The global market for sleeping aids – medicines and medical devices that monitor,diagnose,and treat sleep problems – is projected to reach $168.89 billion within the next decade.
From opium to bromides to barbiturates,sleeping aids have a storied history. Initially marketed as “”,barbiturates sent people to sleep,but were also addictive and easy to overdose on (they were implicated in the deaths of many including Marilyn Monroe,Judy Garland,and Jimi Hendrix).
Later drugs created to help people sleep,like Ambien,which was inspired by the structure of LSD,were considered better at first. That was before labels had to be updated warning about the risk of “preparing and eating food,making phone calls,or having sex”,as well as more serious consequences of depression,suicide and car accidents.
Today,a new class of medications,called are widely believed to be safer and,unlike previous sleeping pills,“”,not by knocking the dancer senseless.
Sleeping pills,however,are only one kind of sleep aid. Most aids are non-pharmaceutical and include supplements,and gadgets that range from wearables to pillows,humidifiers and LED lamps and sleep buds. Sleep tech is becoming fancier. I recently came across the Muse S (second generation) headband which monitors your breath,brain activity and heart rate,provides biofeedback and,based on this,guidance via an app to help you meditate,relax,or fall asleep faster. Meanwhile Apple’s latest watchOS 9 “Sleep experience” feature uses signals from the accelerometer and heart rate sensor to detect time spent in core,REM,or deep sleep stages.
Dr Sumbul Desai,Apple’s vice president of Health,said:“Sleep plays such an essential role in our lives,not only in our health but in our quality of life and ability to take on the day. Tracking is a good start,but the Sleep app goes further... and this year,we wanted to give our users even more information about their sleep through the night with sleep stages.”
The future of aids may take this type of tracking a step further. In his book,Why We Sleep,Berkeley neuroscientist Matthew Walker,anticipates that in the next five years there will be devices that track an individual’s sleep and circadian rhythm with high accuracy. This information will then feed back to in-home network devices like thermostats and lighting to “curate” a tailored sleep environment for each individual.
It’s compelling and often expensive stuff,especially for those who are exhausted and just want a decent night’s sleep. But does any of it really help?
Focusing on some popular,readily available aids,instead of pharmacological ones which require a doctor’s prescription,I asked the experts what they thought.
Wearable technology
Researchers like Sydney University’s Ron Grunstein love sleep gadgets,but that doesn’t mean they think we should use them.
“From a research point of view all the information is great,” says Grunstein. “The problem I have is patients coming in and showing me endless data from their watch. There’s a lot of health anxiety out there – more than when I started practising – and a lot of it is driven by these wearable devices.”
Moira Junge,chief executive of the Sleep Health Foundation,adds that not all the data from wearables is equal. “Sometimes they work off heart-rate variability,which is quite accurate,but sometimes they might be working off this algorithm of what movement constitutes sleep and what movement constitutes being awake and sometimes that can be inaccurate.”
‘Most of the gadgets on the market are not really tested and mostly,they’re not very good.’
Sean Cain,Monash University
Gadgets also rarely address sleep-specific anxieties,overworking tendencies or phone addiction. “They’re still things you need to work on,” Junge says,adding:“It’s helpful if it works for you.”
Being too obsessed with tracking our sleep can also create anxiety,thereby having the opposite of the desired effect:better sleep.
Typically,the evidence is lacking,says Sean Cain,a circadian biologist and Associate Professor of Psychology at Monash University:“Most of the gadgets on the market are not really tested and mostly,they’re not very good.”
Sleep supplements
Melatonin is a hormone that our brain secretes when it gets dark. It helps with the timing of our circadian rhythms and makes us feel sleepy.
It is also a popular over-the-counter sleep supplement,that is often thought of as harmless. Except the experts are unconvinced.
“The data is not great,” says Grunstein. He says most studies into melatonin have been small,poorly designed and funded by companies that make the supplements.
He believes they can be beneficial in the short term for specific issues such as jet lag or for people trying to shift their sleep rhythms back to an earlier time. The impact of long-term use,however,is unknown.
A massive manufacturing hub for medicinal cannabis sleep capsules has been built in Victoria.
As for other popular sleep supplements,like magnesium and valerian,the jury is out.
“People swear magnesium is good for leg cramps and restless legs. We’ve not seen good evidence for that,” Grunstein says. Valerian has got “some mild hypnotic properties” he adds,but,it’s not patentable,so pharmaceutical companies are not interested in funding research.
“There is no substance – food or anything – that we take into our body that only works on one part of our body. We have to weigh up the pros and cons,” says Associate Professor Delwyn Bartlett,a sleep specialist from the Woolcock Institute of Medical Research.
“How many rows and rows are there now of tablets to sort out anything and everything? I find that quite scary. When someone says it will sort out your sleep,I’m not anti a lot of this stuff,but,I just don’t think we really understand a lot of the other things to say ‘this is good this is not good’.”
Other gadgets
Our body needs to drop its core temperature by about 0.5 to 1 degrees Celsius to fall asleep and remain asleep. If we’re too hot,it and rapid eye movement sleep. Setting our room temperature to about 18 degrees Celsius,therefore,is a simple way to help sleep happen.
for people with obstructive sleep and to reduce back and neck pain.
Changing our lightbulbs is another easy solution.
“You wouldn’t have coffee right before bed,but light is like having coffee,” explains Cain. “Those special cells in the eye that send signals to your brain that its daytime,they don’t turn on and off quickly. Once they’re activated,they stay activated for a long time.”
This means that if we go to bed,if we have been sitting in a brightly lit room and then go to bed,our brain is still getting a signal that it’s time to be awake,even though we have switched off the lights:“You might fall asleep,but it won’t be as deep.”
So,Cain uses Lifex bulbs on a timer,so they become dim and orange in the evening.
Poor sleep is often caused by poor light/dark exposure,he explains. This is because bright light in the morning and during the day sets our body’s internal clock for the day and sleep pressure starts building. When we then dim the lights in the evening,our clocks keep their time,and sleep pressure peaks:“Getting good light is so powerful because your body just takes over.”
Sleep take home:Sleep aids can certainly help some people,but they often lack good evidence and sometimes can make sleep problems worse.
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