How Do You Cope?

Chronic insomnia is not just a nighttime thing.  The sleep loss from worry and anxiety about sleep usually leads to problems functioning during the day.  We are more sedentary, we avoid social situations, we may consume high amounts of caffeine, etc.  Studies have shown that we consume higher calorie foods without even realizing it.  Essentially, we cope.

Coping is a natural human response.  We have to work, take care of dependents, and get through our day.  But with sleep loss, our normal daily tasks can feel daunting, so we cope.  Unfortunately, the common coping strategies for sleep loss tend to perpetuate the very sleep loss we are trying to avoid.  Less active days, both physically and socially, can lead to more stress and tension at night.  It can increase chances of depression and obesity, two conditions that are highly associated with poor sleep.  Depressed people often experience early morning awakenings, while obesity dramatically increases chances of snoring and sleep apnea, a serious health problem.  Extra morning caffeine and sugar can spike cortisol and insulin levels, leading to an afternoon energy crash.  Caffeine in the late afternoon can make getting to sleep more difficult because caffeine is a long acting stimulant.

Following a day of coping strategies for sleep loss, the approaching evening can bring on two of the most popular coping strategies: alcohol and sleeping pills.  While alcohol is a strong CNS depressant and can make us relaxed and even sleepy, it has well-documented adverse effects on our sleep and our health in general.  In regards to sleep, alcohol is metabolized while we sleep, essentially turning into a sugar.  Sugar is a stimulant, the last thing your sleeping brain needs in the middle of the night.  It is also a diuretic, and it’s sedating effects worsen snoring and sleep apnea.

Sleeping pills come in many forms, with different half lives.  Some are designed for putting you to sleep, some for keeping you asleep.  All FDA-approved sleeping medications are safe when used as directed.  Sleeping pills, however, are often not used as directed.  They are designed to be used for short periods of time, such as during a time of acute stress.  They should not be used with alcohol, or with sedating medications.  And most are not designed to be taken in the middle of the night as this can lead to morning grogginess.  In the elderly, sleeping medications can lead to increased risk of falling during the night and in the morning because our metabolism rate slows as we age.

So is there a way to effectively cope with sleep loss, whether from insomnia or just plain old “didn’t get enough sleep “?

Yes.  Sleep training with the SleepQ app in the late afternoon or early evening for an hour or two following any rough night of sleep can restore confidence in your ability to get to sleep and/or back to sleep, which in turn reduces worry about sleep.  SleepQ eliminates the need for all those coping strategies that feed our insomnia.  It is non-drug, convenient and affordable…just a quick visit to the App Store and you can put that insomnia to rest!

Til Morning,

Michael

Worthwhile Effort

The SleepQ app for iPhone is powerful, convenient and affordable.  As an at-home sleep trainer, it has the potential to rapidly improve confidence and awareness in sleep, which in turn can lead to less dependency on sleeping pills or alcohol for sleep.  This improvement in sleep can be accomplished in the comfort of your own home, in the perhaps not-so-comfortable setting of your bedroom where insomnia dwells.  Based on the scientifically-proven method of Intensive Sleep Retraining, SleepQ is available in the App Store for under $5, about the cost of one large espresso drink or a couple nights of sleeping pills.

But despite all of the compelling reasons to download and use the app, one fact will always remain about behavioral conditioning:  It takes effort.  Just like physical conditioning, but without the euphoria.  Let’s be honest:  When we’re out of shape physically, we all know what we need to do:  work out (train).  When you’re really tired because you haven’t been sleeping well, you just want to, well, sleep.  Like physical exercise, you need to train for sleep efficiently and effectively.  In a gym, you have machines and devices with timers, variable resistance, different amounts of weight, etc.  Runners and bikers can track miles.  Swimmers do laps.  You know the drill.

But how about sleep training?  Assuming you don’t have a clinical sleep laboratory with expensive equipment and technicians, how do you do it?  Set your alarm clock for short naps?  That would work well if only your clock knew when you fell asleep.  Ask your spouse to wake you over and over?  Not likely to work very well.  And after a couple of hours of sleep training, it would be nice to see how you did on a graph.

Yep, you guessed it:  the SleepQ app for iPhone can do all this.  It knows when you fall asleep, it wakes you after just the right amount of sleep, guides you from one sleep trial to the next, then provides you with a very informative summary graph that you can save and share (e.g., with your doctor).  To increase your chances of falling asleep each sleep trial, you need to be tired/sleepy, so a couple hours in the late afternoon/early evening after any rough night of sleep is best.

It takes some effort to condition yourself to sleep better.  But it is oh so worthwhile!

Til Morning,

Michael

One and Done!

The Sleep app for iPhone is an at-home way to do Intensive Sleep Retraining.  There are two ways to use the app:  1) periodically in the late afternoon for an hour or two following any rough night of sleep, or 2) for 24 hours, all-night and then all-day, starting and ending at bedtime.  This second method (24-hours) was used in the original sleep training research, and the success of this method was clear.

Preliminary results of users of the SleepQ app indicate that the majority have done this 24 hour method, mostly because they have “tried everything” or “hate sleeping pills”.  There is usually a sense of urgency with insomnia.  Having worked with patients with sleep disorders for over 25 years, I understand the feeling of desperation in someone with chronic insomnia.  Let’s be honest – sleep deprivation is used as torture in horrible places around the world.  People suffering with insomnia want relief fast, which unfortunately is what causes many to become dependent on fast acting and potentially dangerous substances: sleeping pills and/or alcohol.

So what does it take to do this 24-hour (all-night and then all-day) intensive method?  For starters, it is imperative that you have discussed your sleep with your doctor.  Chronic insomnia can be caused by organic sleep disorders like sleep apnea, restless legs, or narcolepsy, and your doctor can order a formal sleep study to test for those.  Your doctor needs to know what you are doing about your health, which includes your sleep.  Do not embark on a 24-hour sleep training session without first discussing your plans with your doctor.

Cleared of any organic sleep disorders, you need to be weaned off any sleeping pills.  This follows the original Intensive Sleep Retraining research protocol, and again requires close guidance from your doctor.  Sleeping pills should never be stopped “cold turkey”.  Many are very powerful drugs that create tolerance over time, and there have been reports of problems when abruptly stopping (e.g., seizures).  The goal of sleep training with SleepQ is to learn to put yourself to sleep, so it really does not make sense to begin 24 hours of sleep training after taking sleeping medication or consuming a significant amount of alcohol.

With the OK from your doctor, plan ahead for your 24-hour session.  Remember: it will run bedtime to bedtime.  Many of our users choose a Thursday or Friday night to begin the 24 hours to best fit their schedule, and also because it gives them a couple full nights of recovery sleep.  Ideally, no naps should be taken the day leading up to the start at bedtime.  In fact, if you are not feeling somewhat sleepy at bedtime, stay up a while and begin later in the night.  With SleepQ you can take short breaks along the way, and in fact between each sleep trial you should leave the bed for a couple minutes (the SleepQ app has a timer to guide you) to stretch, use the bathroom, get a drink of water, etc.  Returning to bed each time will begin to reinforce the act with falling asleep.  There is a “Skip” button to go straight to the next trial, but this should be used sparingly if at all.

As the sun comes up, you may naturally become a bit alert for a little while, even after little sleep in your sleep training during the night.  This is normal (caused by your circadian rhythm), and you you may want to take a short break for a snack and a stretch.  There is no rush – just remember not to let yourself fall asleep for the day.  You must keep your sleep training going until that night.  And use common sense – don’t drive or do anything during the day that requires vigilance for safety.

After each trial, the SleepQ app asks if you would like to continue.  You can choose “No Thanks” anytime to see your summary graph being built, and then hit the “Back” button to keep training.  This graph shows your progress, and when you are done it can be saved or shared.  You can even send it to me if you’d like and I’ll give you my thoughts about your sleep training session.  You can even share your graph on the SleepQ facebook page 🙂

Perhaps the best, consistent feedback I’ve received is that sleep training with the SleepQ app reduces fear of not sleeping.  This is accomplished by the patented way the app detects sleep (not responding to a tone), then asking you if you thought you fell asleep each trial.  Over time, your awareness of falling asleep improves…you “learn” what it feels like to fall asleep.  This learned skill was shown to last for over six months in the original Intensive Sleep Training research from Australia.  All it took was one 24 hour session.  One and done!

Til Morning,

Michael

 

The Journey

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It’s a GO!

This week, Apple approved the release of the SleepQ app for iOS!  As I waited those final moments (clicking “refresh” until my finger was numb :), I took a moment to reflect on the SleepQ  journey.  From solid/interesting insomnia research out of Australia, to an idea for a mechanical device that detected sleep, to weeks of tinkering in a college Electronics class, to fledgling Kickstarter and Indigogo campaigns, to an app with a completely different way to detect sleep… crazy!

And now here we are:  a way to allow chronic insomniacs to do Intensive Sleep Retraining anywhere, anytime, for as little or as long as they wish, and share their results.  As a Clinical Sleep Educator for many moons, I’m proud to have created something that can really help literally millions who struggle with sleep – both falling asleep and getting back to sleep – without pills.  It’s like anything you can learn through practice:  music, art, speech, cooking, etc.  The list is long, and sleep is on that list.

The statement on our website from Drs. Speilman and Glovinsky, two HUGE names in sleep research on insomnia, regarding the Intensive Sleep Retraining (ISR) research of Harris et al. in Australia have echoed through my mind each time I felt that maybe I was on the wrong path over the last couple of years:

“The findings of Harris et al. suggest that ISR holds great promise. Patients await a non-drug treatment for insomnia that brings relief as rapidly as medication. Clinicians in the community look forward to more widely applicable ISR-like procedures that can be implemented at home, without expensive and complicated sleep technology, by non-sleep experts. This stunning demonstration by Harris and colleagues should serve as a challenge to the field to create the next generation of theoretically driven non-pharmacological treatments for insomnia.”

SleepQ is ISR, and for about the cost of one morning latte, it is now complete!   Here’s the link   If the iPhone version is popular, we’ll do an Android version next.

I hope you will share the link with someone you know who is one of the approx. 20 million adults who struggles frequently with slumber 🙂

Til Morning,

Michael

 

Getting Healthy

Aside from your genetic make-up, your overall health is essentially made up of three things: what you eat, your activity level, and how well you sleep.  Your health “structure” will likely fall if one of the three is suffering.

Readily-accessible information about proper diet, exercise and sleep abounds.  An internet search “eating better” will produce hundreds of sites describing foods, meals, gardening techniques, etc., to guide you to a better way of eating.  Searching “exercises for health” produces a plethora of sites to help you find the right activities to improve your fitness.  And yes a search of “better sleep” brings up a myriad of ways to try to get those elusive Zzz’s.  Not all internet sites are based on proven research, so common sense must always be used when considering a change in diet, exercise or sleep.  Your doctor should always be made aware of changes to your health routines.

Despite all the information available about diet, exercise and sleep, Americans continue to be generally unhealthy.  A CDC report indicates that obesity rates doubled in the U.S. from 1980 – 2000.  A summary from Harvard University showed that another CDC report found that only 18% of Americans get the necessary 75 minutes of vigorous cardiovascular exercise plus the two muscle strengthening sessions per week they need.  And as you’ve probably heard me mention, that third pillar of health is also being neglected.  A recent CDC report on sleep lead the CDC to describe America’s lack of adequate sleep as an “epidemic”.

So what are we to do?  When I come across statistics like these, I have to admit my first reaction is to feel overwhelmed.  These number are daunting,  and it’s easy to make knee-jerk drastic changes: throw away the cookies and ice cream and fill up the fridge drawers with vegetables, get the laundry off the treadmill and renew the gym membership, hit the mattress stores for a new bed.  Drastic times call for drastic measures, right?

The problem is that such draconian steps usually don’t work for the long run, and for one simple reason: what you eat, what you do, and how you sleep are life-long events.  Just having the “tools” does not build the structure.  A couple of tofu/broccoli meals will not impact your health any more than a couple hours of Zumba.  And with sleep, spending 10 hours in bed one night will not magically fix things.  All three pillars must be developed, rebuilt from the ground up in a systematic way.

Home Screen

For your on-going sleeping troubles, the SleepQ app will help you do just that.  Occasional sleep training (short, repeated attempts to sleep with immediate feedback about whether you fell asleep) for an hour or two before bedtime is our variation of Intensive Sleep Retraining (ISR), a powerful laboratory technique developed in Australia for overcoming chronic insomnia.  The SleepQ app addresses the issues of feasibility and convenience that plague lab-based ISR, all for about the cost of that regular morning latte you may be sipping on right now 🙂

The app is done, and we are just waiting for final approval from Apple, so it won’t be long now!

Til Morning,

Michael

Need a Nap?

Home ScreenThe SleepQ app is being developed to help the millions of people who suffer frequent difficulty getting to sleep, getting back to sleep, or who are working with their doctor to reduce their dependency on sleeping medication or alcohol. The SleepQ app will provide a convenient and affordable way to do an at-home variation of sleep retraining, the scientifically-proven method of treating chronic insomnia.  But SleepQ will also offer another module for helping with sleep: customized daytime naps.

Sometimes we don’t get enough sleep for reasons other than on-going insomnia: work, childcare, eldercare, pets, a snoring spouse, a windy night, a leaky faucet…the list is long!  Coping with excessive daytime sleepiness for reasons other than insomnia takes some planning.  The extra afternoon coffee can provide a late-day kickstart, but as caffeine is strong and long-lasting substance, it can cause problems getting to sleep that night.  So this applies to energy drinks too, which usually have the added challenge of a high sugar content.

For those whose schedule allows, a non-caffeine strategy may be taken: a big late-afternoon nap.  This can feel great!  Short sleep at night usually most affects our amount of REM (dream) sleep, which helps us with learning, memory and generally thinking clearly during the day.  A nap of an hour or more usually will contain some REM sleep.

Another popular napping strategy is the “power nap”.  The theory is that you will feel more refreshed if you end your nap before deeper sleep begins, which is usually about 20-30 minutes after falling asleep.  Best if done as early in the afternoon as possible, this type of nap is a favorite of daytime 9-5 workers.  Close the office door, or park the car in a shady spot, and nod off for few minutes.

Remember that if you also struggle with insomnia, keeping naps as short and early as possible is the best strategy for not adversely affecting your nighttime sleep.

So where does the SleepQ app come in?  SleepQ can help with your naps in one very big way: it knows if and when you fall asleep.  You see, just lying down for a nap does not mean that you fall asleep, or even know if you did and for how long.

Nap screenUsing SleepQ for your nap, either a short power nap or a customized nap of any duration, will ensure that you get the recovery sleep you need.  If you did fall asleep, SleepQ will tell you how long it took, and because you set the nap duration, SleepQ will never let you oversleep.

So whether it’s sleep training or recovery napping, SleepQ has you covered.  Completion of the app and placement in the App Store is still on track for next month.  Almost siesta time!

Til Morning,

Michael

Sneak Peek

The SleepQ iOS app is moving forward rapidly! We are very encouraged with the progress our design/programming team has been making, and I want to share a sample screen shot:

Graph

I chose to show this screen because, although it is only partially complete showing just two sleep trials, it highlights two significant features of sleep training with SleepQ: variable training intensity, and awareness of sleep.

Sleep training is similar to any other behavioral conditioning. For example, when you exercise, increasingly intense training routines lead to being stronger, faster, etc. The same concept is true with learning a musical instrument. With SleepQ, the duration of time the user is given to fall asleep each sleep trial adjusts. Specifically, it gets shorter when the user was able to fall asleep in the previous sleep trial and longer when sleep did not occur. This variable sleep training intensity keeps the user at the optimal level of training.

The hypothetical summary graph above shows an increase in sleep trail time from trial 1 to trial 2. This means that the user did not fall asleep in trial 1, and therefore was given more time in trial 2. Over a number of sleep trials, a downward trend would represent improving ability to get to sleep.

Beside variable training intensity, SleepQ will also help improve awareness in sleep. Most people with chronic insomnia feel they sleep very little, not at all on some nights, especially if they are attempting to reduce their sleeping medication. People with chronic insomnia usually sleep more than they think they do. Similar to how overweight people are often not aware of how full they are, chronic insomniacs can poorly estimate their sleepiness level.

In the graph above, awareness of sleep is displayed by color: a red bar indicates the user was not correct in their estimate of sleep for that sleep trial; a blue bar indicates the user was correct in their estimate. This color feedback will easily give the user a sense of their sleep, or lack of it.

A full graph of 10-20 sleep trials done in the afternoon/evening will be highly informative to someone with chronic insomnia. Sleep trial times, representing ability to fall asleep, will show a pattern or trend. Color, representing awareness of sleep, will also show a pattern or trend. Combined, these two types of information were shown to have a powerful effect in reducing insomnia in Australian sleep research called Intensive Sleep Retraining. And yes of course, you will be able to save and share your summary graph with your friends, showing them how you are learning to “sleep on cue” 🙂

Til Morning,

Michael

Work Zone

It’s been awhile since I last posted, so I wanted to take a moment to get everyone up to speed.

As I last posted, SleepQ will be an iPhone/Ipad app to start.  Development has begun and we are on-track for a February release in the App Store!  Should the app be popular, we will begin development for Android phones.

The app will allow the user (with on-going sleep troubles) to do sleep training:  repeated short naps for an hour or two in the late afternoon following any rough night of sleep.  Sleep will be detected by user response to a periodic tone with a slight shake of the phone.  No shake responses mean sleep has begun and the SleepQ app will wake the user, ask if sleep was perceived, give the correct answer, then repeat the process after a couple minutes.  This is sleep training.

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The goal is to reduce worry and anxiety about sleep, increasing confidence in sleep, and ultimately reducing or eliminating dependency on sleeping medication or alcohol for sleep.  A summary graph will show sleep trial times (which adjust each trial) and awareness in sleep (yes or no estimates after each sleep trial).  You’ll even be able to share your graph via email or Facebook 🙂

The SleepQ app will be convenient, research-based and affordable.  We’re still deciding on a price, but thinking under $5 with no ads.  Compared to $10-$20/month for sleeping pills we’re hoping it will be a good non-drug option for improving sleep.  We’re even programing in a module for taking a custom nap after a short night of sleep from something other than insomnia:  the choice will be either a quick “power nap”, or a custom nap where the user chooses how long they want to sleep after SleepQ detects that they fell asleep.

SleepQ is sleep training, not simply sleep tracking.  Yes, sleep training for insomnia takes some effort.  But so does getting through each day on very little sleep, right?

Til Morning,

Michael

Is There an App for That?

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Yes!

After intensive design and function testing, it has been determined that SleepQ will be an app.  Here at Microsleep, we are very excited with this development!  If you’ve been following the development of the SleepQ sleep training device, the main difference in design is in how the onset of sleep will be detected:  (not) responding to auditory tones, automatically emitted from your smartphone.  SleepQ will no longer detect sleep by being dropped.  Being unresponsive to sounds was shown in the 1930s to occur precisely at the start of stable sleep…”stage 2″ in sleep lingo.  Waking at this moment leads to a much more reliable feeling of having been asleep.  This awareness is one of the big keys to successful sleep training.

This method opens up a new world of sleep training, and the benefits are immense:

more effective sleep training

better user feedback

easily sharing your results of sleep training

a “smart” napping feature

much more affordable

The initial version of the SleepQ app is scheduled to be released in early spring.  This could be even sooner as we no longer have hardware development.  As for our Indiegogo campaign, we will need to let it finish its run.  With our “fixed” Indiegogo campaign not reaching our funding goal, all funds will be returned automatically to contributors at the end of the campaign (December 23rd).  Our heartfelt thanks goes out to all who made a contribution!  Your generous offer will always be remembered.

Again, we are so excited to share this news with all of you who have been following our SleepQ story!  We feel that we will be able to reach a much larger group of users with our app.  Many of you have noticed the high number of sleep apps in the app store, and I see them too.  I have downloaded many of them to check them out.  Most of these sleep apps track your sleep through motion sensing, emit soothing sounds sounds to try to get you to fall asleep, or function as a “smart” alarm clock to try to wake you at the “right” time.  Non of these apps do what the SleepQ app will do: train you to sleep better.

The initial release will be in iOS format, and if successful, we will release an Andriod version soon after.  Updates and screen-shots will be coming to sleeponQ.com, so be sure to check back and share the news!

Til Morning,

Michael

Did You Get the Memo?

Sleep is important.  It’s a message that’s ringing so loud and clear now that I don’t even bother with the declaration when working with patients who have insomnia.  Sleep is in the news more than ever, a welcome progression from the mid 1980s when I first began taping wires to patients being tested in a sleep lab.  And the medical community is also more in tuned-in about sleep than ever before.

Despite the memo, sleep deprivation (not enough time allotted for sleep) remains a public health concern.  An epidemic actually, if you ask the Centers for Disease Control.  And I’m only talking about people without sleep disorders (e.g., insomnia, sleep apnea, narcolepsy, etc.).  Reasons for people not getting adequate sleep are numerous and sometimes complicated.  Consider someone recently put in charge of caring for an elderly parent around the clock versus someone who plays computer games late into the night.  In either scenario, sleep is insufficient.

Brandon Peters, M.D, a sleep specialist at the Stanford Sleep Center, recently wrote an article summarizing the adverse effects of sleep deprivation.  His article highlights the wide range of problems, from health to safety issues.  He also stresses the psychological effects of reduced sleep including depression, anxiety, and even temporary psychosis with hallucinations seen sometimes with extreme acute sleep deprivation!

My posts are usually about insomnia, which is different than sleep deprivation.  People with insomnia try to sleep enough.  The information Dr. Peters discusses presents a challenge to this group because heightened emphasis on the importance of sleep can cause more anxiety about sleep, which in turn worsens insomnia.  But challenges are meant to be overcome, and sleep is no exception.  When it comes to overcoming chronic insomnia, research on Intensive Sleep Retraining (ISR) uncovered a rapid, effective way to reduce insomnia and increase confidence in sleep.  SleepQ will add convenience and affordability to the benefits of ISR.

Dr. Peters’ article IS the memo, and I encourage EVERYONE to read it.  Then join our SleepQ Kickstarter campaign this month!!

Til Morning,

Michael