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How to spark the conversation with your doctor about sleep

Even though sleep is such an important part of health and well being, most primary care doctors do not ask us much about it.  

Most doctor appointments are rushed, typically lasting only about 15 minutes, and there is little time to do more than what is needed in the moment.  Most primary care doctors do not have formal training in sleep assessment. In fact, few have more than 2-3 hours of education on sleep during their medical training experience. Even after practicing, one study showed that primary care physicians have poor knowledge about sleep.

Sometimes, we have physical symptoms of possible sleep disorders as soon as our head hits the pillow, like a strange need to move our legs just when we’re about to fall asleep. Others remark on how loudly their bed partner snores, or how tired they feel the day after a supposed “good” night of sleep. You may have experienced these feelings or situations or know someone who has. These are all warning signs for not having adequate sleep, something you should talk to your primary care doctor about.  

When we visit the doctor, they take our weight, blood pressure, pulse rate, and sometimes check the levels of oxygen in our blood. They might ask about exercise, smoking, or how much we drink alcohol and possibly diet. But rarely will anyone ask about our sleep!  

We often dismiss what happens during the night as a reflection on how we are feeling during the day, questioning how the things that go on as we sleep could possibly affect us in our waking lives. Some shrug it off, figuring it must be something else causing them to feel this way.  

Think about this: if we live to be 90 years old, we will have slept for 30 years! This fact alone means that sleep is a very important and essential component to our health and well-being. A lack of sleep holds a lot of weight, so it’s important that we be aware of the consequences.

Here are just a few things that good sleep is needed for:

  • staying alert while driving
  • our work-life productivity
  • our body’s ability to use sugar
  • our body’s ability to fight infection
  • our ability to handle stressful situations

All this and more is directly tied to getting the right amount and quality of sleep. Poor sleep can make other medical conditions worse. The reverse can happen too, with medical conditions worsening sleep quality and quantity.

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If you’re concerned about your sleep, what can you do? First, you can start by assessing your sleep at home. This can be accomplished by completing a daily sleep-wake calendar, logged over the course of at least one week. A calendar will help you to be able to have a better overview of how you sleep, and can also be helpful in setting and meeting goals for how long and well you sleep. Sleep calendar apps like Sleep Cycle and Sleep Better are accessible from your phone, or you can be traditional and use pen and paper. The important part is that you’ll consistently track your sleep and use your calendar.

If you are having problems, your calendar can serve as a record to provide a good conversation starter with your primary care doctor.

Feeling sleepy during the day? You might have insomnia, or something else, like sleep apnea. There are many parallel symptoms that sleep apnea and insomnia share, like impaired cognitive functioning during the day, feeling tired all the time, and falling asleep during the day without meaning to.

High quality, restful sleep can make a difference in how we live, feel, and interact with others.  Having a sluggish a day following one night of inadequate sleep is common, but if you don’t sleep well night after night, think about how it affects you, your family and friends, and your workplace colleagues. Sleep apnea has been linked to many health issues, including: irregular heartbeat, high blood pressure, type 2 diabetes, depression, heart attack, and stroke. A lack of deep, restorative sleep can also impair attention and short-term memory.

Think of the importance of good sleep like this: imagine a three legged stool, where the “seat” is your body. Each of the three legs represent nutrition, exercise and sleep. In order for the body to be balanced, the legs all have to be even. If one of the legs is too long (i.e., eating too much) or too short (not sleeping enough), the body becomes unbalanced. Each of the three legs need to be the correct length to keep ourselves stable and healthy.

I like to say, “we are how we sleep.”  If you are having sleep issues, whether short or long-term problems, bring up your concerns not just with your primary care physician, but a specialist trained in sleep health medicine. The discussion may very well save your life.

Robyn Woidtke's entry into the sleep medicine world came through the neonatal field and conducting SIDS research at Stanford. In addition to her sleep background, she has extensive clinical affairs experience in medical device product development, clinical marketing, and the integration of sleep testing for clinical research professionals. Robyn is certified in Clinical Sleep Health and has been published in numerous respiratory, sleep, and clinical research journals. She has a Masters degree in Nursing and an undergraduate degree from The George Washington University.

July 30, 2018