Benca Sleep Gadgets 082520 - UCI MIND
Transcript of Benca Sleep Gadgets 082520 - UCI MIND
SleepGadgetsRuthM.Benca,MD,PhD
DepartmentofPsychiatryandHumanBehaviorUCISleepCenter
Disclosures
Ihavenocommercialrelationshipstoanyoftheproductsorcompanieslisted,andinclusioninthistalkdoesnotrepresentanendorsement.
Typesofgadgets
• Wearablestotrackyoursleep• Devicestohelpyousleep• Appsandinternetbasedapproaches
Wearables• Allbasedonmeasuringmovements• Usuallywornonthenon-dominantwrist
Whatdoactivitymonitorsdo?• Trackrest-activitypatterns,withsoftwaretoquantitatemovementandsleep• Somewithprogramsthatestimatetypesofsleep(e.g.“deep”sleep,REMsleep)• Advantages
• Capableofmonitoringmultiplephysiologicalparameters(e.g cardiacrhythm)tomonitorclinicalconditions
• Technologycontinuestoimprove• Datacanbefedintointernet-basedtherapiesforinsomnia• Atapopulationlevel,theyincreaseawarenessofsleephealth
Caveatsaboutusingactivitymonitors
• Dataarenotnecessarilyaccurate;sleepstagedatanotreliable• Mayincreaseanxietyaboutsleepandthusworseninsomnia• Increasefocusonminutesofsleepratherthanqualityofsleep• Manydevicesonthemarket,fewhavebeenproperlyvalidated
Bluelightblockingglasses• Thecircadianclockinthebrainismostsensitivetobluelight;exposureatnightshiftssleeponsetlaterinthenightaswellasincreasingactivation• Wearingamberlensesfor1.5- 2hoursbeforebedimprovedsleepinindividualswithinsomnia(bothsubjectivesleepandactigraphydata)insomestudies
WhiteNoiseMachines• Emitcalming,monotonoussounds(e.g.,wind,rushingwater)• Usefultodrownoutintermittentenvironmentalnoises(e.g.,traffic,snoring,householdnoise)• Mayalsoaidindividualswithtinnitus
Coolingdevices
EbbSleepCap
Chilipad cube
BedJet
Rationale
• Coolingthebrainordroppingcorebodytemperaturereducesneuralactivityandpromotessleep• Brainandbodytemperaturecoolduringsleep,particularlyduringNREMslowwavesleep• Headcoolingdevicescausedropsinbothbrainandbodytemperature• Evidenceforimprovedsleepwithbraincoolingdevice• Minimaldataforothercoolingdevices
Stimulatingslowwavesleepthroughtones
Dreem Headband(Rhythm)
SmartSleep DeepSleepHeadband(Philips)
SleepShepherdBlue(SleepShepherd)
Rationale
• Slowwavesareprevalentindeepeststagesofnon-rapideyemovement(NREM)sleep• Slowwavefunctionsincludelearningandmemory(likelythroughnormalizationofsynapses),clearanceoftoxicsubstancesfrombrain(amyloidandtauproteins)
Howitworks
Evidenceforeffects
• Devicesincreaseslowwavesduringsleepinnormalsubjects• Effectsgreaterinyounger(<40yrs)thanolder(>40yrs)adults• Noeffectontotalsleeporsleepstageamounts• Effectsoncognition,daytimefunction,physiologyunclear;moreresearchneeded
Electromagneticstimulationofslowwavesusingpulsedelectromagneticfrequency(PEMF)
SR1PEMFSomniresonance Oska Pulse
CranialElectrotherapyStimulation(CES)
Alpha-Stim
Rationaleandresults
• Deliversstimulationtothebrain,PEMFlikemildtranscranialmagneticstimulation(TMS);CESlikeverymildelectroconvulsivetherapy“ECTlight”• Therapiesdevelopedformooddisordersandpainrelief• TMSandECTincreasewakingbrainactivitywhichresultsinincreasedslowwavesleep--??Ifthisisthemechanism• CEScausesdeactivationofbrainafterapplication• Veryminimaldataonsleepeffects;somestudiessuggestimprovedsleeponselfreport.OnestudythatmeasuredsleepinlabshowednoeffectofCES
Newerapproachesunderdevelopment• Transcranialelectricalstimulation;transcranialmagneticstimulation[TMS]• “Topdown”;canbetargetedtospecificbrainregions• MaybeabletotargetvariousbrainEEGwaveforms
• Otherformsofsensorystimulation(e.g.,auditory,olfactory,visual,somatosensory,visual,vestibular)• “Bottom-up”;lesslocallyspecific
Clocks
SmartSleep WakeUpLightTherapyLamp– PhilipshOmelabs SunrisealarmclockBiobrite Sunriseclock
Rationale
• Lightwavelengthandintensityentraincircadianrhythmsandhavedirectalertingeffects• Circadiansystemmostsensitivetobluelight• Light-emittingclocksimulatesundownandsunrise• Shifttoredspectrumanddecreasingintensityintheevening• Shifttobluespectrumandincreasingintensityinthemorning
• Usefulforhearingimpairedindividuals
CognitiveBehavioralTherapyforInsomnia(CBT-I)• Usuallyprovidedbytrainedtherapist• Computer-basedformsavailable• Meta-analysisof6RCTsofcomputerizedCBT-I1• Treatmenthadgoodacceptability(78%completed)• Estimatedthat1in4patientswillrecoverfromchronicinsomniawithcomputerizedCBT-I
• Examples:• Sleepio www.sleepio.com• VACBT-i Coach(free)https://www.ptsd.va.gov/appvid/mobile/cbticoach_app_public.asp)
1.ChengSKandDizon J,Psychother Psychosom (2012)81:206-216.
Questions?