the factors that play a role in helping you support your circadian rhythm, we try to gather all the information and provide it to you.

Krystal: Since launching AYO, have you delved deeper into the world of sleep research?

Alex: Absolutely. Since the early beginning we have been focusing on bridging a way from science to the consumer to provide a solution in this novel field of circadian health. And we’ve been grounded in research. We were lucky enough to win some business competitions since the very beginning, and we took part in an accelerator program at the Erasmus Center for Entrepreneurship. Through that, we were able to connect with some of the chronobiologists at the Erasmus Medical Center; and from there the whole group of leading chronobiologists in Germany and the region. We were lucky enough to meet our chief scientific officer, Dr. Thomas Kantermann, a leading chronobiologist, and even his mentor who is the father of social jet lag, and many other experts throughout that year.

We were able to develop the product under the guidance of some of those experts and really learn from their insights and create a solution that is based on science, but also focused on helping consumers really support their circadian health, and understand it. We have also been fortunate to take part in numerous research projects clinical trials. Two of them have been finalised, one with the US Department of Defense, and another with the University of Reykjavik, showing that AYO helps reduce sleep problems, improve sleep, and improve subjective performance as well. We are currently taking part in almost 20 research projects throughout the whole world.

Krystal: That’s amazing. That’s definitely one of the biggest things in sleep research, is how do you take what you learn in those studies and translate it into practical advice that consumers can use so it can actually make a lasting change in people’s homes and in their personal sleep schedules.

It’s interesting to find a way to bridge research to consumers and to be able to translate that information.

Alex: Absolutely. I think it’s crucial to collaborate and I think this is the key that is very important in this field of circadian health, because it’s very novel. There are a lot of things that we know, but also a lot of things that we do not know. And by collaborating and being part of a different organisations and trying to connect, it really makes a difference. And this is one of the goals that we have, and that’s why we also take part in organisations such as the Good Light Group, which is an organisation focused on healthy light, and we are part of the Sleep Tech Council, the National Sleep Foundation, and also supporting the Society for Light Therapy and Biological Rhythms.

And really trying to be there to connect the different parties and also provide a solution that is helpful.

Krystal: In your opinion, what are some of the most pressing issues in sleep at the moment, or health related concerns in sleep, and how do you think they can be addressed?

Alex: Unfortunately, even though we know a lot about sleep and sleep is on the agenda of many organisations, even governmental institutions, etc, we are still are struggling with sleep. A lot of people are not sleeping well, and obviously sleep is complex so there are many things affecting sleep. But I think something that was covered from some of your previous guests on the podcast is shift work and shift work disorder. Shift work is essential, we need shift workers, and around 15 to 20 percent of the global working population are working on shifts. We know shift work not only affects your quality of life, because you need to work when other people are sleeping and you need to sleep when your family is awake, but it also affects your health. So it increases the risk of basically any modern disease and chronic disease that we know.

It’s important to address this, but it’s obviously complex because typically it involves different players such as employers, employees, organisations, and even government in some ways. So I think at the end of the day, it’s a circadian disruption. Using sleep and circadian health to really assist is important and kind of really understanding the impact of shift work to move this into a healthier way of doing shift work, in the sense of not rotating shifts too frequently and really educating the employees how they can help their bodies cope with that in terms of light, mealtime and exercise, etc.

Outside of shift work, another thing that I would like to mention is we know that the wearable market is enormous. There’s a $50billion market expected to rise to over $100billion in the upcoming few years.

Krystal: Is that globally?

Alex: I think that’s globally. And there are so many trackers out there and they’re great at helping you identify a problem of sleep or health, but they’re not that great in actually helping you improve on your sleep outcomes. And that’s why we think that combining sleep with circadian health really makes a difference because light is essential. Circadian health is a foundation to general health and by really helping you with your sleep wake cycle, light exposure, meal timing, etc, it can make a lasting difference. So this is something that I think society should better understand and really focus on.

Krystal: What do you think is required to take a lot of these learnings from sleep research into the mainstream? Is it more education programs? Is it going through clinics? Is it taking it into social media campaigns? What do you think would actually have a big impact on that education piece?

Alex: I think it’s probably most of that and at the same time, I think it starts with the willingness of the different players in the market to help people improve their health, and by collaborating.

So I refer to organisations, to the media as well, to corporations, the government, and university institutes because we need to bring it all together. There is no single entity or organisation that can make a lasting change without the collaboration of other institutions and other players.

No matter if you’re Apple or a small company like ours, you really need to collaborate. One thing that we noticed is that the educational piece is becoming more and more prevalent. Especially after COVID, I feel that people are much more health conscious now and they try different solutions, and they are listening, and a lot of experts are sharing their knowledge for free in many ways. So there are a lot of things happening, which are positive, but obviously there are a lot more things to be done in the sense of collaborating, really educating and helping people provide solutions.

Krystal: Bringing it back to AYO. What are some of the biggest wins you’ve had with AYO? What’s gotten you most excited through this journey of developing a wearable device?

Alex: Yeah, well, the unique thing about AYO is that it really is a combination of hardware and software, health and innovation, and science. So you need to bring all these pieces together and it was challenging in the beginning to do that. I would say one of the main wins we had in the early days was just to develop the product and to put it in the hands of people and see that it works, that it helps them. Just because it’s a unique combination of all these elements we were fortunate enough to get a lot of media exposure to win different accolades, such as the Red Dot Award for Product Design, The National Sleep Foundation Sleep Tech Award, as well as Men’s Health Best Sleep Tech and Best Light Therapy Product throughout the years.

And what really is humbling for us is that we not only won these awards, but also we won them amongst or after great products with very big resources such as the Apple Watch or Garmin Fitbit. So that was very humbling. Another thing is that it being somewhat a unique solution we got a lot of interest also from athletes, from executives. For example, Novak Djokovic has been an early user of the device, or actually the prototypes, and he even won Australia Open back in 2015 or 16 when he started using the device to help him manage jet lag. And we have many other stories like this with LeBron James, the national Spanish football team, and many others who have benefited from the device.

Krystal: We’ve been talking a lot about shift work and general health and sleep hygiene, but there’s also a space that’s looking at optimising the circadian rhythm for elite athletes or people who have high pressure jobs, and they really want to work at their optimum. That’s in itself is a really interesting piece of the puzzle, isn’t it?

Alex: Oh, absolutely. And we know that athletes are always looking for the extra 1 percent or even 0. 1 percent that is going to secure their win. They’re open to that. What we’ve seen in the past decade or two is that sleep is a must for athletes. They understood before that training is the most important, sleep comes second, but now, you know, it’s a mix of both. And now we see also light and light therapy becoming crucially important as well. A lot of these athletes are trying this, especially for jetlag. What we did with the Spanish national female football team, they flew to Australia, to New Zealand for the championships and they used the device beforehand so they were able to adapt, or partially adapt, to the new time zone already in Spain. This is something that really shows the potential of improving performance.

Krystal: Yeah, and obviously they went on to win the World Cup, so you can’t have a better endorsement than that really, can you?

Alex: Exactly.

Krystal: What are some research papers that are focusing on blue light therapy or even sleep and circadian rhythms at the moment that you’re really excited to see the outcomes of?

Alex: As we know, light therapy has been undergoing a lot of research in the last maybe five decades, or more than that, but the focus has been increasing. Light therapy has been proven for improving mood and energy and sleep in many ways. What we see now is a bit more specialisation. Or at least what makes me excited about is that for certain groups, such as cancer patients there is a focus of light therapy on cancer related fatigue. Some of the studies we take part in for light therapy for helping mood, energy and sleep in neurodegenerative diseases such as dementia or Alzheimer’s. And also in certain groups of people, for example the military. One of the studies we took part in was with the University of Arizona and the US Department of Defense, focused on improving mental health and sleep and suicidal thinking in ex-military personnel, presumably the largest light therapy study in the world.

So we see a lot of new applications of light therapy, which are being uncovered now, and that makes us quite excited, and obviously there are a lot more research projects going on at the moment.

Krystal: One of my favourite research papers AYO was involved in that I read again recently, was where you were working with the Navy and they were wearing them in the submarines. Reading the feedback from the officers and I could really see where you took a lot of the feedback from that early design of AYO and incorporated what they did and didn’t like about the wearable into the new model. So can you tell me a little bit about how you’ve taken the usability of the device and adjusted it over time based on the feedback from wearers?

Alex: Absolutely. As you said, we are very open to feedback and doing our best to improve the product. One thing I can share is that in the very beginning, the very first version of the device was a connected device that you needed the app in order to turn it on, which gathered a lot of interest from the media and other endorsers, but in, in reality, it didn’t work the best because many people, didn’t want to use the app just to turn on the device or turn it off. They wanted to just open it and use it.

Throughout the years we decoupled this so you can use the device without the app or with the app, depending on your preferences. So this is one, let’s say lesson, that we learned in many ways. We were engineering a lot in the beginning and seeing what works the best and then simplifying the product in some ways and improving in other ways. So it’s been an ongoing curve of learning.

Krystal: Is there anything about the future of AYO that you can share with us, anything you guys are working on to release, whether through the companion app or with the device?

Alex: Yeah, well, we are working on a lot of new functionalities within the app, specialising more in different use cases, so providing more hands-on experience and guidance for people. For example, who wants to use it for improving sleep or energy or winter blues, etc, and integrating with Apple Health and Google Fit, which has been on the roadmap for some time.

And just making it better and better, and even more than that, really collaborating with different players in the field so we can bring it to more people. One of the things that we’re planning to do is to launch a circadian health hub, which is going to be kind of a place where people can learn about circadian health from leading experts and really provide the knowledge that we have gathered to more people.

Krystal: That sounds really exciting.

Just to finish off, what are some books or resources you would recommend to our listeners? And it doesn’t have to be in the realm of sleep. It can be anything you have found really interesting recently.

Alex: Great question. If we think of circadian rhythm and understanding how it works, one book that was already mentioned in the podcast was Russell Foster’s, Lifetime, which is a great source and really written in a way that even the general public can understand and can be more conscious of their circadian rhythm.

On that line Satchin Panda’s, Circadian Code is also great, or even Till Roenneberg’s, Internal Time really explains a lot about circadian rhythm. I think this is a great way to start. And obviously, just following the latest research – the general media is also covering a lot of the research that is taking place now, or typically the results, and once it’s published you can learn a lot if you follow the latest developments.

Krystal: Thank you so much, Alex, for joining us on the podcast today and just for sharing your insight and your experience in developing a product in the sleep space. You know, it’s such a challenge to adapt and take in all the changing information and put it together into something that empowers people to have better sleep and better sleep hygiene and understand themselves a bit better. So thank you very much.

Alex: I appreciate the opportunity.