Sleepless in America: Can Technology Help Insomnia?
By Mia Zaharna, MD and Henry I. Miller, M.S., M.D.
Insomnia is a common and often frustrating sleep disorder that can make it hard to fall asleep, to stay asleep, or cause you to wake up too early and not be able to get back to sleep. It can adversely affect your health, work performance, and quality of life. It can also be hard to treat, even by experts — but help, in the form of technology, is on the way.
Although high-tech gadgets like cell phones and laptops used at bedtime often contribute to poor sleep hygiene and worsen insomnia, some specially designed tech may be beneficial. Using a variety of different approaches, many new apps, gadgets, and devices promise to improve sleep.
“Insomnia disorder” is defined as a subjective report of difficulty falling asleep, staying asleep, or poor-quality, nonrestorative sleep that occurs despite adequate opportunity, resulting in impaired functioning. Daytime impairment may include fatigue, poor memory, disrupted concentration, irritability, and lack of motivation.
Accidents due to sleepiness and physical symptoms such as gastrointestinal complaints or headaches may occur. Insomnia may be acute and related to temporary situational stressors, and may become a chronic condition if it occurs for longer than three months.
Insomnia symptoms occur in approximately a third to half of the adult population, with 10-15% of people experiencing actual distress or impairment. Risk factors for insomnia include female gender; increasing age; comorbid conditions such as psychiatric, medical, or substance abuse disorders; and shift work.
Insomnia: Treatments Proliferate
Treatments include prescription and over-the-counter sleeping pills and cognitive behavioral therapy. Sleeping pills may have unwanted side effects such as morning grogginess, falls, sleepwalking, and dependence. Use of a group of medications called benzodiazepines (which include Valium, Librium, Xanax, and Klonopin) that are widely prescribed for insomnia may increase the risk of dementia, especially if they are used over a long period of time.
Although Cognitive Behavioral Therapy for Insomnia (CBT-I) is recommended as a first line treatment, it is not always readily available. It involves behavioral changes that include improving sleep hygiene, stimulus control, sleep restriction therapy, and relaxation techniques. It has been shown to be very effective (e.g., here and here), but to see results it often takes time, patience, and dedication.
In addition, there are plenty of gadgets that claim to be able to track and treat your sleep problems. Here is a sampling of them:
1. Ebb. The first FDA-approved, non-pharmacologic treatment for insomnia, it uses a cooling headband that is supposed to help you fall asleep and reach deeper stages of restorative sleep. Several clinical trials support the effectiveness of Ebb. Even though it’s just a headband, it requires a prescription to purchase. Initial research shows some promise, but its singular benefit is the benign safety profile compared to hypnotic drugs.
2. Aura Connected Alarm Clock. This is a sleep-tracking system with advanced sound and light programs. It emits light and sound to help you go to sleep and wake up. It’s essentially an elegant and sophisticated alarm clock. Although the bedside device has a beautiful design, we were unable to locate any research to validate its effectiveness.
3. The Sleep Tracker by Eight. This is a mattress cover that converts your bed into a “smart bed” that can monitor room temperature, humidity, noise and light levels and also can detect snoring. It makes temperature adjustments in your mattress and also communicates with other smart home devices to help create your most optimal sleep environment. It’s the mattress that knows everything. (Maybe a better name for it would be “… by 1984,” as in George Orwell’s dystopian novel about government surveillance and control.)
The company provides free shipping, free returns, and a 100-day trial period so although at $399 it’s the most expensive product on the list, it may be worth a try.
4. Kortex. A virtual-reality (VR) device that users strap to the back of their head, it purports to increase melatonin and serotonin levels and decrease cortisol to decrease stress and provide a calming effect. It’s a combination of neurostimulation (transcranial magnetic stimulation) and meditative VR that prepares your body for sleep.
This device is identical in technology to the Fisher Wallace Stimulator which is FDA approved to treat depression, anxiety, and insomnia. The Fisher Wallace Kortex has been redefined as a “general wellness device because it is intended to help people manage stress and sleep,”according to the company’s website. Research has shown some improvement in sleep in depressed patients receiving transcranial magnetic stimulation (TMS) for depression, and a pilot study showed some promise for treatment of insomnia alone.
5. Sleep Score Max. This is a non-contact sensor placed on the bedside that uses ultra-low-power radio waves to measure the quality and quantity of sleep. An app allows you to view your “sleep score” each morning and provides suggestions on how to improve your sleep. this is basically phone-based Cognitive Behavioral Therapy that integrates feedback from your personal sleep data.
There are many such devices on the market, but this one is unique in that it does not require wearing a mask or headband or any other device on your body. Despite its promise to provide better sleep, the potential advantage of Sleep Score Max is on the analytics end, but implementing the treatment — i.e., changing your behavior — is up to you.
These products range in price from about $150 to $400.
The bottom line: Insomnia can be debilitating, so if it is severe enough to interfere with your daily activities, try one of the new gadgets, or seek professional help.