It seems these days that everyone knows something about ADHD (Attention Deficit Hyperactivity Disorder). 

Teachers swap stories about dealing with ADHD students, parents debate the pros and cons of medication, and health organizations like the National Sleep Foundation warn that people with ADHD are more likely to have sleep problems, such as an inability to "turn off their mind" or restless leg syndrome.

As someone with ADHD I can tell you that these problems are not unfounded.  I know that my medication--which is a stimulant--can keep me up if I abuse it.  I know that I also can't focus and be productive without it so I'm willing to trade a small bad for a big good. But I was curious about what this trade off could look like. 

Being an engineer, I'm all about how things work--my body's no exception--and I decided to look at my Zeo data to see what I could find. Before I dive into all the data, let me just let give you a bit of back story here.

I was a Sleep Athlete

I used to be an incredible sleeper; given the time, I could sleep 12+ hours on most nights.  I'd fall asleep as soon as I hit the bed and could even fall asleep with the sun in my eyes and friends yapping in my ear during car rides.  I never knew what a luxury that was until all of my superhuman sleeping powers came to an end sometime during college.

To be fair, the decline was a gradual thing that I never could have detected.  You get older, your sleep quality declines; it's natural.   Personally, there was also a lot going on and I really wasn't thinking about my sleep. I was formally diagnosed with ADHD and prescribed a common stimulant to help me focus.  My God, what a difference it made!  I could suddenly concentrate, study, whatever, whenever, and forever (if needed), and as a result my academics improved--so much that my GPA jumped nearly a whole point.

Take as Directed

The flip side was that these same wonder pills could keep me up. 

I once decided to see how long I could stay up by taking the meds as needed.  Like most people, I've done my fair share of dumb stuff and that was certainly up there.  After being up for 69 hours, I was physically and mentally useless by the end.  Not fun and definitely not recommended.In short, I know ADHD meds can keep me awake if I abuse them. 

That said, I often wonder how taking them as prescribed affects my sleep.  My particular medication's half life is about 13 hours, so when I take a dose in the morning I still have 40% of the drug remaining in my system by bedtime.  

As a general rule, I try not to take any medication during the weekend, which means that I have about 11% in my system on Saturday night and 3% by Sunday night. However, I often find myself lying in bed awake at night, frustrated because my mind is endlessly "ranting"--and for this, I blame my meds.

It's all about the Zeo Data, baby

While I like to argue, I generally do it best when I've got some data to back it up.

To prove that my medication can keep me up, I exported my 463 nights of sleep records (collected over the last few years) and crunched them into excel graphs as prettily as I could.

Below is a graph of a summary of all my nights since Nov 2007 (one of the perks of working for Zeo; you get to use the product well before anyone else.)

To get an even better picture, I took that same data set and viewed each sleep phase by percentages. 

Generally, my time in REM sleep is at its lowest on Monday and gradually increases until Sunday, when Monday rolls around again, it drops abruptly again.  It could be because my body adapts to the drugs retention  in my system for most of the week. 

During the weekend, the level drops down to 3% and by Monday it needs to re-adapt all over again.   Monday is also the day when the effects of my medication are felt most strongly.

To my surprise my deep sleep is consistent through out the week. 

My deep sleep occurs earlier in the night--which is normal-- and it seems completely unaffected by both the medication and the late bedtimes.

Yet when I took that same data and graphed it by absolute time, I was shocked to see that my sleep varies so regularly.  While lifestyle does impact my sleep (see A Note about Control), the only think that I can think of to explain why I sleep 40 minutes more every single Wednesday than Tuesday is the increase in medication within my system.

It also takes me about 10 more minutes on average to fall asleep on Tuesdays than any other day.

A Note about Control

I am awful at keeping a routine schedule (but I've got an excuse, right?).  

My weekend/weekday schedule has a noticeable impact on my sleep, as I typically go out on Friday and Saturday nights.   This pushes my bed time back a whopping one and a half hours on average.

However, the data shows that I fall asleep about twice as fast on Friday and Saturday nights than other nights of the week. 

If my time to sleep (a.k.a. Time to Z) was influenced by my medication, then I suspect my Time to Z would be the same on Friday as Thursday--and that Saturday and Sunday would be much faster than all the rest.  On Sunday, when the medication is almost completely gone from my body, my Time to Z is similar to days when I'm on medication (though this could be from my bedtime shifting forward again).

So does my ADHD medication mess with my sleep?  I can make a case for it, but it's not conclusive.  I think this calls for some more experimentation and a later blog post, not to mention more data and stories from other ADHD Zeo users.  But don't worry; I won't be staying up for 69 hours straight ever again.

Kuji Nakano is an engineer at Zeo and (still) holds the company ZQ record. He was instrumental in the design and development of Zeo Bedside and Zeo Mobile and continues to find new ways to bring sleep science into your home.

A few weeks ago, we posted a clip sent to us from Zeo user Noel Hanna up on Mt Everest.  If you haven't watched it (or it's been a while) check it out again:

Did you notice his breathing?  It was pretty quick and shallow, wouldn't you agree?

What's likely going on here is that Noel's body is trying to cope with decreased amounts of oxygen.  It's a well noted phenomenon that the body starts responding to the change in altitude.  For breathing, this means that you need to pull in as much oxygen as before; if each breath only takes in 85% of what it needs, you then need to breathe quicker to keep humming. Thus, hyperventilation (smart, huh?).

Okay, great.  But what does that have to do with sleep?

A couple of things, actually.

Where's the Sleep?

It's thought that this new pattern is related to instances of high altitude periodic breathing, something Zeo user Andrew "Moose" Schwartz experienced when he was up trekking in Nepal. 

One of the side effects of hyperventilation at high altitudes is that it tends to produce lower CO2 levels...which then signal to your body that you don't need to breathe.  So you don't--until another body alarm says:

"Hey! Breathe!"

And you start all over again.

When this happens during sleep, you momentarily wake up.  As you may have guessed, this can keep you from getting much deep sleep.  If you're hiking up to the top of the world--and your body needs to keep repairing itself night after night--it might take longer than if you had done an equally demanding workout at a lower altitude.

If you don't believe me, check out Noel's Deep sleep levels Noel Hanna: Time in Deep

Also look at the number of awakenings;  did you notice how his best nights of Deep Sleep correspond to a lower number of awakenings?

Noel Hanna: Number of Times Woken

Don't know Much Biology?

The consensus among scientists is that hyperventilating--and by association, periodic breathing--at high altitudes is a good thing. Even Sherpas do it. 

If your body doesn't sync to this new pattern, it could put you at risk for Altitude sickness. Strangely enough, even when supplemental oxygen is used, the body still experiences periodic awakenings.

What hyperventilation does not appear to do is shorten people's sleep patterns.  Notice how Noel's Total Sleep Time remained fairly close to the average during his time on Mt. Everest.                                                                                                                                    Noel Hanna: Total Sleep Time 

Conversely there is no significant decrease in REM, like there is in Deep.  Scientists are certainly puzzled by this but at least all of your restorative sleep didn't go "out the tent window". 

In a similar vein, the awakenings associated with periodic breathing don't appear to be as disruptive as awakenings associated with sleep apnea.

Noel Hanna: Time in REM

Finally, sleep actually seems to improve as the body acclimatizes.  The number of periodic awakenings decrease (but do not go away) the longer the body remains at a stable altitude.  In fact, mountaineers may already know this via the practice of "climb high, sleep low."

Think about it:  if your body is used to sleeping at 2500 meters, then it would be a good idea to climb up to a certain point, then retreat down to a base camp for your R&R instead of trying to adapt at a new level.

Sweet Dreams Are Made of This

When we're in REM sleep, we're generally not aware of the fact that we are dreaming.  It's only after awakening that we (sometimes) remember the images and events that our brain shuffled through during this time. However, a remarkable exception occurs when one has a lucid dream.  During this state, the dreamer is aware that s/he is dreaming (LaBerge, 2000, 2007).

In fact, one can think and reason clearly,  recall circumstances from waking life, and can intentionally act upon self-reflection while remaining in a dreamworld--a dreamworld, by the way, that is often indistinguishable from the "real world" (Kahan et al, 1997).  No game console could ever compete with that kind of immersiveness, let alone for free.

Our mission at Lucidipedia is to provide grounded educational resources that allow people to effectively learn and (hopefully) enjoy lucid dreaming as much as we do!

Why learn Lucid Dreaming Techniques?

The lucid dream state provides a multi-sensory experience in which you embody all of your dream senses (taste, touch, sight, sound, and smell) in the same way that you do in waking life with one difference:  it allows you to deliberately and voluntarily direct the lucid dream--from isolated elements to the whole plot--in any way you desire.

Imagine using this to help you overcome a particular fear, or to take a "leap of faith" and experience something that you might shy away from in your daily life.  It's possible that such experiences could make you feel more confident and capable (and, indirectly, more self-assured and happy) as a person.

For instance, imagine applying lucid dreaming techniques within the following (popular) scenarios:

• Learning to fly
• Resolving nightmares or fears
• Rehearse waking life events
• Experiment with new behavior, such as fantasies that might be considered taboo
• Explore states of consciousness

With all these amazing possibilities, it's no surprise that many people enjoy lucid dreams--it is an awesome "spiritual" sport.

How to Lucid Dream In 3 Easy Steps

In reality (and in dreams), learning how to lucid dream is pretty straightforward and easy.  How easy?   So easy that you really need 3 basic steps:

1. Recall Your Dreams
2. Discover Dreamsigns
3. Recognize Dreamsigns

Sounds too good to be true, right? Let me break it down a little.

1.  Recall Your Dreams

In Lucid Dreaming, dream recall--that is, remembering your dreams--functions as your stepping stone for dream analysis; if you didn't learn how to recall your dreams, you might not be able to take control of the dream itself the next time you're in REM sleep. 

The actual recall part is simple; upon waking up, ask yourself " What was I dreaming about?"  As you remember, write down any memories in a journal.  While this can be a little frustrating as first, don't worry if you can't remember everything.  Lie still, keep your eyes closes, and let your mind do the hard work.

2. Discover Dreamsigns

Once you've amassed 2-3 weeks worth of dream recollections in your journal, take the time to review your notes and identify any recurrent dream-like features (anything bizarre or out of the ordinary is a good clue)--these are your dreamsigns.  When rereading, ask yourself "Are there any particular dreamsigns that reoccur within multiple dreams?  If so, you've found your target dreamsign.

3. Recognize Dreamsigns

Once you've established what your dreamsigns are, you can now start going to bed prepared.  As you fall asleep, say to yourself "The next time I see my dreamsign, I will tell myself that I'm dreaming."  Once you start to do this within the dream--a.k.a "turn lucid"--you can then learn how to master your dreams using various techniques.

Lucid Dreaming with Zeo

For me, the greatest feature of the Zeo PSC for those looking to induce lucid dreaming is the SmartWake™setting.  Since it wakes you after leaving a deeper stage of sleep--and dream-rich REM sleep tends to occur towards the latter half of the night--this feature not only helps you to better recall your dreams but can also help you enter a lucid dream state.

To experience Lucid Dreaming with Zeo and SmartWake™, try the following techniques:

1. Enable SmartWake™ to wake you up after about 6 hours of sleep (in order to ensure that you're in or close to REM sleep cycles)

2. Once you wake up, immediately practice Dream Recall.

3. Try to enter a dream by using Lucidipedia's WILD (Wake-Initiated Lucid Dreaming) technique.  WILD's aim is to fall asleep while staying lucid (i.e. remembering that you're dreaming) throughout the entire process.  However, WILD is only shown to be effective after awakening from REM sleep, so make sure to check your Zeo to see what state you were in when the alarm went off!

 Increasingly, more researchers speculate that lucid dreams can be used as test cases for theories of dreaming to investigate the nature of consciousness and dreaming (Hobsom, Kahn, and Pace-Schott, 1994; Hobsom, 2009; LaBerge, 2000).

As such, it's possible that a device like Zeo could become one of the tools of choice for lucid dreamers (especially since the Raw Data Library is now available!).  We here at Lucidipedia are excited to see what the future--and our dreams--hold!

Sweet Dreams! ---Lucidipedia

Tim Post is the founder of Lucidipedia, an online educational community that teaches lucid dreaming to help anyone learn how to lucid dream, or improve their own techniques.

My story of sleep apnea is the unfortunate but classic self-diagnosis case. All through my twenties I was constantly exhausted, and finally around age 30 I went to a doctor to ask about it; he told me everyone's exhausted and literally threw me out of his office. This cycle repeated itself over the next ten years with few results

 Kevin Kruse (right) and Ben Rubin presenting at ePatient Connections 2010

What changed everything was that I started working on some medical education projects related to sleep medicine and, as a result, learned about sleep apnea. It was like a light bulb went off:  "Oh, so this is why I choke myself awake at night!"  I saw a new doctor, explained the fatigue and night-time breathing problems, and asked for a sleep study. He agreed and the results confirmed that I have intermediate to severe sleep apnea and I got a CPAP.

Self-Tracking is a path to Self-Knowledge

I was really excited to start using the Zeo, partly because I wanted to see the difference that the CPAP machine made on REM and Deep sleep. Like a lot CPAP users, my compliance isn't great. I know all the health reasons why I should use it, but it's just a pain in the butt and I often don't put it on. So I was curious to see how my sleep data changed with and without the CPAP.

To my surprise, I didn't see much of a difference in Deep sleep with the CPAP. Even with 8 hours of sleep I only get about 15 minutes of Deep and I still feel exhausted.

This is part of why my compliance with CPAP isn't great; unlike other CPAP users I know, I don't feel rested or better when I use it.

At first, I was really puzzled by this, but I was also using the Zeo website to track other sleep habits. It pointed out to me that I'm always on caffeine, which is true.

Because I'm tired all the time, I'm a big coffee drinker even at night. I didn't think it was a problem, since I can always fall asleep immediately, but that caffeine could be interfering with my ability to get Deep sleep even when I'm on CPAP. So now I'm in the process of weaning myself off caffeine and I'm using the Zeo to see if I can get my Deep sleep up while staying on CPAP.

Your Body Revolts when you Skimp on Sleep

In 2009 I launch the e-Patient Connections conference--the first time I've ever done a conference before--and it was tons of work, full of mistakes and the usual "start up"experience.

While I worked my butt off to focus on the details, what went out the window was exercise, healthy eating, and sleep.

I spent a year working like a lunatic to make sure a 2-day event would be great and by the time it arrived, I had literally made myself sick. I looked like crap, felt like crap, and was loosing my voice. I sipped hot honey-water for two days and killed my vocal chords to get through it.

So for 2010 I made a promise to myself that I'd work my butt off, but not at the expense of my health. I really do believe we need to have more of a "corporate athlete" mentality; to focus as much on energy management as we do on time management. For a couple months before the conference I ate clean 6 days a week, hit most of my workouts, and used Zeo to make sure I was getting a decent ZQ.  

It made a world of difference; I dropped ten pounds and felt good and focused. E-patient Connections is all about the "connections" and this year I had the energy to really get around and socialize during the event and hit all the stuff at night.

You and your doctor are in this together

I think we're just at the beginning of the technology adoption curve when it comes to personal biometric devices--both in terms of people using them, and of doctors being receptive to the data. It's currently the "innovators" who are sharing their DNA test results from 23andMe, or their sleep data from Zeo.

As with the broader e-patient movement, those who are faced with more acute or serious conditions are more likely to have the motivation to take action and embrace what personal biometric devices can do. Hopefully as the devices become more common and the benefits become more obvious, we'll see broader usage in the general population.