Unlock Better Sleep With Smart Tech Choices

Daniel Gartenberg, PhD

Thank you, Dr. Wells. It is an absolute pleasure to be here.

Audrey Wells, MD

It is a fantastic pleasure to have you. I want to jump into a question that I have about technology, and I am sure other people are wondering as well. Technology, electronics, screens—all of these things are a mixed blessing and a curse when we think about the last hundred years of human development. I wonder if you can explain how you view technology as both a helper for sleep and a potential sleep hindrance.

Daniel Gartenberg, PhD

Yes. Similar to nuclear technology, it can be used to power the world forever or to destroy the world in a nuclear blast. That is the way that I think about this problem of technology. Technology is just a tool. It is up to us humans to build it in a way that helps people and does not hurt people. As you elegantly said, I think for the past 100 years, technology has generally been good for society, but it has come at a major cost to sleep health. I would say since it started with electricity, which only became commonplace in the 1920s, it made shift work, where everyone had electric light in their home and whatnot. This made things shift. staying out and partying, and other things that negatively impact the circadian rhythm. It made that possible. 

There was a good Gallup poll when we first started tracking sleep in the 50s, showing that Americans have progressively slept less and less since the 50s going into 2010. It is about an hour less than we used to sleep. I will think about it, as our circadian rhythm is disrupted by these technologies, I think what has happened recently is that the blue light from the devices combined with TV is one thing, and there is blue light from that. One of my collaborators at Penn State, Dr. Anne Marie Chang, has done some pioneering work on how blue light disrupts melatonin and prevents you from falling asleep. But I think in the last 10 years, things have accelerated in the wrong direction because of social media. Having the screen pinned up to your face and scrolling through Instagram in this weird, double-mean cortisol experience has hindered sleep health, especially for younger kids and adolescents. This is why I think there is a bad problem with depression, and anxiety reports showing for the younger population. It is a combination of the devices and poor sleep health. 

That is the negative side of things. The positive side is if we use technology in the right way, sorry, there is one more negative side. That is Orthosomnia. A lot of times there is a new phrase in sleep science where your OURA Ring, your WHOOP tells you you have a bad sleep score. Maybe you are already anxious about your sleep. You naturally have a worrisome thinking style, something like this, and you see a bad score on your device, which makes you more anxious, and you end up sleeping worse. I know you know about Orthosomnia. It was a relatively new concept around two years ago when all these devices started taking hold. It is knowing how to interpret the data. Sometimes, if a device tells you something, it leaves more questions than answers. 

Those are the hard things that we have to navigate when it comes to technology. But there is a way. We can make technology that does anything we want. I have tried to focus on a way of presenting the data understandably, contextualizing the data for people, and then trying to make tech that separates the phone, which I see as an accurate sensor, but also tries to use the phone and other devices for sensing while putting the device in its place. I have some technology that we can go into around that, using sound, light, and temperature to enhance sleep. These are the positive things that technology can bring into the fold. It is up to us to understand how to use it in a way that is going to help us.

Audrey Wells, MD

That is very well said. Like anything, there is a balance in how people are approaching technology, particularly at night. I think in addition to the light stimulus, there is also that emotional stimulus from scrolling or interacting with social media that can compete with not only getting to sleep but also staying asleep. I wonder, in your work, what are some of the limitations that you have seen with wearables and neural devices tracking sleep or giving reports about sleep quality or quantity?

Daniel Gartenberg, PhD

Yes, I know this intimately. I have studied in a lab, OURA Ring, the Apple Watch, and Spectrum Pro, which is a more clinical device. There is more. Both of them have fallen by the wayside. Sensei AI, and we will study them alongside polysomnography. Hooking people up to the electrodes. I built open-source models based on these data sets for predicting sleep. We just published a paper in the journal Sleep Health where we are making our algorithm available to clinicians and researchers so they can understand the error for the devices because that is a major problem for billion-dollar companies like Oura and Fitbit. They will not open up their algorithm because they see a lot of value in it. 

We decided to build, I think, the most accurate algorithm from wearables and then open up our sleep-wake detection algorithm so clinicians and researchers can use it in a way where they can evaluate if there is an error or not. In the data and the margin of error, something that happened a while ago was that Fitbit randomly changed their algorithm, and then everyone just started getting a half hour more of sleep or something like that. That is an issue with Black Boxing. You cannot do a postmortem on the data to see how it shifts or recently changes its algorithm, too. 

When I am looking at the data and so many people ask me, my OURA Ring says this, and SleepSpace says that. What does it mean? It says I am only getting half an hour of deep sleep. 

This is where the Orthosomnia thing comes in. I have to say to them: think about the data in more relative terms than absolute value terms. Building these algorithms, I know how accurate and inaccurate they are. If you are familiar with signal detection theory, which is a little bit nerdy, you can think of it as a measure of accuracy from 0 to 1. Sleep-wake, the area under the curve, which is how we think about accuracy for a wearable is 0.95. That is my current algorithm. For light sleep, it is 0.77. For deep sleep, it is 0.8. For REM, it is 0.85, or something like that.

Audrey Wells, MD

The higher the number, the more accurate the signal is reporting.

Daniel Gartenberg, PhD

Yes. It is good for sleep. Wake when we have a heart rate and motion sensor on the wrist or a finger. Another part of this is that the algorithms are made for healthy white people. That is another aspect of this as well. There is a lawsuit now going on against Apple because their sensor is a little bit racist. Because there is a pigment issue with the wrist,

Audrey Wells, MD

Detecting that oxygen level?

Daniel Gartenberg, PhD

Yes. For pulse oxygenation, photoplethysmography is what they used, PPG and the green light do not distinguish certain skins as well. Also, keep in mind that a lot of these algorithms are made for healthy populations. OURA algorithm used to fall apart for super-healthy people who had a low heart rate. It would say you got 3 hours of deep sleep, which is essentially not possible unless you are a developing child. It is hard for an adult to get 3 hours of deep sleep. That is another thing. It is the population that is why the Ring Form Factor is better because it does not have that pigment issue. The hands are generally the same pigment, no matter their layers. The Form Ring Factor for the finger is just a little bit better for a couple of reasons. As you can see, it is a complicated discussion. The other part of it is that if you have an issue with insomnia, there are a couple of things to do with that. There is one thing if you are optimizing your sleep, there is nothing if you have sleep. If you think you might have sleep apnea, we can go into that. Speaking about insomnia for a second, time in bed is an important measure.

If you are trying to use cognitive behavioral therapy for insomnia, which is the recommended treatment for insomnia. A lot of times, you will try to do stimulus control, where you associate the bed with sleeping. The rest do not know if you are in bed or not. that the sensor does not know. That is why I also combine a bed sensor, and I have a way of doing this with my tech with a risk sensor. That is the best possible bang for your buck. But on top of that, your perception is the most important thing when it comes to insomnia. As I am sure you are aware, there is sleep state misperception. Is this a type of insomnia where you think you are sleeping a lot worse than you are? It is still insomnia. You are perceiving that you are sleeping poorly, but you are not sleeping as badly as you think you are.

Audrey Wells, MD

Yet you still establish the psychological effects of feeling like you have insomnia or daytime problems with concentration or mood. All of those are still present for somebody who thinks that they are not sleeping.

Daniel Gartenberg, PhD

Exactly. That is why, if you have insomnia, your perception is almost more important than anything that any wearable is ever going to tell you. That is why we have the consensus sleep diary as an important measure. As you can see, it is complicated. It matters about your issue. It requires metacognition to know what your issue is. If you think you have some underlying apnea, then you should use an FDA-approved device that can be used to measure pulse oxygenation or diagnose apnea. Westborough. There are a bunch of them now. Watch pad, as I am sure you know, Chenone. Now, I use this Circul Plus. It is not FDA-approved yet, but it has some pretty good measures of pulse oxygenation.

Audrey Wells, MD

Absolutely. I want to highlight a few of these points that you made, because what you are saying is so in line with my clinical experience of people who struggle with their sleep. Orthosomnia is the anxiety around the interpretation of the data you are getting from your wearable devices, which are by definition, at this point, flawed or limited, at least in terms of sleep staging, especially. One of the things I love about the wearables, though, is that they elevate your sleep and your consciousness, which helps people focus on that and maybe make some changes to improve their sleep. What do you think about that in terms of looking at the overall picture from one night to the next? To the next to the next.

Daniel Gartenberg, PhD

Exactly. Thank you for bringing out the pot. I was dashing them for a little while, but thank you for bringing that out. That is the positive aspect. When I tell people to use the data, I usually suggest that they use it in relativistic terms. I think there is a good signal. If my OURA Ring told me I got 40 minutes of deep sleep one night and then an hour and a half another night, there is a signal there, and then they can use that relative truth to identify whether it was that alcohol. One of the main things that people identify once they start using these trackers is how much alcohol destroys deep sleep. Another one they might notice is that THC can inhibit the REM, which is just another example. Yes, they are looking at the positive.

Audrey Wells, MD

This is a little bit near and dear to my heart because I have been using OURA for a while, and they changed their algorithm a little bit. What I noticed was that all of a sudden I was getting a lot less deep sleep, and it left me feeling a little disappointed because I was waking up and seeing that I was getting a certain percentage of deep sleep the night before. As a sleep medicine physician, I can understand that that was just an artifact of how deep sleep was measured. But as a human being, I still had that adherence to performance. I think it is tough when you are looking at sleep as a performance measure because you are unconscious. You cannot affect that too well when you are sleeping. Instead, your sleep must be supported by daytime activities—alcohol consumption, for one. I wonder if you can list some other factors that would affect the measurement of your sleep with a wearable device or a neurable device.

Daniel Gartenberg, PhD

Yes. There are some weird things that you might not expect sometimes. I remember you must be one of those people who is pretty healthy with a low heart rate because that is or was very biased towards your type of person. It is because it was a proxy for overall health in a way. It almost made sense in a way that they had it that way. They are saying you are a healthy person. They are erroneously saying that that means you are getting more deep sleep. Interesting.

Audrey Wells, MD

On some nights, I would have a deep sleep report of two and a half to three hours, just as you said. I knew that was not possible at my age. I was already incorporating that, taking it with a grain of salt, if you will. But again, when it changed, I was a little disappointed.

Daniel Gartenberg, PhD

Yes. back to that question. It was that whole situation that was interesting. There is weird stuff I have seen, especially for the neurable sensor that we have—cats jumping on the bed. We will create a big artifact. I know one of my clients has four cats. You can see the cat; it looks like she is sleeping horribly, but it is the cat being a nocturnal creature and jumping on the bed at all times, which is something. But that is also a relevant signal, because that is, Hey, listen, maybe we can try to do something to get the animals out of bed. Also, with measuring the bedrooms, the bedtime sensor and the sleep partner play a role too. factoring that in or out, and we have some ways of doing that by having a sensor on each side of the bed. That is another thing that can play a role. 

What I have seen in the literature is that there are some counterintuitive things or some 

interesting things that you may not realize that can improve your deep sleep. Most of this comes from mouse studies, but it has also been replicated in humans, which means that learning new tasks during the day will help you produce more deep sleep. This is one of the best things for reducing dementia and Alzheimer ‘s-related dementia and cognitive decline: learning a new skill, whether it is a language or even meeting people. One of the hacks that I have is if you exercise to try to take it outside, to try to take different routes because you are encoding different information. It is just subtle things that, when we are constantly learning, give our body a reason to have more deep sleep, because deep sleep is how we process information, essentially, through exercise, sunlight, consistent bedtime, and wake time.

Audrey Wells, MD

Things are ingested. You mentioned the alcohol. I am thinking of caffeine. How late in the day do you eat your medications?

Daniel Gartenberg, PhD

Yes. Those are big factors, too. I have a pretty high tolerance now. I will just stop at two. I am pretty good at stopping at 2 p.m. with the caffeine. Also, caffeine can be your friend, too, if you are trying to stay awake a little bit. If you have a sleep problem, I am not. There are benefits to caffeine, but it can have a negative effect as well. One little hack is to cycle in decaf for one week out of the month and reduce your tolerance for it. You are not having to constantly take more and more caffeine to feel the effects. It is a subtle hack. Then, if you do have sleep apnea, which is very common. I do not know if you have been following my journey with a diagnosed thing; I have a mild case of it myself. I gained around 20 pounds over COVID, and the statistics are that by 2030, half of Americans will have sleep apnea. Due to the obesity epidemic and people getting older, the muscles just get weaker when you get older. It is common. Even if you have four hypotenuses per hour, you should probably have less than that, which is less than the diagnosis. Five is usually the threshold. Trying to solve that problem is one of the first places to start. Yes. Do you have any others?

Audrey Wells, MD

I endorse what you are saying, and I think when I talk to people about their experience with wearable devices, there are a few questions that come up as common. One question is: which one is the best? Another question is, if I have a sleep disorder, will this pick it up? The third is: how do I improve things? We touched on how to increase sleep and improve deep sleep and REM. I wonder if you can speak more about your favorite trackers, presumably the ones that are most accurate and easy to use, and then also, how people who have a sleep diagnosis would view the data from their tracker.

Daniel Gartenberg, PhD

Yes. I have gone through this journey myself. Originally, I just had small contracts with these companies, just to investigate how well their devices worked. Then I stumbled upon the fact that I had a problem, which was an interesting thing to discover. If you think you might have, when I try to get someone to rule out a breathing problem, I will recommend that they try Wesper. This is my suggestion, it is two patches, FDA-approved. To be used by a clinician. A clinician can use it to diagnose sleep apnea. It requires three days, which I have. It is rechargeable because I have had issues. For example, with myself since I am a mild case. One night, I will not show up. I am not exactly sure what it is because I barely drink and stuff like this. Maybe it is my position, or I am not sure. Maybe it is a stressful thing for that night. One night I will show no signs, and then another night I will show signs, which was an interesting finding that I got from Westborough. But they have a thing just for $79. You can get the device for a month. 

Which gives you the information you need to get diagnosed. You can either, I think, set yourself up with a doctor for $160 or, I think, bring the data to your doctor and they can diagnose you. I got the actual diagnosis from a medical doctor for, I guess, $250 total when it was said. You do not have to, do you? If it says you have no problem, you could probably not go to the M.D. for the extra $160. You can rule out the problem for 80 bucks. That is what I recommend for that problem now. Then for continuous monitoring. I do not necessarily want to wear two patches every night. I like this Circul Plus for continuous monitoring because of the problem with OURA, and I have not tried the new OURA that has pulse oxygenation, but I know that it is averaging over 5 minutes or something like that.

Audrey Wells, MD

Right. Whereas the.

Daniel Gartenberg, PhD

Actual Yes.

Audrey Wells, MD

The Circul Plus is measuring every second.

Daniel Gartenberg, PhD

Every second.

Audrey Wells, MD

It shows a very high fidelity to simultaneous ABG gas measurements. Where the blood gas is sampled directly from the blood vessel and compared to the readout from the Circul Plus ring.

Daniel Gartenberg, PhD

You know more about it than me. I did not have details. Meyer Krieger works with them. He is the author of Sleep Apnea. That is a pretty legit person on your team. Yes, I have been liking them. Getting the one-second resolution lets me make actionable things from it. Do you know what the actual resolution of OURA is?

Audrey Wells, MD

I know that is an average, but I do not know how it is computed.

Daniel Gartenberg, PhD

But that is the thing. You need the granularity because you are looking at changes over a very brief period. Since it is always such a high value, typically, OURA is all saying you have a 94% average, but that could still be a problem if you are having these drops.

Audrey Wells, MD

Definitely. Yes. I think it is one of the limitations of these consumer-grade products. I would be hesitant to rule out any sleep diagnosis from a wearable, simply because any home sleep test, especially a home sleep apnea test, does tend to underestimate the number of airway obstructions, especially the airway obstructions that cause a brief arousal or awakening from sleep. This could explain some of the variability you are seeing with your testing. If you wake up a little bit instead of dropping your blood oxygen level, that device does not necessarily capture those events. Overall, the severity of sleep apnea can become diluted. I think it is true. It is the direction we are moving in to add EEG to home testing as a way to capture the arousal coming from a blocked airway. I think that is going to be a phenomenal revolution in-home testing. I wonder what else you can talk about that is the future of sleep technology and how we are going to move in that direction.

Daniel Gartenberg, PhD

Yes, sure. To your point, Apple just released a patent with their Apple earbuds to include an EEG in them.

Audrey Wells, MD

That is fantastic.

Daniel Gartenberg, PhD

Just to go back to this is not FDA-approved or anything. This is still a consumer. I think they are getting the pulse oxygenation FDA-approved, but it is not there yet. This is still considered a consumer thing. But this is the best consumer continuous monitor I would say.

Audrey Wells, MD

Agree.

Daniel Gartenberg, PhD

Agree with everything that you said that you cannot rule it out. But if it does mention a certain problem, you can get pointed in the right direction.

Audrey Wells, MD

Yes, in a way, the home test devices are only useful if they are positive, and if they are not showing anything, I would say they are inconclusive. In the presence of symptoms, a person should seek medical care for them.

Daniel Gartenberg, PhD

Yes. Okay. The future. This is what I see, and I think you will be excited about this future vision too. Beyond my vision of the ideal sound and light temperature environment to promote deeper sleep, I have nailed sound and light. I want to do more temperature stuff. There are eight sleeps, and there is a pillow for this now Luna is not publicly available yet, but there is a theoretically ideal sleep environment that will make everyone sleep more deeply. My tech, had just a sound machine such that we could more effectively block out noise pollution with the speakers of the phone. But beyond this, for sleep medicine, I think the future is when the different branches of this diverse field start speaking and talking to each other.

Audrey Wells, MD

Integration, yes.

Daniel Gartenberg, PhD

It is crazy how the ASM and then the Association of Dentists have different solutions for this problem. There is CPAP, which is the recommended solution. Let us just talk about apnea for a second. The recommended solution for sleep apnea is CPAP. If you are non-compliant, which around 50% of people are, or a mild to moderate case, the dentists can make a mandatory advancement device that also has efficacy. Also, when you combine these two, they are not necessarily mutually exclusive to one another. Some studies are showing that when you combine them, it is even better. 

However, the dentists and the pulmonologists do not work together. You rarely see that happening. Some dentists can take business from the pulmonologist. There is that thought, and vice versa. Then the other part of this, there is a good randomized clinical trial showing that people with COMISA, which is about 40, so say COMISA, have Co-Morbid Obstructive Sleep Apnea and Insomnia, and it is very common. About 40% of people who have OSA also have insomnia, partly because their insomnia is about having a high arousal ability. If you are not breathing throughout the night, you are going to be more susceptible to arousal. There is a recent randomized clinical trial showing that treating people with cognitive behavioral therapy for insomnia who have COMISA, reduces hypoxemia and breathing issues. Which is interesting.

Audrey Wells, MD

It is. I think these two conditions interact negatively with each other in a way that we do not quite understand yet. Being that they are the two most common sleep medicine diagnoses. That is one of the reasons why they are paired for this summit so that people can understand that within one individual, both conditions may be coexisting and interacting negatively. Thank you for mentioning that.

Daniel Gartenberg, PhD

That is why I am trying to make something new. I am working on this now. This is cutting-edge stuff, but we are trying to validate a new treatment for the COMISA that brings together all of these effective modalities within some artificial intelligence, digital-based cognitive behavioral therapy, and that is the future that I see. I would love it. Dr. Wells, you could maybe be a part of this too If I get this next batch of grants, it would be great to work with you on some of this stuff too. But I imagine that when you go to your doctor when you go to your dentist, there is some way to determine which solutions would work best for your issues, and you would get a treatment that is tailored to you for a precision medicine solution.

Audrey Wells, MD

I love that idea, and it is something that I am trying to create because I think that behind the doors of traditional medicine, traditional health care, and the health care delivery system, it is hard to implement that. People are not seeing their physician frequently enough, and even then only for 20 or 30 minutes at a time, which does not allow for that personalization component or even the education necessary to cultivate that for yourself. I wonder if you can talk more about the ways that sleep space has taken on to help people understand their sleep and understand what may be an issue that needs to be tracked or brought to medical attention.

Daniel Gartenberg, PhD

Yes. Thank you for bringing that up, anyone can try it out for free for 30 days with this code that I think that I am going to make available on this. We have developed a cognitive-behavioral therapy-based solution that integrates and augments typical therapy. We ran a randomized clinical trial not to replace the cognitive-behavioral therapists. These are usually psychologists, but to augment their practice. There have been other solutions in the past that have been FDA-approved. They are called digital therapeutics. An example was Somryst, and another was Nerivio so they are designed to replace the clinician. That is not our approach, where we are trying to augment the clinician with new tools that make them more effective. 

We are showing that compared to sleep hygiene control and treatment as usual, shows that when that therapist uses our Internet of Things solution where there are meditations, there are lights that turn red and then ramp up at bedtime that the clinician suggests bedtime and wake time. That it will ramp up at the wake time for a smart wake experience. We have this thing called a sleep journey which has ocean waves that go into a sound machine that goes into 528 hertz and affirmations in the morning. Then every day they get a new task that is part of their six weeks of cognitive behavioral therapy for insomnia. We just completed the last participant a couple of weeks ago, and we are going to unblind the data literally in a week or two to see if we are the most effective treatment for insomnia when a clinician uses our system compared to when they do not, they do their typical treatment.

Audrey Wells, MD

That sounds exciting.

Daniel Gartenberg, PhD

Hopefully, it works.

Audrey Wells, MD

I have used the app, I have been on a sleep journey and I want to say that it is enlightening because you get information that is evidence-based and solid, high-quality information. I noticed that the sound component of the SleepSpace App is something that helps to sleep. I have also had occasions when I am waking up in the middle of the night toward the front of the night, and I notice different pulses in that sound. Is that a feature of the app?

Daniel Gartenberg, PhD

Yes. We do this thing called deep sleep stimulation, and it works better if you have a smart bed. We have a phone charger that detects micromotions and turns off the sound. If you start to wake up, you are supposed to be underneath consciousness. You should not be conscious of the sound. But what got me interested in this is that we have a peer-reviewed paper showing that this is possible in a laboratory environment and that if you pulsate sounds at the delta wave frequency during sleep, it can prime these regenerative brainwaves.

Audrey Wells, MD

That sounds great to me. Anything that says regenerative brainwaves sounds like a plus.

Daniel Gartenberg, PhD

Yes, so It is easier said than done. you probably should not have been perceptually aware of it. That means that hopefully, it did not cause any problems. But It is supposed we try to do it at the level where you are not going to be perceptually aware of it. Then if we have if you are using an Apple Watch or our Sleep-based smart bed you can place the phone on the bed at the foot of the bed, which is a bad sleep hygiene thing. But, if you put it if you have a big bed and not a sleep partner, it could make sense then were more accurate at delivering the deep sleep stimulation sound. That is why getting the phone in the same place every night was very important for me because I want to play the sounds very precisely. But the issue is if you play a sound too loud, it easily wakes the person up. That is the tightrope walk is how to play the sound so that the brain responds to it, but it does not push them into an arousal.

Audrey Wells, MD

Got it. I think one of the limitations in my case was that I was not using your smart bed feature and my phone was on the bedside table. Yes.

Daniel Gartenberg, PhD

It does not work as well. Yes.

Audrey Wells, MD

That Yes. I still thought it was interesting. In preparing for this interview today, I also wanted to be sure and ask you about targeted memory reactivation. Can you explain what that is?

Daniel Gartenberg, PhD

Yes, that is also the future that I am working on. That is another line of research that I am exploring. There are some classic papers around targeted memory reactivation, which you can Google and see all the science in there. It is not necessarily my thing that I have discovered, but I added to it in a way. The classic study was that people would do a cognitive task, a memory task, or something like this while they smelled the scent of roses. Then, there is a recent meta-analysis recently showing that during and to sleep, it is most effective if you reintroduce the smell of the roses, that you created this association between the task and the smell during the day, that it primes that association. Those individuals do better on that task the next day. It is a fancy scientific term for Inception if you are familiar with that. That movie with Leonardo DiCaprio. I have this whole method where you can focus on meditation, play a sound while you are doing the meditation, like rain sounds, and then you will try to build that association, and then we will replay the rain sounds when you are in different stages of sleep and try to get you to prime that association. I think it can be useful for nightmares, things with memory, and even trying to actualize your ideal self. It is a better way to meditate and get into the mind space because it augments the meditation by integrating that into your dreams.

Audrey Wells, MD

That is so fascinating. My mind is going crazy with potential applications, and I am also impressed with how much of a sensory experience sleep is. Light primarily drives sleep and wake. Temperature can signal a sleeper’s wake. Sound, and smell. This brings us back to our roots as human beings, and how we have to honor that. Honor sleep is a biological need. It is fascinating to hear how we can apply technology to accentuate that augmented all in a way that does not involve pills.

Daniel Gartenberg, PhD

Exactly. Yes. That is, the vision is non-pharmacological multisensory solutions. It is just easier said than done, This stuff with the sound is pretty complicated. If you want it to go into temperature, it is complicated. Even the limbs—how you respond to how your limbs respond to a temperature—are different from how your core might respond to a temperature. There is a way of doing it. It is just a complicated science to do it the way it is.

Audrey Wells, MD

Well, I so appreciate that you are working on this to distill out the important factors as we wrap up here. Dr. Gartenberg, I wonder if you can tell me how people who are watching this can find you.

Daniel Gartenberg, PhD

Yes. My tech is at sleepspace.com, and anyone can try it for free for 30 days. If it works for you, then great. Then, after 30 days, maybe you can pay a small subscription fee. They go to sleepspace.com/union, and you can cancel any time before that, and you will not be charged any at any point. You will not be charged at all. That is sleepspace.com/union.

Audrey Wells, MD

Got it. I certainly appreciate your time today. Thank you so much for talking to me and bringing your expertise to the discussion about sleep and technology.

Daniel Gartenberg, PhD

Thank you so much. Appreciate it.

Audrey Wells, MD

Take good care. Bye bye.