Plugging In For A Better Night's Sleep

Read Anahad O'Connor's New York Times piece on sleep apps.

High-tech gadgets, like smartphones, keep us connected at all hours and are making it more difficult to get a good night's sleep. But several new smartphone apps claim to help users sleep better. New York Times health and fitness reporter Anahad O'Connor explains the science behind apps.

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JENNIFER LUDDEN, HOST:

Do you have trouble sleeping? There is an app for that - or more accurately, there are some new smartphone apps that claim to help you sleep better and wake up more rested. There's irony here, of course. For years, experts have been telling us that tapping on our smartphone, staring at screens in bed, and staying connected at all hours is bad for our sleep. But the makers of several new apps say their products can actually improve our night's rest. New York Times health and fitness reporter Anahad O'Connor tried one of the apps himself, and talked to experts about the science behind the claims.

Have you used a sleep app? If you haven't, what are your questions? Call us at 800-989-8255. Our email address is talk@npr.org. And you can join the conversation at our website. Go to npr.org and click on TALK OF THE NATION. And Anahad O'Connor joins us now from The New York Times offices in New York. Welcome to the program.

ANAHAD O'CONNOR: Hi. Thanks for having me.

LUDDEN: So how do these apps work?

O'CONNOR: Well, these things have been around for some time, but lately they've been making, I think, increasingly bold claims. And the newest generation claim to basically detect movement at night to determine what stage of sleep you're in. And they say that they can wake you up in your lightest stage of sleep, which leads to less grogginess and something that researchers call sleep inertia in the morning.

LUDDEN: So you're not jolted out of a deep sleep.

O'CONNOR: Exactly.

LUDDEN: Huh. How do they do that?

O'CONNOR: Well, they claim to use radio sensors. So basically you download the app. There's this one program called Sleep Renew. You download the app and you plug your phone into a device, a bedside unit at night, and that device has radio sensors. And it can supposedly detect your movement. Then there's also...

LUDDEN: I mean, are you wearing little wires or something?

O'CONNOR: Well, the Sleep Renew app is the first one that claims to be - there's nothing that you wear, and it's the first one that's completely - doesn't have any equipment. But there's one called the Zeo where you use a headband at night. There's another one where you wear a wristband. But the Sleep Renew is the first one that claims to be completely wireless.

LUDDEN: OK. So it's monitoring your what, your REM cycle, your sleep cycle?

O'CONNOR: Yeah. Well, it says that it's basically doing this indirectly. So these radio sensors can detect the amount of movement that you're having at night, and there's research showing that the amount of movement at night correlates with the stage of sleep that you're in. So you go through different stages of sleep in a sleep cycle, which is about 90 minutes long. And in certain stages of sleep, you - there's more bodily movement. And in the other stages of sleep, you're more immobile.

LUDDEN: OK. So then how does the wake up happen?

O'CONNOR: And so you basically set a window of time in the morning. Let's say you want to be up around 7:20. So you set sort of a 40-minute window where you tell the app wake me up between, let's say, 7:00 a.m. and about - or 6:40 and 7:20 a.m. And so it knows that you have to be up by 7:20, and it picks the point of sleep before then where you're at the lightest stage.

LUDDEN: OK. So you interviewed a woman who wanted one of these because her kid kept screaming out at 5:30 in the morning. So...

O'CONNOR: Yes.

LUDDEN: ...is basically the idea that waking up if you're in a light stage of sleep at 4:45 or 5:00 a.m. is better than lying there until 5:30 if you're, well, woken in a deep state of sleep?

O'CONNOR: Yeah, that's the claim that these apps are making. But if you look at the research - and there's been a lot of research on, you know, this question of sleep inertia and when is the best time to wake up during the sleep cycle, and there is some research showing that if you wake up in the lighter stages of sleep, stage one or stage two, then there might be less grogginess, you know, this sort of overwhelming desire to crawl back into bed. But then there's also other research that contrast with that and shows that for some people it makes no difference at all.

And when I talk to the experts, they say that there - they believe there's a small minority of people who have something called sleep drunkenness, and that's where they have a lot of trouble with the transition from sleep to wakefulness in the morning. And then in these people, waking up in the light stage of sleep may make a difference. But for the overall population, it's not clear that waking up in a lighter stage of sleep will actually reduce your level of grogginess.

LUDDEN: Interesting. All right. Well, we've got some users on the line here. Let's hear from Kyle in Charlottesville, Virginia. Hi, Kyle.

KYLE: Hey there. Yeah, I got the Smart Alarm app for my iPhone for 99 cents about a year ago. And I did a lot of research about it. I just heard it through a friend. And I am pretty well convinced that scientifically it doesn't work, but the placebo effect is awesome.

(LAUGHTER)

KYLE: Whenever I use it, I feel so much more awake in the morning. So it really does kill that grogginess factor. And then to top it off, because I paid - I've got the paid version, it actually records all my noises I make at night. And I discovered I was a terrible snorer and waking up multiple times in the night through that, and I ended up getting my tonsils removed because of that. So, you know, even if it doesn't help me, I actually feel more awake in the morning. It sure as heck seems like it, and it actually helped me become a better sleeper in other ways too.

LUDDEN: All right. Kyle, thanks so much.

KYLE: Yes, ma'am. Thank you.

LUDDEN: Let's also go to Jo here. Jo in Greensboro, North Carolina. Hi there.

JO: Hi. Yeah, I use a sleep app too, and I'm just - I have had chronic insomnia. And the problem with a lot of the solutions that are put out there for grogginess and chronic insomnia is that they, you know, there are things that you do during the day or you're in therapy or you're - or at night, you're - the only thing that was available to address the problem when it's happening is pharmaceuticals. So anything that gives me some sense of control over this without drugs is wonderful. I actually tried two or three different ones, but the one that really clicked and worked the best for me was Sleepio. So it was - yeah, it's just amazing how much better you feel after a good night's sleep.

LUDDEN: And what - so this does - does this wake you up at a certain stage of your sleep, Jo? How does it work?

JO: Well, that's an option, but it's more about a systematic approach to insomnia and to issues of insomnia, and you kind of personalize it so that it's addressing what your primary problems are, whether, for example, if it's falling asleep or waking up in the middle of the night or something like that.

LUDDEN: So what changes have you made since you've started using it?

JO: Well, basically it gives me a resource when I can't sleep that now it feels as though I have - I've kind of conditioned myself following the program through, and it's almost like a relaxation process for me to just - to get on and to use the resources on the site. And I mean it works I'd say, like, 98 percent of the time.

LUDDEN: All right. Jo, thanks for the call.

JO: Thank you.

LUDDEN: So, Anahad, these apps, some of them do more than just wake you up at a certain time in the morning, right? What else are they doing?

O'CONNOR: Yeah. And that's actually an important point to make. And I think the first caller's point actually refers to that as well. So these apps, many of them claim to wake up at a certain time in the morning and (unintelligible) better for you. And while that's still debatable, one thing that's not debatable is the fact that these apps can help get people a lot of data on the amount of sleep that they're getting, and information is power. And so that's one area where even the experts who question this claim about waking up in light sleep, you know, they say at the very least these apps can help people - they can tell when someone's awake or not.

LUDDEN: So you maybe think you're getting six naps, seven hours of sleep a night, but this will help you understand you're not?

O'CONNOR: Yeah. A lot of times when people go into sleep labs, you know, they will say, oh, I'm getting, you know, six, seven hours of sleep pretty consistently. But then when they actually start recording, you know, keeping notes on how much sleep they're getting and what time they're going to bed on weekends versus, you know, weeknights, people realize, oh, I'm actually getting four and a half hours several nights a week. So people are very good at lying to themselves about their habits. And that's actually something that we see in many areas of health.

I mean I've written a lot about, you know, weight loss, for example. And there are all these weight loss apps that are very good. And studies show that usually people will underestimate the amount of calories that they're taking in. And so then when they actually start tracking the amount of calories that they're taking in from the different foods, they're usually off by about anywhere from three to 500 calories on average. And people, you know, are very good at sort of underestimating these things. And so these apps can really force people to confront their bad sleep habits.

LUDDEN: So doctors told you that was a good thing, but then some of these apps also kind of, as I understand it, give you advice which may not be doctor approved.

O'CONNOR: Yeah. And that's the thing, is that a lot of these tips are not - should not be universally recommended. For example, it's well known that most people shouldn't, you know, drink caffeine after a certain time of the evening. But, you know, there are also a lot of people who can eat dinner and then have, you know, a single shot of espresso after their dinner and they're able to sleep just fine.

There's also research showing that for a lot of people, exercising in the evening can disrupt sleep, but then there are other people for whom exercise may actually help them get off to bed even sooner. So a lot of these apps sort of have these blanket statements like, oh, you should, you know, avoid caffeine after this time or you should shoot for, you know, seven and a half hours, but this sort of advice shouldn't be universally recommended. I mean, there are people who can get six and a half hours and be just fine, for example.

LUDDEN: Let's take another call now. Bill is in Colorado Springs. Hi there, Bill.

BILL: Hello. How are you doing?

LUDDEN: Good. What's your sleep story?

BILL: Well, I've been an insomniac for more than 30 years, and I got my iPhone and someone recommended that I download a program called Sleep Cycle. And it's an app where you just lay the phone on your bed, face down, and it tracks how you're sleeping and so forth. And for the last 262 nights, I can tell you I've been sleeping, and that's unheard of for me.

LUDDEN: You've been counting.

(LAUGHTER)

BILL: Well, it keeps track of it on the phone even.

LUDDEN: Ah.

BILL: And it tells me how much time I've been sleeping and everything, and I can tell you I have a lot more energy when I wake up in the morning, and late in the evening I start to get drowsy in a way that I didn't used to. And so I'm more able to fall asleep. I've tried medications, herbal remedies, exercises, all kinds of stuff. None of it ever worked more than a week or two. This has been working.

LUDDEN: Hang with me a moment there, Bill. Your - let me tell people you're listening to TALK OF THE NATION from NPR News. Bill, what are you doing differently now? What have you learned from your app?

BILL: Well, I think the main thing is, is that it does wake me up when I'm not in a deep sleep. And that when you're awakened - because sometimes I'll get a call before this thing wakes me up and I do end up having a pretty miserable day after that call, and I find that I'm in a deeper portion of the sleep. It's got a chart that shows where you are, and I guess it's through the motion. But if I get something that disrupts that cycle early, it's a pretty miserable day for me. And so I think just falling asleep and waking up at a time when I'm closer to being awake anyway has been what made the difference.

LUDDEN: All right. Well, Bill, thanks so much for calling.

BILL: Thank you.

LUDDEN: Anahad, some of the doctors told you that actually most people aren't in that deep a sleep early in the morning.

O'CONNOR: Yeah, that was one of the sort of issues that an expert at Yale University that I spoke to, Dr. Mary Krieger, brought up, is that most people early in the morning are no longer indeed getting as much deep sleep as they are before that.

LUDDEN: Unless, of course, you've been awake all night tossing and turning, and then you only fall deeply asleep when your alarm is about to go off.

(LAUGHTER)

O'CONNOR: Exactly. But - so his point was that, you know, if you wake up someone at this point in time, there's a pretty good chance that they may not be in deep sleep anyway, whereas if someone, you know, gets a phone call an hour before that, there's a chance that they will probably be getting more deep sleep at that point in time.

LUDDEN: But these testimonials are really passionate here.

O'CONNOR: Yeah. You know, I've talked to people who swear by these things. You know, the research, they say the research may not, you know, be very persuasive. But I've tried everything, and then I get one of these apps, and suddenly I am not only just much more mindful of the amount of sleep I'm getting, but also I just don't have the grogginess anymore. And, you know, it may just be that these are people who are in, you know, that minority of really bad wakers who have the sleep drunkenness effect, or you know, it could also just be that the research hasn't caught up with what these apps claim.

But I think for most people these apps are going make a difference as long as they don't expect too much from them, you know. If it's going to help show you that you're getting, you know, five hours of sleep when you think you're getting six and a half or seven, then that alone is going to help make you - make a difference because it's going to force you to be more mindful and help you get into bed a little sooner. I realized when I started - when I gave one of these apps a test run, it made me actually get into bed about an hour earlier.

LUDDEN: Really?

O'CONNOR: I was eager to try this thing out, and I was thinking about sleep that evening, and it was something else on my mind. And so I think there's also that effect.

LUDDEN: So you - it's not that you didn't realized how much sleep you were getting. You were just sort of in the sleep mind frame - frame of mind and got to bed earlier?

O'CONNOR: Yeah, I was excited to see what this app could tell me or show me and to see whether it will actually have a difference in the morning.

LUDDEN: So what happened?

O'CONNOR: You know, I actually didn't notice that much of a difference.

(LAUGHTER)

O'CONNOR: But I usually try to get at least seven hours a night anyway. But I - and I am aware of people, for example, who, with some of these apps, they - it sort of becomes a game for them. You know, they - you get a score. The app will say, OK, you got five and a half hours this night and you had a little bit of caffeine at 8:00 and you woke up at this time, and here's your sleep score. You know, you're in the red when you could be - you do a few things differently and you could be in the green, so some sort of a challenge and people...

LUDDEN: Appealing to our competitive nature, or I guess...

O'CONNOR: Yeah.

LUDDEN: ...competing with yourself.

O'CONNOR: Exactly. Yeah. And I've also noticed the same thing with people who use weight loss apps like Lose It! You know, they are constantly trying to improve the number of calories they're taking in and their weight loss gains and things like that. And so that's one of the fun things about these apps.

LUDDEN: All right. Any final word of advice for anyone who's thinking of downloading it out there?

O'CONNOR: Yeah, I would say that if you're a problem sleeper and you're someone who wants better sleep, as most Americans do, then - and this is something you're considering - it's certainly worth a shot, although you just shouldn't set your expectations too high. Then again, if you're someone who is getting very bad - who's a very bad chronic sleeper and you suspect you may have a more serious problem like sleep apnea, then you may want to actually go see a sleep specialist because while these apps can help you track the amount of sleep you get, and may be able to nudge you awake certain time in the morning, they can't diagnose real sleep problems like sleep apnea.

LUDDEN: All right. Anahad O'Connor, health and fitness reporter for the New York Times. He joined us from the New York Times office. Wishing you good sleeping tonight. Anahad, thank you so much.

O'CONNOR: Thank you.

LUDDEN: This is TALK OF THE NATION from NPR News. I'm Jennifer Ludden in Washington.

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