Resting Better: A Sleep Tech Landscape - The Bakery %

Resting Better: A Sleep Tech Landscape

The Bakery

Sleep — how much we had last night and the effect it is currently having on us that day, will consume a large part of our waking thoughts. But how many of us truly understand it?

In my role at The Bakery, researching technology solutions for large corporates, I have spent many hours in recent months speaking with founders who are working on technologies to help us prevent, diagnose and manage sleep disorders. These conversations were insightful in many ways, in particular, helping me to navigate my way through a multitude of solutions and point out the truly effective ones.

@logannolin

The reaction many people have upon hearing of the slightly counterintuitive combination of ‘technology’ and ‘sleep’ is that it must be distracting, or intrusive, to have technology in the bedroom. Many fear that tech could only induce moreanxiety and indeed, several studies have shown that often sleep apps can do just this. However, it is my aim to show you how the world of sleep technology can provide tangible benefits to our health and wellbeing — whether you have a serious sleep disorder or simply don’t feel your best during the day.

This article will cover some basics about sleep, what ‘sleep tech’ actually is, the current state of the market, and what you need to think about when choosing a solution for yourself.

Sleep basics: the fundamentals

Before we talk about technology, I felt it was worth sharing some common misconceptions and statistics I’ve learnt about sleep in and of itself.

Firstly, how does sleep actually work? Despite common boasts we hear from people who say they can function fine on just 3–4 hours of sleep per day, most research points to the fact that they probably can’t.

We know now that:

  • People need 7–9 hours of sleep per night (on average).
  • The quality of your sleep and wakefulness is affected by your circadian rhythms, which are in turn affected by the amount of light you receive throughout the day. This will become relevant when we talk about some of the solutions later.
  • Most people have a chronotype, i.e. a type that affects whether you are more of a morning or night person (or something in between).
  • Our sleep goes through four cycles: 1, 2, 3 and REM (rapid eye movement) sleep. Find more on how these work here.

@stillsbyhernan

Disrupted sleep affects 67% of adults and while 26% consider improving their sleep habits as their biggest health ambition, only about 49% of them do anything about it. Of those that do, 13% are doing it through sleeping tablets or alcohol. Most people intuitively know that these methods are not exactly healthy.

However, if you want to know why they are not effective, then it is because alcohol affects the REM phase, which is often considered to be the most restorative part of your sleep. You may fall asleep faster but your energy, memory and mental health will not quite be the same the next day. In a worse scenario, alcohol can suppress breathing, which if you have something like sleep apnea (a condition which can interrupt normal breathing) is a particularly inadvisable remedy.

Sleep is not only a consumer concern either, as employers are waking up to the realities of how productivity levels are impacted by their teams’ sleep patterns. This means that today, more and more companies are actively investing in solutions to help their employees sleep better.

Now that we are armed with some sleep basics, let’s take a look at the range of solutions out there.

What does the market look like?

Despite its seemingly self-explanatory name, in my conversations, I’ve found that for many people, ‘sleep tech’ is a relatively new and unknown concept.

For many people, their knowledge of sleep tech includes phone-based sleep trackers or luminescent alarm clocks. These products do comprise a large part of the market but technologies in this area span much wider, collectively estimated to be worth $30–40 billion and addressing a number of diverse sleeping disorders, of which I have learnt there are many. To name just a few, some common ones include insomnia, sleep apnea, jet lag, narcolepsy, night terrors, sleepwalking, bruxism and others.

In my research, I have identified five key categories:

  1. Wearables
    • Biometric. Anything which measures biometric data, e.g pulse rates, EEG, ECG, respiration patterns, actigraphy, or others. Solutions within this segment tend to focus on integrating their product within clinical pathways and on average, have the most product evidence/research as a result.
    • Non-biometric. These are less concerned with collecting data and instead, focus more of their attention on offering relief to the individual. Think devices that attempt to stabilise your breathing, music therapy headphones and others.

Here is a high-level overview of the key solutions I reviewed across the first three themes. Inclusion in the maps does not mean that I endorse or recommend them.

2. Light tech. With light being one of the primary forces behind our circadian rhythms, many solutions focus on using lights as a way to help users to fall asleep, stay awake or understand their energy levels during the day. This category is dominated by light-changing lamps but there are several other innovative solutions that I will talk about below.

3. Digital solutions. As one of the biggest categories, digital solutions include everything from traditional sleep-tracking apps to clinical therapies and jet lag technologies. This area is the most affordable and focused on wellbeing (vs. Medical).

Sleep tech map (continued)

4. Bed accessories. A large segment of companies on the market — bed accessories help people to improve their sleeping behaviours without the need to wear any uncomfortable devices at night. Some examples of solutions are position-changing mats, pillow sensors, smart beds and blankets.

5. Environmental sensors. These focus on understanding and controlling external factors, such as the level of temperature or noise inside/outside a room. Several solutions offer an easy way to eliminate common issues associated with sleep without significant user involvement.

Whilst there is some overlap between the areas, I have used companies’ dominant value proposition for categorisation.

What should you look out for in sleep tech?

One thing to point out is the fact that this tech is not just for those with serious sleeping disorders. If you have ever felt a bit low on energy during the day, struggled to focus or in a completely different scenario, could not adjust your body to a different time zone — the cause might have had something to do with your circadian rhythms.

I would encourage everyone to invest some time into exploring what works best for them — a small change might make a big difference and given the affordability of most solutions on the market (the price ranges from £3 for an app up to £700 for a more specialised wearable), trying something out is easier than ever.

Clearly, it benefits you to begin by considering which solution will tackle your specific condition within the price range you can afford, but above and beyond, I believe there are 2 main factors to take into consideration:

  1. Your objectives. The main question being — do you want to change your sleeping behaviour or just fix a particular external problem? For example, if your biggest sleeping problem is noise, there are a few devices that will block out sound coming from outside a room and you need to look no further.

However, the more common problem tends to have something to do either with your body or with what you do throughout the day and in that case, solutions that can lead to behaviour change are more interesting. Here, look out for solutions that do not simply offer you, say, analytics but also give you actionable advice and feedbacking mechanisms that will allow you to check on your progress. For this purpose, bed accessories and environmental sensors are probably not quite right as they do little to help people change themselves and instead, focus on understanding and eliminating external factors.

@all_who_wander

2. Scientific validity. Because entry barriers into the sleep market are relatively low (affordable startup costs, few regulatory hurdles, etc.) there are many, many, many solutions out there. What really differentiates the great ones from the mediocre ones is how seriously the founders take their science. You will see plenty of sleep apps but check how many of them have actually based their product on solid evidence-based techniques or have done testing/clinical trials and you’ll soon see that number drastically decrease.

I have come across companies claiming to induce sleep by exposing you to specific frequencies via their hardware, stickers that shut your mouth to stop you from snoring, huggable sleep robots, etc. I might be being reductive, but if it looks doubtful, it probably is.

The gold standard of sleep testing is polysomnography, which involves you sleeping in a medical facility, hooked up to a scary number of wires. Consumer products tend to be lighter and more seamlessly integrated into your routine but that does, of course, mean that most will sacrifice some of their accuracy. This is not necessarily a problem as long as a certain level is met — it always helps to check the evidence behind your chosen solution.

My favourites

I’ve thought about the ones that after analysing a large number, above all, I would recommend to anyone. My suggestions are below — they all address different issues but have adopted incredibly creative approaches to the prevention, diagnosis and management of sleeping disorders.

  • LYS — a small light-tracking wearable and an app that continuously monitors and assesses a user’s daily light intake. Based on this information, LYS is able to understand the person’s chronotype and light patterns to produce an individualised report and behavioural change advice.

LYS wearable light tracker.

The first thing that comes to attention with LYS is their approach. While most solutions focus on sleep, LYS takes a step back and asks us to think more about the rest of our day. As how we feel is largely influenced by our light intake (e.g. we feel groggy in office environments because they tend to be too dark), it makes a lot of sense to use technology as a way to become aware of our surroundings.

  • Ectosense — a reusable ring for the diagnosis of sleep apnea at home. Night Owl, the company’s first product, is a medical-grade device: performing rigorous clinical studies, publishing papers in prestigious journals and embedding itself within clinical pathways.

Ectosense sleep apnea wearable.

As briefly mentioned, traditional testing is difficult and depending on where you live, can also be expensive. Night Owl is a great solution to that problem, allowing you to be tested for sleep apnea in the comfort of your home with only a small ring on while you sleep.

  • Timeshifter — an app that helps travellers to apply a ‘practicality filter’ to their journeys. Recognising that most travellers are not able to immediately go to sleep upon arrival as most jet lag advice recommends, the filter uses small and easy-to-implement behavioural changes (such as exposing yourself to light or eating immediately upon arrival) to nudge your circadian rhythms in the desired direction and avoid serious jet lag.

Timeshifter’s app interface.

It is personalised, clever and solves a big problem that many would feel at least at some point in their lives, especially if you travel for work. You can even start adjusting your body to a new time zone before you fly — what is there not to like?

  • Circadia — a connected suite of products for the tracking, analysis and improvement of sleep. The contactless respiration and heart rate sensor is Circadia’s newest product, acting as a clinically-validated, self-assessment tool for various sleeping patterns and disorders. The sensor is complemented by an app which offers users a personalised insight report and coaching, and a lamp that emits red or blue light depending on whether the user needs to stay awake or fall asleep.

Circadia Sensor. Currently available by invitation only.

For me, the best thing is that each of Circadia’s products reinforces the other and provides a much more seamless experience for the user than the majority of other devices on the market.

Conclusion

What excites me the most about sleep tech is how much of a nascent market it still is, where a lot is changing as I write. As with any market, it is difficult to predict exactly where it will go, but with any luck, the next few years will see companies addressing an ever more diverse range of sleep issues, clinical validation as a common standard and more widespread adoption of sleep technologies in general.

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