Sleep and Dreams? IDK!

In my many years working in the field of sleep disorders, I have often been asked two questions: 1) What do my dreams mean? 2) Why do I always wake up and can’t get back to sleep? The short answer to both is simply, “I don’t know.” Or as my kids would say: “IDK”. Honestly.

The truth is that sleeping and dreaming are two of the most physiologically complex processes that happen to us, and so without further investigation and questioning, I always stick with IDK. Because studying dreams is difficult at best, I typically recommend finding a book on dreaming theories and picking the one you like best. Into deep thoughts and the subconscious mind? Try Freud or Jung. Comfortable talking about computer processing, organization and file cabinets? Look into Pavlides and Winson. Neurons and synapses? Check out Hobson/McCarley.

I’ve never really been into dream interpretation, probably to my detriment. I guess that’s the practical, midwest side of me (born in Nebraska). What does your dream mean? IDK. Just be glad you got some REM!

The other question of why someone (you) might be waking up early every night is actually more solvable for me than the dream question. With an open Q&A discussion, common reasons tend to be alcohol, medications, stress, pain, circadian rhythm shift, sleep apnea, or age. And because I’ve learned not to play doctor, anyone with a sleeping problem such as frequent early awakening that cannot be resolved through better sleep hygiene (the normal do’s and don’ts of sleep) should run it by their doctor. Sleep (like wake) is a whole body process, affected by and affecting just about any other health conditions, and keeping your regular doctor informed is imperative. If/when organic medical conditions can be ruled out, then a powerful behavioral sleep strategy like Intensive Sleep Retraining (ISR) may be just the thing!

So keep an eye out for our SleepQ project coming to Kickstarter this fall. “IK” that “ISR” with “Q” will be a great help for those who want a better confidence in and awareness of their sleep, and less dependence on sleeping pills!

Til morning,



Michael


The Story of SleepQ (up til now)

Welcome to the very first blog post at SleeponQ.com! I am very excited to share some of my thoughts and experiences about my first 25 years as a sleep tech (#394), university instructor, lab manager, DME owner, and clinical sleep educator. I’ve seen a lot of discoveries about sleep over the years and I continue to learn about more all the time! And as you can see, I am developing a sleep-training device for helping people improve their sleep.

One of my passions has been helping people who have struggled with their sleep to learn simple behavioral strategies that can really help improve confidence in their sleep. These strategies involve the concepts of cognitive behavioral therapy for insomnia: sleep hygiene, stimulus control, sleep restriction, relaxation and worry reduction. These concepts can be learned by anyone with primary chronic insomnia, and they have been shown to be effective in the long run. However, these behavioral strategies can take a while to work, and there are not many fully qualified people trained to deliver them.

It was through some of my normal frequent searches for new and better applications of these cognitive behavioral concepts where I came across a study out of Australia that was investigating a behavioral procedure called Intensive Sleep Retraining (ISR). The researchers found that significant improvement in the sleep of chronic insomniacs could be made rapidly non-pharmacologically. With the theory that chronic (psychophysiologic) insomnia was a conditioned response caused by nightly difficulty falling or staying asleep, the researchers demonstrated that with feedback about sleep onset, subjects could rapidly gain confidence in and better awareness of their sleep. The keys were to have the subject sleepy when they began the sleep trials, and to let them sleep a few minutes before waking them with feedback about sleep onset.

With the main problem of ISR being logistical (how to offer it to the many people with insomnia), I began to brainstorm about home versions. Here is a rough outline of my thought process:

How can sleep onset be detected without expensive equipment?
When I fall asleep, it is often while reading, and I drop my book.
But the book makes a “clunk” and wakes me up right away.
What could be dropped that would let me sleep a few minutes before waking me?
What could someone use that would not be so “clunky” as a book?

After doing some research, I read where the famous artist Salvadore Dali would hold a spoon in his hand during naps in his chair. With a plate on his lap, Dali would drop the spoon onto the plate as he began to fall asleep, which woke him up. This lead him to have all sorts of creative images for his paintings. I found that sleep researchers back in the 1930s were comparing the dropping of hand-held objects to the new discovery of EEG (brainwaves), which slowed when awareness waned and sleep began. In 1939, Nathaniel Kleitman (the “father of sleep medicine”) experimented by dropping a wooden spool. He discovered the drop happened shortly after the EEG pattern changed from wake to sleep.

So I thought, “Maybe I needed a “smart” spoon or spool?”
I realized I needed something electronic with a sensor.
And I needed to find the right shape, size, weight and texture.
So I began dropping all sorts of objects off the side of my bed each night when I fell asleep.
I found that small, round, light-weight and low-tactile objects were the least likely to be detected when dropped.
I noticed that the sleepier I was, the less likely I was to detect that I dropped something. This was key.

I also noticed that objects always made a little sound when they hit the floor. But the more I padded the object for impact, the bigger and heavier it got. So I did what any good son would do: talked with Mom.

She said that people didn’t want to crawl around on the floor looking for this thing after they dropped it. She envisioned a tether attached to the bed. This also solved the sound issue. Brilliant!

I then enlisted the expertise of a local college engineering program (RCC in southern Oregon – great program!) to create a prototype device, which they graciously did, all for some of my wife’s delicious chocolate-chip banana bread. I call this device “SleepQ”, as in learn to fall asleep “on cue”. You can see a demo of the prototype in the video on the homepage. Late last year I found a business partner, and we’re now moving SleepQ ahead full speed! We found a wonderful product engineering firm and have initial design specs for a final version. But they need more than banana bread. So we’re gearing up for a Kickstarter campaign in Fall 2013. Please join us! Help millions of insomniacs to learn to fall asleep on cue. Yes – with SleepQ!

Until morning,

Michael