Sleep experts all agree on how to sleep better. Good sleep begins with good sleep hygiene and optimizing sleep through technology does not mean reducing sleep duration. What’s your take on it? This post from Fast Company weighs sleep apps, sleep hacking, and experimental sleep technology against basic sleep hygiene.
The fantasy of sleeping less while achieving more is far older than the Internet, where today you can find a slew of tips and new, high-tech solutions that claim to track and optimize our sleep into submission, with the dream that, perhaps, we could get by on more sleep. But does sleep hacking actually work? “
To better understand our growing arsenal of sleep-hacking techniques and technologies, I asked Zandieh and Nathaniel F. Watson, the president elect of the American Academy of Sleep Medicine, for their input. They responded with more basic, general advice: Good sleep begins with good sleep hygiene.
No gadgets, just hygiene.
“We have a low sleep IQ in general,” says Watson. “I think there is a need for more education in our communities not only about the importance of sleep but the strategies for how to optimize it. Nobody is taught these sleep hygiene aspects.”
Good sleep hygiene consists of a batch of behaviors that can help improve sleep efficiency—that is, the percentage of time in bed spent asleep as opposed to trying to sleep—as well as sleep duration and quality. Consistent wake times, exercise, and exposure to daylight promote healthy sleep, as does cutting down on naps, stimulants, light exposure, and screen time in the evenings. The ideal sleep environment is cool, dark, and quiet.
“I would challenge your readers to have them prioritize their sleep,” says Watson. “What you find is that if people go through a two- to three-week period where they sleep until they feel rested that their mood improves, their ability to think clearly improves, their overall quality of life improves to the point where they would likely spend a little more time in bed and a little less time awake in order to have a higher-quality wakeful experience.”
HOW MUCH SLEEP DO YOU REALLY NEED?
How much sleep a particular individual needs seems to depend on age, genetics, and other, still undetermined factors. Teenagers, for example, need more sleep than adults. A number of gene variations including hDEC2 and BHLHE41 have been found in short sleepers, people who do not seem to suffer from sleep deprivation even when they sleep six hours or less. Researchers estimate that less than 5% of people are true short sleepers. Most of us need considerably more shut-eye to function optimally. “We don’t have a way to measure how sleep deprived a person is or how much sleep they need,” cautions Watson.
The effects of not getting enough sleep are well established. “Insufficient sleep or poor sleep quality is associated with detrimental effects such as impaired ability to concentrate and retain information, mood disorders, impaired motor skills, and poor overall health and immune function,” says Zandieh. “Depending on an individual’s environmental and genetic susceptibilities, some suffer more and others less with the same amount of sleep debt.”
Another slippery concept at the heart of the science of snoozing is sleep quality. Measuring quality often means assessing whether a person has sleep onset insomnia (trouble getting to sleep), sleep maintenance insomnia (fragmented sleep), or early awakenings. “How does a person feel when they wake up in the morning?” says Watson. “Do they have residual grogginess, fatigue during the day, night-time awakenings, those sorts of things?”
Sleep deprivation is not just a health issue, but also a social justice issue, researchers say. Adults who work multiple jobs, for example, are 61% more likely than others toreport sleeping six hours or less on weekdays. The lower your level of family income and education, the higher your odds are of getting less sleep than you need.
IT’S HARD TO MEASURE SLEEP DEPRIVATION
“It would be great if there was some salivary test or some breath test that could be done to measure the level of sleep deprivation,” says Watson. He cites studies on amylase, a biomarker highly correlated with sleep drive, as one possible research direction. The build up of adenosine, a neuromodulator believed to play a role in promoting sleep, in the brain could also eventually yield a test. Until then we still need to use more ad hoc methods to determine whether we are getting enough sleep.
A growing catalog of gadgets promises to help us get more of it; some aim to help us feel more wakeful when we wake up sooner than we’d like. All pose sleep as a problem that technology can solve. That’s not a new approach, but it may be more ironic than ever, given the amount of sleep we now give up to technology. Nevertheless, they could be helpful, say Zandieh and Watson—in some cases.
Motion Tracking Sleep Apps
Motion tracking apps like Sleep Cycle or bracelets like Actiwatch or Fitbit use an accelerometer to detect your movements in bed, in order to determine whether you are awake or are in lighter or deeper sleep. “Really none of those things (like movement) are measuring sleep,” says Watson, who treats all kinds of clinical sleep disorders. (One study in the journal Sleep and Breathing found that movement-based activity monitors, “consistently misidentify wake as sleep and thus overestimate both sleep time and quality.”) “They would be considered to be indirect measures of sleep.” Sleep specialists like Watson, in contrast, use an EEG to detect changes in brain activity that indicate different stages of sleep.
Also, most consumer devices haven’t been tested rigorously by the scientific community. Orfeu Buxton, an associate professor at Penn State University who studies sleep, recently told my colleague Shaunacy Ferro that consumer sleep tracking technology tends to make questionable claims. “While there may be some science underlying it, rarely is it peer-reviewed and shared and evaluated” by independent researchers, he says.
Sound-Recording Sleep Apps
Some sleep-related applications record nighttime sounds like snoring or external noise in order to help identify sleep issues. “Let me direct you to another articlewhere the app only worked well in a soundproof environment,” says Zandieh. This study found that a variety of recording sleep apps had difficulties in telling snoring sounds apart from other noises.
Sleepers cycle through four sleep stages where brain waves gradually slow and sleep deepens. After the final stage of deep sleep comes a spurt of REM (rapid eye movement) sleep, where your eyes dart back and forth and during which you are most likely to dream. Using various sensors, smart alarms claim to use the aforementioned sleep measuring systems to rouse you during lighter, non-REM sleep. One device, the Aura (Withings, $299.95) tracks heart rate and activity through a sensor placed under the mattress, and wakes you up with a blue light designed to suppress the body’s production of the hormone melatonin, which regulates our bodies’ internal clocks.
But Zandieh issues a caveat: “All of these apps try to work on physiologic processes of our sleep-wake cycle, which is complicated and often cannot be captured through algorithms.” While people awakened from deep sleep often feel groggy and disoriented, she doesn’t see evidence for avoiding waking during REM sleep. “To this day, I have not found any research articles that report that waking up from REM sleep is any different than waking up after NREM (non rapid eye movement) sleep with regards to feeling more refreshed or not,” says Zandieh. “There is literature stating that this may affect parasomnias (abnormal sleep behaviors such as sleepwalking, nightmares, sleep paralysis and sleep aggression) but not overall sleep efficiency.” Somneo Sleep Trainer
An experimental mask designed to help soldiers reach deeper sleep more quickly, the Somneo sleep trainer screens ambient noise and visual distractions and carries a heating element around the eyes, based on the finding that facial warming helps send people to sleep. It also has an EEG monitor.
“We do know that the ideal sleep environment is cool, dark, and quiet,” says Watson. “And quiet, yes, but really what you want to avoid are spikes in noise from the background.”
The mask’s warming aspect is interesting, he says: “There’s some research out there that taking a warm bath before going to sleep can increase deep non-REM sleep.” Some more recent research suggests that a cool cap can help insomniacs. “Whether or not heat or cold applied to the head area is conducive to sleep may depend on the person and what their issues are,” says Watson. Dietary Supplements
Omega-3 fatty acids, such as those found in fish oils, are being used by the military to help soldiers to sustain performance over 48 hours without sleep as well as boosting attention and learning. Researchers from the University of Oxford have shown thatchildren who receive omega-3 experience fewer sleep disturbances.
Watson has another well-known dietary suggestion for more sleep: “There’s some evidence that the tryptophans in some foods can be sedating.” Tryptophan is a precursor of serotonin that is thought to produce healthy sleep and a stable mood. High tryptophan foods include nuts, seeds, cheese, tofu, some meats and fish, oats, beans, lentils, and eggs. Drugs For Alertness
Provigil is a prescription medicine that helps to elevate levels of hypothalamic histamine, a wakefulness-promoting agent. It’s usually prescribed to patients who experience excessive sleepiness due to sleep disorders.
“The military are using medication like Provigil to help soldiers stay more alert when they are awake, which are not stimulants like Ritalin and thus less addictive,” says Zandieh. Studies are also underway in police and fire departments to see whether Provigil can help personnel working night shifts. “Using medications like Provigil and many of the over-the-counter medications should be discussed first with your physician,” adds Zandieh.
Transcranial Magnetic Stimulation
Transcranial magnetic stimulation (TMS) uses a magnetic coil placed over the scalp to generate brief magnetic pulses that cause neurons in the brain to fire—a technique that has been used to treat depression and other affective disorders. (Transcranial direct stimulation, a related approach, is also a growing research topic.) Neuroscientists at Duke University have also used TMS to induce the type of slow brain wave activity seen in deep sleep. The thinking is that with these particularly intense slow waves induced by TMS, people could .
Watson says it’s hard to offer a conclusive assessment. “Sleep is really a complicated physiology which is driven by areas which are deep within the brain: the hypothalamus and the pons (it plays a key role in REM sleep and dreaming) and the medulla (it helps with breathing, swallowing and heart rate). I would imagine that those are areas more difficult to influence with transcranial magnetic stimulation than some of the more cortical areas that you might stimulate for mood.” Sleep Schedules
“We know that shift workers sleep less than those who sleep during nighttime and we know that there are a lot of untoward consequences to shift work, including increased risk for cardiovascular disease, cancer, motor vehicle accidents, and things of that nature,” says Watson. “We evolved a light-dark cycle and our bodies are most efficient at performing the critical activities of sleep at nighttime in our normal circadian rhythm.”
Optimizing sleep through technology, Zandieh emphasizes, does not mean reducing sleep duration. “There are none and probably will not be any ‘good’ solutions until the nature of sleep is better understood,” she says.