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mccoy

<15% REM sleep increases HR significantly

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From Al Pater's posts, a study correlating duration of REM sleep and all cause mortality HRatios. A low duration of REM sleep seems to increase all cause mortality, if no reverse causation is present.

This may be a good argument against the chronic, non-therapeutical use of Marijuana, which is known as a potent suppressive agent of REM sleep. The association is not strong by medical standards (strong from HR =2 upward).

 

Quote

Association of Rapid Eye Movement Sleep With Mortality in Middle-aged and Older Adults.
Leary EB, Watson KT, Ancoli-Israel S, Redline S, Yaffe K, Ravelo LA, Peppard PE, Zou J, Goodman SN, Mignot E, Stone KL.
JAMA Neurol. 2020 Jul 6. doi: 10.1001/jamaneurol.2020.2108. Online ahead of print.
PMID: 32628261
Abstract
Importance: Rapid eye movement (REM) sleep has been linked with health outcomes, but little is known about the relationship between REM sleep and mortality.
Objective: To investigate whether REM sleep is associated with greater risk of mortality in 2 independent cohorts and to explore whether another sleep stage could be driving the findings.
Design, setting, and participants: This multicenter population-based cross-sectional study used data from the Outcomes of Sleep Disorders in Older Men (MrOS) Sleep Study and Wisconsin Sleep Cohort (WSC). MrOS participants were recruited from December 2003 to March 2005, and WSC began in 1988. MrOS and WSC participants who had REM sleep and mortality data were included. Analysis began May 2018 and ended December 2019.
Main outcomes and measures: All-cause and cause-specific mortality confirmed with death certificates.
Results: The MrOS cohort included 2675 individuals (2675 men [100%]; mean [SD] age, 76.3 [5.5] years) and was followed up for a median (interquartile range) of 12.1 (7.8-13.2) years. The WSC cohort included 1386 individuals (753 men [54.3%]; mean [SD] age, 51.5 [8.5] years) and was followed up for a median (interquartile range) of 20.8 (17.9-22.4) years. MrOS participants had a 13% higher mortality rate for every 5% reduction in REM sleep (percentage REM sleep SD = 6.6%) after adjusting for multiple demographic, sleep, and health covariates (age-adjusted hazard ratio, 1.12; fully adjusted hazard ratio, 1.13; 95% CI, 1.08-1.19). Results were similar for cardiovascular and other causes of death. Possible threshold effects were seen on the Kaplan-Meier curves, particularly for cancer; individuals with less than 15% REM sleep had a higher mortality rate compared with individuals with 15% or more for each mortality outcome with odds ratios ranging from 1.20 to 1.35. Findings were replicated in the WSC cohort despite younger age, inclusion of women, and longer follow-up (hazard ratio, 1.13; 95% CI, 1.08-1.19). A random forest model identified REM sleep as the most important sleep stage associated with survival.
Conclusions and relevance: Decreased percentage REM sleep was associated with greater risk of all-cause, cardiovascular, and other noncancer-related mortality in 2 independent cohorts.

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Edited by mccoy

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On 7/16/2020 at 8:32 AM, mccoy said:

This may be a good argument against the chronic, non-therapeutical use of Marijuana, which is known as a potent suppressive agent of REM sleep

Just to note that while when sleeping with pot I am not aware of dreaming, Fitbit registers REM sleep.

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1 hour ago, Ron Put said:

Just to note that while when sleeping with pot I am not aware of dreaming, Fitbit registers REM sleep.

How much REM sleep? And in what degree is Fitbit reliable as an hypnogram? 

Maybe I would trust more the DREEM device for these hypnograms.

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23 hours ago, InquilineKea said:

REM more than deep sleep?

Probably (surely) both are vital and the lack of both contributes to undermining health and longevity.

Maybe for elders deep sleep is more important, since its duration shortens with age.

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On 7/18/2020 at 3:41 PM, mccoy said:

How much REM sleep? And in what degree is Fitbit reliable as an hypnogram? 

Maybe I would trust more the DREEM device for these hypnograms.

Fitbit is generally considered to be pretty accurate.  I just did a quick search and I found this:

A validation study of Fitbit Charge 2™ compared with polysomnography in adults

I personally have stopped pot and am dreaming fine now, or at least remembering my dreams 🙂

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From the article, Fitbit would seem good if you don't desire a reliable hypnogram (intervals and durations of all sleep phases). Especially good for actual sleep duration.

Edited by mccoy

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It does give a decent approximation of sleep stages though, which is better than nothing and useful to make long-run estimates.

I've also noticed that the score it assigns to how restful sleep was during the night, generally correlates with how I feel during the day.

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Fitbit, over DREEM, has also probably the advantage of price and wearability. The DREEM cask runs at 400 US$ and must be worn on the head while sleeping. It is surely more accurate, but at a substantial price. So it really depends on how much accuracy you require in sleep tracking.

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9 hours ago, mccoy said:

The DREEM cask ... must be worn on the head while sleeping.

It will certainly put a damper on one's love life 😄

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I exaggerated, it's more like a soft, convoluted headband, but some people are not able to sleep with it

 

image.png.3afe8fa6b1bc35e8b472dbe238e81301.png

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Yes, it has been tested for accuracy. You can find the relevant research papers on their website. And it is now an approved medical device -- even in the U.S.

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Hm, I did a search and look what popped up:

This Smart Headband Was Supposed To Help Me Sleep Better, But Fuck I'm Tired

The Dreem claims it improves sleep—it even says it has clinical studies, but as Julie Kientz, an Associate Professor in the department of Human Centered Design & Engineering at the University of Washington, noted, those studies aren’t actually published anywhere. “While it’s great that Dreem has spent significant effort focusing on comfort, it’s hard to know whether it’s accurate without evidence from a peer-reviewed clinical trial,” she told Gizmodo.

I am not picking an argument here, I was genuinely curious.

Edited by Ron Put

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It is reasonable to do a search and find a Feb 2018 commentary, but why not at least look at the DREEM website for scientific references?

The Dreem 2 is an FDA Registered Class II device. For clinical validation, they claim "Extensive trials and 15 peer-reviewed articles and publications in leading journals."

 

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Ron, the DREEM sites provides a very favourable comparison with PSG and other references like Todd says, but you can always read some independent reviews like the following.

https://sleepgadgets.io/dreem-2-headband-review/

 

The favourable reports from the site can also be always challenged by consumers association and if too far from reality, fraud may be invoked. A possibility, but the company seems to be serious. The report seems maybe too good, but that's what I would expect from an hi-tech, 400 US$ piece of electronics.

image.png.b5117911868d9c4aeb545905512f49a6.png

 

 

 

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10 hours ago, mccoy said:

Ron, the DREEM sites provides a very favourable comparison with PSG and other references like Todd says

I did a bit of research on this. I'd buy a product like this if I am convinced that it has value, but I am not convinced about DREEM.  My problem is that virtually all of the information is provided or generated by DREEM.  Virtually all the positive reviews are also on small blogs which can be easily influenced by advertising click or rewards, or even by a free product.  Many appear to review only obscure products and don't feature the bigger brands in this space, which makes me suspect that they review only "free" samples provided by the manufacturers.

Be that as it may.  I saw a DREEM statement that their algorithm is based on data collected by (5) five doctors.  While the EEG sensors are great to have, the devil, IMO, is in the algorithm and I am not convinced, based on what I read so far, that it is up to snuff. Some of the reviews indicate that DREEM's marketing is aggressive in asking for good reviews.   I also see comments complaining that DREEM detects watching TV as "light sleep."

This is similar to what I experienced occasionally with Fitbit when I switched to their platform two years ago (I've used various trackers for about a decade or more now), but their algorithm has significantly improved since, and nowadays it's actually pretty spot-on as far as duration goes, which is all I can really tell.  I'd assume that their algorithms for determining sleep stages has also improved since the 2018 study I posted above.  BTW, Withings is also certified (their new version is certified only in Europe, not in the US, which seems to have a bit more onerous standards).

If someone is curious, here is some of the data Fitbit provides:
372616124_ScreenShot2020-07-25at08_43_15.png.eadd042a9ce352ed776b6bfa40e58da9.png
 

Screenshot_2020-07-25-08-47-01-249_com.fitbit.FitbitMobile.thumb.jpg.8b81e165be905f0779b57060795d1b6e.jpg

Screenshot_2020-07-25-08-47-22-021_com.fitbit.FitbitMobile.jpg.187b441c4874767c9bd2b6f3c24c62a6.jpg

 

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Ron, yours are all legitimate observation, but after having visited the Fitbit site, I remain doubtful about the real accuracy of this device, since the parameters it collects would not seem to be able to yield a precise report on sleep. The sentence I marked in bold makes me a little skeptical. Of course, the prices I saw are less than half the DREEM band. My impression is that Fitbit has borne as a fitness tracking device and has been adapted to sleep, whereas DREEM was designed for sleep only. Probably there is no comparison about accuracy.

Another advertised sleep tracking device is the OURA ring (Dr Peter Attia has a share in it), but I just saw it comes at 424US$.

Quote

Track your sleep in the Fitbit app to better understand your sleep patterns and quality.

OpenHow does my Fitbit device automatically detect sleep?

All wrist-based Fitbit devices automatically detect your sleep when you wear your device to bed. We recommend wearing your device in a snug wristband while sleeping; don’t wear your device in a clip or pendant accessory.

When your body is completely at rest and you haven’t moved for about an hour, your Fitbit device records that you’re asleep.

OpenWhat sleep information does my Fitbit device track?

If your device doesn’t track heart rate, you see your sleep pattern in the Fitbit app. Your sleep pattern includes your time spent awake, restless, and asleep. Restless sleep indicates that you moved in your sleep, like tossing and turning. If your device detects excessive movement—enough that restful sleep would not be possible—your device records time spent awake.

Fitbit devices that track heart rate (except Charge HR and Surge) also track sleep stages. For more information, see What should I know about Fitbit

 

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Tried it months ago. Useless for me. Used it for thirty days. But I will say this they refunded my money no problems. 

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Mccoy,

Mike's September 14, 2019 post about the DREEM 1 band was

"I tried the 1st one and found it to be totally useless. I returned it after using it for thirty days. I had no problem getting a refund, so Giving it a try makes sense."

He didn't indicate what his expectation was in trying it that was not met.

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12 hours ago, Todd S said:

He didn't indicate what his expectation was in trying it that was not met.

Right, expectations...Once you spend 400 bucks for a gadget, what to expect?

I would expect a reliable hypnogram so that I would know how much total sleep, how much REM sleep and above all how much NREM sleep I experience. Also, how fragmented the sleep is.

Then, I would try and intervene on the issues. In my case, fragmentation is a sure issue, whereas a suspected issue is NREM sleep. Too little of it, would be like a deficiency in some nutrients. The remedies can be found in the literature: sleep earlier, eat less at night, adjust the lighting conditions and so on... But first, it should be clear if there really is an issue and how significant it is.

 

 

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20 hours ago, Todd S said:

Mccoy,

Mike's September 14, 2019 post about the DREEM 1 band was

"I tried the 1st one and found it to be totally useless. I returned it after using it for thirty days. I had no problem getting a refund, so Giving it a try makes sense."

He didn't indicate what his expectation was in trying it that was not met.

My expectations were that it would at the least indicate why my sleep is so fragmented. 4-5 awakening a night. It reported great results. Plenty of deep sleep and rem etc. everything was fine. Well all I can say is it was not fine. I know what good sleep is and I don’t sleep as good as I did most of my life. What I figure is happening is that Fragmented sleep in my case  is a result of the sleep cycle and as we get older the tendency is to wake up at the lighter end stage Of the cycle. The best thing for me has been to Completely ignore all the sleep science/ cognitive behavior sleep restriction bullshit which I tried relentlessly and simply accept the fragmentation. Then practice all the other sleep advice. Then do this:

stay in bed, do not get up as is advised after 20 minutes, stay in bed, learn to meditate and go back to sleep even if it takes an hour. This has worked for me quite well! 

Edited by Mike41

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There is an old thread about DREEM here: 

 

After reading this thread I was super intrigued and wanted to try it, but the price just seemed too much. Then I started reading several books about sleep and that made me want to get a more reliable way to track my sleep, so I dug deep and sprung for a DREEM 2. One thing I wish I had known before I did that is that the DREEM 2 does not have the "auditory closed-loop stimulation" that is intended to produce more deep sleep if you buy it in the US. If you buy it in Europe (and presumably most other places in the world) it does have that functionality. My understanding is that that the research backing up the effectiveness of this technology to produce deep sleep is going to have to be more robust before the FDA approves it, and without FDA approval the US version doesn't include that feature. That was the main feature I was interested in but oh well.

For the most part I don't mind the headset, and I do wear it and sleep fine. I don't have a fitbit so I can't compare it to that, but it is much more accurate than the dumb cheap apps I was trying on my phone.

I want this technology to keep getting better and I've participated in a few surveys, trials and interviews with DREEM. I wasn't sure if I would think it was worth it, but for now I'm glad I have it and I intend to keep using it until something better is available.

In general I get plenty of REM sleep (on the nights when I sleep long enough), and I am a bit troubled by how little deep sleep I get. I'm not sure much can be done about that for now. I also wish I understood the science better on that front because I have a lot of questions based on the reading I've done.

Some sleep researchers created a giant bed swing, basically hanging a bed from the ceiling in the lab. The bed-swing rocked in perfect synch with the deep sleep brain waves and that seemed to produce more deep sleep.

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