Episode 234 Show Notes
Grant and Heavey tackle a listener’s question regarding postural aids for sleeping such as specialized pillows. He thinks it’s a load of bollocks. So are these helpful in getting better sleep and improving posture?
[05:50] Effect of Sleep Aids on Sleep Apnea
Heavey presents this study on the Usage of Positional Therapy in Adults with Obstructive Sleep Apnea. They evaluated 40 people over 12 weeks and used two techniques – a waistband that doesn’t allow them to sleep on their back and the other one was a tennis ball technique. Both of which are designed to keep them off their back during sleep.
They found the therapy to be successful in 68% of the participants. They measured the Apnea-Hypopnea Index (AHI) which depicts the severity of sleep apnea. They found that even though it was effective over the short term, people were non-compliant over the long-term. They just had trouble sticking to it eventually.
[07:10] So What Are the Sleep Aids That Work
First off, Grant points out how marketing works. If you click on one of those ads on your social media feed, it intuitively thinks you’re interested in those particular products. Then you’re going to get more of those. This is the nature of internet marketing.
But truth be told that there are so much out there! It’s an incredibly large market that just keeps growing. Grant further found a study on sleep technologies, specifically, Consumer Sleep Technologies: A Review of the Landscape.
There are so many sleep technologies coming up that these six PhDs got together and did a review on consumer sleep products. They looked through a wide range of publications and studies. They used search terms such as sleep technology, sleep app, and sleep monitoring.
They ended up reviewing it all and classifying the different sleep products into one of the following categories: software (mobile device apps), wearable devices, embedded devices, accessory devices, conventional resources.
For instance, smart mattresses would fall under the Embedded Devices category, wherein the technology is integrated into the furniture or other fixtures in the native sleep environment.
The researchers have concluded that not only are these consumer sleep technologies changing the landscape of sleep and health but technologies being introduced into the market have the potential to both improve as well as impair collective and individual sleep.
[12:30] The Mattress: Are You Sleeping Comfortably?
You’ve probably seen a lot of advertising on the mattress in a box because buying a mattress is a pain in the ass. It’s expensive! No one really likes to do it and so these products have taken over the market since they easily get delivered to your house. However, they’re nearly all foam mattresses.
Grant has yet found two more studies looking into the effect of the types of mattress on sleep quality, particularly: Quantitative Effects of Mattress Types: Comfortable vs. Uncomfortable on Sleep Quality Through Polysomnography and Skin Temperature and Comparative Effects of Sleep on a Standard Mattress to a Foam Surface on Sleep Architecture.
The more comfortable you report yourself to be laying on a mattress, the better your sleep quality. Your perceived comfort directly correlates to the quality of your deep sleep, REM, amount of disturbances, etc. So when shopping for a mattress, pay attention to what you feel comfortable on.
As far as sleep quality goes, the reported comfort of the individual correlated directly to the quality of their sleep.
[15:30] Sleep Problems and Musculoskeletal Pains
Heavey also found another study that looked at musculoskeletal pain in over 4,000 healthy men and women. Those with sleep problems like difficulty falling asleep, trouble staying asleep, waking up early – were significantly more likely to develop chronic musculoskeletal pain after one year.
Some vicious cycle could be playing here in terms of the cause and effect. But what we do know is that sleep disturbances disrupt muscle relaxation and healing that normally occur during sleep. That being said, this is a complicated problem with multiple variables. Heavey believes having a comfortable mattress may just be the way to go as it seems that it can reduce some pain based on the findings of the study.
[16:50] Which Mattress Should You Choose?
Back to the study on the comfortable mattress, they looked at 10 different people. The results showed no differences in sleep stages, the number of wakes, or total sleep time between the two mattress conditions.
Taking those two studies together, Grant concludes that you go for whatever mattress you feel more comfortable on.
All of this research on which is better, according to just the sleep quality you get, doesn’t really matter. Choose what you like.
[18:00] What About Smart Mattresses – Do They Work?
It’s crazy how much technology is in mattresses right now! Grant did some research on some of the products and he found that they generally work. But the real question is: is it worth it?
For instance, the Pod has dual heating and cooling zones. So if you and your sleep partner want different temperatures, the mattress automatically cools based on your sleep rhythms. So when you’re moving more, it will cool it down. And if you want, it can wake you up by heating itself up.
Basically, it looks at your heart rate and sleep patterns to know what your temperature should be. But it’s just a lot of money. Not to mention, that almost all of these things they offer can actually just be bought in the form of accessories instead of embedded devices. Hence, you won’t have to spend $8,000 on the mattress.
[20:30] The Cooling Mattress: The Effect of Temperature on Sleep
Every big mattress brand is now coming out with a built-in cooling technology in their mattresses. So Grant found a couple of studies on the effect of temperature on sleep. One was a meta-analysis of 104 studies. And this highly supports the existence of these devices.
They found that the thermal environment is one of the most important factors that can affect human sleep. In real-life situations, where bedding and clothing are used, heat exposure increases wakefulness and decreases slow-wave sleep and rapid eye movement.
Grant cites another study wherein they made people sleep with a heat blanket versus a control group without the heat blanket. They found that those sleeping with heat blanket have disrupted sleep.
[23:48] The Effect of Noise on Sleep Quality
Grant looked at studies on the effect of white noise and ambient noise on sleep. There were four different scenarios. One was the baseline of sleep – normal, quiet environment. The other one was a white noise sleep, where they increased the baseline level. The third study was using peak noises, from a quiet environment versus a white noise environment.
This was to test whether a white noise affected sleep compared to the control or it was the peak noise. They wanted to find out whether a loud, sudden noise or a random noise would affect sleep or just any noise in general.
They found that it was the change in sound from baseline to peak rather than the peak sound level which determined whether arousal occurred. It was the same for ICU noise and white noise ICU condition.
It was the difference between that normal ambient sound level and the loudest sound that affects sleep quality. So if you’re in a quiet environment and there’s something that bangs or beeps, that bothers you a lot more. Whereas the white noise truly does provide better sleep if you’re in a noisy place. You can use that to bring up that base level and little sounds won’t affect your sleep as much.
[26:40] The Effect of Noise on Falling Asleep
Grant presents this study that looked at newborns and found that 80% of the babies studied fell asleep within 5 minutes in response to white noise compared to only 25% who fell asleep spontaneously within 5 minutes in the control group without white noise.
Not only does white noise help reduce the delta between ambient and peak and make you sleep better, but it also actually makes you fall asleep easier.
[27:40] Do Sleep Tracking Apps Work?
What’s cool about the Apple Watch is that you can use multiple apps at once so you can compare and contrast how they work. Grant found it takes a bit of tweaking. So if you want to tweak the data, it guesses what it thinks you’re doing. Then eventually as you’re using it, it gets more and more accurate.
The problem is there’s just little data they can get such as your movement, heart rate, etc. This being said, Heavey points out how there are no validated data from that device to really infer what’s happening during sleep. It’s simply based more on guessing.
Moreover, there are a number of other devices that can actually do more than just looking at your wrist movement or heart rate. They could actually tell your breathing rate, body temperature, etc.
Grant found a study that looked at 1,000 people reporting whether or not they used any sleep tracking and the effects from before to after. Only 30% of respondents tracked their sleep. And of that percentage, 73% used wearables, and 5% used smart mattresses or apps.
They found that it didn’t matter how good the sensors were. They’re just tracking anyway. 55% said they’ve got more sleep than they’ve had before. So if you’ve got any sleep tracking app, just start using that thing and see if you sleep better.
The reason for this is because the saying “what is measured gets managed” is even applicable to this sort of stuff.
[33:20] Pillows
Pillows are the one thing that made the biggest difference to pain in relation to sleep. This hits on the listener’s point the closest because it speaks to pain and posture.
Grant found that matching your pillow to your sleep style is very important. If you sleep on your back, you want to use a pillow that’s not too tall and keeps your neck in a neutral position. If you sleep on your side, have a pillow with a taller gusset to keep your head in a neutral position.
Additionally, Grant found a study that looked at regular pillows versus rubber pillows. They found that people who used rubber pillows that didn’t conform as much ended up having better sleep cycles as it kept their body in a more firm position.
On a side note, Grant finds feather pillows to be always the worst pillow since there’s not rigidity to them.
[36:00] The Main Cause of Insomnia
Stress is the biggest cause of poor sleep. Like so many other parts of health and wellbeing, stress and sleep are interconnected. If you’re sleeping poorly, it may not be your mattress or your pillow. It may be your head and you might want to work on your level of stress. All this being said, work on your mental health to improve your physical health.
This takes practice and training. So consider a mindfulness practice to start making sleep improvements.
[38:40] Posture Aids
Grant found a study that talked about how poor posture is because of smartphones and devices. The mobility aspect of laptops and tablets showed a magnified degraded posture.
Braces work pretty well. But the trick to getting all this to work is to train your muscles to engage and properly hold your structure in the right places. The brace is more of a band-aid. It can help but it doesn’t really get your muscles to activate such that you can do it on your own.
The best thing to do is some physical therapy if you really want to improve your posture.
Links
Usage of Positional Therapy in Adults with Obstructive Sleep Apnea
Consumer Sleep Technologies: A Review of the Landscape
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