Over the last few pandemic years, at times it seemed as if many of our waking moments were conspiring to make sleep especially elusive. Anxiety was running high, routines were turned upside down, kids (and parents) were home all day, professional lives rolled into a seemingly endless blur of Zoom calls – and our sleeping hours paid the price. Even now, I’m still hearing from a number of patients that the seven or eight hours of respectable nightly Zs that, pre-pandemic, they used to be able to count on, are still tough to come by.
For them, and for you, I’ve got two messages. The core good-sleep habits that I’ve advocated for long before our lives were upended, are now even more important (and I’ll get to them in a minute). And: you’ve now got a new sleep ally in your corner – in the form of an array of sleep tracking devices that have the potential to change the rules of the sleep game in your favor. Where to start? Here’s my in-a-nutshell guide to the ‘sleep tech’ that’s ‘disrupting’ sleep in a good way – and why you should take advantage:
Sleep tech is a tool, but it doesn’t do the lifestyle work for you.
There is no shortage of research out there to support the idea that chronically poor sleep is one of the major modulators of health as we age, so finding ways to improve your sleep – and by extension, your health – is a worthwhile investment of time, energy and, of course, money. But, let’s be clear here: just because you can spend anywhere from $50 to a $1,000 on a sleep tracker, that doesn’t mean you’ve buying yourself nights of deep, restful sleep. What you’re buying is an extremely helpful digital tool, the one you need to help you figure out why you’re not getting a good night’s sleep. Once you’ve accurately identified the not-helpful habits that are undermining your sleep, it becomes a lot easier to zero in on the lifestyle factors that lead to a refreshing sleep. In other words, you can enhance what’s working and deep-six what’s not. Which is huge.
Class is in session: Sleep Tech 101
The first question you might ask is, what’s the difference between the data these consumer devices spit out and what you’d get in a hospital or university sleep lab? The sleep labs use polysomnography (PSG) technology that directly measures brain waves (among other things), the gold standard for diagnosing clinical disorders like sleep apnea. Certainly a good way to go it you have the time and the money.
Whereas for the most part, consumer devices primarily measure sleep somewhat more indirectly, by measuring sleep stand-ins, like how much or little your body moves in bed or how being asleep (or not) affects your heart rate. That’s enough, after the data is crunched by a device’s algorithm (and typically, uploaded to your smart phone) to give you an approximate read-out of many of the key sleep metrics: how long did it take you to fall asleep?; how many hours were you asleep?; how many times did you wake up, or sort-of wake up; and, roughly, how long did you spend in the different stages of sleep: light, deep and REM. The mission is to maximize the time you spend in those last two, health-restorative, zones, but you can’t consciously will it to happen. It’s all about good sleep habits and setting yourself up to succeed at sleep at night.
That information you get from these devices won’t be as accurate as what you would get over the course of one weird night wired up in a sleep lab. But in many respects, it’s better. Because you’re monitoring your sleep with a tracker on some kind of regular basis over time (up to you if it’s an every night thing), you can identify patterns which will help you answer some basic sleep questions. Do you get a longer, more restful sleep if you go to bed earlier and get up earlier (maybe, maybe not)? Does having a (seemingly) relaxing alcoholic drink later in the evening disrupt your sleep? (Generally speaking, the answer is yes, but everyone’s sensitivities are different.) Does getting a session of vigorous exercise during the day set you up for a lights-out deep slumber? Or might a gentle long walk in the park serve the same purpose, and possibly do it better? How does that kind of steady movement stack up to stretching or yoga before bed, or even a hot bath, sleep-wise. (My advice: do it all if you can.) Well, when you pull up the sleep metrics data on your smart phone, you should be able to figure out the answer. In the case of sleep, as with most things, knowledge is power.
Lost in the sleep supermarket?
Understanding the sleep tracker concept is often easier than navigating the burgeoning tracker market and figuring out which device is best for you. I recommend visiting a few web sites with the space and resources to guide you in detail through the pros and cons of many of the devices out there, but I can give you a few questions to ask yourself before you invest.
My first piece of advice is, before you get too lost in the weeds, ask yourself some basic questions. How much do you want to spend? Are you looking for a tracker that is mostly or wholly dedicated to tracking your sleep or are you willing to spend a little more for a multi-purpose device to monitor other things as well, for instance, heart rate and heart rate variability (HRV) and work-out duration and intensity?
What’s out there: to wear or not to wear…
Sleep trackers come in all shapes and sizes but probably the biggest category is the “wearables.” The smallest and sveltest of the bunch (and the one I use) is the Oura Ring Gen3 (about $300). Its sensors measure heart rate, body temperature and blood O2 levels to create a digital picture of your sleep. And it also measures heart rate variability and doubles as a (sort of ) fitness tracker. Not bad for a titanium band not much bigger than a wedding ring.
Next up in size and versality are the wrist-worn trackers like the Whoop 4.0, the Garmin Vivosmart 4 and the Fitbit Charge. They track the sleep metrics just fine but more from the point of view of the recreational athlete who wants to more accurately balance work-outs with recovery. If the device thinks you need a good night’s sleep more than a hard session at the gym, it will generally tell you. (Heart rate variability is the key metric here.)
The Fitbit comes in around $135 and the Garmin around $200 while the Whoop device is, technically, “free,” but comes with a subscription program that, depending on the plan, can run you from $18 to $30 a month. The Whoop does have some a nifty extra features, like an alarm that wakes you up with gentle vibrations and, within a pre-set time range, only when you’re in the lightest phase of sleep so you don’t wake up groggy.
The Biostrap EVO (around $250) is another versatile sleep/fitness tracker, worn either as a wristband or a chest strap, with a range of sensing capabilities, including measuring oxygen saturation levels. (If the idea sounds familiar, for a lot of us, O2 saturation was one very closely-monitored number during the worst of the pandemic.) It crunches info about sleep stages and heart and breathing rates to arrive at a single 1-100 Sleep Score. Even the less technically adept will know in an instant if they’re excelling or merely passing or worse.
The Apple Watch Series 6 (starting around $200) is rather large and clunky, not everyone’s idea of a comfortable bed companion. But it allows you to monitor an impressive swath of your physiology, especially cardiovascular function. Again, popular with the work-out set. When it comes to sleep, it will give you a weekly trend report which could be helpful for people inclined to obsess about their nightly numbers. One downside: if you wear it at night, you’ll likely have to recharge the battery every day.
Calling all trackers
Believe it nor not, I’ve only scratched the surface of the sleep tracker market. For instance, if you’re a sleeper who’s easily bothered by noise, you might try the Kokoon Nightbuds (around $250), ear buds that track sleep metrics while pumping in music or white noise to cancel out unwanted noise, the audio turning off after the buds sense you’ve fallen asleep.
No contact, please, I’m trying to sleep.
For people who don’t want the wear their sleep tech, there are a range of “contactless” sleep trackers. The most basic among them come in the form of smartphone apps, that monitor your movement and the sounds you make (coughing, snoring, etc.). A step up from there are the “bedside sensors” like the Google Nest Hub, the SleepScore Max and the Amazon Halo Rise, in the $100 to $200 range, which do a similar job, better, if not quite with the sensitivity of the “wearables.”
Then there are trackers that slip under the mattress, like the Withings Sleep ($130), which interpret the vibrations that pass through the mattress to in effect, read your sleep. From there, things can get a bit more deluxe, not to mention expensive, with “smart beds” that use sensors to monitor sleep patterns and collect data on how well (or not) you’re sleeping.
Sleeping “old school.”
As helpful as sleep tech is though, keep in mind that the actual rules of healthy sleep haven’t changed just because we have new ways of measuring it. So, if high-tech devices simply aren’t your thing – or if they are your thing and you’re inclined to fixate on the data and miss the bigger sleep picture – don’t worry. Simply follow the basics: rise and shine at the same time every day, weekends included; lose the afternoon caffeine, the evening booze and high-carb noshing; take in the early morning light, outside if you can, and power down all electronics within an hour or two of bedtime – no bright lights and no screens, especially in the bed. And, if you find yourself going through a rough sleep patch, keep a sleep journal, to help make the connections between what you did during the day (eating, drinking, moving the body, etc.) and how you slept at night.
After all, in the end, the most important metric is: did you wake up feeling refreshed? If not, then its time to acquaint yourself with a few of my favorite sleep-better-tonight tips.