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THE DREEM HEADBAND FOR INSOMNIA

(started May 16, 2021; updated May 28, 2021)

Before I tried the Eight Sleep Cover, I had decided I wanted the Dreem headband in November 2020. Unfortunately, the device had been placed on a backorder status. After a few months of promising more stock, the company finally admitted it had a new CEO and was no longer available to consumers. Instead, the French company was only going to make the device available to doctors and sleep labs. However, representatives continue to provide some support online and it seems the headbands still receive firmware updates. As of this writing, the app is no longer available on the app store and the last update was December 4, 2020. Still battling sleep-maintenance insomnia where I will wake up several times a night and unable to fall back to sleep, I was determined to see what it could do. Mainly because it claims to assist in recovery with the help of CBT-i coaching. Cognitive Behavioral Therapy for Insomnia is a proven method to help people overcome all forms of insomnia, with a high success rate of 70-80% among patients with sleep disorders. I have also decided to finally make an appointment with a sleep medicine doctor for a sleep study.

Just like the Eight Sleep reviews that I had found, the majority of Dreem reviews are done by people who do not have sleep issues. Why these people feel their opinions matter is beyond rationale. And nowhere was I able to find any information regarding how the CBT-i sleep training worked - even the Dreem site is vague. With the device no longer available to the general public, I began bidding on used headbands on eBay. There are two iterations of the Dreem: the original Dreem 1 and the updated Dreem 2. The key differences are essentially this: the Dreem 2 is more comfortable, is adjustable, is more accurate, and has better audio (they both have an audio jack, though); the sensors on the Dreem 2 are spring-loaded for a lighter and more even touch; both feature the same sensors, although Dreem 2 adds a sonometer to detect sleep apnea (both count breathing cycles per minute); Dreem 2 headbands sold outside of Europe do not stimulate deep sleep* via pink noise, while the Dreem 1 does so worldwide.

* this seems to have been due to the FDA approval being too difficult (it is registered with the FDA, not approved), but I don't understand how they snuck pink noise into the first version. The pink noise is not unlockable via the app - from what I can gather, it is the hardware and the US devices are not hackable.

I finally procured one within my desired budget: a Dreem 1 v2 for $550 early May 2021. Although I would prefer the improved Dreem 2, I had a direct communication with an employee last year who stated the Dreem 1 was still a good option. Plus, prices skyrocketed in 2021, especially for overseas Dreem 2 models that were capable of producing pink noise - this was something I wanted to try due to my belief that I was not getting adequate deep sleep.

The App, The Manual, and Customer Support
Since the product is no longer available to the public, I had to download and install the APK from a third party site. FAQ-style support is still available (and continues to be updated) on the Dreem website. The Dreem 1 and Dreem 2 both use the same app (and the same instruction manual, which is on the page I linked). The app takes a little bit of time to navigate through at first, but is loaded with plenty of information that the Eight Sleep does not provide. It also has buttons that will link to the website page that corresponds with that variable to explain it further, making it a very informative app. Initially, portions of the app are locked until after it has gathered seven nights of sleep data. There are four questionnaires that should be addressed regarding your current sleep situation so the app can try to help you in the best way.

My used Dreem 1 has a charging issue where it does not fully charge and on certain days it is worse, charging to only 91%. I had seen posts by employees stating they will continue to provide help to legacy owners. So, I inquired through the Dreem site mid-May 2021 and within a few hours, Jonathan had replied telling me he would evaluate the headband. I gave him my login ID so he could verify which headband to remotely take a look at. The next day, he sent me a screenshot of my charging history from the previous few days and assured me that my Dreem was fine. He believes it is reaching full and then discharging a little - I don't think this is the issue (I'm thinking natural battery degradation and/or it is out of calibration), but I was impressed at how responsive he was. So, customer service is still there for private users and is very good.

The Device
Keep in mind that I am using the Dreem 1 that is said to be less pleasant to wear. Sleeping with the headband may not be comfortable and is something that might not improve over time, which seems to be a universal gripe for both versions. I personally did not find it uncomfortable in an annoying way, but in a painful way the first few nights: it applies pressure across my forehead where the sensors are. This may be more problematic in people like me, who have more tender sinus areas. It's wasn't terrible and I was desperate enough to tough out the slight headache that it initially caaused me. It can also leave a band and sensor imprint across my forehead that remains there for up to two hours after I wake up. Furthermore, because I have the Dreem 1, which is not adjustable and because I want to maximize accuracy, I choose to wear a neck gaiter over the device to help the front and rear sensors remain in better contact.

Turning the device on can be tricky because there is no audio verification - start up is usually a minor nuisance because of this. If you're unsure, the app conveniently lets you test that the sensors are reading your brainwaves. After that, you click the Sleep button and the app tells you that you can leave the app and go to sleep (you should also hear the device verbalize this). During the first couple of nights, this is where you hope you did everything right - though if you don't see the one red LED sensor on the inside of the band lit up, that's a good indicator it is not recording. Once the recording starts, the Dreem will eventually turn off the Bluetooth and Wi-Fi so that there is minimal power usage and no signal transmissions. When you wake up, you hold the button down to turn the device completely off (a crescendo verifies this) and then plug it into the charger. The headband then pairs with your phone and the data uploads automatically so that you can review it. During the first seven nights, sleeping options are limited to only setting an alarm - you may not hear it if you rely on white noise and aren't using headphones or ear plugs. Once the first data collection week is over, all options and programs will become available.

Audio Quality
Initially, I had trouble hearing the headband because I like to sleep with white noise via an air purifier - I blamed this on the Dreem 1 having lower sound quality. I was aware that the Dreem uses bone conduction to transmit sound, and yet I mistakenly thought that I was hearing it normally. With the purifier running, I could not make out what the headband was saying and became worried that the pink noise would be totally ineffective. About a week in, I ordered a headband with headphones in it. The night before they arrived, I used earplugs (the ones that are all wax) and was shocked at the clarity of the sound. Although it would be nice if it could be louder at max volume, my concerns about audio quality have been squashed. Oddly, I have never seen anything on the site recommending the use of ear plugs, but I feel these are boarderline essential for pink noise performance.

The Data
Click on the date that appears on the app's home screen: the app will show when you went to bed, how long until you fell asleep, how many times you woke, how long you were awake, your average heart rate, average breathing rate, when you woke, and the total time slept. If you scroll across the sleep stage graph, it will zoom in to tell you the exact time of that sleep stage, what your heart rate was, what your breathing rate was, and what body position you were in. Clicking on a stage at the bottom of the graph will tell you the total time spent in that particular stage. Clicking on deep sleep will show you when pink noise was utilized.

Unfortunately, the headband can sometimes misinterpret some people as being asleep when they are actually awake. I've found this to be especially true in the mornings when I wake up too early and try to return to sleep. Alpha waves occur while resting with our eyes closed and then these waves will disappear during sleep. Dreem claims that certain people do not produce many alpha waves, so if they are lying very still while awake, the device may interpret this as being asleep. Of course, this also means that the Dreem's time stamp for when I first fall alseep is usually earlier than I think it should be. From my experience, it will usually mark this error as light sleep. So, if you lie awake for hours in the middle night, it may still say you had an efficient night of sleep. Fortunately, this does not seem to affect the CBT-i program.

CBT-i
As I had hoped, the Dreem app is far better than any of the CBT-i coaches that I found in the app store. Again, Cognitive Behavioral Therapy for Insomnia is a proven method to help people overcome all forms of insomnia, with a high success rate of 70-80% among patients with sleep disorders. This program wasn't actually recommended for me by the app, likely because I answered a question awhile back about working a shift schedule.* I chose it anyways. It starts off slow, which is probably a good thing as it doesn't overwhelm you right away. Each morning, you get a few cards to read about how certain circumstances can adversely affect sleep until the app eventually starts recommending sleep hygiene changes. These do not appear to be based on individual patient needs, but rather as a universal program. To be honest, I like the way the Dreem app approaches this by slowly adding a few goals at a time. The other apps I have tried give you no guidance and are essentially an unorganized pile of seek and find tips. However, you might want to take notes or occasionally re-read the Dreem's cards because there is no reminder as your bedtime approaches. The app is trying to help you develop good habits that will reprogram your body to know when to sleep. I've tried correcting my sleep hygiene before, but some of the tips are new to me and some of the ones I already knew are better explained on the Dreem app. I'm only a week in and I am very impressed with their program layout so far.

* my shift schedule is 24hrs on and 48hrs off, but I am now fortunate enough to be at a fire station that isn't up all night, every friggin night ...so I have a good chance at a normal sleep schedule. I think the app classifies shift work as overnights, where you are defying your body's Circadian Rhythm several times a week. Running calls all night is partly what got me here - and let me tell you, those calls were rarely serious and/or emergent, which made it extremely frustrating to not sleep. Unfortunately, a CBT-i program will not work well for someone that can't maintain a consistent and normal sleep window. I'm sorry, but I don't know what advice to give you except to recommend that you switch to day shifts.

Current Thoughts
Reviewing the data from my first night (May 15-16, 2021), I am far more confident in the readings than I was with the Eight Sleep. They appear more accurate and are far more detailed. It remains to be seen what use this data will be to me. That morning, I ran across an Australian website who's lead (Pete Field) has used the Dreem and asked the same question: what good is this data? Their device plans to use sleep stage detection to initiate sounds that control sleep stage length, just like the Dreem attempts with pink noise. The prototype has already been used by the lead, who has insomnia issues, to manipulate his quality of sleep and win the first World Sleep Championship, which is a friendly competition that uses an Oura Ring to rank how well amateur competitors slept.

Other Devices
URGOnight, which looks like the Dreem, but is instead used during the day to train your brain to produce SMR waves that are associated with alertness. The belief seems to be that if you produce more SMR waves during the day, your brain will be more prepared for sleep at night. The company recommends app-based training with the headband at least one hour a week over a five to ten week period and that you maintain good sleep hygiene. They spent fours years developing their "neurofeedback technology" and promise that it will lessen time to fall asleep and reduce the number of awakenings within three weeks of use. The company claims the URGOnight helps 91% of users and, on average, increases nightly sleep time by 57mins.

Cove seems to be similar to the previous headband in that it is also used during the day ...and was developed over the span of four years. But instead of training your brain through what looks like game-style exercises, the Cove attempts to increase alpha waves that stimulate relaxation and calmness, much like meditation. This headband doesn't read your brain waves, it stimulates them with skin vibrations while you are free to do other tasks and can be used during the day and/or before bed. The Cove is worn at least once a day for twenty minutes and promises dramatic improvement to all sleep metrics after a month of use, with boasts of some subjects noticing a difference the first night. The company claims that the Cove helps 86% of users and, on average, increases nightly sleep time by 65mins.

Each of these devices costs $500 and offer payment plans. It would be interesting to get a baseline with the Dreem and then use one to see if a difference is noted with the Dreem's EEG data.

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CrankyGypsy (established 2001)