Category: Sleep Health

Why Single-Night Sleep Studies Miss the Full Picture

Posted on May 6, 2025 by - Sleep Health

Multi-Night Sleep Testing

Join Dr. Nishi Bhopal, MD and Dr. Sahil Chopra, MD as they dive deep into the evolving field of sleep medicine. They discuss the critical insights into sleep apnea, debunk common myths, and explore the latest advancements in longitudinal sleep testing. Learn how Empower Sleep is transforming the diagnosis and treatment of sleep disorders with cutting-edge technology and personalized care. This episode is packed with valuable information for healthcare practitioners looking to enhance their understanding and approach to sleep-related health issues. Don’t miss out on practical tips for improving patient care and future trends in sleep medicine!

Pink, Brown, and White Noise for Sleep

Posted on April 21, 2025 by - Sleep Health

As always, it's essential to make personalized recommendations and to “look under the hood” to see what else might be going on with your patient’s sleep.

This question came up twice this week – once in my insomnia group program, and again in a patient visit:

“Does white noise help with sleep?”

During sleep, the auditory system remains active and the brain continues to process environmental sounds.

When I was living in downtown Chicago, there was constant background noise, which can disrupt sleep.

Nowadays there are tons of apps, YouTube videos, noise machines, and other devices providing auditory stimulation (like white, pink, and brown noise, binaural tones, etc.)
to block noise and promote sleep.

First of all, what are white, pink, and brown noise?

White noise is often used to mask sounds in the environment. Examples include radio static or a whirring fan.

Pink noise is thought to be more pleasant than white noise. Examples include steady rainfall or gentle ocean waves.

Brown noise involves lower frequencies than white or pink noise. Examples include thunder or crashing waves.

Do they help with sleep?

White noise is quite popular – in fact, I have a white noise machine on right now while I’m working. However studies on sleep show mixed results.

Less than a third of research on white noise demonstrates positive effects on sleep quality. (1)

Some studies even suggest white noise could potentially have negative effects on brain function and cognition, more evidence is needed.

Pink noise has been suggested as a potentially more effective alternative to white noise, though research is still limited.
It may improve sleep quality for some individuals, but, like white noise, the rigor of studies on pink noise remains weak.
Brown noise has also gained attention as a sleep aid. While it’s less studied than white and pink noise, some people report that the deeper tones of brown noise help them sleep more soundly.

As with the other types, more research is needed to conclusively determine its effectiveness.

It’s also possible that listening to the same thing each night can trigger a conditioned response, where people associate the noise with falling asleep.

Interestingly, hospital settings have begun experimenting with audio interventions to improve sleep for patients.

When I was in residency, they used to play classical music on the general medical floor and I found it calming as a sleep-deprived resident. But it was only played during the day.
Given the noise-sensitive environments in many hospitals, noise reduction strategies paired with audio interventions may help improve sleep quality in these settings.

Is it safe?

There’s no strong evidence to suggest that audio interventions like white, pink, or brown noise are harmful when used short-term.

In fact, they may be a good option for patients struggling to sleep in noisy environments.
A small study done in NYC found that white noise significantly improved sleep latency and reduced wake after sleep onset (WASO) in people exposed to high levels of environmental noise. (2)

However, like a Pavlovian response, people may inadvertently condition themselves to rely on the sounds, potentially making it difficult for them to sleep without them.

There are also potential concerns about not allowing the auditory system to switch off, rest, and repair overnight.

Continuous exposure to high levels of white noise could potentially lead to hearing damage. White noise machines can sometimes hit unsafe noise levels, especially if they’re turned up too loud. (3)

Another study indicated that prolonged exposure to white noise can induce maladaptive changes in the brain, potentially impacting neurological health and cognition. (4)

Back to sleep, some studies suggest that continuous noise may actually disrupt sleep. (1)

Bottom line

The evidence is still inconclusive, but this area of sleep science is evolving.

If patients ask you about this, here are considerations:

  • Mixed Effectiveness: Research on white, pink, and brown noise for sleep shows mixed results, with some studies reporting benefits and others showing limited or no effect.
  • Conditioned Response: Regular use of noise for sleep may create a dependency, making it harder to sleep without it.
  • Safety Concerns: Long-term exposure to high volumes of background noise may cause hearing damage.

How I guide my patients: I wouldn’t recommend using white, pink, or brown noise continuously.

However, if it helps them wind down and fall asleep, using it for a set time at night could be helpful. And of course, be mindful of the volume and risks of hearing loss.

As always, it’s essential to make personalized recommendations and to “look under the hood” to see what else might be going on with your patient’s sleep.

References

(1) Riedy SM, Smith MG, Rocha S, Basner M. Noise as a sleep aid: A systematic review. Sleep Med Rev. 2021 Feb;55:101385. doi: 10.1016/j.smrv.2020.101385. Epub 2020 Sep 9. PMID: 33007706.

(2) Ebben MR, Yan P, Krieger AC. The effects of white noise on sleep and duration in individuals living in a high noise environment in New York City. Sleep Med. 2021 Jul;83:256-259. doi: 10.1016/j.sleep.2021.03.031. Epub 2021 Apr 6. PMID: 34049045.

(3) De Jong RW, Davis GS, Chelf CJ, Marinelli JP, Erbele ID, Bowe SN. Continuous white noise exposure during sleep and childhood development: A scoping review. Sleep Med. 2024 Jul;119:88-94. doi: 10.1016/j.sleep.2024.04.006. Epub 2024 Apr 16. PMID: 38663282.

(4) Attarha M, Bigelow J, Merzenich MM. Unintended Consequences of White Noise Therapy for Tinnitus-Otolaryngology’s Cobra Effect: A Review. JAMA Otolaryngol Head Neck Surg. 2018 Oct 1;144(10):938-943. doi: 10.1001/jamaoto.2018.1856. PMID: 30178067.

Hypnosis for Sleep: Science-Backed Tool or Hype?

Posted on April 15, 2025 by - Sleep Health

Sleep Hypnosis Legit or Pseudoscience

In this episode, Dr. Nishi Bhopal interviews Lara Kassir, a certified clinical hypnotherapist and brainspotting practitioner, about the transformative role of hypnotherapy in treating sleep disorders. Lara delves into her professional background and how hypnotherapy can address chronic insomnia, anxiety, and other sleep-related issues. She explains the difference between therapeutic hypnotherapy and common misconceptions tied to stage hypnosis. The conversation further explores the applications of brainspotting for trauma and how hypnotherapy can be a potent adjunct to cognitive behavioral therapy for insomnia (CBTI). Lara also touches on the importance of a holistic approach, combining mind and body, in effective sleep treatment. This episode is a must-watch for physicians and health practitioners looking to incorporate hypnotherapy into their clinical practice.

Can Electrolytes Improve Sleep? We Asked the Doctor Who Created Dr. Raindrop

Posted on April 8, 2025 by - Sleep Health

Can Electrolytes Improve Sleep? We Asked the Doctor Who Created Dr. Raindrop

Join us in an enlightening conversation with Dr. Sandhu, a nephrologist, as we dive deep into the relationship between hydration, electrolytes, and sleep. Discover why supplements can be essential, even with a balanced diet, and learn about Dr. Sandhu’s journey in creating Dr. Raindrop, an effective electrolyte powder. We also touch on common deficiencies, the impact of modern lifestyle factors, and practical tips on optimizing both your hydration and sleep patterns. Perfect for doctors and health practitioners looking to enhance their clinical practice with practical sleep medicine knowledge. Don’t miss out on the insights and expert advice in this episode. Check out more information in the description below!

Mastering the CPAP Adjustment: Here’s what works.

Posted on April 3, 2025 by - Sleep Health

Mastering the CPAP Adjustment: Here's what works. Expert Tips from a Behavioral Sleep Psychologist

In this episode, we dive into the challenges patients face when adjusting to CPAP therapy with Dr. Sarah Silverman MD, a behavioral sleep psychologist. Discover actionable strategies to help patients overcome issues like claustrophobia and insomnia, and learn about the importance of personalized approaches and follow-ups. Dr. Silverman also discusses the significance of ensuring the right mask fit and how daytime acclimation can ease the adjustment process. This conversation highlights the efficacy of CBT for CPAP adherence and provides essential resources for healthcare professionals to support their patients. Tune in for valuable insights into improving CPAP compliance and enhancing patient care in clinical sleep medicine.

Common Drugs That Leave You Nutrient Starved

Posted on March 18, 2025 by - Sleep Health, Supplements

In this episode, we explore the impact of medications on melatonin and other nutrient levels, guided by an effective tool called Mytavin. Learn how certain medications like fluoxetine and metoprolol cause nutrient depletions and how Mytavin can help identify these deficiencies. Understand the relevant studies and research, and see why this tool is invaluable for clinical practice. Follow along for practical insights and real-world applications that can enhance your patient care.

Sleep Doctor Reveals: Melatonin or Ramelteon For Better Sleep?

Posted on March 4, 2025 by - Sleep Health

In this video, Dr. Nishi Bhopal, a board-certified sleep medicine physician and psychiatrist, addresses a question from a fellow physician about the use of melatonin versus ramelteon (Rozerem) in clinical practice. Dr. Bhopal explains the differences between these two treatments, their indications, and when to use each. She discusses the role of melatonin in regulating the sleep-wake cycle and highlights the versatility of melatonin for different conditions, including circadian rhythm disorders and pediatric uses. Dr. Bhopal also compares this with ramelteon’s targeted action on sleep regulation and its specific use for sleep onset insomnia. For healthcare practitioners looking to deepen their knowledge, she offers a free melatonin brand guide and invites them to her upcoming masterclass on sleep supplements. Subscribe to the channel for more practical sleep medicine tips!

Wean Off Sleeping Pills: Sleep Doctor’s 5-Step Method

Posted on February 25, 2025 by - Sleep Health

Weaning off sleeping pills

Tapering off sleeping pills can be challenging, but with the right approach, patients can regain natural sleep and confidence. Dr. Nishi Bhopal, a board-certified physician in sleep medicine and psychiatry, shares a comprehensive five-step guide to effectively tapering off sleep aids. This episode covers understanding the root causes of insomnia, employing cognitive behavioral therapy, the importance of a gradual tapering process, hyperbolic tapering techniques, and providing adequate patient support. Perfect for healthcare professionals seeking to enhance their sleep medicine knowledge. Don’t forget to download Dr. Bhopal’s free melatonin brand guide for high-quality supplement recommendations!

Why Sleeping Pills Don’t Work: Chronic Insomnia Explained by a Sleep Doctor

Posted on February 19, 2025 by - Sleep Health

Why sleeping pills don't work

In this episode, Dr. Nishi Bhopal, a physician board certified in sleep medicine and integrative psychiatry, discusses why she does not recommend medications for chronic insomnia. She explains the concept of hyperarousal, which is a common cause of chronic insomnia, and highlights the shortcomings and potential negative impacts of using sleeping pills, including dependency and reduced glymphatic clearance. Dr. Bhopal advocates for Cognitive Behavioral Therapy for Insomnia (CBTI) as the first-line treatment, supported by practices like Acceptance and Commitment Therapy (ACT) and mindfulness. Download her free melatonin brand guide at intrabalance.com/melatonin.