Chris: Okay. Tressa has her hand up. I see the insomnia question. Let’s see, long-term insomnia, maybe you can ask on live. There you go. Except you’re on mute. There you are.
Tressa: Okay. Hi!
Chris: Hi!
Tressa: I thought I typed it in the Q&A, but just long-term insomnia, people haven’t been sleeping for 10, 15, 20 years. It’s still really hard to get them to sleep, and then they’re on some form of Kavinace of course, GABA, 5-HTP, maybe rotating. Any success getting them off?
Chris: Yes, but you have to be super methodical in terms of titrating the doses down and go really slowly and then also layer in other things that range from being easy to do and pretty accessible to being more expensive and more challenging. Some of the things that I’ve seen make really big differences have been pulsed electromagnetic field therapy, PEMF. BioBalance is the device that I think hits the best compromise between features and cost, but it’s still fairly expensive and out of reach for many people. It’s about $2,300, I think. Let me just make sure that that’s the right …
Tressa: And that’s another electric electromagnetic field.
Chris: Yes. I mean, Bemer is the one that’s been around for a long time, but Bemer is over $5,000. BioBalance is a mat that you can lay on, and also it’s a shorter pad to focus on parts of the body, but you can leave it on for up to 12 hours straight, so people can use it all night while they’re sleeping, and there have been some pretty good studies on the PEMF and long-term insomnia as something like 76 percent of people with insomnia resolved with PEMF.
Tressa: Do they not use it anymore or did they always have to use it?
Chris: I don’t think that study looked at the longitudinal impact, but, I mean, once you buy it, there’s pretty not much incremental cost of continuing to use it if you have to. The chiliPAD, which is now that I think called Ooler, by Kryo, it’s kind of like a thin cover that you put over your bed that has little plastic tubes in it that you circulate water through, and it decreases the temperature of the surface of the bed. There are a lot of studies that have shown—and you think about it from an evolutionary perspective, we evolved sleeping on a cool surface. We might have had animal skins on top us to keep us warm, but the surface of the ground was cool, and that helps regulate our body temperature, and so a lot of patients are having success with this.
I use one myself and it’s one of the things that’s really improved deep sleep in a lot of patients, like people who are even if their sleep overall is okay, they’re getting enough REM but not getting much deep sleep. This seems to have one of the biggest impacts on deep sleep. Ben Greenfield, we have our disagreements, but he wrote a book, really long—he didn’t write it, it was someone from Finland, interestingly enough, a lot of the sleep research and sleep devices are coming out of Finland, so that Oura Ring sleep tracking device is the finished product. I’m wearing one right here. It’s the best sleep tracker on the market. It tracks your sleep quality and duration, but also your sleep architecture, so it tells you how much REM sleep you’re getting, how much deep sleep you’re getting, what your wakefulness is, what your heart rate variability is, what your heart rate is, and that can give you some tips and ideas for how to intervene because the solutions for lack of deep sleep are a little bit different, maybe, than for lack of REM sleep.
Lyndsey, let’s see, I’m going to see if I can find the Ben Greenfield article on deep sleep because there are actually—the guy who wrote that, that’s where I was going with Finland is Ollie … I forget his name, but I think he’s Finnish and he is the author of Biohacker’s Handbook, which is actually a really good book. He has kind of collected all of the most impactful interventions for improving deep sleep, which is often the biggest problem in people who have long-term insomnia. I just found it. I’m going to type in the chat box here.
Tressa: Do you ever use or recommend Earthing?
Chris: Yes. I mean, that’s certainly worth a try. I think PEMF is more typically more powerful, but it’s also more expensive and less accessible. One other thing would be red light therapy, like near-infrared therapy, so I don’t know if you guys have seen this. I have got my near-infrared bulb here that I use—it is single-directional light—sometimes during the day, but I also have a near-infrared sauna. I’ve definitely had patients who just only near-infrared sauna use has cured their longstanding insomnia, so, like, doing it for 20 or 30 minutes before bed, taking a shower and then going to sleep, that’s been the big shift for them. Unfortunately, it’s usually a big process of trial and error and finding out, like, what makes the biggest difference for people, and even then you usually have to slowly back off of Kavinace or whatever else they’ve been on for a while because there can be a process of habituation a little bit there.
Tressa: Okay. Thank you very much.
Chris: Good luck. All right.