I personally believe that one single night of a sleep study is not enough data to understand how someone's sleep patterns are, whether that's a home test, hooked up to a sleep watch, a loaned out...
I personally believe that one single night of a sleep study is not enough data to understand how someone's sleep patterns are, whether that's a home test, hooked up to a sleep watch, a loaned out sleep kit, or at a clinic being monitored. Not every night is the same, especially for AFAB people whose hormones fluctuate throughout the day, let alone nightly or daily. What part of a cycle you're on can drastically change how your sleep is.
I took two at home sleep studies 4 years apart with the exact same equipment and got drastically different results. The only differences between the two times were 1. me (I am female, and aged 4 years from that point) and 2. I added a few more medications to my nightly list, none of which should disrupt sleep or change my sleep patterns. Neither test was really conclusive either, and my doctors essentially threw out the results of both tests.
I know my own data is anecdotal. I still firmly believe it, unless someone can show me data to disprove it.
As a trans woman - I can also verify you are absolutely correct. Not only is the field medicine heavily tailored towards cis male bodies[1] - sometimes even for things concerning women's health -...
Exemplary
Not every night is the same, especially for AFAB people whose hormones fluctuate throughout the day, let alone nightly or daily. What part of a cycle you're on can drastically change how your sleep is.
As a trans woman - I can also verify you are absolutely correct. Not only is the field medicine heavily tailored towards cis male bodies[1] - sometimes even for things concerning women's health - but, absolutely, I can confirm first-hand how different hormone levels and their fluctuations have affected my sleep patterns - especially in the case of progesterone[2] which is naturally metabolised by the body into neurosteroids like allopregnanolone[3] , which have shown direct correlation with sleep quality among other effects.
Myself, I have observed very noticeable and highly repeatable differences between my sleep quality and sleep patterns in the four distinct stages I've myself experienced: an androgen-dominant endocrinal system; a post-menopausal-like endocrinal system; an estrogen-dominant endocrinal system, and an estrogen+progesterone-dominant endocrinal system. In case #1, my sleep was overwhelmingly light, stable, often lacked dreams, and - if I woke up - I found it easy to fall back asleep easily. In case #2, my sleep was shit in all regards. In case #3, my sleep was deeper (albeit shorter) and more restful than case #1, and with very real-feeling dreams, but I found it really hard to fall back asleep again if I woke up. In case #4, my sleep quality is the best it's been, because it gives me all the benefits of #3 without any of the negative parts of #3.
But also, hell - [most] AFAB women's bodies go through a lot every month. Although it's something I will sadly never get to experience myself[ᵃ], y'all know how harsh menstruation can be on your bodies both physically and mentally, even if the experience differs a lot from person to person. If that wouldn't affect your sleep, what would‽
Yeah, as a lifelong insomniac, I was hopeful when my family got me a Fitbit to track my sleep. However, after many miserable nights and Fitbit congratulating me on said night of sleep, I lost...
Yeah, as a lifelong insomniac, I was hopeful when my family got me a Fitbit to track my sleep. However, after many miserable nights and Fitbit congratulating me on said night of sleep, I lost trust in a lot of the easy tests.
I still do need to at least try the official test. Maybe it will help, only time will tell. But I haven't had the money or time recently to look into it.
For me, at least my perception, the real thing that sleep studies are good for is determining if apnea is an issue. And that's something that could certainly be figured out in one study,...
For me, at least my perception, the real thing that sleep studies are good for is determining if apnea is an issue. And that's something that could certainly be figured out in one study, potentially at least. But it's possible that's more variable than I'm aware of?
For me the take-home test was to check for the possibility of sleep apnea. After it showed negative, then I went in for the overnight sleep test with the multiple sleep latency test the next day....
For me the take-home test was to check for the possibility of sleep apnea. After it showed negative, then I went in for the overnight sleep test with the multiple sleep latency test the next day. That ruled out narcolepsy type 1 and 2 but I was given the diagnosis of idiopathic hypersomnia. In the MSLT's 5 nap sessions I fell asleep quickly enough each time but never hit the REM stage. Even though it was assumed that apnea wasn't the issue they still had to rule it out with the take-home test.
For any body measurement, I think the most important question to ask is: what is the natural human sensation for this measurement, when can the reading from the device and human feeling diverge,...
For any body measurement, I think the most important question to ask is: what is the natural human sensation for this measurement, when can the reading from the device and human feeling diverge, and is that a useful signal?
For sleep, I don't think we have studies indicating it is. We all have some sense of how well we slept. When you wake up and feel like dying, that's pretty obvious not good. So the two scenarios at play are
You feel great in the morning, but your fitness/sleep tracker says you slept poorly.
You feel awful in the morning, but your fitness/sleep tracker says you slept well
I don't think there's much science for either case being particularly useful. For 2), most of the ways we tell if we slept well or not are pretty practical. Who cares if your apple watch says you slept well if you have a terrible migraine?
For 1), I don't think there's any scientific evidence that there are circumstances where your watch knows better than you do, that there are circumstances where you feel sharp but you are actually suffering in some unknown way that your sleep tracking is helping you with.
As a result, I think just noting down your subjective feeling every morning is perhaps a more useful exercise if you're trying to adjust your sleep schedule.
To contrast with some "good" uses of metrics, resting heartrate is one. We just don't have a good sense of our resting heartrate. If it's 50 or 90, is going to feel the same to people. If it's 90 you probably need to do more cardio, though.
Fever temperature is another one. We can feel when we are sick, but it is difficult to give it an objective level in the same way body temperature measurements do. This is useful to tell if the fever is worsening or abiding.
This is my problem with the "body battery" Garmin recently added. My watch isn't compatible thankfully, but my wife's is and she's constantly going on about how it says her body battery is low but...
This is my problem with the "body battery" Garmin recently added. My watch isn't compatible thankfully, but my wife's is and she's constantly going on about how it says her body battery is low but I ask her how she feels and usually she feels just fine. But for some reason she wants to believe the Garmin knows something she doesn't or it's tracking a trend she can't see, etc. It just feels more gimmicky to me than anything and I don't know that I trust it.
I also don't really trust my sleep tracker because I know I have sleep issues and it will often state I had a great 8 hours of sleep when in reality I know I was awake for 3 of those hours. Other times it will do the opposite.
I personally believe that one single night of a sleep study is not enough data to understand how someone's sleep patterns are, whether that's a home test, hooked up to a sleep watch, a loaned out sleep kit, or at a clinic being monitored. Not every night is the same, especially for AFAB people whose hormones fluctuate throughout the day, let alone nightly or daily. What part of a cycle you're on can drastically change how your sleep is.
I took two at home sleep studies 4 years apart with the exact same equipment and got drastically different results. The only differences between the two times were 1. me (I am female, and aged 4 years from that point) and 2. I added a few more medications to my nightly list, none of which should disrupt sleep or change my sleep patterns. Neither test was really conclusive either, and my doctors essentially threw out the results of both tests.
I know my own data is anecdotal. I still firmly believe it, unless someone can show me data to disprove it.
As a trans woman - I can also verify you are absolutely correct. Not only is the field medicine heavily tailored towards cis male bodies[1] - sometimes even for things concerning women's health - but, absolutely, I can confirm first-hand how different hormone levels and their fluctuations have affected my sleep patterns - especially in the case of progesterone[2] which is naturally metabolised by the body into neurosteroids like allopregnanolone[3] , which have shown direct correlation with sleep quality among other effects.
Myself, I have observed very noticeable and highly repeatable differences between my sleep quality and sleep patterns in the four distinct stages I've myself experienced: an androgen-dominant endocrinal system; a post-menopausal-like endocrinal system; an estrogen-dominant endocrinal system, and an estrogen+progesterone-dominant endocrinal system. In case #1, my sleep was overwhelmingly light, stable, often lacked dreams, and - if I woke up - I found it easy to fall back asleep easily. In case #2, my sleep was shit in all regards. In case #3, my sleep was deeper (albeit shorter) and more restful than case #1, and with very real-feeling dreams, but I found it really hard to fall back asleep again if I woke up. In case #4, my sleep quality is the best it's been, because it gives me all the benefits of #3 without any of the negative parts of #3.
But also, hell - [most] AFAB women's bodies go through a lot every month. Although it's something I will sadly never get to experience myself[ᵃ], y'all know how harsh menstruation can be on your bodies both physically and mentally, even if the experience differs a lot from person to person. If that wouldn't affect your sleep, what would‽
1: https://www.goodreads.com/book/show/41104077-invisible-women (part IV, IIRC?)
---2: https://pubmed.ncbi.nlm.nih.gov/18676087/
3: https://doi.org/10.2174%2F138955712802762167
a: Some trans women, myself included, have reported experiencing some physical and mental cycle-like behaviour on a monthly basis, but this phenomenon is highly understudied. It could be happening exclusively because of the hypothalamus, or it could be happening due to other endocrinal reasons, but there's no definitive answer yet.
Thank you so much for replying. I appreciate the information, and I'm so sorry that your hormones also affect your sleep the way they do.
Yeah, as a lifelong insomniac, I was hopeful when my family got me a Fitbit to track my sleep. However, after many miserable nights and Fitbit congratulating me on said night of sleep, I lost trust in a lot of the easy tests.
I still do need to at least try the official test. Maybe it will help, only time will tell. But I haven't had the money or time recently to look into it.
I hope you can look into it soon. Sleep is so important, and we just never get the chance to really make sure we're getting the best sleep we can.
For me, at least my perception, the real thing that sleep studies are good for is determining if apnea is an issue. And that's something that could certainly be figured out in one study, potentially at least. But it's possible that's more variable than I'm aware of?
For me the take-home test was to check for the possibility of sleep apnea. After it showed negative, then I went in for the overnight sleep test with the multiple sleep latency test the next day. That ruled out narcolepsy type 1 and 2 but I was given the diagnosis of idiopathic hypersomnia. In the MSLT's 5 nap sessions I fell asleep quickly enough each time but never hit the REM stage. Even though it was assumed that apnea wasn't the issue they still had to rule it out with the take-home test.
For any body measurement, I think the most important question to ask is: what is the natural human sensation for this measurement, when can the reading from the device and human feeling diverge, and is that a useful signal?
For sleep, I don't think we have studies indicating it is. We all have some sense of how well we slept. When you wake up and feel like dying, that's pretty obvious not good. So the two scenarios at play are
You feel great in the morning, but your fitness/sleep tracker says you slept poorly.
You feel awful in the morning, but your fitness/sleep tracker says you slept well
I don't think there's much science for either case being particularly useful. For 2), most of the ways we tell if we slept well or not are pretty practical. Who cares if your apple watch says you slept well if you have a terrible migraine?
For 1), I don't think there's any scientific evidence that there are circumstances where your watch knows better than you do, that there are circumstances where you feel sharp but you are actually suffering in some unknown way that your sleep tracking is helping you with.
As a result, I think just noting down your subjective feeling every morning is perhaps a more useful exercise if you're trying to adjust your sleep schedule.
To contrast with some "good" uses of metrics, resting heartrate is one. We just don't have a good sense of our resting heartrate. If it's 50 or 90, is going to feel the same to people. If it's 90 you probably need to do more cardio, though.
Fever temperature is another one. We can feel when we are sick, but it is difficult to give it an objective level in the same way body temperature measurements do. This is useful to tell if the fever is worsening or abiding.
This is my problem with the "body battery" Garmin recently added. My watch isn't compatible thankfully, but my wife's is and she's constantly going on about how it says her body battery is low but I ask her how she feels and usually she feels just fine. But for some reason she wants to believe the Garmin knows something she doesn't or it's tracking a trend she can't see, etc. It just feels more gimmicky to me than anything and I don't know that I trust it.
I also don't really trust my sleep tracker because I know I have sleep issues and it will often state I had a great 8 hours of sleep when in reality I know I was awake for 3 of those hours. Other times it will do the opposite.