Yo-El Ju

So, you know, I encourage my patients or people who, you know, come up and ask me when they say, how do I know if I'm getting good sleep?

And I say, well, if you're, you know,

Waking up in the morning and preferably without an alarm clock and you feel like your sleep was refreshing, you probably had good sleep.

I think that sometimes we lose the ability to sense that and to sense the quality of our sleep if we rely too much on wearables or other ways to measure that.

So, um, I, some have, but I don't know if they revalidate every time they upgrade their algorithms.

Yeah.

And in general, for my research, where we use actigraphs a lot, which are motion sensors, we use research-grade ones that do have concurrent polysomnography or sleep study data.

We generally don't use ones that are available over-the-counter, shall we say, just because we simply do not know whether that algorithm has changed since then.

you know, they gathered the original validation data or if it will change during the study.

So, you know, I think it's great if people use those devices to help be accountable to themselves, you know, to get to bed on time or to, you know, to get up at a regular time.

That's great.

But I think, you know, people should be aware of the limitations of using these devices.

Um, so I, I guess I'll start with melatonin because that one I think is used the most.

Um, there, um,

There is decent data to show, you know, in large meta-analyses, that they do help, and I believe it's in a subset of people, and those are people who have delayed circadian rhythms, meaning they're night owls, who take it a couple hours before their desired bedtime to shift their internal clocks.

It does help them.

There was a meta-analysis for looking at melatonin in insomnia, you know, not related to being a night owl, and it probably doesn't help them very much.

And, you know, I think a problem with a lot of insomnia studies or drugs or things tested for insomnia is that, you

Even compared to other conditions, insomnia is exquisitely sensitive to the placebo effect, meaning even when measured by sleep studies, a gold standard, placebo has an amazing effect.

It's probably responsible for about two-thirds of the effects seen in clinical trials for sleep drugs.