GUIDED CBT-i (highly recommended)
THE DREEM HEADBAND FOR INSOMNIA (discontinued)
* SEE MYWAVES & FRENZ AT BOTTOM OF PAGE *

(started May 16, 2021; updated May 16, 2024)

GUIDED CBT-i

Although I have improved over the last few years, I still suffer from sleep fragmentation or sleep maintenance insomnia in 2024.* Helping a friend, I re-found this post about sleep consolidation on the old Dreem site. This sparked my interest in readdressing my interrupted sleep. Dreem had an excellent guided program and the accurate EEG headband did all the data inputting for me, but that is no longer an option. There are several structured CBT-i apps available, which can cost up to $300 for the 6-8week program. Some countries have already made quality sleep a health priority, offering free guided CBT-i apps to the public - the United States is not one of them. Indirectly, the US Department of Veteran Affairs commissioned one for military members suffering from PTSD called CBT-i Coach (by VA Mobile) and it is available to anyone. Unfortunately, CBT-i Coach refuses to connect to my Google Fit app like it should - it will not receive my sleep app data, so I am forced to enter it manually. Once CBT-i Coach logs 5days of sleep data, it should start making recommendations.

* I sought help from a leading sleep doctor, but she was unable to find the root of my issue. My problem may be due to a May 2010 hip fracture (dirtbike accident) that could have caused nerve problems that trick my sleeping brain into thinking I have a full bladder. I tend to wake 2-3 times a night, many times with a feeling of urgency.

During my Eight Sleep trial in 2021, I used the free Sleep Tracker app - this is now called Sleep Cycle: Sleep Tracker and requires a subscription for the finer details I was used to. For 2024, I am trying out Sleep for Android - first impressions are that it is a bit wonky to navigate. Even with a subscription, it does not seem to note how long it took to fall asleep and I am questioning it's overall accuracy. Not that Sleep Cycle is any better as I accidentally turned it on while watching TV and it thought I was asleep. Dreem did not have these issues.

Something I don't recall from my 2021 trial: being a light sleeper, I have been a proponent of white noise for many years, especially at the fire station. I have a large air purifier that is very loud (50db) and have kept it near my bed at home since January 2011* - I have become dependent on it. Coming back to this in 2024, I read that in 2010 The WHO recommended that a sleep environment should not be louder than 30db. For comparison, 40db+ is the sound of a quiet library and rustling of covers can produce 50db+. It is theorized by some that sleeping with constant white noise above 40db can cause your brain to work overtime and dump stress hormones while also damaging your hearing. I will experiment with no background noise and/or earplugs (to me, the wax ones are best). Granted, we are not all wired the same and colored noise may be beneficial to some, like those suffering from tinnitus.

* looking back at this: my hip fracture, and perceived overactive bladder, occurred May 2010; I started using my 50db air purifier in January 2011; I began working for the fire department in March 2012 and was practically an insomniac circas 2017 and 2019. By 2022, my sleep had improved greatly (I changed to a much slower fire station in mid-2020), but I was not satisfied. Now in 2024, I can see how all of these factors might have contributed to this situation and I need to start addressing the issues systematically.

 

 

THE DREEM EEG HEADBAND (discontinued for public)

MAY 2024 UPDATE: Dreem disconnected their servers from the public in 2023, despite saying this would not happen. Even if you install the old apk (or any Dreem or Dreem Health app) and have a headband, the apps will not allow you to complete setup. The company now goes by Dreem Health and currently makes the Dreem 3 for clinical use only. My favorite aspect of the Dreem app was the guided CBT-i program, as I found most other options were piles of info. The Dreem’s was well structured and prompted you each night, while making very accurate sleep logging simple. There is a Discord group working on regaining support from Dreem. There may be ways around the server registration when using a VPN from Germany.

PREFACE: 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 (update: my sleep doctor failed to find my root cause - sleep is still a very unexplored science).

DREEM
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 found no benefit from it.

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. I have gotten used to it and it does not affect my sleep at all. However, sleeping with either version of the headband may not be comfortable and is something that might not improve over time. I initially did not find it uncomfortable in an annoying way, but in a painful way the first few nights only: it applied pressure across my forehead where the sensors are. This may be more problematic in people like me, who have more tender sinus areas. It wasn't terrible and I was desperate enough to tough out the slight headache that it initially caused me. It also left a band and sensor imprint across my forehead that remained there for up to two hours after I woke up. But all of these issues weren't noticeable after the first week. 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.

The CBT-i Program
After about a week, the Dreem app will allow you to access the sleep programs. 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 recommended for me by the Dreem app, likely because I answered a question awhile back about working a shift schedule.* I chose it anyways. The program maintains a very manageable pace, so it never feels overwhelming. Each morning, you get a few "cards" to read about how certain circumstances can adversely affect sleep until the app eventually also recommends sleep hygiene changes. I really like the way the Dreem app slowly adds a few goals at a time, and the delivery of this information is top-notch. The other apps I have tried give you no real guidance and are essentially an unorganized pile of tips. I've attempted to correct my sleep hygiene several times before, but some of the Dreem's recommendations are new to me and others are better explained in the Dreem app.

* 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 ...so I have a good chance at developing 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. Unfortunately, a CBT-i program will not work well for someone that can't maintain a consistent and normal sleep window.

There may have been a bit of a lull in the app during the second week of the CBT-i program, as it collected data - I wasn't interacting with it as I had been because no new cards were popping up. Then after another week, everything was again coming in as normal. In any case, I kept at it and all has been running flawlessly at day twenty-six. My sleep is still not what I would like, but I am definitely experiencing less awakenings. Honestly, I haven't been as dedicated as I should be (due to personal circumstances), but the program continues to impress me after four weeks. I am having the most difficulty committing to waking at the same time every morning, which is my own fault. I simply like to sleep in when I can, which is a bad habit that the program has been gently reminding me to correct.

In summary, I can't express how well the Dreem's guided CBT-i program is put together and I cannot recommend it enough to anyone wanting to take a serious go at CBT-i. It is in a different universe compared to every other program I've looked into. Unfortunately, you will need to find a headband on the used market as prices continue to rise. It is a shame that Dreem is no longer selling these to the public.

Pink Noise
I cannot say that I am noticing any difference in the amount of deep sleep I am getting with the addition of the pink noise. As mentioned, I use ear plugs, so I know that I'm hearing the bone conduction perfectly clear. If you are in the market for a used Dreem, I currently cannot recommend spending the extra effort or money to find one with this capability (Dreem 1 or Dreem 2 EU version).

Accuracy
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. Though not perfect, they appear more accurate and are far more detailed. 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. That 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 (May 2024: appears to be discontinued), which looks like the Dreem, but is instead used during the day to train your brain to produce sensorimotor rhythm 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 (discontinued sales to the public in 2022) 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.

The Europe-based Hypnodyne ZMax EEG was released in 2018 and the base unit starts at $1000. The device looks impressive and seems to offer a lot of possibilities. It's an advanced device and the site offers little to the layman.

SleepLoop is an EEG coming out of Switzerland and seems to still be in the reseach phase (May 2024).

I had considered the Canadian-made Muse S headband back when I got interested in the Dreem. This device is still available for $300. I felt the Dreem was geared specifically for sleep correction, while the Muse seemed to be intended more for daytime meditation and helping to get to sleep. Granted, the Muse does do sleep tracking (albiet the accuracy has been said to be questionable), but there is no mention of a guided CBT-i program. To me, a guided CBT-i program should be the flagship feature of every one of these devices. A few years later and my desire to try this device has dwindled completely.

BrainTap claims that its visual and auditory stimuli will reduce stress and burnout, which then improves brain health by helping to form new neural connections. You can choose an "entrainment" for energy, relaxation, or sleep. It's $900 to get started and requires a pricey annual subscription. A friend of mine told me his mom has one and she loves it.

OpenBCI is essentially a home version of the hospital-grade sleep study devices. Getting started will run $1300 for the board and a very basic EEG cap and there is no CBT-i program. There isn't even a phone app as this device is for advanced nerding only - it appears to strictly be an EEG recorder.

The Apollo Neuro is a wrist device that delivers vibrations to stimulate and calm your body for improved health and sleep. The Neuro is currently available on Amazon for $350, so there are reviews ... though they are mixed with lots of band quality issues. There is no mention of a guided CBT-i program and I feel the price to try it isn't worth it when FRENZ is an option.

ZenBud, not to be confused with ZenBuds. The oddest of the bunch, this headset transmits ultrasound to your vagus nerve to promote relaxation and calmness. The website is a scroll-fest of words that really don't say much about the product. It is recommended to use the device 1-2 times a day for 5-30 minutes. This may be effective for people with sleep problems caused by cortisol issues, but that is just my guess. I don't think this is intended to be worn for sleep, so no sleep tracking or CBT-i. $500 and requires additional contact gel so the device can interface with the body.

Dodow is a $60 device you place next to your bed. Touch the Dodow and it projects a light on the ceiling to coach you through a breathing excercise that promotes tiredness. Since it is backed by Amazon's return policy, this might be something worth trying. However, I am immediately turned off by the fact that the projected light is blue.

The above devices do not seem like a great fit. For meditation, another option would be the Headspace app.

FRENZ
Based in Colorado, the FRENZ might be the best alternative to the Dreem ...and possibly an upgrade. Research for this headband started at least as far back as 2018 and the device began shipping Q1 2024 for an intro price of $490 - that's less than what I paid for a used Dreem 1 in 2021. A downloadable user manual would be nice, as the site is currently pretty sparse outside of vague promotional videos and overly-pastel daytime photos that border on absurd (granted, they all do this). The FRENZ headband and app seem to promise all that the Dreem did, including "Deep Sleep Boosting" which likely means it adds sound to prolong deep sleep. Like the Dreem, the FRENZ app includes CBT-i, appearing to be guided to make suggestions for improving sleep - I am not sure why this isn't pushed at all in the promo videos. The FRENZ also seems to be intended for daytime use to increase relaxation and focus.

And finally, a review on a sleep device from someone who actually has sleep issues. This review was from someone claiming to have sleep-onset insomnia.

The FRENZ is on Amazon (I had to search for the link via Google), so I was able to read a few reviews that appeared to be by verified users. Interestingly, and I had not clearly read this elsewhere, the FRENZ tests different sounds out and the AI eventually learns what provides you the best sleep.

MYWAVES
Adhere this interesting device to your forehead one night every three months so that this "pebble" can record your unique delta brainwaves. This data is sent to MyWaves, which returns a few personalized sound files for you to play the following nights - hearing these tracks encourages your brain to fall asleep. There is no sound played while you sleep and i imagine you would start the track over if you wake up again. Introductory priced for 2024 at $260, with a retail of $600. It appears that an annual $60 audio subscription will be required after the first year for each user. However, it seems you only need one pebble kit for the entire household. There is no sleep tracking or CBT-i. The concept of this device causes me to question how well the Dreem and FRENZ might use sound to promote sleep. The MyWaves research alledgedly found that we all cannot benefit from the same sound track. The MyWaves should start shipping Q4 2024. I am intersted in this device as my biggest issue in 2024 is getting back to sleep when (not if) I wake in the middle of the night. My hang-up is that if the company ceases to provide new sound tracks (ie takes the servers offline like Dreem did), the device loses its effectiveness - I would hope it possible they could provide the software if they ever close shop.

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