A Sleep Experts Take on Sleep App Technology

The market for sleep apps and sleep-sensing devices is booming, as marketers and software developers alike work hard to take advantage of America’s booming obsession to take control of their sleep shortage. Though many take comfort in the idea of knowing every last aspect of their night-time movements and sounds, a noted sleep scientist urges that people remain realistic about exactly what the new technology is able to deliver and what it cannot.  Dr. Dev Banerjee, sleep expert and medical director of the Woolcock Institute of Medical Research says that sleep tracking apps available through Apple’s App Store or Google Play, and even the beds with built-in monitors that record your movements and respond to them, are limited in both their accuracy and their ability to assess what is really going on while you are asleep. Sleep is an important physical function, and it is also extremely complex. Medical science is still working to understand exactly what goes on within the brain when we sleep, and what the many purposes are that sleep serves, so an application that supplies us with relaxing sounds or beats or the soothing sounds of sleep whisperers may be helpful for some but sorely lacking for others. Dr. Banerjee says, “Regarding sleep apps like the beat apps, they are a way of distracting the racing mind. A common cause of difficulty in initiating sleep is due to inability to relax and switch off. Binaural beat apps are not hypnotic as such, like sleeping medications, and therefore cannot in my opinion technically alone induce sleep. But in some patients they may be a useful aid to focus away from a busy day and switch off by listening to monotonous sounds. They are akin to relaxation tapes, that is, part of psychological self-hypnosis therapy.” As for the apps that track sleep and provide feedback, Dr. Banerjee cautions that people need to understand the limitations in the monitoring that they can provide, as well as in any interpretations or analysis that is being offered. “The smartphone senses movements by means of accelerometer techniques, i.e. any movements will register as a ‘blip’ on the data collection. The overall overnight data will therefore show a bar chart type of picture, where bars on the summary chart indicate movement. They are useful as an indirect measure of sleep, on the assumption that sleep equates to low activity/movement, and awake is equivalent to movement artifact on the data page. They will give an indirect measure of time in bed spent asleep, i.e. sleep efficiency. They will not indicate whether the sleep is deep sleep, light sleep or dream sleep. Only electrical leads attached to the scalp measuring electrical activity of the brain, called electroencephalography or EEG, can determine this.” In other words, though the information provided may be interesting, they are not going to provide the kind of feedback that is necessary to help identify and correct a true sleep disorder. Only a sleep study conducted by a professional medical sleep lab will be able to provide that kind of information.  Sleep studies are done overnight and are often affiliated with hospitals or major medical centers. Patients requiring sleep studies are often referred by their physicians following the discovery of symptoms leading to concerns about apnea or other physical conditions. The patients arrive in the evening and are assigned to individual rooms in which they are monitored while they sleep. Electrodes are placed all over their scalps, faces and other areas of the body to measure electrical impulses, temperature, rate of respiration and more. With the information that is measured as well as actual observation by medical professionals while they sleep, patients are diagnosed with a variety of conditions, or else notified that they do not have a sleep disorder. Dr. Banerjee does not entirely dismiss the use of sleep apps, as he acknowledges that they do no harm and that their results may be interesting or even useful as relaxation aids, but he wants to make sure that people understand them for what they are. Referring to devices and apps that promise specific results, such as lucid dream apps that claim to deliver the ability to control the tenor or tone of dreams or to make dreams more pleasant, he offers little more than a shake of his head. “Dreams occur in a sleep phase called ‘rapid eye movement’ sleep. The times and lengths of REM sleep are determined biologically by the cycling of different sleep phases. In other words, when we go to sleep we go into non-REM sleep, and when the brain cycles into REM sleep, will do so when the brain is ready. There is no evidence that apps can regulate dream sleep, particularly frequency or length or content while one is asleep. The mechanism of this app is unclear. When we go into sleep there is a tendency for imagery formation, but this is not related to dream sleep of REM sleep. The images are very unidimensional, abstract and short lived, and may not be like REM sleep, which is purposeful and story-like in many cases. It may be that the individual listens to the audio and this is at the same time as falling asleep, which may alter their experience of the imagery formation, as the individual is half asleep and half awake, and therefore will have some conscious awareness before heading into deeper non-REM sleep. However, there is no evidence that this app in my opinion increases content or quality of sleep, once asleep.” Dr. Banerjee’s final advice on sleep apps and other devices? Realize what they are and make sure that you don’t give them more weight then they deserve and you will be fine. “At the end of the day, it’s a bit of fun, and for many who suffer from sleep issues there’s no harm in trying if they are prepared to make a loss if the app does not work. If individuals are struggling with their sleep, the best advice is to seek assistance from a sleep clinic.”

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