Sleep and the Sleep Cycle App

 As a doctor I often end up talking to people about sleep; about how important it is, how truly critical it is to our health, and in talking about it I see how many people have abnormal sleep patterns.  It is one of those chicken and the egg issues; is it their comorbidities affecting their sleep or their sleep affecting their comorbidities?  I usually don’t have the answer for that, other than that many people I see who are struggling with their weight also have abnormal sleep (ok my friend over at Go Maleo, I’m just waiting for you to blog about this!).  Anyway, sleep is critical, there is no debating the evidence for that: if you don’t sleep at all you will die (in the short term) and if you don’t sleep much you will definitely die sooner than you should (in the long term).  So why, when I am knowledgeable on this subject do I personally suck at taking my own advice?  Probably for whatever the same reason most people tend to lack insight about some of the things that negatively affect their life the most (it would take a lot of psychological theory to delve into this and it is not the point so I’m just going to gloss over the “why” right now and move on).  Anyway, the point is, I don’t sleep as much as would be healthy. 

            I’m not the only one you know!  Our whole society is burning the candle at both ends, you can read all about it all over the internet I’m sure!  Somehow that makes me feel better, that I’m not the only one, but in the end I really know better than to fall back on a group mentality like that. I have read a lot about this and I have gone to lectures given by doctors who specialize in sleep medicine (that’s right, there is an ENTIRE FIELD OF MEDICINE DEDICATED TO THE TOPIC) and it is pretty clear to me that I have probably shaved 5-10 years off my life expectancy by shorting myself on sleep in a chronic fashion.  That means if I was going to be average and make it to 75 or 80 I’ll now be lucky to make it to 70.  I better get crackin’ on some of my life goals because 70 is just around the corner!

 I could blame my career (damn you medical school and residency!) but the reality is that I was the kid under the blankets reading books with a flashlight past my bedtime and then waking up at 5:30 am for swim practice long before my profession got a hold of me.   Recognizing you have a problem is the first step they say.  Personally my next step is always “data collection.”  It’s just my nature to want to fully analyze the problem before I work on the solution.  So 2 months ago I started using an app called Sleep Cycle.

Sleep Cycle works by sensing your body movements in your bed at night (you lay your phone near your head – I don’t even want to think about my increased brain cancer risk right now so don’t go there!).  If you’re moving a lot it puts you in the “awake” category and if you’re moving less it puts you in the “sleep” category and if you are completely still you are in the “deep sleep” category.  I can’t really speak to the validity of the methods of this app because while body movements are part of your sleep cycle I don’t think this method alone can really say what sleep state you are in (unless they also make an EEG app and little electrodes pop out of your phone and attach to your scalp).  But in the morning you get a nice little graph showing you your sleep cycles based on your movements throughout the night.  It ends up that, like most humans, I have 90 minute sleep cycles, which doesn’t really surprise me.  What did surprise me is how little I have been sleeping!

Now, you might say, “but you just said you have never slept that much” and yes, I know that is true, I said that!  But when I actually looked at the hard data that was showing me what time I went to bed each night, what time I wake up each morning, how much sleep I get total and what the relative “quality” of that sleep is and then look at a graph of those numbers (with averages as well) it makes the situation look much more dire.   

As a fun side note, it has an option where you can add notes about your day and then correlate them to your “rating” of how well you slept.  For example you can click “drank coffee” or “stressful day” and then the next morning it will give you a frowny face, a “meh” face, or a smiley face so that you can rate your night of sleep and it will then correlate those factors over time with your opinion of your sleep quality.  Again, not hard science there, but kind of a fun little correlation tool for personal use. 

Using that part of the app I have discovered that I feel like I have slept better in the morning if I have green tea at night before I go to bed.  So, let me emphasize, this is CORRELATION not CAUSATION.  I am not saying green tea helps me sleep, but that somehow the two tend to happen at the same time.  If I had to guess I would actually say that when I have green tea before I go to bed I tend to sit and meditatively drink my tea and relax at the same time ,which, if we’re looking for causation, seems more likely to be the underlying cause of the improved sleep quality.

Another fun little feature of this app is that it has an alarm clock in it that is supposed to wake you up at the natural point of being “most awake” in your sleep cycle.  You give it a window of time (I have mine set to 30 minute window) and it notices when you start having “wakeful” body movements and the alarm goes off at that point, avoiding your “deep sleep” time.  This works great if you have a somewhat flexible schedule or if you’re ok with potentially waking up 30 minutes before you really need to be awake.  I really like this feature so far although I can't really tell how well it works because I have small children who are serving as my true alarm clocks.  I do think I have had fewer or those really really groggy awakenings you sometimes get from an alarm when it wakes you out of a deep sleep by using this app as my alarm clock.

Moving on.  I collected the data.  I have numbers.  NOW WHAT? If I was sitting down with myself in my office I would say:  make small changes, set achievable goals. And this is where it gets hard for me, and hard for everyone who tries to make behavioral changes (because if it was easy we would have all done it already, right?) the actual change part is so painful!  I honestly love sleep and I am fortunate to be a really good sleeper once I get there, so again, you would think it would be easy to do more of something you love to do!  But I also like getting shit done, especially with my level of daily anxiety.  I have become accustomed to having more time in the day to do the things that I feel are important and if I spend more of that time sleeping, I will have less time.  The thought of having less time in the day may just throw me into a panic attack right at this very moment!  I know I need to shift my paradigm; what needs to be done all comes down to perspective, but again, those big shifts in thinking are hard and so I’ll try to refocus on the small stuff.  My first goal is to try to get at least 7 hours of sleep a night for the next 4 days; small and achievable.  I have noticed, through this sleep cycle app, that on the rare occasion I do get more than 7 hours of sleep, that I tend to choose the “smiley face” when I wake up.  This is not going to be easy, but more smiley faces has got to mean something good.  I’ll let you know how it goes!