Sleep health manager

We are never supervisors who give you general guidelines of "no cell phones before going to bed" and "must sleep 8 hours a day", nor are we selling melatonin or sleep aid pillows. Instead, we are "sleep personal coaches" who follow your life rhythm and physical condition to help you find out and solve the problems of poor sleep.

I just picked up a 27-year-old Internet operation girl last month. When she arrived, her eyes were so blue that she felt like she had been punched twice. She said that she could lie in bed for at least two hours and turn over and over before she could fall asleep. She bought a drawer full of melatonin, steam eye masks, and noise-canceling headphones, but they were useless. If she continued to endure the pain, she would have to go to the hospital to get sleeping pills. I was not in a hurry to change her schedule. I first let her wear a medical sleep monitoring bracelet for seven days, and recorded her diet and work rhythm simultaneously. When I finally checked the records, I found that the problem was not before going to bed at all - she would order a double shot of condensed ice Americano at 3pm every day, and she even said plausibly, "I have been drinking it for three years, and it has no refreshing effect on me at all." Keren's caffeine metabolism is three times different from person to person. She has a slow-metabolizing constitution. The coffee she drank at 3 p.m. still contains nearly half of the active ingredients in her blood at 1 a.m., so she can't sleep at all. Later, she was asked to change her afternoon coffee to half-sugar oolong tea. Within a week, she sent a message saying that she could drift off to sleep after lying down for 20 minutes. If she had known it was so simple, she wouldn't have stayed up for more than half a year.

To be honest, the longer I work in this business, the less I dare to prescribe generic medicines to people. A 62-year-old retired teacher came to me before and said that he woke up at 5 o'clock on time every day and always felt that he "didn't get enough sleep" and forced himself to lie down until 7 o'clock. As a result, the more he lay down, the more dizzy he became and he always felt chest tightness. After measuring his sleep structure for a week, we found that his deep sleep accounted for 22%, which is much higher than the average level of 15% for the same age group. He is a typical natural short sleeper. Sleeping for 5-6 hours a day can fully meet the body's needs. Lying down hard disrupts his sleep rhythm, making him more tired the more he sleeps. Later, I asked him to get up and go for a walk in the park as soon as he woke up. Half a month later, he said he was no longer dizzy, and even the cervical pain he had suffered for a long time was much better. You see, even the "truth" that everyone defaults to "sleep eight hours a day" may not be applicable to individuals.

There are actually two obvious intervention schools in the industry now. No one is right or wrong, but the applicable scenarios are different. One group is a staunch supporter of CBT-I (Cognitive Behavioral Therapy for Insomnia, currently the preferred non-pharmacological intervention for insomnia globally recognized by academic circles). I have a friend in the same industry who does not even recommend users to take melatonin, saying that external supplementation will inhibit their own melatonin secretion, which will easily lead to dependence. He used to make adjustments to a high school senior who was under great stress and had insomnia. He relied on behavioral interventions such as sleep restriction and stimulus control. He did not take any supplements for four weeks. Later, the child's sleep returned to normal and he exceeded the first-tier score by 60 points in the college entrance examination. The parents specially sent him a banner. I belong to the group of integrated interventionists. If a user has been sleeping less than 4 hours a day for half a month and is unable to walk steadily during the day, I would recommend taking a small dose of melatonin for 3 days to transition the disordered biological clock back to a rough track, and then cooperate with behavioral adjustments. The user's compliance will be higher and it will not be easy to give up halfway. Of course, for special groups such as pregnant women and children under 12 years old, no matter what the situation, we will definitely give priority to non-pharmacological intervention. This is the bottom line.

I would also like to remind everyone to avoid this pitfall. Nowadays, there are many people on the market who claim to be "sleep health managers". They ask you if you have insomnia and then recommend you a sleep aid or sleep package worth several thousand yuan. These are basically unreliable. The first step in formal sleep management is always to check and rule out whether the sleep problem is caused by pathological reasons - such as hyperthyroidism, depression, sleep apnea syndrome, etc. If it is a pathological problem, we will directly recommend that you go to the hospital to find a clinician first, and we will not even start to adjust it for you ourselves. This is the most basic professional requirement.

A few days ago, a young man who works in design came to me and said that he also knew that going to bed early is good, but only the two hours before going to bed are completely his own. He would watch short videos and work on models for a while, but he couldn't bear to sleep. He forced himself to go to bed early and kept his eyes open until two o'clock. I didn't ask him to forcefully change his schedule, so I gave him a small request: split the two hours of entertainment time before going to bed in half, do what you like as usual for one and a half hours, lie down in advance for the remaining half hour, turn the screen to the lowest brightness and turn on night mode, sleep when you can, and lie down and relax if you can't. He sent me a message last week, saying that he can basically fall asleep at 12:30 now, and he doesn’t feel that he has missed entertainment time, and he is no longer groggy during the day.

To put it bluntly, our job in this industry has never been to "correct" your sleep, let alone to force you to go against your own living habits and force standard answers. It is just to help you find a way to coexist peacefully with your biological clock - after all, a good night's sleep is the cheapest and most practical way to maintain your health.