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Thursday, January 19, 2017

Restless Quest for Sleep from Dr. Mercola

Restless Quest for Sleep

January 19, 2017 | 23,058 views

By Dr. Mercola
On any given night, about half of Americans toss and turn, unable to fall asleep or stay asleep.1 Lacking in this fundamental human necessity takes a heavy toll, raising the risk of chronic diseases, obesity and premature death while costing the U.S. economy up to $411 billion a year in lost productivity alone.2
Needless to say, a tried-and-true solution to the epidemic of not sleeping, especially one that doesn't involve taking risky and often-addictive sleeping pills, could yield immeasurable benefits to society. Tech devices are among the newest additions in the battle against insomnia, but they're also increasingly popular — and expanding.
There's Sense, the product of a 2014 Kickstarter campaign that raised $2.4 million, which uses sensors to collect your tosses, turns and other sleep data, which are then analyzed via a smartphone app to give you personalized insights into your sleep.3
Other tech-based devices to help people get more of the elusive "shut-eye" include the Sleep Shepherd headband, which monitors your brain waves while you sleep and, one of my favorites, Muse, which is a personal meditation assistant that promotes relaxation. When used before bedtime, it may help lull you into a restful night's sleep.

Can Technology Help People Sleep Better?

There are many anecdotal reports of sleep trackers and apps helping people to get more sleep, but the reality is many of these products are so new that longer-term studies proving their effectiveness have yet to be done.
It's ironic, too, that technology is being used to cure sleep troubles that may be caused by the same technological advances; use of smartphones, computers and tablets after dark is a leading contributor to insomnia because their blue light interferes with melatonin production that's important for restful sleep (and other health benefits, like cancer prevention).
Still, while there are hundreds of apps to track your sleeping habits, many do so successfully without interfering with sleep. Fitness-tracking wristbands, such as Jawbone's UP3, tell you what activities led to your best sleep and what factors resulted in poor sleep.
There are also smart mattresses and mattress pads that track your sleep and provide reports so you can adjust your sleeping habits accordingly. Some even claim to help users regulate their body temperature during sleep.
Once you're armed with empirical data, it's then up to you to make changes to support your sleep. No app or other sleep device can do that for you.
There's also the issue of how accurate these devices really are, which Hawley Montgomery-Downs, Ph.D., a sleep expert and an associate professor of psychology at West Virginia University, believes has much room for improvement.
She told The New York Times, "Sleep sensors are feeding back inaccurate information … They're telling people they sleep better than they do."4

Smart Sleep Devices Gather Your Data — and Then What?

I've found sleep trackers to be useful for revealing the actual time I spend asleep (as opposed to the time spent in bed), which allowed me to adjust my bedtime to get my desired number of sleep hours each night.
But others have found their data collection to be less useful, for instance letting the user know that they wake up in the middle of the night, something the user already knew. There are now smart pillowcases, smart pajama belts, bed sensors and smart alarm clocks, all of which promise to give you detailed reports on how you sleep.
But while knowing your precise minutes of REM sleep, light sleep and other odds and ends that occur during sleep is arguably intriguing, it's not going to help you feel more rested or translate into helping you fall asleep faster.
Ultimately, the data needs to be translated into a platform that gives users useful personalized feedback and advice that translates into a better night's rest.
Still, in the meantime, having access to your sleep data could prompt you to pay more attention to your sleeping habits. At least one study has found activity trackers to be useful in the realm of sleep, with users reporting 30 minutes more sleep per night after a year of use.5
Study author Laura Pugliese, deputy director of innovation research at New York-based Healthcare Innovation & Technology Lab, told STAT, "People didn't realize how little they were sleeping, and it wasn't until it was in front of them and aggregated that they realized."6

Online Insomnia Therapy Puts Insomniacs to Sleep

Another way technology may help fight insomnia is via online therapy programs. One recent start-up company created an online sleep improvement program called Sleepio, which features a virtual therapist, for instance.7
Cognitive behavior therapy for insomnia (CBT-I) is considered the gold standard treatment for insomniacs, but specialists in this area are hard to come by and many do not receive treatment. An online program could provide a way for people to get the help they need from anywhere with a working internet connection.
In a study published in JAMA Psychiatry, more than half of people with chronic insomnia reported sleeping better within weeks of starting the online program and most were sleeping better one year later.8 According to the study:
"In this randomized clinical trial of 303 adults with chronic insomnia, those who received the internet cognitive behavior therapy for insomnia intervention (Sleep Healthy Using the Internet [SHUTi]) had significantly improved sleep compared with those who received access to the patient education website, with 56.6 percent achieving insomnia remission status and 69.7 percent deemed treatment responders at [one] year."

Misuse of Over-the-Counter Sleep Aids Common

Beyond tech devices, over-the-counter (OTC) drugs are a popular crutch used by many desperate for a good night's sleep. Yet, these medications can be dangerous, particularly when used for longer periods of time, a common practice according to a 2015 Consumer Reports survey.9
The survey included more than 4,000 Americans, 20 percent of whom had used an OTC medication for the purpose of improving sleep within the past year. Eighteen percent of them used such drugs daily, and 41 percent used the drugs for a year or more.
The OTC drugs in question include Advil PM, Nytol, Simply Sleep, Sominex, Tylenol PM, Unisom SleepMinis, ZzzQuil and others, which include the active ingredient diphenhydramine, an antihistamine that can lead to next-day drowsiness and problems with coordination and driving performance, along with constipation, dizziness and confusion.
The drug is only meant to be used for short periods of time (not longer than two weeks), as longer use can be habit-forming, leading to psychological dependence. Despite this, many of the drug packages advertise them as being "non-habit-forming."
One study also linked its long-term use to an increased risk of dementia, including Alzheimer's disease.10
Many of the medications also contain other drugs, such as ibuprofen and acetaminophen, which carry other risks, including gastrointestinal problems, ulcers and liver damage.
Considering the steep physical risks — and the mental and emotional toll chronic insomnia can take — you may be willing to try anything, even sleeping pills, to get some sound sleep.
However, psychotherapy, specifically CBT-I, which helps people change their thoughts and behaviors regarding sleep, has been proven to be more effective than drugs.
In a set of reviews commissioned by the American College of Physicians (ACP), CBT-I was the clear winner, helping to relieve insomnia with minimal side effects, as opposed to insomnia medications, which carried sometimes-severe risks.11
The American Academy of Sleep Medicine (AASM) also recommends psychotherapy as a first-line treatment for insomnia. In this way, technology, namely online CBT-I therapy, may prove beneficial in helping people avoid the pitfalls of sleeping pills, including OTC varieties.

What Else Works for a Good Night's Sleep?

If you're having trouble sleeping, I suggest reading my Guide to a Good Night's Sleep for 33 tips on improving your sleep. While tracking your sleeping patterns and time spent asleep may be helpful for some people, getting back to the basics of improving your sleeping environment is also important.
No. 1 on my list? Avoid exposure to blue light, including LEDs, after sunset. Wearing blue-blocking glasses is a simple way to achieve this. Further:
Avoid watching TV or using your computer/smartphone or tablet in the evening, at least an hour or so before going to bed.
Make sure you get BRIGHT sun exposure regularly. Your pineal gland produces melatonin roughly in approximation to the contrast of bright sun exposure in the day and complete darkness at night. If you are in darkness all day long, it can't appreciate the difference and will not optimize your melatonin production.
Get some sun in the morning. Your circadian system needs bright light to reset itself. Ten to 15 minutes of morning sunlight will send a strong message to your internal clock that day has arrived, making it less likely to be confused by weaker light signals during the night.
Sleep in complete darkness, or as close to it as possible. Even the tiniest glow from your clock radio could be interfering with your sleep, so cover your clock radio up at night or get rid of it altogether. Move all electrical devices at least 3 feet away from your bed. You may want to cover your windows with drapes or blackout shades, or wear an eye mask when you sleep.
Install a low-wattage yellow, orange or red light bulb if you need a source of light for navigation at night. Light in these bandwidths does not shut down melatonin production in the way that white and blue bandwidth light does. Salt lamps are handy for this purpose, as are natural, non-toxic candles.
Keep the temperature in your bedroom no higher than 70 degrees F. Many people keep their homes too warm (particularly their upstairs bedrooms). Studies show that the optimal room temperature for sleep is between 60 to 68 degrees F.
Take a hot bath 90 to 120 minutes before bedtime. This increases your core body temperature, and when you get out of the bath it abruptly drops, signaling your body that you are ready to sleep.
Avoid using loud alarm clocks. Being jolted awake each morning can be very stressful. If you are regularly getting enough sleep, you might not even need an alarm, as you'll wake up naturally.
Be mindful of electromagnetic fields (EMFs) in your bedroom. EMFs can disrupt your pineal gland and its melatonin production, and may have other negative biological effects as well. A gauss meter is required if you want to measure EMF levels in various areas of your home.
If possible, install a kill switch to turn off all electricity to your bedroom. If you need a clock, use a battery-operated one.
[+] Sources and References

January 19, 2017 | 23,058 views

By Dr. Mercola
On any given night, about half of Americans toss and turn, unable to fall asleep or stay asleep.1 Lacking in this fundamental human necessity takes a heavy toll, raising the risk of chronic diseases, obesity and premature death while costing the U.S. economy up to $411 billion a year in lost productivity alone.2
Needless to say, a tried-and-true solution to the epidemic of not sleeping, especially one that doesn't involve taking risky and often-addictive sleeping pills, could yield immeasurable benefits to society. Tech devices are among the newest additions in the battle against insomnia, but they're also increasingly popular — and expanding.
There's Sense, the product of a 2014 Kickstarter campaign that raised $2.4 million, which uses sensors to collect your tosses, turns and other sleep data, which are then analyzed via a smartphone app to give you personalized insights into your sleep.3
Other tech-based devices to help people get more of the elusive "shut-eye" include the Sleep Shepherd headband, which monitors your brain waves while you sleep and, one of my favorites, Muse, which is a personal meditation assistant that promotes relaxation. When used before bedtime, it may help lull you into a restful night's sleep.

Can Technology Help People Sleep Better?

There are many anecdotal reports of sleep trackers and apps helping people to get more sleep, but the reality is many of these products are so new that longer-term studies proving their effectiveness have yet to be done.
It's ironic, too, that technology is being used to cure sleep troubles that may be caused by the same technological advances; use of smartphones, computers and tablets after dark is a leading contributor to insomnia because their blue light interferes with melatonin production that's important for restful sleep (and other health benefits, like cancer prevention).
Still, while there are hundreds of apps to track your sleeping habits, many do so successfully without interfering with sleep. Fitness-tracking wristbands, such as Jawbone's UP3, tell you what activities led to your best sleep and what factors resulted in poor sleep.
There are also smart mattresses and mattress pads that track your sleep and provide reports so you can adjust your sleeping habits accordingly. Some even claim to help users regulate their body temperature during sleep.
Once you're armed with empirical data, it's then up to you to make changes to support your sleep. No app or other sleep device can do that for you.
There's also the issue of how accurate these devices really are, which Hawley Montgomery-Downs, Ph.D., a sleep expert and an associate professor of psychology at West Virginia University, believes has much room for improvement.
She told The New York Times, "Sleep sensors are feeding back inaccurate information … They're telling people they sleep better than they do."4

Smart Sleep Devices Gather Your Data — and Then What?

I've found sleep trackers to be useful for revealing the actual time I spend asleep (as opposed to the time spent in bed), which allowed me to adjust my bedtime to get my desired number of sleep hours each night.
But others have found their data collection to be less useful, for instance letting the user know that they wake up in the middle of the night, something the user already knew. There are now smart pillowcases, smart pajama belts, bed sensors and smart alarm clocks, all of which promise to give you detailed reports on how you sleep.
But while knowing your precise minutes of REM sleep, light sleep and other odds and ends that occur during sleep is arguably intriguing, it's not going to help you feel more rested or translate into helping you fall asleep faster.
Ultimately, the data needs to be translated into a platform that gives users useful personalized feedback and advice that translates into a better night's rest.
Still, in the meantime, having access to your sleep data could prompt you to pay more attention to your sleeping habits. At least one study has found activity trackers to be useful in the realm of sleep, with users reporting 30 minutes more sleep per night after a year of use.5
Study author Laura Pugliese, deputy director of innovation research at New York-based Healthcare Innovation & Technology Lab, told STAT, "People didn't realize how little they were sleeping, and it wasn't until it was in front of them and aggregated that they realized."6

Online Insomnia Therapy Puts Insomniacs to Sleep

Another way technology may help fight insomnia is via online therapy programs. One recent start-up company created an online sleep improvement program called Sleepio, which features a virtual therapist, for instance.7
Cognitive behavior therapy for insomnia (CBT-I) is considered the gold standard treatment for insomniacs, but specialists in this area are hard to come by and many do not receive treatment. An online program could provide a way for people to get the help they need from anywhere with a working internet connection.
In a study published in JAMA Psychiatry, more than half of people with chronic insomnia reported sleeping better within weeks of starting the online program and most were sleeping better one year later.8 According to the study:
"In this randomized clinical trial of 303 adults with chronic insomnia, those who received the internet cognitive behavior therapy for insomnia intervention (Sleep Healthy Using the Internet [SHUTi]) had significantly improved sleep compared with those who received access to the patient education website, with 56.6 percent achieving insomnia remission status and 69.7 percent deemed treatment responders at [one] year."

Misuse of Over-the-Counter Sleep Aids Common

Beyond tech devices, over-the-counter (OTC) drugs are a popular crutch used by many desperate for a good night's sleep. Yet, these medications can be dangerous, particularly when used for longer periods of time, a common practice according to a 2015 Consumer Reports survey.9
The survey included more than 4,000 Americans, 20 percent of whom had used an OTC medication for the purpose of improving sleep within the past year. Eighteen percent of them used such drugs daily, and 41 percent used the drugs for a year or more.
The OTC drugs in question include Advil PM, Nytol, Simply Sleep, Sominex, Tylenol PM, Unisom SleepMinis, ZzzQuil and others, which include the active ingredient diphenhydramine, an antihistamine that can lead to next-day drowsiness and problems with coordination and driving performance, along with constipation, dizziness and confusion.
The drug is only meant to be used for short periods of time (not longer than two weeks), as longer use can be habit-forming, leading to psychological dependence. Despite this, many of the drug packages advertise them as being "non-habit-forming."
One study also linked its long-term use to an increased risk of dementia, including Alzheimer's disease.10
Many of the medications also contain other drugs, such as ibuprofen and acetaminophen, which carry other risks, including gastrointestinal problems, ulcers and liver damage.
Considering the steep physical risks — and the mental and emotional toll chronic insomnia can take — you may be willing to try anything, even sleeping pills, to get some sound sleep.
However, psychotherapy, specifically CBT-I, which helps people change their thoughts and behaviors regarding sleep, has been proven to be more effective than drugs.
In a set of reviews commissioned by the American College of Physicians (ACP), CBT-I was the clear winner, helping to relieve insomnia with minimal side effects, as opposed to insomnia medications, which carried sometimes-severe risks.11
The American Academy of Sleep Medicine (AASM) also recommends psychotherapy as a first-line treatment for insomnia. In this way, technology, namely online CBT-I therapy, may prove beneficial in helping people avoid the pitfalls of sleeping pills, including OTC varieties.

What Else Works for a Good Night's Sleep?

If you're having trouble sleeping, I suggest reading my Guide to a Good Night's Sleep for 33 tips on improving your sleep. While tracking your sleeping patterns and time spent asleep may be helpful for some people, getting back to the basics of improving your sleeping environment is also important.
No. 1 on my list? Avoid exposure to blue light, including LEDs, after sunset. Wearing blue-blocking glasses is a simple way to achieve this. Further:
Avoid watching TV or using your computer/smartphone or tablet in the evening, at least an hour or so before going to bed.
Make sure you get BRIGHT sun exposure regularly. Your pineal gland produces melatonin roughly in approximation to the contrast of bright sun exposure in the day and complete darkness at night. If you are in darkness all day long, it can't appreciate the difference and will not optimize your melatonin production.
Get some sun in the morning. Your circadian system needs bright light to reset itself. Ten to 15 minutes of morning sunlight will send a strong message to your internal clock that day has arrived, making it less likely to be confused by weaker light signals during the night.
Sleep in complete darkness, or as close to it as possible. Even the tiniest glow from your clock radio could be interfering with your sleep, so cover your clock radio up at night or get rid of it altogether. Move all electrical devices at least 3 feet away from your bed. You may want to cover your windows with drapes or blackout shades, or wear an eye mask when you sleep.
Install a low-wattage yellow, orange or red light bulb if you need a source of light for navigation at night. Light in these bandwidths does not shut down melatonin production in the way that white and blue bandwidth light does. Salt lamps are handy for this purpose, as are natural, non-toxic candles.
Keep the temperature in your bedroom no higher than 70 degrees F. Many people keep their homes too warm (particularly their upstairs bedrooms). Studies show that the optimal room temperature for sleep is between 60 to 68 degrees F.
Take a hot bath 90 to 120 minutes before bedtime. This increases your core body temperature, and when you get out of the bath it abruptly drops, signaling your body that you are ready to sleep.
Avoid using loud alarm clocks. Being jolted awake each morning can be very stressful. If you are regularly getting enough sleep, you might not even need an alarm, as you'll wake up naturally.
Be mindful of electromagnetic fields (EMFs) in your bedroom. EMFs can disrupt your pineal gland and its melatonin production, and may have other negative biological effects as well. A gauss meter is required if you want to measure EMF levels in various areas of your home.
If possible, install a kill switch to turn off all electricity to your bedroom. If you need a clock, use a battery-operated one.
[+] Sources and References

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