Whenever Apple releases a new iOS update, my iPhone usually receives the upgrade from my carrier, T-Mobile, several weeks after the patch went live. By then, all the Mac-philes in the world have already downloaded, installed, and had their lives ruined by whatever temporary ‘bug’ threw a wrinkle in their otherwise-smooth, effortlessly-interconnected lives. First world problems, am I right?
So I’ve only just now (in October) begun to play with the new iOS 10 features, and my middle age was never more evident than when I gave up trying to text my friend and instead called to say “What happened to iMessage?! I don’t like change!!” After sulking for quite a while (and finding myself far more relaxed and productive without that anchor in my hand), I finally picked my iPhone back up and searched out Apple’s latest feature many of my sleep patients at the sleep clinic had already been asking me about: Night Shift and Bedtime Sleep Analysis.
The “Night Shift” mode is a scheduled (or manually activated) mode that, on the label, adjusts the colors of your display at night to reduce eye strain. This appears to differ from the prior-available functionality of reducing brightness on the screen (automatically or manually) based on the current light level. If you go into your iPhone’s Settings app, a longer description reads “Night Shift automatically shifts the colors of your display to the warmer end of the color spectrum after dark. This may help you get a better night’s sleep.”
It’s already well-documented the disruption blue light emitted from smart phones and tablets have on your brain’s natural production of melatonin in regulating your body’s circadian rhythm. For reference, you can read articles here, here, here, and here about how LED and mobile device blue light interrupt your sleep and increase your risk for hypertension, diabetes, obesity, stroke, and cancer.
The brain is hard-wired to ‘see’ sunlight and begin the process of waking up. This is why shift workers have to use black-out curtains to sleep during the day. When the sun sets, the brain ‘sees’ the darkness onset and begins releasing hormones and neurotransmitters (melatonin being the most well-known) to induce sleep. This is a function of the human circadian rhythm, and it’s why people in Alaska nearer to the North Pole, for example, have different sleep patterns than people in Hawai‘i down near the Equator.
Insomnia patients often ask me at the sleep clinic why, if electronic light inhibits melatonin secretion, why they can fall asleep with a television on in the bedroom but their phones keep them up all night. Part of the equation is the distance from the light source, with researches finding that distances under 12 inches inhibit melatonin. Televisions usually are several feet away, whereas people hold their smart phones, tablets, and e-readers directly up to their face. (Parents, get a ruler out and hold it up to your kids and see what damage your children are doing to their eyes with that phone you bought them ‘just for emergencies’).
The other (and more important) reason television wasn’t as disruptive as phones are now is that television viewing is passive (even moreso when one considers the mind-numbing banality of late-night programming). Smart phones and tablets are active, engaging your mind in multi-tasking and actions similar to when you are at work. Sure, you think you’re just watching Netflix or playing Candy Crush, but your phone is constantly sending you push notifications, text messages, and alerts. If you used a paper and pencil to record every single time you got a notification, text, or toggled between apps or screens on your phone while you were watching a 2 hour movie in bed, you’d be amazed. And if you’re wondering if there’s an app you can use to track that, you need to take a moment and recognize the irony.
If this is you, then you already know the source of the problem.
Along comes Apple with their “Night Shift” and Sleep Analysis. Does it improve sleep and reduce insomnia? No. And I can say that categorically and absolutely without any scientific testing.
How?
Look at FitBits and other activity trackers. Increasing evidence here and here suggests users of these devices lose no more weight than their non-user counterparts – and in some cases, even gain weight. Why? There are a host of reasons, but the simplest is this: an app doesn’t do the eating and exercising for you. If you don’t do the work, the weight loss won’t happen. It’s not magic.
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The same basic principle can be applied to “Night Shift.” In theory, holding the phone at least 12 inches from your face can prevent the blue light from disrupting your melatonin. In practice, most people won’t do that. A basic principle of sleep hygiene requires a patient seek mental relaxation to prepare for sleep, something that a push-notification-heavy culture won’t adopt. In the Old Days (aka 10 years ago), people talked to their loved ones, watched television, or read a book in bed – all activities that, while perhaps not universally relaxing, were far less stimulating to the wakeful brain. Now, however, those activities have been almost entirely replaced with smart phone usage. A coworker waited until midnight to email you about something happening in two weeks? A cousin liked you picture on Facebook or Instagram? You ex from college just Snapchatted me? Forget about sleep! This will not wait until tomorrow! You totally have to check your phone now!
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Smart phone-inducing insomnia has a cumulative effect. By keeping you awake later, insomnia patients resort to sedative medications like Ambien, Lunesta, Trazadone, or Xanax to rapidly induce sleep because they otherwise ‘can’t turn their brain off.’ These medications alter the sleep architecture, which in turn reduces total night restorative sleep cycles. The insomnia patient awakens the next morning groggy, exhausted, and then uses caffeine and stimulants to stay awake during the day. The next night, the phone continues to keep them awake, and they repeat the cycle over and over. It usually requires a sentinel event like falling asleep at work or while driving before the patient finally relents and comes to see me at SleepSomatics for comprehensive sleep evaluation.
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Does this mean “Night Shift” isn’t a good thing? Again, no. There’s evidence to suggest that it can reduce eye strain, something my own optometrist would be happy about. But as with all apps that promise magical solutions to otherwise-simple problems, the actual ‘magic’ necessitates basic changes to your lifestyle that you were capable of making before the app was created.
When patients ask me if an app will improve their sleep and cure their insomnia, I say no.
There’s an app for everything. There’s even an app reminding you to drink water. Yes, there is a market of consumers who need their phone to remind them to drink water … because the human body’s thirst mechanism is insufficient.
We live in a culture today of apps and iOS updates and phones whose technology rivals anything ever seen in a Star Trek communicator. To patients who wonder if an app can fix their insomnia and sleep problems, I think of the water drinking app, and I am reminded of the old adage: you can lead a horse to water, but you can’t make it drink.
Or in this case, you can lead a horse to its bed, but you can’t make it turn that darn phone off and go to sleep.
Having trouble sleeping? Don’t feel like you’re getting sufficient, restorative sleep? Get your sleep issues evaluated today by scheduling a comprehensive sleep assessment at Austin’s top-rated sleep lab, SleepSomatics.
