Sleep monitor

For everything and anything else not covered in the other RLS sections.
leggo_my_legs
Posts: 349
Joined: Sun Oct 16, 2016 12:29 am

Re: Sleep monitor

Post by leggo_my_legs »

I use a free app called Camera Trigger to motion trigger videotape on my samsung S2 tablet. I was using Wardencam but this is better. I find it helpful, validating, (and right now upsetting because I'm not doing well yet). But I like it bc it gives me data for the doctor. For example, I know there's been no change in sleep quality from gabapentin 300 to 600.

You can set a lot of parameters, such as how long to videotape when it senses motion. You have to sleep with the light on though. It can save locally and to google drive, but GD is unly at 10 min intervals so If you want all, you have to look at the local files.

stjohnh
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Joined: Sun Feb 14, 2016 3:13 pm
Location: Palo Alto, California

Re: Sleep monitor

Post by stjohnh »

The basic problem that I had in trying to evaluate my sleep using monitoring apps and techniques is that the data from ones that I tried did not correlate with how I felt. I used numerous movement monitors, heart rate monitors, sound monitors, and heart rate variability monitors.

There were many times an app would indicate I had a good night and I still felt terrible the next day. Also many times an app would indicate I had a bad night and I felt "OK" the next day (I never have truly good days anymore).
Blessings,
Holland

stjohnh
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Joined: Sun Feb 14, 2016 3:13 pm
Location: Palo Alto, California

Re: Sleep monitor

Post by stjohnh »

I have been experimenting with medications over the past couple of weeks in attempts to get better control of my restless leg syndrome, insomnia, and malaise.

That has rekindled my interest in having a better measure of deep sleep rather than how I feel the next day, which at best can be classified as okay, bad, or terrible.

To that end I have re-evaluated the use of heart rate variability (HRV) as a proxy for deep sleep. Also the apps available compared to a year-and-a-half ago have improved, although none are really well tailored for complete monitoring of a night's sleep.

I have found the combination of the Polar H7 chest strap and Elite HRV app to be a better combination than anything I tried a year-and-a-half ago. I also have better understanding of how to correlate heart rate and HRV to use them together to help determine an episode of deep sleep. I'll be happy to provide the details for anyone that is interested in going this route. The Polar H7 chest strap sensor is about $70 on Amazon, there is a newer one that has been recently released, the Polar H10 which is about $5 more, reviews seem to indicate that it is probably better than the H7. The app is free. There seems to be growing interest in using HRV to help determine episodes of deep sleep, so I am hopeful that over the next year or two that better apps will be released. The Elite HRV app is functional, however it is sort of slow and doesn't provide the types of graphs that I would really like.

I also evaluated the possibility that heart rate variability patterns in patients with RLS do not accurately reflect the actual amount of deep sleep. Heart rate variability is influenced in a complex way by a variety of medical problems, heart problems and neurologic problems. Happily I found a paper that discusses this particular concern and they found that heart rate variability in people with RLS has the same implications when used for sleep evaluation as for people without RLS
Blessings,
Holland

ViewsAskew
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Location: Los Angeles

Re: Sleep monitor

Post by ViewsAskew »

Hope I remember to ask when I am not stumbling along at 3 AM awake with RLS!
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

yawny
Posts: 264
Joined: Sun Nov 08, 2015 4:20 pm

Re: Sleep monitor

Post by yawny »

My husband tracks his sleep with the Apple watch and the AutoSleep app. He likes it and thinks it’s pretty accurate.

Frunobulax
Posts: 422
Joined: Mon Jun 02, 2014 7:41 pm

Re: Sleep monitor

Post by Frunobulax »

stjohnh wrote:To that end I have re-evaluated the use of heart rate variability (HRV) as a proxy for deep sleep. Also the apps available compared to a year-and-a-half ago have improved, although none are really well tailored for complete monitoring of a night's sleep.


Do you have some data on how to distinguish between sleep and being awake? I developed an App myself that tracks leg movements (I strap the phone to my legs), because I found all existing apps to be very lacking, back in 2014. But I basically stopped development because there was little interest, and I would need both a group of reference patients and some scientific support, like checking the results of my app against the result of a sleep lab report. My main interest would be not only to detect sleep, but to determine which sleep phases I'm in. Just "sleep" isn't enough, it's crucial to detect the sleep quality too, the soundness of the sleep cycles. Are there decent publications that link stats like heart rate, breathing frequency etc. to the different sleep states that one could access without returning to college for a year? :)

Anyway, using heart rate is an interesting thought. (I did consider using data from a CPAP device, but couldn't access the data because my device wasn't supported by Sleepyhead, a program designed to evaluate this data.) I guess it should be possible to integrate some heart rate tracking to my smartphone app.

stjohnh
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Joined: Sun Feb 14, 2016 3:13 pm
Location: Palo Alto, California

Re: Sleep monitor

Post by stjohnh »

Frunobulax wrote:Do you have some data on how to distinguish between sleep and being awake?....
[/quote]

I don't have any data on determining awake versus being asleep, however heart rate by itself is not likely to be very good for that, since meditating or relaxing can produce a fairly low steady heart rate and still be awake. Movement sensors like fitbit bracelets and the like can help determine movement and that is one indication of the difference between asleep and awake.

I haven't actually cared very much about determining asleep versus awake, I can get that information more or less just by myself. I am much more interested in deep sleep (also called SWS, slow wave sleep or N3 sleep) which is the restorative sleep that is missing in many folks with restless leg syndrome.

Slow steady heart rates are a fair proxy for deep sleep, however REM sleep can sometimes produce that as well. Heart rate variability is a much better measure of deep sleep and is helpful for determining other sleep cycles as well in conjunction with movement sensors and heart rate.

There's lots of information about it, just Google heart rate variability and sleep cycle.

You are correct, the apps are really not well designed for sleep analysis, there are lots for exercise. I would love a good app that integrated heart rate variability with heart rate and movement to determine deep sleep. The hardware is easily available and inexpensive, the software just isn't there yet.

I use the HRV Elite app, it also doesn't work well at all for sleep analysis and I have to print the data graphs on several pages and manually determine which sections have deep sleep, takes me about 15 or 20 minutes each day.
Blessings,
Holland

stjohnh
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Joined: Sun Feb 14, 2016 3:13 pm
Location: Palo Alto, California

Re: Sleep monitor

Post by stjohnh »

SLEEP MONITORING INSTRUCTIONS using Polar chest strap and Elite HRV app. The next post will have the analysis instructions.

Get the Polar H7 or H10 heart rate monitoring strap, 70 to $80 on Amazon. I have the H7 which is the older one, H10 is supposed to be better. Download the free Elite HRV app available for iPhone and Android. Register app so your data can be saved.
BEDTIME SETUP. With the polar transmitting unit connected by only one snap, apply the strap per instructions, leaving the transmitting unit connected by only one snap.
Start the Elite HRV app. Tap the "+" at the bottom, then "open reading." Snap the second snap on the Polar transmitting unit and look at the app, it should say connected.
Tap "start" and the screen should start showing your heart rate. Put your phone to sleep, the app should continue monitoring while phone is in sleep mode. I get up fairly frequently at night and so every 2 or 3 hours or so I stop the monitoring session and start a new session, this makes analysis of the resulting graphs easier than having one all night monitoring session. To end a session or get up in the morning just tap finish, you will have to wait a bit, then tap save at the upper right to save to the cloud servers (takes 60sec or so). You are now done with a night monitoring session.
Blessings,
Holland

stjohnh
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Location: Palo Alto, California

Re: Sleep monitor

Post by stjohnh »

See prior post for data acquisition instructions. The Bedtime setup takes 2 or 3 minutes prior to going to bed. Data analysis takes me about 15 minutes in the morning. It looks long and complicated but after you do it a couple of times it's pretty simple actually.

ANALYSIS OF DATA
You will need to print charts of the data from the Elite HRV app. Start the HRV app, tap the chart symbol at the bottom, between the home and plus symbols. Tap "recent entries," pick the time desired and tap it. You will have to wait a bit. When the Details page appears tap the "intrareading chart" line. You will have to wait a bit again. The "analyze" screen should show in 30 or 60 Seconds.

You will now need to set the chart options, this only needs to be done one time. At the top of the analyze screen is a chart options button, tap it. Set corrected off, HRV off, rolling average on, rolling duration 5 minutes, heart rate on. Tap done and wait until your chart reappears.

Take a screenshot of the chart. On an Android phone this is done by pressing the volume down and the power buttons at the same time. On an iPhone it is done by pressing the power button and home buttons at the same time. Print the screenshot on your printer. Repeat for any other sessions done during the night.

Here is what a printed chart should look like. https://www.dropbox.com/s/dgk6hwv474ojr ... t.jpg?dl=0

EXTRACTING DEEP SLEEP DATA FROM CHARTS
In the example above, notice on the top graph which is the 5-minute rolling average of HRV, at about 4:30 there is a dip lasting about half an hour. Look at the bottom chart which is the heart rate data and notice that it corresponds to a distinct flat spot with fewer artifacts, lower heart rate variation, and abrupt changes from the previous and post deep sleep data. On the sample I have two red marks indicating the start and stop of the Deep Sleep spell. They are at approximately 4:10 a.m. and 4:40. I estimated this to be 31 minutes of deep sleep. Repeat for the other chart sessions and add for the total deep sleep for the night.

NOTES
A normal healthy young adult will have approximately 1.4 - 1.6 hours of Deep Sleep nightly. Deep sleep is marked by lower steady heart rates with little variation. There will also be fewer artifacts as during deep sleep since the body is completely motionless except for breathing. REM sleep is marked by higher heart rates, more heart rate variability and minimal movement, but not completely limp. This is why most sleep monitoring apps don't work well, they can't distinguish between REM sleep and deep sleep based on body movements or sound. Normally there are three to five sleep cycles per night; light sleep, deep sleep, then REM sleep. A normal person has the most deep sleep during the first sleep cycle with decreasing amount of deep sleep for subsequent cycles.
Blessings,
Holland

Oozz
Posts: 217
Joined: Wed Oct 11, 2017 8:09 pm

Re: Sleep monitor

Post by Oozz »

StJohn -

Thank you for posting all this. Quick question, how are you using this data to actually improve your sleep quality?

stjohnh
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Joined: Sun Feb 14, 2016 3:13 pm
Location: Palo Alto, California

Re: Sleep monitor

Post by stjohnh »

LOL... I was hoping it would improve my daytime feeling using medicines to improve my sleeping, however I haven't found enough clear correlation to actually use the data.
Blessings,
Holland

Oozz
Posts: 217
Joined: Wed Oct 11, 2017 8:09 pm

Re: Sleep monitor

Post by Oozz »

So, I bought a Polar H10 and downloaded the sweetbeat app. Although I've tracked my sleep for a few days, I haven't been able to interpret my sleep results very well. Did you happen to try this app?

However, I have also been using the H10 and the app to monitor my HRV (stress levels & recovery) throughout the day. I take timings right when I wake up, twice a day when I mediate, and sporadically after dinner. The findings raise a lot of questions for me and I'm probably jumping ahead of myself, but I think this machine is helping me uncover the root cause of my RLS.

Before going into detail, have you used the h10 to monitor your HRV?

The Details (Disclaimer: Below is my own thesis based on information that I have independently researched "Pseudoscience). I am not a doctor.

My heart rate variability (HRV) and heart rate (HR) seem to be fairly stable and healthy; however, my Low Frequency (LF)/High Frequency (HF) ratio is extremely unbalanced. The LF is an indicator of how your sympathetic nervous system and the HF is an indicator of the presympathetic nervous system (I may have these mixed up, but the point stands). The first corresponds to your flight or flight response and the latter to your recovery response. My LF is extremely high while my HF is extremely low. This would indicate that my body is constantly under some sort of stress and I'm running on overload all the time. Simultaneously, the low HF indicates that my body's recovery system is not responding and even being shut down. This is know as being sympathetic dominant, can lead to insomnia, circadian rhythm dysfunction, etc.. This is highly associated w/people who push themselves or worry too much; I would say that I fit this bill. The odd part about this is that, if a doctor were to look at my Heart rate or HRV (and they have), they would come back and say, "vitals look normal".

I guess one could say, is it the RLS that is causing the unbalanced LF/HF? That could be true, but, if that is the case, why is not affecting my HRV or HR?

Additionally, my RLS goes away when I go on vacation - I mean the night I land I am sleeping like a baby. I'm assuming that my nervous system goes back into equilibrium during this time.

Also, when I injured my back (x2) my RLS went away. I can only imagine that presympathetic nervous system kicked in due to the acute injury.

Now, I've said a lot, but I'm wondering if anyone else has looked at this. You seem very educated, so thought you may be able to shoot some holes in my thesis.

Rustsmith
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Re: Sleep monitor

Post by Rustsmith »

Oozz, there is a lot more that goes into determining your low and high end heart rates. I run competitively and have used a heart rate monitor to guide my training for many years. Your resting HR can be determined by a number of factors. I have a low resting heart rate due to all the running that I do. The running has improved my cardiovascular fitness to the point where my heart is able to do more than most people, which means that it doesn't have to work as hard when I am at rest. A few years ago I saw where a world class cyclist was found to have a resting heart rate of 28, FAR below normal but for him it was simply an indicator of his level of cardiovascular fitness. Unfortunately, there are also heart disease states that can produce a somewhat similar condition. As for "elevated" resting heart rate, this is also a function of a number of factors, which can include stress, reduced cardiovascular fitness and even position (standing, sitting or lying down).

As for max heart rates, they are a factor of age and the max can vary from day to day.

As for your comment about vacation, I wish my RLS had taken a vacation during my recent cruise. Instead of going away, my RLS was the worst that it has been for several months. Even the drunks and party animals disappear at 2AM, so the only people that I saw as I walked the halls and decks were the night time cleaning crew.
Steve

https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Oozz
Posts: 217
Joined: Wed Oct 11, 2017 8:09 pm

Re: Sleep monitor

Post by Oozz »

Steve - Marathons and cruises, you are my hero. That's a bummer that you weren't able to sleep as well on your vacation. With that said, I do believe the root cause of my RLS is different than most.

Per your response, did you happen to recall your LF/HF ratio? That is the only thing I am concerned about. You don't have to disclose, but mine has averaged as high as 20. It is a crude measure of stress; however, I think it opens up some questions. Taking into consideration my sleep, nutrition, exercise, and psychological stresses, I think I can back into what is throwing me off.

stjohnh
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Location: Palo Alto, California

Re: Sleep monitor

Post by stjohnh »

Oozz. I haven't used the H10 nor the sweetbeat app. I have the older H7. Most of the heart rate variability apps available for free or low price do not allow monitoring for more than relatively short periods, or they don't allow printing of the actual heart rate and heart rate variability data over a night period. My primary purpose in monitoring my heart rate variability was to try to determine how much deep sleep I was getting. I think the techniques I detailed in prior posts give a moderately accurate picture of how much deep sleep I am getting. I haven't been using heart rate variability monitoring to determine stress levels, so there's not a whole lot I can say about that.

When I was trying various apps I looked briefly at the sweetbeat app, however I am using an android phone and the Android app has a bunch of terrible reviews so I didn't bother even trying it. Some of the reviews mentioned that the Apple version is much better. Are you using the Apple version? If so, will it give you a full eight hours of graphical data? I have an Apple phone that I can use if I need to.

I actually suspect that your observation of your RLS being much better while on vacation probably gives more insight into your situation than monitoring heart rate variability, but I don't really know.
Blessings,
Holland

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