PHOTO ILLUSTRATION BY MONICA GUAN
If you’re reading this on your phone while you lie awake in bed, you’re likely not alone.
Many of us are stressing, eating, drinking and staring at screens more, and exercising less — all of which can lead to restless nights. In fact, since the pandemic hit, nearly one in five people worldwide have had trouble sleeping. Among healthcare workers, it’s one in three. Sleep problems have become so prevalent that experts have even coined a new term: coronasomnia.
“A major trend that we’ve seen during the COVID-19 pandemic is an increase in reports of insomnia and poor sleep quality in people of all ages,” says Sara Pintwala, an officer with the Canadian Sleep Society, and a PhD candidate studying the sleep disorder narcolepsy at the University of Toronto. “This is really challenging because healthy sleep is more important than ever to build resilience and to cope with the complications of the pandemic.”
As a result, many people are looking for help getting a good night’s sleep, and companies with novel solutions are benefitting from growing investment and rising sales. Retailer Sleep Country recently took a 25-percent stake in Sleepout, a startup that makes portable blackout blinds that can hang just about anywhere. There’s also a growing number of sleep apps and smart beds that can help you doze off and analyze your sleep patterns. Some analysts predict the global sleep technology market could be worth U.S.$40 billion in five years, up from U.S.$12.5 billion in 2020. As these innovations proliferate, they could do more than just improve our sleep — they could boost our health and happiness, too.
“Anything that helps people sleep better is always a good thing, but we do need to make sure that there is good evidence behind these interventions,” Pintwala says.
Lack of sleep doesn’t just make you tired.
“Sleep plays a fundamental role for both mental and physical health,” says Pintwala. “It’s important for emotional regulation, cognition — including memory consolidation — as well as the function of your immune system.”
Chronic sleep deprivation can make you more vulnerable to COVID and lead to a long list of serious health issues including depression, diabetes and high blood pressure. Pintwala calls sleep “one of the three pillars of long-term health,” the other two being nutrition and exercise.
One of the most important things to remember about sleep, Pintwala notes, is that it’s a behaviour. “It’s really easy to think of sleep as something you just snap into when you lie down in bed, but it’s a behaviour and as such, it needs to be trained,” she says..
This is where a sleep coach can come in handy. Interest in this kind of specialized counselling is growing. Like a life or executive coach, a sleep coach can help you understand your challenges and set goals, monitor your progress and keep you accountable. For instance, they may help you develop strategies to slow down your racing thoughts so you can fall asleep, like jotting them down in a journal and reframing them. Or they may help you break your habit of binging on snacks and Netflix before bed and replace it with a healthy bedtime routine like putting down your phone and reading a book.
Last year, the National Research Council announced that it was developing a digital sleep coach for stressed-out front-line healthcare workers. The tool aims to improve their mental health by promoting good sleep and fatigue management.
In November, Toronto-based Precision Nutrition — which usually creates software and training programs for nutrition coaches — launched its Level 1 Sleep, Stress Management, and Recovery Coaching Certification. The online certification program teaches health and fitness professionals about the physiology and psychology of sleep, so they can help clients through face-to-face or virtual coaching sessions. Precision Nutrition also offers a digital coaching platform that enables coaches to connect with clients through instant messaging and online check-ins.
“There’s a very tight relationship between nutrition, movement, sleep, stress management and recovery,” says Timothy Jones, Precision Nutrition’s CEO. “Lack of sleep and stress can drive up cravings big time. When we don’t eat well and when we don’t move a whole lot, it can affect how we sleep.”
While Precision Nutrition was developing the certification prior to the pandemic, Jones says the health crisis has created more demand for the training. In the first month the program was offered, 1,500 people started it. “The pandemic has really turned on a conscious awareness of how much of an impact sleep, stress and recovery have on our lives,” he says.
Toronto-based startup Smart Nora, which makes a digital anti-snoring system, has also seen demand for its product jump during the pandemic — sales were up 20-percent in 2020 over 2019.
Weight gain, drinking, exhaustion and COVID itself all make people more likely to snore, potentially waking up themselves or their partners. When your throat muscles relax, your airway narrows and your tissues can vibrate when you breathe, making the snoring sound. Once stirred, many people have a hard time getting back to sleep because their minds start racing, which can make them even more exhausted and stressed out the next day. “It can become a self-reinforcing downward spiral,” says Smart Nora co-founder and CEO Behrouz Hariri.
Smart Nora’s system has three components: a “pebble” that listens for snoring, a padded insert that goes under your pillow and a silent pump. When Smart Nora detects the early signs of snoring, it inflates the pillow insert. This gentle movement stimulates the users’ throat muscles and opens their airway without waking them up. A study of Smart Nora commissioned by the company found that the device helped snorers have a 20-percent increased ability to sleep through the night while partners had a 31-percent increased ability.
“The partner benefits quite a bit, but the snorer also benefits in terms of quality of sleep because now they’re not getting nudged, they’re not getting grief in the morning,” Hariri says. “And one of the things that really affects the quality of sleep is the stress around sleep itself. Taking that guilt away is very helpful.”
Hariri adds that, unlike other snoring solutions such as mouthguards or chinstraps, the device can also help couples keep the romance alive. “It’s way more attractive to say good night without something in your mouth.”
Sometimes having trouble sleeping is a sign of a serious health problem. About a quarter of Canadians are at high risk of developing sleep apnea, which involves repeatedly stopping breathing while sleeping and can lead to heart disease and stroke. However, the condition is likely underdiagnosed and undertreated, partly because it’s cumbersome to diagnose. The gold-standard test for sleep apnea is polysomnography: you go to a clinic, get hooked up to all kinds of machines and try to have a normal sleep, which isn’t exactly easy. But here, too, the pandemic has changed the game.
Peter Bloch, CEO of Bresotec, a Toronto company that has developed a home-testing system for sleep apnea, says COVID has caused “a massive shift” away from in-clinic testing. According to Bloch, in the U.S., prior to COVID, 30 percent of tests were done at home and 70 percent were done in a clinic. Now it’s 50:50.
“People don’t want to have an uncomfortable night’s sleep in a lab, which is often in a hospital that puts you at risk,” says Bloch, adding that he expects home testing to continue to expand.
Bresotec’s system is designed to be worn when a user goes to bed as usual in their own home. It consists of a sensor that sticks above the sternum to record breathing and body movement and a pulse oximeter that attaches to the finger to measure blood oxygen saturation. The company’s clinical trials found that the system’s results have a 93-percent correlation with polysomnography. In January, it filed for FDA approval and plans to seek Health Canada approval next.
Bloch points out that Bresotec’s system will give sleep doctors more time to focus on treating patients rather than testing them.
“A lot of people are suffering and a lot of people are undiagnosed, and we can reduce stroke and heart disease and heart attack significantly by treating patients,” Bloch says. “We can also help people get a good night’s sleep and feel better during the day.”
Which is something we all need during the pandemic and beyond.
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