The Science of Smart Sleep Recently, Washington Post columnist, Geoffrey

Fowler provided an insider account of the

newest sleep tech from the Consumer

Electronic Show. His recount of products

making strides falls into four areas: measuring

sleep, stop the snore, making you comfy, and

adjusting your mind.

Measuring Sleep

Sleep Number has developed a smart bed with

sensors throughout the mattress. The sensors

measure movement, heart rate and respiration.

If the bed senses restlessness, the mattress

firmness adjusts to sooth the sleeper. All the

data is collected and saved to the cloud.

A new wireless tracker, Beddr Sleep Tuner is a

small sensor that is placed on the forehead. It

records movement, oxygen levels and tries to

identify when breathing stops.

The free app SleepScore, tracks sleep stages

using sonar. With your smartphone next to your

bed, the app sends waves to bounce off your

body during sleep to identify light, deep and

REM stage sleep.

Stop the Snore

“Smart Nora and the 10Minds Smart Motion

Pillow use microphones to listen for snoring and

activate pumps or motors to shift your head to

positions where you’re less likely to snore-all

without waking you up.”

The Hupnos eye & nose mask listens and

responds much like the pillows but as a second

measure will blow air through your nose to keep

your airway open, if it senses continued snoring.

Making you Comfy

Triple-threat, Aromarest is a lamp, white noise,

and diffuser combination device. With morning

and evening programming, you can wake up to

birds and citrus after falling asleep to crickets

Don’t let sleep tech keep you up at night An estimated 15% of US adults own a

wearable fitness/sleep-tracking device, such

as Fitbit or Apple Watch, and another 50%

might consider buying one.

When it comes to sleep, that enthusiasm for

the devices may overshadow what they can

deliver. According to the Journal of Clinical

Sleep Medicine lead author, Kelly Glazer

Baron, PhD, MPH said, “It’s great that so

many people want to improve their sleep.

However, the claims of these devices really

outweigh validation of what they have been

shown to be doing. The devices are unable

to accurately discriminate stages of sleep

(can’t differentiate between light and deep

sleep.) They are not valid for diagnosing

sleep apnea. They don’t do a good job of

estimating sleep accurately,” according to

Baron. She said the use of these devices

follows a pattern reflected in the title of the

Sleep Medicine study “Orothosomnia: Are

Some Patients Taking the Quantified Self too

Far?”

Sleep tracking apps could in fact be disrupting

your shut-eye, according to new research

which notes the rise of “orthosomnia”—

disrupted sleep resulting from the quest for

perfect rest.

Dr. Neil Stanley, an independent sleep expert,

argues that while orthosomnia might be a

“silly word” (‘ortho’ means correct, while

‘somnia’ means sleep), it describes a very real

issue. You can’t drift off if you’re stressed – “so

if you’re thinking or are worried about sleep

itself, then you’re going to have a problem

sleeping,” he says.

“In this case, the solution is to stop tracking

sleep! That is not too much to ask.”

The Dreem cap is a brainwave-reading device

that tracks your brain activity, heart,

respiration and movement. It is meant to be

worn while doing breathing and relaxation

exercises. The data is then used to provide

feedback on the body’s response to the

exercises.

A number of physicians were consulted as part

of the review. Although there was some

skepticism about any device that claims to

accelerate restorative sleep, overall there was

a positive response about getting people

thinking about their sleep. Readers were

cautioned to practice good sleep hygiene, eat

right and exercise as a first measure for good

sleep. Also, before making a purchase, ask

about the return policy.

and lavender.

“Building on evidence we fall asleep faster in

cooler places, the Ooler is a water-chilled

mattress topper and Moona is a pillow that

does the same for just the head. “

The Rocking Bed uses a slow sideways sway

intended to enhance sleep and promote a

deeper level of relaxation.

Adjusting your Mind

Headspace is a meditation app that uses

breathing exercises and soothing music to help

you wind down.

An interesting gadget, Somnox, is a soft, bean-

shaped robot that helps you sleep. Held

closely at bedtime, it “breathes” encouraging

you to synchronize your own breath to the

slowing pattern.

National Sleep Awareness Week March 10-16 th

SLEEP News and Views Information about sleep, sleep disorders and how to get a better night’s sleep.

A MedBridge Healthcare Publication

Washingtonpost.com

The American Academy of Sleep Medicine recommends that

TEENS BETWEEN 13 AND 18 YEARS OF AGE NEED TO SLEEP AT LEAST 8 TO 10 HOURS PER NIGHT ON A REGULAR BASIS to promote

optimal health. #MakeTimetoSleep

A r e Y o u G e t t i n g E n o u g h S l e e p ? The scientific evidence is clear: Sleep is

essential for optimal health. But how much

sleep should adults get each night? To answer

this question the American Academy of Sleep

Medicine and the Sleep Research Society

gathered 15 leading sleep experts in 2015.

They reviewed thousands of published studies

linking sleep duration and health. Then they

graded the evidence and held multiple rounds

of voting.

Finally they agreed on the following

statement:

Adults should sleep 7 or more hours per

night on a regular basis to promote opti-

mal health. Spread the word. #7andUp

Research provides strong evidence that you

may be harming your health by restricting your

sleep. Getting less than 7 hours of sleep on a

regular basis increases your risk of several

adverse health outcomes. Health problems

linked to insufficient sleep include: weight gain

and obesity, diabetes, high blood pressure,

heart disease, stroke, depression impaired

immune system, and increased risk of death.

Sleeping less than 7 hours per night also can

impair your performance. You have an

increased risk of errors and accidents when

you don’t get enough sleep each night.

Exactly how much sleep is right for you?

It may be more than 7 hours. Some adults may

need a longer sleep duration of more than 9

hours per night. Long sleepers may include

young adults and those who have a chronic

illness. A small percentage of adults are short

sleepers who feel alert and refreshed after

sleeping less than 6 hours per night. Genetic

factors help determine how much sleep you

need.

But 7 hours of sleep is the best starting point

for adults. Make it one of your top health

priorities to sleep at least 7 hours each night.

Keep in mind that healthy sleep also requires

good quality and regularity.

Seven and up: Optimize your health with

7 hours of sleep or more each night!

#MakeTimetoSleep

For the first time, the American

Academy of Sleep Medicine (AASM) has

released official consensus

recommendations for the amount of

sleep needed to promote optimal

health in children and teenagers to

avoid the health risks of insufficient

sleep.

The panel found that sleeping the number of

recommended hours on a regular basis is

associated with overall better health

outcomes including: improved attention,

behavior, learning, memory, emotional

regulation, quality of life, and mental and

physical health.

The panel found that sleeping fewer than the

recommended hours is associated with

attention, behavior and learning problems.

Insufficient sleep also increases the risk of

accidents, injuries, hypertension, obesity,

diabetes and depression. The panel also found

that insufficient sleep in teenagers is

associated with increased risk of self-harm,

suicidal thoughts and suicide attempts.

Making sure there is ample time for

sleep is one of the best ways to

promote a healthy lifestyle for a child.

Many teens are unable to #MakeTime2Sleep

because school starts too early. During

adolescence a natural shift occurs in the

timing of the body’s internal circadian clock.

HEALTHY SLEEP IN CHILDREN AND TEENS

http://sleepeducation.org/

http://www.aasmnet.org/

As a result most teens tend to have a biological

preference for a late-night bedtime and later

wake time. Early school start times require

teens to adhere to an early bedtime that may

be unrealistic for their age. This is one reason

why many teens fail to get enough sleep during

the school week.

The American Academy of Sleep

Medicine recommends that the school

day should begin at 8:30 a.m. or later for

middle school and high school students.

Urge your local school board and policy makers

to adopt a school start time of 8:30 a.m. or later

for middle schools and high schools in your

district.

Infant 4-11 months Toddler

1-2 years Pre-School 3-5 years

School Age 6-13 years Adult

18-64 years Senior 65+ years

Healthy Sleep Durations by Age

12-15 Hours 11-14

Hours 10-13 Hours

9-11 Hours

14-17 years

Teen

8-10 Hours

7-9 Hours

7-8 Hours

FOR HEALTHY SLEEP HABITS

BEHAVIORS CAN HAVE A MAJOR IMPACT ON SLEEP AND

CAN CONTRIBUTE TO SLEEPLESSNESS.

Actions during the day, especially before bedtime, can make it

difficult to fall asleep, stay asleep, or get restful sleep. Daily

routines such as food & beverage choices, medications, daytime

schedules, and evening routines can significantly impact quality of

sleep. Even a few slight adjustments can, in some cases, mean

the difference between sound sleep and a restless night.

THE TERM “SLEEP HYGIENE” REFERS TO A SERIES OF

HABITS AND RITUALS THAT CAN IMPROVE THE ABILITY

TO FALL ASLEEP AND STAY ASLEEP.

Board certified sleep physicians recommend following a series of

common-sense, healthy sleep habits to promote better sleep.

These healthy sleep habits are a cornerstone of cognitive

behavioral therapy, the most effective long-term treatment for

patients with insomnia. CBT-I can help address the detrimental

thoughts and behaviors that are preventing good quality sleep. It

also includes techniques for stress reduction, relaxation and sleep

schedule management.

SLEEP SPECIALISTS RECOMMEND THE FOLLOWING

HEALTHY SLEEP HABITS:

1. Keep a consistent sleep schedule. Get up at the same time

every day, even on weekends.

2. Set a bedtime that is early enough to get at least seven

hours of sleep.

3. Don’t go to bed unless feeling sleepy and avoid naps,

especially in the afternoon if you have trouble sleeping.

4. If sleep is not achieved after 20 minutes, go into another

room & do something relaxing until you feel tired.

5. Wind down and establish relaxing bedtime rituals away

from bright light. Avoid electronics before bed.

6. Take electronics out of the bedroom and use the bed for

only for sleep and sex.

7. Make the bedroom quiet and relaxing. Keep the room at a

comfortable, cool temperature.

8. Limit exposure to light in the evenings.

9. Don’t eat a large meal before bedtime. If hungry at night,

eat a light, healthy snack.

10. Exercise daily and maintain a healthy diet.

11. Avoid caffeine, alcohol, and cigarettes before bedtime.

12. Sleep on a comfortable mattress and pillow. The average

life expectancy is about 9-10 years for most good quality

mattresses. Use pillows that are free of allergens.

TIPS

STOP BANG QUESTIONNAIRE For the assessment of Obstructive Sleep Apnea risk

1. Snoring: Do you snore loudly (loud enough to be

heard through closed doors)?

2. Tired: Do you often feel tired, fatigued, or sleepy

3. Observed: Has anyone observed you stop

breathing during your sleep?

4. Blood pressure: Do you have or are you being

treated for high blood pressure?

5. BMI: answer yes if your weight exceeds the

amount listed for your height on the table

6. Age: Is your age over 50 yr old?

7.

8.

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO To score, add up all

‘yes’ answers

Interpretation

5-8 High risk of OSA

3-4 Intermediate risk

0-2 Low risk of OSA

LEVEL OF RISK #

YES

Please answer the following eight questions Yes or No

Have you been previously diagnosed with sleep apnea?

If so, are you currently using CPAP to treat your OSA?

http://sleepfoundation.org/

Is it time for a Sleep Evaluation? According to the National Institutes of

Health, 50 to 70 million Americans are

affected by chronic sleep disorders and

intermittent sleep problems that can

significantly diminish health, alertness, and

safety. Untreated sleep disorders have been

linked to hypertension, heart disease, stroke,

depression, diabetes, and other chronic

diseases. Sleep problems can take many forms

and can involve too little sleep, too much sleep,

or inadequate quality of sleep.

Most people know when to seek medical help

for physical discomfort such as pain or a fever,

however, sleep problems are often overlooked

or ignored.

The majority of people with sleep

disorders are undiagnosed and

untreated.

To determine whether a sleep evaluation is

indicated, consider the following questions:

1. Do you regularly have difficulty getting to

sleep or staying asleep?

2. Do you snore? Has anyone told you that

you have pauses in breathing or gasp while

sleeping?

3. Are your legs active at night? Do you feel

tingling, creeping, itching, pulling, or

aching in your legs?

4. Are you so tired when you wake up in the

morning that you can not function

normally during the day?

5. Does sleepiness and fatigue persist for

more than 2-3 weeks?

If the answer is “yes” to any of these

questions, consider a complete sleep

evaluation.

Dayl ight

Saving Tips

Go to bed 15 or 20 minutes

earlier each night before

the time change.

The spring forward to daylight saving

time will happen at 2 a.m. on Sunday,

March 10th. This annual event can be a

shock to the body. Losing an hour of

sleep during the time change can

disrupt the body clock. This can make it

difficult to get enough sleep during the

following week.

With some advance preparation, the

effects of the change to daylight saving

time can be minimized.

Start to prepare at least one week

in advance:

Set the clocks ahead early in

the evening and go to sleep

at your normal bedtime.

After the time change, head

outdoors for some early

morning sunlight on Sunday.

Stick to your usual bedtime

to get plenty of sleep

Begin to adjust the timing of

other daily routines that are

“time cues” for your body.

Is the “Spring Forward”, setting you back?

An hour may not seem like a lot, but the time

shift can have significant effects on the body,

says Dr. Kumar, medical director of the Sleep

Disorders Center at Wake Forest Baptist Medical

Center. “With the spring time change, you

essentially have to go to bed earlier and get up

earlier, which is difficult for many of us to do,”

she says. “Most of us end up losing 40 to 50

minutes of sleep those first few days—and as a

nation that’s significantly sleep deprived to

begin with, even that little change can impact

health.” Studies have noted all kinds of physical

and mental effects associated with Daylight

Saving Time (DST). Some include:

Heart attacks spike after the spring time

change. A 2014 study published in Open Heart

found a 25% jump in the number of heart

attacks occurring the Monday after DST starts,

compared to other Mondays during the year.

The total number of heart attacks didn’t change

for the whole week, though; the burden just

shifted to earlier in the week.

Stroke rates rise when DST starts and

ends. Heart attacks aren’t the only

cardiovascular risk associated with changing

clocks: Preliminary research presented at the

2016 American Academy of Neurology's annual

meeting found that stroke rates in Finland are

8% higher, on average, in the two days following

both time changes—spring and fall—compared

to the two weeks before or after. Older adults,

and people with cancer, seemed to have the

most increased risk during this time. Disturbed

sleep patterns can contribute to high blood

pressure and poor mental health, says Dr. Kumar

(who was not involved in the studies mentioned

here), both of which are risk factors for heart

attack and stroke.

Teens are especially exhausted. High

school students may be particularly vulnerable

to Daylight Saving-induced sleep loss, says Dr.

Kumar, since their internal clocks make it difficult

for them to shift their sleep patterns an hour

earlier. A 2015 study in the Journal of Clinical

Sleep Medicine found that teens lost significant

sleep after the spring time change, and showed

increased sleepiness, delayed reaction time, and

more lapses in attention on subsequent days.

Studies have reported increases in fatal

automobile accidents in the days following the

spring time change.

To minimize the health effects of daylight saving

time, go to bed at least 10 minutes earlier every

night (progressively) until the clock change, so

that the shock to body is minimized, especially

for children and teens. http://www.health.com/

For more information call, 866-527-5970

medbridgehealthcare.com

Introduction to Consumer Sleep Technology At the Consumer Electronics show (CES)

in Las Vegas, Nevada, participants were

introduced to new tech gadgets. Sleep

technology generated a lot of interest -

the sleep technology portion of the show

has grown 22% since last year, making it

one of the fastest growing areas in health

and wellness technology. The interest in

sleep tech has been so high that the

National Sleep Foundation hosted its first

ever consumer facing exhibit titled Sleep

Show in March of this year.

Consumer sleep technology includes

apps, wearables, and nearables (devices

that are not worn but are placed nearby

to monitor or facilitate sleep). This

technology is getting smarter. The days of

data gathering are quickly being replaced

by a two-way conversation between

devices. We now have smart phones

that talk to smart thermostats to create

an ideal sleep temperature. The smart

phone talks to the smart bed to make

adjustments that promise a more restful

sleep. The smart phone also signals the

device plugged into the wall (Nightingale)

to play relaxing sounds as you wind down

and go to sleep. The bed and the smart

phone collect sleep-related data to fine-

tune recommendations to further

improve your sleep tomorrow. Relying on

smart phones as the conduit, many

devices are adding artificial intelligence,

blurring freshly defined category lines.

Consumer sleep technology carries with it

the promise of unlocking the mysteries of

our sleep. It may be a powerful way to

screen for sleep disorders, such as sleep

apnea. They key is in understanding what

the measurements mean. What is a good

sleep score? What is meant by light sleep?

Deep sleep? If my sleep technology is

warning me about something, what does

that mean? Has this data been validated?

Can my phone actually help me to sleep

better?

What happens when it doesn’t work? Are

we destined to never sleep well again?

While these devices are intriguing, they

don’t replace the basic tenets of good

sleep – unplug from media for 30-60

minutes before bedtime. Establish a

relaxation routine. Have a set bed time

and rise time, even on weekends. Avoid

caffeine for six hours before bed. Exercise

on a regular basis. It is undeniable, though,

that technology is shaping our evening

hours either by disrupting our relaxation

routine or by enhancing it.

We believe that consumer sleep

technology will be part of our lives for the

foreseeable future. With this in mind, we

will begin to highlight some sleep

technology in our newsletters. This is not

an endorsement, but rather recognition

that the field of sleep medicine is changing

and that we need to understand and

embrace these changes. If there is a

particular sleep technology you would like

to see featured in this newsletter, please

email us at

newsletter@medbridgegroup.com. We

thank you for your continued support and

look forward to working with you and your

patients as we navigate this changing field

together.

Smart Sleep

A MedBridge Healthcare Publication

Is there a particular sleep technology you would like to see

featured?

Email us with questions or comments, newsletter@medbridgegroup.com

Consumer Sleep Technology: An American Academy of Sleep Medicine

Position Statement link to full article here.

Consumer Sleep Technology: How to Balance the Promises of New Tech-

nology with Evidence-Based Medicine and Clinical Guidelines link to full

article here