My history with /r/iama: Hello all. Earlier this year I did an AMA, but underestimated the size of response I’d get. Since I still get questions PM’ed to me I am taking a day to respond to questions here so everyone in the community can benefit.

My short bio: I went to med school at Tufts, then did my sleep fellowship at Stanford before creating and accrediting a sleep center in the Bay Area dedicated to making tech professionals more focused and productive.

Then I gave it all up to start PeerWell. PeerWell is dedicated to helping people improve health through community. We take clinically validated medical advice and present it through peer to peer groups that we match based on similarity.

Recently, at PeerWell I have been working with leading experts in psychiatry on a mental health program that improves sleep, focus and mood while helping people control stress and anxiety.

I am here to answer any questions you have about sleep, mental health, med school, starting a clinic, being a doctor in California, starting a company and everything in-between!

Also, if you'd like to be a part of a pilot we are running on the PeerWell system please click here

If you'd like to participate and are a veteran please click here

I can give general information on medical conditions here but I can't give specific medical advice or make a diagnosis.

My Proof: Twitter

Update: This was a blast, but unfortunately I have to go. Big thanks to everyone who asked questions and to the mods! Please vote on what unanswered questions you'd like to see me address and I will do so in a blog post. Also I'd love to see you in one of our pilots so please click to participate!

Comments: 2554 • Responses: 70  • Date: 

Mutt1223702 karma

Please tell us more about this "exploding head syndrome"? I find it difficult to believe people could experience this more than once.

alienwell939 karma

Sure, it isn't that common, but it can be life changing. I had a patient who had a prestigious job and all of a sudden one night, right as she was falling asleep, heard a loud bang. She was pretty sure it was inside her head. She panicked because she was sure it was a brain aneurysm and rushed to the hospital. The hospital did a CT scan and other test, all normal. She went to sleep the next night and it happened again. And then every night for a month. While there was no pain, she was so anxious she hardly slept. And quit her job. That was my first patient with exploding head syndrome. BTW: they definitely need a better name for this!

AverageFatGuy432 karma

I think my wife may have this. A few times a month, just after falling asleep, she will wake up in a panic and make me get up and check that someone isn't trying to kick the front door in. She says she hears a single loud bang. Takes me a while to convince her that there was no sound.

Audreyu240 karma

That's definitely what that is! It's usually right when you're about to slip all the way into sleep. Mine always sound like extremely loud electrical zaps. It's extremely disorienting and if you don't know what it is it can cause a lot of anxiety. I've been getting them since I was around 12, when I started puberty. Tell her what it is but make sure you assure her that it does not physically damage you in any way!

vincentkahrune85 karma

Yes, i hear this all the time! Sometimes the zapping noise sounds like tv static, with a burst of light, but mostly it sounds like a zap or a popping kind of noise. Sometimes it takes a very long time to fall back asleep because my heart is pumping a million beats per minute.

alienwell154 karma

Interesting, there are quite a few people with zapping going on at sleep onset. This is a rare group. Someone should make a forum for this...

PacManDreaming36 karma

I find it difficult to believe people could experience this more than once.

I typically experience it two or three times a month. And it's been that way for over 30 years.

It's also usually the same sounds, but I had a new one get added earlier this month. It's usually someone yelling my name, screaming loudly or a car door or trunk lid slamming shut. For the first time ever, I heard someone snapping a large rubber band across my forehead.

EHS is usually more irritating than anything else. It just wakes me up. Of course, the chronic insomnia keeps me up. And I don't get sleep paralysis as often as I did in my teens and twenties, which is a plus.

Neurological sleep disorders run in my family. Chronic insomnia being the common one. I'm the only one that gets sleep paralysis.

ethanolin72 karma

I believe he was making a joke, saying that if your head explodes, you would not be alive afterwards to experience another one.

alienwell23 karma

exploding head syndrome is some name, huh!

lockd0wn289 karma

I learned that some Buddhist monks sleep in a sitting position. How would this affect a person long term?

alienwell455 karma

That's pretty cool, I didn't know that. So I'm sure they are fine with it (I assume they've been doing this for thousands of years). But I'd be curious about their sleep quality. I'd want to wire them to sleep monitoring equipment to see if they get the usual stages of sleep in the usual architecture. If the quality is good, then I'd want to ensure their neck position is usually straight, and then I'd want to see if they have any lower back issues (like disc displacement, etc.). Cool question...

ambidancerous421170 karma

I've done several short (10 day) meditation courses. And have always felt like some states of meditation were just as restful as a full nights sleep to the point where I'm usually only sleeping every other night when I do a course. I'd love to see more research into this to see how much similarity there really is.

alienwell180 karma

I studied a monk once, and asked for him to mediate at the start of the sleep study. I was excited because I had EEG electrodes on him. When he was meditating, I saw EEGs consistent with eyes closed and awake. It was pretty cool.

xsladex243 karma

Hi there, I was a long time sufferer of sleep apnea. After learning how to circular breath on a didgeridoo, I can whole heartedly tell you that I don't suffer anymore.

If I stop playing for over a month it tends to come back. Never quite as bad as I once had it though.

My question to you is, have you heard of this before? If so do you recommend it to people whom you've met with?

For me it's truly life saving and so much better than wearing a mask. I tell people about it and I think they get the impression I'm either lying or weird. I don't care to be honest because it's night and day for me.

alienwell51 karma

I am not sure if answered this here or in another place. The BMJ did an article on this. They found around a 6 AHI reduction with frequent use. The scientific method would be to try it out (while still on conventional treatment) and get retested. Here is the link:

alienwell33 karma

There was a BMJ article about didgeridoo. Here it is:

grinr242 karma

I've been using a color temperature program F.lux that changes the tone of my screen(s) over the course of the day which purports to help with sleep by modeling appropriately colored light.

Is this hogwash? It does seem to work for me, but I've been thinking placebo effect. How does light affect sleep?

alienwell322 karma

I use it too. I kick myself for not inventing it. It's awesome.

__dilligaf__226 karma

What causes (and what cures) Restless Leg Syndrome? If I take an extra sleeping pill my legs get jumpy. My SO think it's in my head, and I'm not 100% sure he's wrong. It seems too trivial and infrequent a thing to take to the DR, but it sure is annoying when it happens.

*Edit - Thanks for all the suggestions. I will definitely try them. It's a hard thing to explain to someone who hasn't experienced it.

alienwell312 karma

Hey, this is a really good question. So for full disclosure: I was on the advisory group for a few drugs for restless legs (RLS) because I write books on it. So I won't mention any drugs. RLS is pretty common, and for a long time people didn't believe it was a real condition. After all, imagine someone saying "my legs feel bad" but they're fine during the day. I once followed a famous neurologist in school who only recently believed it was a real condition too. But back to your q. RLS can be made worse with certain drugs, and any drug that makes you sleepy can make it worse. Definitely go and talk to your doctor. To my patients, I often ask them to try massage for a while. Massage your legs at bedtime. That often helps, and it's nice because you can potentially feel better without medications. Good luck, and feel better!

myjenaissance14 karma

When I was a teen I would also get it in my arms. I remember being in biology class and feeling like my arms wanted to run away from me. I couldn't get the feeling to go away - I tried shaking my arms and waving them about. It eventually went away on it's own. I still get it from time to time, but nothing like when I was younger. It was bizarre to say the least and I got very strange looks from my parents when I explained the sensation. I'm glad the syndrome in legs has been given a name, though I never hear about it being in arms as well.

alienwell9 karma

20% of RLS occur in arms too. Good point!

something_amusing214 karma

Is it normal to go for months or even years at a time without remembering a single dream? Every night I go to sleep, then I just wake up. Nothing in between. I'm sure I dream, because it is my understanding that everyone does. But there is absolutely nothing when I wake up. Not even a wisp of something that slips away. Just nothing. I've tried different techniques to help remember dreams, but I've never even gotten so much as a hint of anything I've dreamed about. Then once every year or two I'll wake up and remember a vivid dream.

alienwell157 karma

Sorry to hear that. The answer is: depends. That's because some people don't remember their dreams, and that's fine. But other people don't remember their dreams because they have a sleep condition (sometimes apnea). This either disrupts their REM sleep and they can't remember their dreams or it disrupts their sleep so much they have very vivid dreams. I'd first make sure you don't have any other sleep condition. Good luck!

b1khoa111 karma

What is your favourite sleeping position?

Sometime at night I can't sleep because of constant conversation in my mind.

How can I get rid of the conversation?

alienwell210 karma

Hi, I'm not sure a sleeping position can help with that, but having racing thoughts before bed is pretty common. And counting sheep usually doesn't work for that. Instead, it's good to do something just a little engaging and distracting. This can be different for different people. Some people listen to music, look at photos, do breathing exercises, or read a book they like (and have read many times). This allows the brain to focus on one thing, and makes you sleepy. The problem with doing something super boring is that it's not really relaxing or distracting. For example: If you are counting sheep, you're hardly using any brain bandwidth. And your mind is free to roam wildly. So it's good to stick with something like breathing exercises. Good luck!

cuporphyry87 karma

Could you talk a little bit about sexsomnia? How common is this? What are the causes? Are there any treatments?

alienwell93 karma

So you can do almost any activity during sleep. It's important to find out whether it is in the first or second half of the night, and whether the person remembers it the next day. But often it is in the first half, not remembered, and a part of slow wave or delta sleep. In other words, it's a parasomnia, much like sleep walking or sleep talking. It can be treated, but usually you need a sleep doc to help. In general the goal of treatment is to make slow wave sleep as consistent and undisturbed as possible. Less disturbances mean less partial arousals of the brain during sleep. This can be done with sleep hygeine, or sometimes, with drugs. So the good news is that it is treatable, but likely the person will need a doctor's help. Most likely a specialist.

aurthurallan82 karma

What's your opinion on pillows that position a sleeper's head and neck to open the airway?

alienwell83 karma

Hi, good question! I think they can help, but only in very specific cases. There are specific cases of snoring or apnea where it is worse if someone sleeps on their back. Having a device that positions them away from the back can help (but may not eliminate it). Thanks!

ykelle73 karma

I'm a nurse who works morning and night shifts. After weeks or months of night shifts, it's really hard for me to get back my normal sleeping cycle, which is sleep during the night and awake during the day. Are there any non pharmacological way to reset your circadian rhythm?

alienwell128 karma

Hi, sorry to hear about the rough shifts. This is really common in nurses. Besides drugs, the solution is changing the environment. Blackout blinds, ear plugs, phone turned off pre sleep. Post wake you need very bright lights. Not quite as strong as meds, but this works pretty well for my nurse patients in the past. Another option, is after your last night shift of the week, either stay awake until night (very effective but very difficult) or take just a 1 hour nap. The goal is to maximize your sleep drive for your first off-day. That increases your sleep drive more than usual to help fall asleep at night. Good luck!

boomfarmer71 karma

Is it normal to wake up in the morning with the feeling of firm pressure in one ear, accompanied by what feels like warm breath and a gentle rumbling? I'm not sure if this is some weird sleep disorder or my neighbor's cat.

alienwell105 karma

I think your neighbor's cat is breaking into your house!

HairBrian66 karma

I have a problem of sleeping all day and night if I don't have stimulants. I always run out and my Doctor never prescribes more. Is it unhealthy for me to sleep 22 hrs a day for a week or so each month?

alienwell101 karma

Hi, I'm sorry to hear you're suffering. This is a difficult problem. You definitely shouldn't be so sleepy, because it means you're missing out on the day. But the good news is that it's often treatable. I'd first try to find out why you're sleepy. If it is a endocrine issue, a sleep issue, or a pain med issue, treating it at the source can often help. The stimulants certainly help, but as you are realizing, they are difficult to manage since they run out, and they are very controlled. While there are a truely tiny percentage of people who simply need more hours of sleep, usually when someone is this sleepy, it deserves a closer look by specialists. Good luck, and I hope you feel better!

senorbroccoli57 karma

What is your opinion of this device being crowd funded in indiegogo, the Airing? Seems like a dream come true for me but interested in a professionals opinion on this.

Link for reference:

alienwell53 karma

It's in interesting concept, and the mock ups look beautiful. Most important to me is that they have doctors from good hospitals. Hopefully they can get it approved with a 510(k) but it is pretty unique. It'd be great if it works!

Cheapo_Sam56 karma

Can you induce sleep paralysis in a lab environment? Is it genetic or can anyone be affected by it? Also when I was younger my brother used to talk in his sleep, but like really really fucking fast, it was not gobbledigook but actual words.. I'm sure he would love it if you could put a name to it..

alienwell53 karma

Sleep talking really fast is interesting, but there isn't a special name on that (other than sleep talking). Sleep paralysis is tough because someone who has it frequently may not have it the night of the test. The sleep test would look for other things that can increase sleep paralysis so doctors can treat the root cause. Thanks!

sulukipedia55 karma

Hi and thanks for being here.

So ever since I've known myself, I cannot wake up, by myself, without the help of someone. And I mean I set 3-4-5 alarms, and yet cannot wake up unless someone calls me and makes me talk and assures I'm out of bed, walking around. I realize I'm turning off the alarms, without even remembering doing so.

I've been referred to a sleep clinic but the waiting period is over a year and it's really effecting my life, as well as others around me. (I live alone and have a 9-5 job, someone always has to wake me up, otherwise I'll wake up midday)

There are times I'm called hundreds of times (literally) and I cannot hear the phone and just keep sleeping.

There are times I am awaken by someone and I realize my bladder is about to explode, because I couldn't wake up to use the washroom. I cannot even wake up to my own pain.

What can this possibly be? Going on for over 20 years, never changing?

Thank you!

alienwell43 karma

Hi sorry to hear you're having such difficulty waking. The problem is that there is a global shortage of sleep docs. A year waiting list is rough, I'd also call all the others you can reach. Tell them to put you on a waiting list too, so if someone cancels, they call you asap. It could be dsps, narcolepsy, or something else. It's hard to fix without knowing what we're dealing with. Good luck!

crescin54 karma

1.Narcolepsy is usually portrayed as something funny in movies/TV etc. but I imagine it can be pretty horrible in real life.Do you have any thoughts on this?

2.Have you ever met anyone who slept with their eyes open?

alienwell77 karma

People with narcolepsy have much of their lives affected by it. Most of my narcolepsy patients had a good sense of humor about it, though.

I knew someone who slept with her eyes partially open. They often don't know until someone tells them.

fishchilibob44 karma

What percentage of your patients are on antidepressants? Insomnia is a common side effect of these meds.

alienwell80 karma

It's a tough situation, because both depression and antidepressants can worsen insomnia. The good part is that both can be improved by CBT (cognitive behavioral therapy).

COTAnerd29 karma

Hi! Sorry if this has been asked before; the previous one had a lot of comments and I didn't sift through them all.

What causes chronic recurring nightmares? As in nightly, terrifying, but a cycle of the same nightmares over and over.

All through my childhood and teenage years I suffered from a minimum of 12 (I feel like I've forgotten some) recurring nightmares that I experienced almost nightly. If it wasn't a recurring nightmare, it was one-off nightmare. Since moving out of home into a far less stressful environment, the nightmares stopped within a matter of months.

alienwell74 karma

Good question. Nightmares often repeat, and it's common to go to sleep fearing a nightmare, and it feels like a self-fulfilling prophecy. One technique is to slowly reduce the fear of it. For example: if you have a dream that someone is chasing you, when you wake up with a racing heart, continue to think of the dream. You think of that person chasing you handing your wallet back to you. Or handing you a trophy. Basically you re-write the dream while awake into a good story. But you have to make the good part very vivid. Over time the fear of the dream reduces. Having a calm environment before sleep helps too. But if someone has PTSD from a traumatic event, they'd need a professional to walk them through it. Good luck!

vman440228 karma

Do you have any recommendations for trying to sleep while your mind is racing? I'll lay in bed for hours with my mind going a million different directions.

alienwell30 karma

Good question! I think some sleep hygiene could help you. Take a look at my answer above where I talked about the things that can help slow a racing mind. Good luck!

GoldStubb28 karma

I have what my doctors consider severe apnea. I wake 250+ times an hour. My cpap is great and all, but I still am not feeling 100% rested most of the time. Would surgery benefit? Heard success rates on surgery are only about 50%

alienwell33 karma

An AHI of 250+ is severe (in fact anything over 30 is severe). I've had severe apnea patients who after wearing CPAP don't feel fully rested. I want to make sure they don't have other things (pain meds, endocrine issues, other sleep issues) going on. Surgery is worth exploring via an ENT surgeon. In come cases even if the surgery doesn't cure, it helps enough where CPAP pressures can be lowered. A good surgeon will check to see if the anatomy is a goof fit for surgery. Good luck!

papipapichulo28 karma

What are sure fire ways that can help reduce loud snoring? My "partner" snores like crazy?

alienwell36 karma

Good question! Make sure your "partner" :) doesn't hold their breath during their sleep or is overweight. Because that could mean they have apnea, and a doctor is needed to fix that. But, if it is only snoring, then your "partner" can try sleeping on their side. That can help. Good luck!

papipapichulo27 karma

Is there any way go fix apnea without having to wear that freakin mask. I, "my partner" doesn't want to look like bane while he's sleeping

alienwell26 karma

Good question! Apnea is fixable without the mask, but it's important to be careful since these other options don't always work. There are certain surgeries done by an ENT surgeon that work, but not for all types of apneas. Also, for more mild cases of apnea, a dentist can make an oral appliance that can help. The good news is that there are a few new technologies being researched to treat it too. Good luck!

PadreMigliaccio27 karma

I occasionally compete in long-distance endurance events that keep me awake for ~48-60 hours at a time. Assuming my sleeping and sleep schedule are both normal (~8 hours a night, 7 days a week) otherwise, should I expect any cognitive or neurological problems down the road? Thanks.

alienwell29 karma

If there were long term consequences of staying up for long periods of time, most doctors / residents would be in trouble! But yes, 48-60 hours straight is a very long time to go without sleep, it's something the brain isn't made for. The closest thing studied is the effect of shift workers and how their sleep was effected even after the retired. The consequences were that they'd have some difficulty falling asleep for a few years. You'd want to have really good sleep before the event and get extra sleep just the night before to minimize sleep debt before the race. Good luck!

flyingviolin24 karma

I wake up about 4-5 times a night and when I wake up, I absolutely have to get up and go to the bathroom. It doesn't bother me too much, and I usually fall asleep again pretty quickly. Is this a physical need, or have I "trained" my mind that I have to go to the bathroom before I can go to sleep again?

alienwell30 karma

Good question. It depends. I've seen some people do this because they drink too much before bed. Often I see people do this because they have apnea and don't realize it (and sometimes don't even snore). Apnea causes people to wake from their sleep frequently and the frequent arousals cause the body to make more urine than usual, causing frequent bathroom breaks. I'd first rule out apnea, then see what happens. Good luck!

plus21 karma

I was recently diagnosed with idiopathic hypersomnolence, and it's still unclear to me whether that is an actual diagnosis or my doctor not being able to figure out why I am always so tired (I did not enter REM during the daytime sleepiness test). Is there any physiological or neurological basis for the diagnosis of idiopathic hypersomnolence, like there is for narcolepsy? Are there any medically accepted treatments for it besides stimulants (which mask the daytime symptoms but not the excessive sleepiness at night)?

alienwell17 karma

Idiopathic hypersomnia is a tough diagnosis. It's true. When there is significant sleepiness with no other known cause, that's the diagnosis. The typical treatment is similar to narcolepsy. But with my patients I look under every rock to find a cause before I diagnosis it. Good luck!

Indydegrees221 karma

I'm a university student, so as you can imagine, sleep is often neglected.
My question is what is the fastest way to fall asleep?

alienwell47 karma

So I was helping firefighters with the same issue, because they are usually wired after a call, and then they can't get back to sleep. The fastest way to sleep is by changing what you do 1-2 hours before bed. Reduce the volume of all speakers /headphones. Dim any screens. Even change music to something more relaxing if possible. Doing this a few hours before bed gives your brain a signal to sleep faster and deeper. It doesn't work on the first day, but after a week or two, sleep will gradually improve. Good luck with school!

Securus77720 karma

I use an app called "Sleep As Android" to not only track my sleeping pattern but mostly to take advantage of the "Smart Alarm" that is suppose to track my movement, and based on my level of movement determine I am out of REM and in a lighter stage of sleep, and then wake me up. It seems to help quite a bit but I was interested in your scientific experience. Does this sound viable? Does waking during non REM or deep sleep make a difference in sleep quality and alertness during initial waking?

alienwell18 karma

Good question. There are two ways to address this. You can have something that wakes you up if you happen to wake near the time of your alarm. That sounds like what your app does. Another way to address it is by waking at the same time every day. More painful in the beginning, but over time you brain automatically adapts. It's like moving to a new time zone. The goal is the same though. Waking up and getting out of bed at the end (not middle) of a sleep cycle helps you feel fresher upon awakening. Good luck!

MikeMo24318 karma

Do people ever go to for frequent cases of sleep paralysis? Also, do you lucid dream?

alienwell16 karma

Do you mean go to the doctor for sleep paralysis? Yes, they do, especially if it is frequent. It's often scary for people during the event, they sometimes think they're going to stop breathing. Sleep deprivation and irregular sleep worsen it. Lucid dreaming is possible. I think I've had it before.

Slaytounge17 karma

I've ben experiencing exploding head syndrome for a couple years now, started when I was probably 20 years old. What all do we know about it? Also, when I'm lying down ready to go to bed sometimes it will happen right when I'm drifting off and it will jolt me awake but other times I can feel a pressure starting in my ears and if I concentrate I can "release" it and I'll get the typical loud noise and bright flash. What do you think is happening here?

I'm not trying to ask for specific medical advice...sort of. Just there is such little information I can find and I'm wondering if you know any more about it, just curious what this might mean generally as a condition.

alienwell27 karma

I'm sorry that you're suffering. I hope you get better soon. I usually recommend a sleep evaluation. Exploding head syndrome is related to hypnic jerks, which describe an even at sleep onset. This means that during the transition from wake to sleep, there is a transient instability in the brain. I'd read up on hypnic jerks. I listed some ways to treat it (take a look at above if you have time). Good luck!

mc_ribbon316 karma

What is your opinion on sleep trackers? (Fitbit, Garmin, Jawbone ect) Do you think they are accurate?

alienwell7 karma

Some of these companies didn't benefit from a sleep doc so they mainly use actigraphy. Check out my wish list on a prior post to add real sleep tracking!

Not_a_tasty_fish15 karma

Why do people even need to sleep? What evolutionary purpose does this serve?

alienwell34 karma

There are certain things that happen during sleep, such as consolidation of memories and skills learned. During sleep the brain is being restructured and reorganized. This is part of one theory: brain plasticity.

Stinkysnarly14 karma

I have very vivid dreams and remember them in the morning. At least half of my dreams are practicing an activity (like the steps of sewing a dress I've planned to make). I do the same steps over and over. Even if I wake, I'll go back to sleep and continue. Sometimes it makes me feel like I have had a crappy sleep and sometimes I feel fine. Are these dreams common? Is there any research about whether this dream practice helps you to complete those tasks in real life?

alienwell16 karma

Good question, thanks! These kinds of dreams are common, especially if you are preparing to do something important to you. As long as the dreams are not disruptive (wake you from sleep, or prevent you from falling back asleep) they are not going to cause problems. Good luck with the dress!

TurdKennedyJrIII12 karma


alienwell18 karma

Hi, sorry to hear of your suffering, I hope you feel better soon! There is definitely a better method. I'd recommend you see a doctor, esp a sleep doctor if one is nearby. They're likely to get you started on some CBT. CBT is useful for anxiety and sleep. I'd love for the root cause to be fixed so you don't need the alcohol and pills. Good luck!

Cataclysma10 karma

What are the optimal time blocks of sleep to ensure you feel the best when you wake up? I've heard various answers from a few different sources but I usually aim for 8 hours sleep, and then if not I've heard 4 hours is also an acceptable amount.

Also, is it true that if I were to sleep for longer than the optimal amount (e.g 10 hours if 8 was optimal), then that 2 hours extra sleep would actually make me feel worse?

alienwell15 karma

Good question, I'm asked this all the time. So unless someone is an extreme night owl or morning person, the goal is to sleep / wake at the same time everyday. Over time, for 98% of people, the brain adapts to use that time to sleep deeply. The opposite is jet lag, because even if you get 8 hours in a different time zone, you'll be really tired. I usually recommend an experiment of 2 weeks of testing a time / duration of sleep. Don't try things one day this, and another day that because the brain doesn't get a chance to adapt. Hope this helps!

ParadoxAssault9 karma

I find it very hard to stay asleep. I wake up rather easily and feel tired during the day. Do you have any tips that i can impliment now to assist with me having a full nights sleep without medication? Thanks.

alienwell12 karma

Good question, and I like you're trying to solve the problem before considering meds. That's great! My general advice is this: Sleep hygiene is worth trying out for a week or two. Most people think that it's just to help fall asleep, but it also effects the middle of sleep as well. The goal is to do sleep hygiene so that the slow wave sleep is maximized. This is the kind of sleep kids have where you can lift them up, put them to bed, and they don't even wake up. Good luck, I hope you feel better.

supersyllable5 karma

Can you comment on the mortality rate of otherwise healthy people with severe sleep apnea? Specifically, how much does a CPAP machine decrease risk of death?

alienwell4 karma

Severe OSA increased the risk of heart attacks and strokes. Pretty significant. If the CPAP is well adjusted, it should remove that extra risk. Here is an article for you to check out:

It also talks about the extra risk in the second half of the night.

69420dairysmashford5 karma


alienwell12 karma

I haven't recommended it in the past, still waiting for more data from peer-reviewed journals to make it official. But remember, I'm a little biased, and try to fix as many conditions without drugs / supplements whenever possible. You can try an experiment of going off of it for two weeks to test it's effect. Sleep well!

gutter545 karma

Why are polysomnograms so expensive now? I know there is a vast in ranges around the country, but 5 years ago I paid maybe $1000. I just had a second one a month ago and it was $3300. This was at the same place as I took it before. Are they just more profitable now because they are being recommended more often?

alienwell8 karma

Sorry to hear you're getting really high prices! It's so annoying that it's hard to know how much a medical procedure will cost, and usually you find out after it happens. Usually the doctor doesn't even know how much. It's partially due to the fact that the insurance company dictates the price. So if you go to a center with a $900 price or a $10,000 price, if your insurance sets the price at $800, that's the price the provider accepts. The safest way to know the price is to ask the insurance company directly with the right ICD / CPT codes. It's a pain, though. Hopefully things will get better...

robertooooooooo4 karma

What causes sleep paralysis and is there any way to prevent it?

alienwell14 karma

Hi robertooooooooooo! Sleep paralysis is often worsened by irregular sleep patterns or sleep deprivation. I usually recommend an experiment of good sleep hygiene and 8 hours of sleep every day for two weeks and then see if it changes. Good luck!

Jfjjffjfjjffj2 karma

What is your professional opinion on polyphasic sleep? Is it harmful in any way in the long term?

alienwell5 karma

Good question. People have tried this for hundreds of years but no one has done it for a long time. It takes a lot of energy and effort, and usually their lives / activity revolve around their sleep. I haven't done it...

burdturgler11542 karma

I have a tough time falling asleep at night because my mind can't really "shut off" and my thoughts jump from topic to topic.

What can I do to make it easier to quiet my brain and fall asleep?

alienwell2 karma

Good question! I listed some techniques to calm the racing brain above. Take a look, and I hope you feel better!

CoSonfused2 karma

I've been dying to ask this, without sounding like some crazy kook.

Once in a while (this can be within a few weeks, or even months), when I'm in my bed trying to sleep, I get this (and I can't describe it in no other way) a brain zap. I can feel it a split second before it zaps me, and it startles me every time. I wouldn't it hurts me, but it's very, very unpleasant. I can't place a location on it, but i'd say it's in the front of my head.

I'm actually under neurological care for a non-related disease, so every few months I get scans done (eeg and all those acronyms) and once every year I have a Brain MRI done. All are perfectly normal.

I have no reason to believe something is wrong with me because I have had it for years, is nowhere near frequent, doesn't seem to affect me in anyway other than be scared the living dayouts out of me for a second and I still can thunk good with mah headmuscle.

All joking aside, the fuck is going on here?

alienwell2 karma

I can't give a diagnosis or medical advice, but I'd read up on hypnic jerks. These are events that happen during the transition from wake to sleep, and there is a temporary instability in the brain. I listed some techniques that can help, and the process of getting a closer look with EEG based sleep studies. Take a look. Good luck, and I hope you feel better!

artifex01 karma

Have you ever heard of someone getting headaches whenever they oversleep or take naps?

For some reason, whenever I sleep a few hours longer than normal, I feel horrible for the rest of the day- sometimes even to the point of vomiting. I can't seem to find any information about this problem online, however.

alienwell2 karma

Yes, that happens to me too. To avoid it, I try to nap 15-20 minutes at most...

papipapichulo1 karma

Also just wondering:

  • what's your favorite mattress or in your opinion the best?

  • do you believe in soulmates?

  • do you believe in aliens?

alienwell2 karma

I don't have a preferred brand of mattress but we can talk about how to choose one if you'd like. And the answer to your other q is yes. Thanks!

papipapichulo1 karma

So yea, how should I go about choosing one, considering my "partner" snores a lot

And, I'm curious. Why do you believe in aliens. Btw the reason im asking is because of your name (alienwell)

alienwell1 karma

Ok, here is how I recommend picking a mattress. Wear comfortable clothes, and shoes easy to remove. Try to go during non-peak hours and really plan on spending some time in the store. Like 1-2 hours. Don't worry, the sales people there are used to it, and once they know you're serious, hopefully they'll leave you alone. Start at the cheap beds and move up. You'll first get a feel for how firm you want. Then you move up the scale and once you find something, spend some time there. After that, try the same firmness on a cheaper and more expensive bed to compare. This should narrow the bed down to one or two. Good luck!

BTW: chose the alien because of the reddit alien logo...

eoJmIiH1 karma

For the past 20 years(since high school) I've had frequent night terrors a few times a week. Sometimes I'll wake up not knowing where I am scrambling around the room trying to find a light switch. other times I think something is occurring such as the ceiling fan breaking free from the ceiling or the bed is sliding towards the wall which causes me to scramble out of bed. Most commonly I will sit up in bed confused and not knowing who is sleeping next to me even though it is my partner of eight years. I generally come to after a few min and go right back to sleep. Never been violent and maybe remember 1/2 of them.

I've mentioned it to I've doctor I had and he just kind of shrugged it of and said he could recommend a therapist.

I don't drink alcohol or caffeine and don't do drugs. Any suggestions of what I can try? I've attempted various breathing exercises and diets over the years without success.

alienwell1 karma

While I can't give a diagnosis or treatment advice, let me give you what I can. Sorry to hear that you're suffering. Confusional arousals are a form of parasomnias where you have a partial awakening in slow wave sleep, usually in the first half of the night. It's made worse by sleeping meds (sometimes), irregular sleep schedules and habits. A doctor recommending a therapist suggest she / he was thinking you need to work through a traumatic event. Another option would be to see a sleep specialist. Confusional arousals are pretty common for them. Good luck, and feel better!

Jinksy931 karma

Can my nose effect my sleeping habits? I have a permanent blocked nose on one side and my sleep is broken etc.

I've been to the GP numerous times and was given nasal sprays etc but nothing seems to help.

alienwell2 karma

An occluded nose increases the chance of opening your mouth during sleep and increases the chances of poor sleep from apnea. While I can't give medical advice, here is what I recommend to patients. I first recommend them to get a sleep eval. If their sleep is fine, then I usually recommend doing nothing as long as there aren't other issues. If their sleep is poor, then it's time to take a deeper look in the nose (such as stronger meds, or an ENT evaluation). In significant cases, a surgery can help. Good luck!

SrJulioSchlongenburg1 karma

So that bang I hear right as I'm about to fall asleep is exploding head syndrome, that shit is annoying. What can I do?

alienwell2 karma

For people with exploding head syndrome, usually the first step is to see a sleep specialist. They've got tests they can do to see if anything else is going on. They'd work on your sleep patterns, look for causes, and possibly even medications. Good luck!

deathnate41 karma

I find that if I sleep longer than 7.5 hours, waking up is much harder and I even feel sleepier during the day than if I sleep between 5.5 and 7 hours. Do we really need to sleep for 7.5- 8 hours? Is it really healthier?

alienwell3 karma

I'd first do an experiment to see how many hours you need. You start by sleeping the same amount for 2 weeks. Then titrate up/ down for another 2 weeks. I say 2 weeks because it takes time for the brain adjust. Another aspect of your question touches on sleep inertia. It's when you sleep longer than usual and are surprisingly extra tired from it. Good luck!

PoppaDR3W1 karma

How safe is using Melatonin supplementation? At what frequency is it OK to use? What about other supplements like ZMA?

Also, I have Sleep Apnea, or so I'm told. I did an "at home" test years and years ago. How accurate are these "take home" machines? It was small and the module strapped to my chest. There was also nasalcanular tubing (to measure breathing I guess) and a pulse ox meter.

Last but not least, I also have Low Testosterone (27 year old male). How much can "bad sleep" affect testosterone? My diet is not terrible and I exercise 5 or 6 days a week (lifting).

alienwell2 karma

Lots of things to think about, but the most important is to ensure the apnea is being treated. If you have untreated apnea, your sleep / health would be significantly affected. The new home tests are accurate for the common types of apnea. So I'd trust the past test. Now if you doubt it, then I'd recommend you talk to your doc, and even repeat the test so you can be confident you either have it or not. I'd start with that. Good luck!