REVIEW: iPHONE APP ‘Sleep On It’

One of the most popular of the sleep-related apps (applications) for iPhone, ‘Sleep On It’ works by tracking your movements during the night in order to time your morning awakening. What are the pros and cons of this app?

‘Sleep On It’ relies on your iPhone’s accelerometer to monitor movement. The idea is that you place your iPhone near you in bed and that it will register movements. When you are in deeper sleep, especially REM sleep, it will document this stillness. When you are restless towards morning, drifting into lighter stages of sleep, it will seize on this wakefulness to alert you to get up for the day.

The interface of the app is slick. There are five tabs of controls and information. The first tab offers instructions on how best to place your phone and use the app. Under settings, you can choose an alarm sound (including a favorite song) and set your snooze options. You select a 30-minute period during which you wish to awaken. Then, each night after using it, it creates a summary page that includes a hypnogram (showing sleep stages) as well as your bedtime, wake time, and total and average sleep time. There are also options to share this information by email and Facebook.

‘Sleep On It’ is accurate at tracking the consistency of your sleep schedule. This is similar to documenting your sleep patterns with a sleep diary, and akin to monitoring that is better accomplished with an actigraph. But at a cost of just 99 cents, it is much less expensive than actigraphy.

There are unfortunately drawbacks to the ‘Sleep On It’ app:
• In order to function, the program must run overnight and this will slowly drain your battery. Although it will no doubt vary with your battery’s age, it drained mine by 20% over 8 hours. The instructions recommend that you keep your phone plugged in, which could present a choking hazard should you become wrapped in the cord.
• The accelerometer will pick up any movements, including those of bed partners or pets.
• It brings your phone into the bedroom, and unless you put the phone in flight mode, you will be bothered with calls, texts, and alerts throughout the night.
• The sleep cycle hypnogram (for which the app is named) does not appear to be accurate. If you have a soft mattress pad or other bedding, the accuracy will suffer because movements will be missed.

Therefore, though the ‘Sleep On It’ app is an interesting development in inexpensive application technology that may help us to monitor our sleep, it seems that it is really only accurate to track your bedtime and wake time. It should not be used as an alternative to more sophisticated sleep studies.” (Note: your Editor loaded the app on his iPhone and my evaluation is the same as Dr. Peters…. but it is interesting to play around and see what your pattern looks like)

BATTERY POWER FOR CPAP

The Winter Support Group meeting was devoted to a discussion of “Traveling with your CPAP.” Most CPAP machines now run off “inverters” or “sine-wave generators” which output to the CPAP 12 or 24 volts alternating current (depending on the machine). If you are traveling to a country that provides 220 or 240 volts be sure your power supply input will work on those voltages. If not contact your CPAP supplier.

For those who are RV’ing or camping battery power from your vehicle or an auxiliary battery is required. All of these battery solutions will power a CPAP machine for at least 8 hours and some more.

Each of the manufacturers has a slightly different approach. Here are some websites where you can get specific information:

Respironics
http://sleepapnea.respironics.com/accessories/batterypack.aspx

ResMed (2 sites)
http://www.resmed.com/us/assets/documents/service_support/battery_guide/198103_battery-guide_glo_eng.pdf
http://www.resmed.com/us/products/resmed_power_station_ii/resmed-power-stationii.html?nc=patients

Fisher Paykel
http://www.fphcare.com/userfiles/file/OSAfiles/CPAP/Battery%20Quick%20Reference%20Guide%20PM-185045763.pdf

Battery Power Solutions
http://batterypowersolutions.net/C-444_Power_Pack.shtml

ARTHRITIS PATIENTS NEED MORE SLEEP

Poor quality of sleep is equally problematic as joint pain and limited mobility for many people suffering with arthritis. Sleep disruption appears to be an overlooked consequence of arthritis for many people. People suffering with arthritis need to give more attention to the often dismissed symptom of disrupted sleep, according to results from a national study by researchers from the University of North Carolina at Chapel Hill surveyed 937 Medicare recipients, 65 years old or older.

Most people, if asked to list the symptoms of arthritis, would include pain, stiffness, discomfort, and limited mobility in their response. Fatigue also is recognized as a symptom of many types of arthritis, in the sense of being “worn out” or “lacking energy”. Often overlooked though is the impact of arthritis on sleep.

Study results were reported in the Archives of Family Medicine. About one third of the study participants reported a correlation between arthritis and sleep loss.

Insomnia is difficulty getting to sleep or staying asleep, or having nonrefreshing sleep. “Dr. Bones”, a retired rheumatologist, commenting on arthritis and insomnia said, “The insomnia associated with arthritis may be due to chronic pain, arthritis related stress, or one of the many medications required for disease control. In addition, many arthritics are fatigued at bedtime but not physically tired. This is due to reduced physical activity because of joint immobility. Coping with insomnia requires complex treatment including physical reconditioning”.

More attention needs to be paid to the often dismissed symptom of sleeping problems in people with arthritis. Let your doctor know that you are have sleeping problems and explain the problem in detail.

Childrenʼsʼ Sleep

Every living creature needs to sleep to restore brain function. Newborns do not yet have an internal biological clock (circadian rhythm) so their sleep patterns are not related to the night or daylight.

Infants 1 to 12 weeks old usually sleep 15 to 18 hours a day, but only in short periods of 2 to 4 hours irregularly as the baby needs to be fed, changed and nurtured. The baby should be put in crib when drowsy, not asleep. Place baby on the back with face and head clear of blankets and other soft items.

Infants 3 to 12 months old sleep 12 to 14 hours a day and periods of 4 to 6 hours and more regularly in the evening. Establishing healthy sleep habits is important goal. Create a consistent and enjoyable bedtime routine with a “sleep friendly” environment. Encourage baby to fall asleep independently and become a “selfsoother”. Babies have 3 naps and drop to 2 naps a day at 6 months old. They are capable of sleeping through the night after 6 months.

Toddlers 1 to 3 years old sleep 12 to 14 hours a day. Naps will drop from 2 to 1 in the day. Many toddlers experience sleep problems including resisting going to bed, nighttime awakenings, and their ability to get out of bed. Nighttime fears and nightmares are common with the development of the child’s imagination. Toddlers’ drive for independence and an increase in their motor, cognitive and social abilities can interfere with sleep. Daytime sleepiness and behavior problems may signal poor sleep or a sleep problem. A consistent bedtime routine and schedule with consistent, well communicated and enforced limits is essential. A security object such as a blanket or stuffed animal is helpful. Separation anxiety and illness can disrupt sleep. Preschoolers 3 to 5 years old sleep 11 to 13 hours a night and most do not nap after 5 years old. With further development of imagination, nighttime fears are common. Sleep terrors and sleepwalking and sleep talking peak during this time. The child should sleep in the same environment every night in a room that is cool, quiet and dark – and without a TV.

School-aged Children 5 to 12 years old need 10 to 11 hours of sleep. Sleep problems and disorders are prevalent at this age. Poor or inadequate sleep can lead to mood swings, behavioral problems such as hyperactivity and cognitive impairment that impact on their ability to learn in school. Stimulating media and TV programs, the Internet, caffeine products, social activities and the demands of school can interfere with sleep. It is important to teach children about healthy sleep habits and maintain a consistent schedule and bedtime routine. Keep computers and TV out of the bedroom and keep bedroom cool, dark and quiet. Awakening the same time everyday stabilizes the biological clock.

Teenagers 12 to 18 years old still need 8 to 9 hours, however, social pressures, school work, and sports activities all conspire against getting the proper amount and quality of sleep. Many teenagers develop a delayed phase sleep disorder and they stay up way too late and have great difficulty arising in the morning and getting to school. Most teens are chronically sleep deprived and try to “catch up” by sleeping late on weekends. Teens struggle to learn to deal with stress and control emotion – sleep deprivation makes it even more difficult so irritability, lack of self confidence, impaired judgment, and mood swings become even worse with insufficient sleep.

Tips for teenagers (ages 11 to 22):
• Avoid caffeine and nicotine in afternoons. Avoid alcohol
• Avoid heavy studying or stimulating computer games before bed
• Avoid arguing with your adolescent just before bedtime
• Avoid bright light in the evening, but open blinds and turn on lights in mornings
• On weekends sleep no more than 2 to 3 hours late