The Washington Post - USA (2022-05-17)

E6 EZ EE THE WASHINGTON POST.TUESDAY, MAY 17 , 2022

are presented without much con-
text, which can make it tricky to
understand how valuable they
really are. And other numbers,
like the amounts of time you
spend in restorative “deep” sleep,
are in some ways just educated
guesses.
That’s because, despite how
sophisticated some of these
wearables have become, they
cannot precisely measure what
our brains are doing. Instead,
they do their best to estimate
where we are in our nightly sleep
journeys by tracking and inter-
preting the sort of data a watch or
a ring can collect, such as your
heart rate and movement in bed.
“These are a proxy for sleep,
not sleep as traditionally de-
fined,” said Cathy Goldstein, a
sleep researcher and associate
professor or neurology at the
University of Michigan.
None of this means you
shouldn’t try to use your wear-
able tech to better understand
the way you sleep. Goldstein said
these kinds of gadgets can be
helpful because we “don’t other-
wise have a way to track sleep
over time for days and days.”
The trick? Pay attention to the
right kinds of data.
To help, here’s our guide to the
sleep-related numbers your
wearable tech could spit out at
you, and how seriously you
should take them.

Total time asleep

Keeping track of this without a
smartwatch or a fancy ring is
simple enough in theory: make
note of what time you went to
bed and when you woke up, then
do a little arithmetic. But where
wearables come in handy is get-
ting a full picture of your time in
bed.
“Almost all of the commercial
trackers are now really good at
telling you what time you went to
bed, what time you woke up, how
much sleep you got and how
awake you were,” said Joshua
Hagen, director of the Human
Performance Collaborative at
Ohio State University.
Ideally, he says, you should aim
to get between seven and nine
hours of actual sleep a night — a
far different thing from spending
seven to nine hours in bed trying
to nod off. If you fall short of that
watermark, like many of us, see-
ing those numbers spelled out on
your smartphone can help you
recognize that your sleep habits
need fixing.
“It’s kind of like when you
track your calories,” Goldstein
said. “It doesn’t change anything,
but it gives you recognition of the
problem.”
The verdict: This is the most
immediately helpful number to
pay attention to.

Time in different sleep stages

“The things I caution my pa-
tients not to get upset about are
particular amounts of times
spent in REM sleep or deep
sleep,” Goldstein said.
When professionals perform
studies to properly dig into the
quality of a person’s sleep, she
said, they rely on sensors that
directly monitor brain activity,
eye movement, chin and leg mus-
cle motion, plus much more. It’s
only after researchers have col-
lected all those readings over a
full night that they go back and
make determinations about, say,

SLEEP FROM E1

tions from your norm — whatev- er that might be. “Everybody’s numbers are going to be specific to them,” he said. “The more understanding you have, the more actionable that data could be.” The verdict: It’s worth keeping an eye on this over time, but comparing with others might not be helpful.

Getting the right gear Keeping an eye on the right sleep stats can help you understand why you feel the way you do in the morning, but not all wearables are created equal. Here are the gadgets I’ve personally been using lately to help me track my time away from the waking world. Got a sleep-focused wearable you’d like us to try out? Let us know by sending a message to the Help Desk. The battery champ: Garmin Fenix 6x Pro. It’s enormous, it’s expensive and its strap drives me crazy. Even so, I keep coming back to this $699 Garmin watch even though I’m not all that into exercise or the outdoors. That’s for a few reasons: It offers a solid selection of the important sleep stats mentioned, plus the ability to add notes to its nightly sleep records. Most important, it has battery life that’s measured in

ing the day. And checking out your HRV during the day could also give you a clearer understanding of how restful — or not — last night was. The verdict: You probably don’t need to watch it constantly, but it can be enlightening.

Breaths per minute Wearables like smartwatches and rings have gotten surprising- ly good at measuring our breath- ing. But do most people really need to know how many times per minute they breathe while they sleep? That depends on how much context you have. “To the general consumer, looking at your respiration rate every day probably isn’t going to give you a lot of information,” Hagen said. But keeping an eye on this number, and the way it changes over time, could offer key insights into the quality of your sleep. While sleeping, most people tend to hover between 12 and 20 breaths per minute and changes in that rate of respiration could signal serious issues. (A consis- tently low string of breath-per- minute readings while asleep could, for example, be a sign of sleep apnea.) But Hagen said the name of the game is keeping your eyes peeled for consistent devia-

Heart rate variability If your heart rate is 60 beats per minute, it doesn’t beat precisely once per second — there are micro-scale variations in between those lubs and dubs. Col- lectively, those little deviations make up your heart rate variability, which Hagen looks at as a “global stress indicator” that’s measured in milliseconds. And perhaps paradoxically, the higher your HRV, the better. “If you're emotionally super stressed out, it’s very likely you could have a low heart rate variability,” he said. “If you’re sick, you could also have a low HRV. If you’re rested and relaxed and everything’s good in life, you’ll most likely have a more elevated HRV compared to your norm.” Data about the faintest fluctu- ations of your heart sounds pretty esoteric, and it’s true that you could get by just fine without every thinking about it. But Gold- stein said this number can be handy for getting a sense of the toll some of the things you do in your daily life have on the quality of your rest. “If you drank, if you ate certain foods, you may have changes in your heart rate variability,” she said. Those dips in HRV at night may help you suss out habits and practices you should cut out dur-

how long someone spent in each sleep stage. Meanwhile, most popular, commercially available wearable gadgets track just a few of those signals. And none of them can surmise what’s going on in your brain as accurately as the elec- trodes that would be stuck to your scalp during a sleep study “These are states that are defined by their EEG con- structs,” she said, referring to the way phases of sleep appear in electroencephalogram readings. “We just can’t expect [wearables] to be measuring the same thing.” It is possible to read a little too much into some of these sleep stage numbers. Goldstein said researchers frequently do not measure time spent in REM or deep sleep for more than a few days at a time, so they “don't really know the relevance in the changes.” And beyond that, Hagen from Ohio State said there isn’t a whole lot of definitive information about how to increase your deep sleep time, so stressing over that number isn’t worth it. “There's not much you can do about that,” he said. “Your body is going to get what it needs.” The verdict: Take these figures with a grain of salt.

Figuring out the usefulness of data

in sleep wearables can be a bit tricky

weeks, not days, so you won’t need to worry about losing sleep data if you forget to charge it. The general-purpose wearable: Apple Watch. If you’re one of the many people who use an iPhone, an Apple Watch can quickly start serving up some sleep data you might find helpful. You don’t need the newest one, either — I haven’t upgraded my Apple Watch since 2019, and it still dutifully tracks my time asleep and heart rate variability. A few things to keep in mind: Apple’s Health app is pretty good about putting some of that sleep data in context, but seeing all of the stats we’ve discussed involves bouncing between different sec- tions of the app, which can get a little annoying. And the least expensive Apple Watch worth using isn’t the $199 Apple Watch Series 3, but the $279 Apple Watch SE. Apple still sells the former brand new, but the hardware is getting pretty old and reports of issues aren’t uncommon. The more subtle option: Oura Ring Gen 3. I’ve gotten some of the most immediately useful sleep insight from the latest Oura ring ($299 plus $5.99/month subscription), which crams a bunch of sensors into a classy ring design. That said, it’s a little chunkier than many other rings I’ve worn over the years. Its companion app is among the best I’ve seen at presenting the data it captures, and I’ve come to really enjoy how unob- trusive the ring is, but not everyone will love the idea of paying monthly to use a gadget they already spent hundreds of dollars on, even if the first six months of service are free.

BARBARA MALAGOLI FOR THE WASHINGTON POST

BY ELIZABETH TRICOMI AND WESLEY AMEDEN

You want to sit down for an
indoor dinner with friends. A
couple of years ago, this was a
simple enough activity that re-
quired minimal planning. That is
not the case in today’s world.
Many people face a stream of
further considerations about
benefits and risks.
Will I enjoy the experience?
What are the potential down-
sides? Am I comfortable with the
restaurant’s pandemic-related
policies? What’s the ventilation
like? Is it very busy there at this
time of day? Am I planning to see
lots of people, or people with
compromised immune systems,
in the near future?
This is exhausting.
As scientists at the Learning &
Decision-Making Lab at Rutgers
University-Newark, we’ve no-
ticed how many decision-making
processes are affected by the
pandemic. The accumulation of
choices people are making
throughout the day leads to what
psychologists call decision fa-

tigue — you can end up feeling overwhelmed and make bad decisions. The pandemic can make this situation more pronounced, as even the choices and activities that should be the most simple can feel tinged with risk and uncertainty. Risk involves known probabil- ities — for example, the likelihood of losing a certain hand in poker. But uncertainty is an un- known probability — you can never really know the exact chance of catching the coronavirus by engaging in certain activities. Human beings tend to be both risk-averse and uncertainty- averse, meaning that you probably avoid both when you can. And when you can’t — as during a confusing phase of a pandemic — it can be draining to try to decide what to do.

Easy rules, tough choices Before the pandemic, most people didn’t think through some basic decisions in the same way they might now. Even early in the pandemic you didn’t really need to. There were rules to follow whether you liked them. Capacity was limited, hours were restricted or shops were closed. People were strongly urged to opt out of activities they would nor- mally engage in. This is evident in data we collected from university stu-

dents in fall 2020 and spring

One question we asked was,
“What has been the hardest part
of the pandemic for you?” Re-
sponses included “Not being able
to see my friends and family,”
“Having to take classes online,”
“Being forced to stay home” and
many other similar frustrations.
Many of our survey respon-
dents were either not able to do
things they wanted to do or were
forced to do things they didn’t
want to do. In either case, the
guidelines were clear-cut and the
decisions were less of a struggle.
As restrictions ease and people
think about “living with” the
coronavirus, the current phase of
the pandemic brings with it a
new need to make cost-benefit
calculations.
It’s important to remember
that not everyone has experi-
enced these kinds of decisions in
the same way. Throughout the
course of the pandemic, there
have been people who did not
have the luxury of choice and
needed to go to work regardless
of the risk. There have also been
those who have taken risks all
along. On the other end of the
spectrum, some people continue
to stay isolated and avoid almost
every situation with the potential
for contracting the coronavirus.
Those who experience the
most decision fatigue are those
who are in the middle — they

want to avoid the coronavirus but also want to get back to the activities they enjoyed before the pandemic.

Shortcuts vs. decisions Psychologist Daniel Kahne- man wrote in his book “Think- ing, Fast and Slow” that “when faced with a difficult question, we often answer an easier one instead.” Making decisions about risk and uncertainty is hard. For in- stance, trying to think through the probability of catching a potentially deadly virus while going to an indoor movie theater is difficult. So people tend to think in terms of binaries — “this is safe” or “this is unsafe” — because it’s easier. The problem is that answering easier questions instead of tricki- er ones leaves you vulnerable to cognitive biases, or errors in thought that affect your decision- making. One of the most prevalent of these biases is the availability heuristic. That’s what psychologists call the tendency to judge the likelihood of an event based on how easily it comes to mind. How much a certain event is covered in the media, or whether you’ve seen instances of it recently in your life, can sway your estimate. For example, if you’ve seen stories of a plane crash in

the news recently, you may be- lieve the probability of being in a plane crash to be higher than it actually is. The effect of the availability heuristic on pandemic-era decision-making often manifests as making choices based on individ- ual cases rather than on overall trends. On one side, people may feel fine going to a crowded indoor concert because they know others in their lives who have done this and have been fine — so they judge the likelihood of catching the coronavirus to be lower as a result. On the other hand, someone who knows a friend whose child caught the ailment at school may now think the risks of transmission in schools are much higher than they really are. Furthermore, the availability heuristic means these days you think much more about the risks of catching the coronavirus than about other risks life entails that receive less media attention. While you’re worrying about the adequacy of a restaurant’s ventilation system, you overlook the danger of getting into a car accident on your way there.

A constant process Decisions in general, and during a pandemic in particular, are about weighing risks and benefits and dealing with risk and

uncertainty. Because of the nature of probability, you can’t be sure in ad- vance whether you’ll catch the coronavirus after agreeing to dine at a friend’s house. Further- more, the outcome does not make your decision right or wrong. If you weigh the risks and benefits and accept that dinner invitation, only to end up contracting the coronavirus at the meal, it doesn’t mean you made the wrong decision — it just means you rolled the dice and came up short. On the flip side, if you accept the dinner invitation and don’t end up with the coronavirus, don’t get too smug; another time, the outcome might be different. All you can do is try to weigh what you know of the costs and benefits and make the best decisions you can. During this next phase of the pandemic, we recommend re- membering that uncertainty is a part of life. Be kind to yourself and others as we all try to make our best choices.

Elizabeth Tricomi is associate professor of psychology at Rutgers University-Newark. Wesley Ameden is a PhD student in psychology at Rutgers University-Newark.

This article was originally published on theconversation.com.

PERSPECTIVE

Why the pandemic has made it so hard and exhausting to make decisions

People face so many options about risks and health, psychologists say

The Washington Post - USA (2022-05-17)

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