The Snooze Button

In this episode: Jesse Cook, Cathy Goldstein and Olivia Walch grade their own sleep Why the answer to “Do most people need granular sleep-stage data?” is no Clinical sleep definitions versus consumer wearable outputs Why an EEG headband has an advantage over a motion-only tracker — but still is not a polysomnogram Sleep sensitivity, wake specificity and the trap hidden inside a 90% accuracy claim Why REM and deep-sleep staging are harder than basic sleep/wake detection What quiet wakefulness does to wrist-based algorithms Why actionability can matter more than precision Orthosomnia and the risks of sleep perfectionism Why one bad nightly score should not become a crisis How tracker validation changes across populations and sleep disorders Why proprietary algorithm updates can age a validation study overnight The case for access to raw sensor data and shared validation datasets What the World Sleep Society and National Sleep Foundation now recommend for consumer sleep technology Why healthy sleep includes more than duration Sleep regularity, rhythmicity, continuity, timing and daytime functioning Why a low consumer deep-sleep score cannot be translated directly into dementia risk What glymphatic research actually says about sleep stages Neil’s Dreem 2 data and which numbers catch the panel’s attention Temperature, awakenings and using wearable trends to test practical hypotheses Why mainstream trackers may be enough for most behavioral goals The importance of comfort, adherence and battery life FTC and FDA oversight of consumer health and wellness claims What seven-to-nine-hour recommendations actually mean Why trying too hard to sleep can become part of the problem About Jesse Cook Jesse Cook, PhD, is a sleep researcher and clinical psychologist at the University of Wisconsin–Madison. His work has examined sleep and mental health, hypersomnolence, athletes and the performance of wearable sleep technology. Cook previously joined The Snooze Button for a full episode devoted to the question of who validates the trackers themselves. About Dr. Cathy Goldstein Dr. Cathy Goldstein is a Clinical Professor of Neurology at the University of Michigan and a sleep physician whose work includes consumer and clinical sleep technology, circadian rhythm disorders and the use of wearable data. Her research has included efforts to improve and openly evaluate algorithms used to characterize sleep from wearable sensors. About Dr. Olivia Walch Olivia Walch, PhD, is a mathematician and circadian scientist whose research focuses on biological rhythms, sleep timing and mathematical models of the human circadian system. She is affiliated with the University of Michigan Center for Sleep Science and is CEO of Arcascope, which develops circadian-health technology. Archive update, 2026: At the time of this conversation, Walch’s book was still on the way. Sleep Groove: Why Your Body's Clock Is So Messed Up and What To Do About It was published January 28, 2025 by Andrews McMeel. The book uses comics and circadian science to explain why sleep timing goes wrong and what people can realistically do about it. MENTIONED Jesse Cook — University of Wisconsin–Madison Cathy Goldstein — University of Michigan Medical School University of Michigan Center for Sleep Science faculty Olivia Walch and Arcascope Sleep Groove: Why Your Body's Clock Is So Messed Up and What To Do About It Selecting a sleep tracker: EEG-based, multisensor and actigraphy-only devices 2025 validation of six commercial wrist-worn sleep trackers 2026 rapid review: real-world use of consumer sleep devices World Sleep Society recommendations for wearable consumer health trackers that monitor sleep National Sleep Foundation position statement on consumer sleep technology Screening for orthosomnia and sleep-related preoccupation U.S. survey of consumer sleep technology use, trust and sleep-related worry Which sleep health characteristics predict all-cause mortality in older men? Sleep regularity as a predictor of mortality risk American Heart Association statement on multidimensional sleep health 2023 mouse study: sleep-cycle-dependent vascular dynamics and predicted CSF flow Norepinephrine-mediated slow vasomotion and glymphatic clearance during sleep FTC Health Products Compliance Guidance FDA General Wellness: Policy for Low Risk Devices — 2026 guidance AASM/SRS recommended amount of sleep for a healthy adult National Sleep Foundation sleep-duration recommendations

In this episode: Why Jade Wu had just woken from a nap before the interview Why she thinks of naps as snacks What happens when trying to make sleep happen becomes the problem Why Wu wrote Hello Sleep The access problem surrounding Cognitive Behavioral Therapy for Insomnia Who CBT-I is actually for — and what it does not treat Why an overnight sleep study is not routinely necessary for uncomplicated insomnia Neil's periodic limb movements and the case for treating comorbid sleep problems together What happened when a sleep psychologist became a severely sleep-deprived new parent Sleep disruption, postpartum depression and the danger of single-cause explanations Why sleep can be foundational without being the explanation for everything How sleep optimization and sleep trackers can create pressure Why melatonin is a timekeeping hormone rather than a sedative The label-accuracy problem in commercial melatonin products When melatonin may have legitimate circadian uses Why chronotype can collide with school and work schedules How social media and streaming services compete with sleep Why daytime light changes the brain's sensitivity to evening light What the evidence does — and does not — say about screens and blue-light blocking Mindfulness without turning mindfulness into another performance task About Dr. Jade Wu Dr. Jade Wu, PhD, DBSM, is a board-certified sleep psychologist, researcher and author of Hello Sleep: The Science and Art of Overcoming Insomnia Without Medications. Duke University currently lists her as an Associate in Research whose work focuses on treating sleep disorders in people with chronic illness. Her own site describes her broader work in behavioral sleep medicine, public education and her company Thrive; it also lists her as a Clinical Assistant Professor at SUNY Upstate Medical University and says she will join Cornell University's Psychology Department faculty in Fall 2026. Wu earned her undergraduate degree at Cornell, her PhD at Boston University, and completed medical psychology residency and clinical fellowship training at Duke University School of Medicine. MENTIONED Hello Sleep: The Science and Art of Overcoming Insomnia Without Medications — Jade Wu Jade Wu — Duke Department of Neurology Dr. Jade Wu AASM guideline: behavioral and psychological treatments for chronic insomnia 2025 systematic review: CBT for adult insomnia in routine clinical care AASM practice parameters: evaluation of chronic insomnia and use of polysomnography 2017 study: melatonin content variability and serotonin in commercial supplements 2023 study: melatonin and CBD quantities in U.S. melatonin gummies Health Canada: melatonin as a natural health product AASM pharmacologic guideline: melatonin and chronic insomnia The human circadian system adapts to prior photic history 2024 National Sleep Foundation consensus statement on screens and sleep 2025 systematic review and meta-analysis of blue-light blocking glasses and objective sleep The Many Challenges of Insomnia — Dr. Jade Wu Sex & Sleep: Was It Good For You?

In this episode: Why major changes in sleep science often take years to become visible How scientific knowledge becomes more nuanced instead of simply replacing “wrong” answers with “right” ones Why no single sleep stage should automatically be treated as the only stage that matters REM sleep, deep sleep and the brain's overnight fluid dynamics What p-values are trying to tell us about uncertainty Why replication and converging evidence matter The problem with treating scientific revision as scientific failure What “normal sleepers” means in device-validation research Why sleep trackers may mistake motionless wakefulness for sleep Why disagreement between a wearable, a sleep lab and your memory does not have a simple answer How to think about consumer sleep technology as a measurement tool rather than a truth machine The evidence for later middle- and high-school start times Teen driving safety and later school schedules Why sleep and circadian researchers favor permanent standard time The conflict between circadian biology and our preference for brighter evenings Where the idea of a 90-minute sleep cycle comes from Why 90 minutes is an approximation, not a sleep-planning rule How the human appetite for “secret knowledge” turns useful observations into rigid sleep hacks About Dr. Michael Grandner Dr. Michael Grandner is a licensed clinical psychologist and behavioral sleep medicine specialist at the University of Arizona. He directs the Sleep and Health Research Program and the Behavioral Sleep Medicine Clinic at Banner – University Medical Center Tucson, with appointments across psychiatry, medicine, psychology and related programs. His research spans insufficient sleep, sleep health, cardiometabolic and neurocognitive outcomes, social and environmental influences on sleep, health disparities and behavioral interventions. On the day this episode was released — June 3, 2024 — Grandner was receiving the Associated Professional Sleep Societies' Diversity, Equity and Inclusion Leadership Award, recognizing contributions to broadening access and representation and reducing sleep-health disparities. The award has since been renamed the APSS Inclusive Leadership Award. MENTIONED Michael Grandner — University of Arizona College of Medicine APSS Inclusive Leadership Award and past recipients Dementia and Sleep: It's Not Just Deep Sleep That Counts with Dr. Laura Bojarskaitė Bojarskaitė et al.: Sleep cycle-dependent vascular dynamics and predicted cerebrospinal-fluid transport 2025 meta-analysis: consumer wrist-worn sleep trackers compared with polysomnography 2026: Consumer sleep technologies — what we know and what comes next AASM position statement on later middle- and high-school start times Adolescent sleep, school start times and teen motor-vehicle crashes AASM: Permanent standard time is the optimal choice for health and safety Review of human sleep architecture and 90–110 minute NREM/REM cycles

In this episode Why Lawrence Gowan says he often sleeps better on a moving tour bus than almost anywhere else How sleep differs among members of Styx on the road Why trust in the tour-bus driver matters to Gowan's ability to switch off How touring fitness changes when musicians move through their 40s, 50s and beyond Gowan's transition from hockey to weights, yoga, walking and cycling Why performing more than 100 shows a year is physical work in its own right How Gowan thinks about protecting and developing his singing voice with age The deliberately classic progressive-rock sound of Crash of the Crown Queen, Genesis, Yes, Jethro Tull, The Who, vintage keyboards and analog gear Why Styx still isn't in the Rock & Roll Hall of Fame Gowan's practical sleep habits: schedule, less phone time and writing down late-night worries The autobiographical memory exercise he uses when awake at four in the morning Why musicians can obsess for hours over a mistake the audience never noticed Dr. Mark Boulos on restless legs syndrome, periodic limb movements and augmentation Why suddenly worsening RLS should trigger a review of iron, sleep, medications and other conditions Neil's experience of worsening movement symptoms after a mental-health medication change Why vortioxetine/Trintellix should not be described as an SNRI What current evidence does — and does not — say about antidepressants and RLS How current RLS treatment guidance has shifted away from routine dopamine agonists such as pramipexole Why bupropion as an antidepressant option is different from bupropion as an RLS treatment The danger of crowdsourced medication advice when nobody knows the full clinical picture About Lawrence Gowan Lawrence Gowan is a Canadian singer, songwriter and keyboardist whose solo career produced hits including A Criminal Mind, Strange Animal and Moonlight Desires. He joined Styx in 1999 and remains the band's keyboardist and one of its principal vocalists and songwriters. He contributed to Styx's 2025 album Circling From Above, the band's 18th studio album. About Dr. Mark Boulos Dr. Mark Boulos is an Associate Professor of Neurology at the University of Toronto and staff neurologist at Sunnybrook Health Sciences Centre. He serves as Medical Lead for the Sunnybrook Sleep Laboratory and Program Director for the University of Toronto Sleep Neurology Fellowship. His clinical and research interests include sleep-related movement disorders, sleep and stroke, home sleep monitoring, sleep data and novel approaches to diagnosing and treating sleep disorders. MENTIONED Styx — current band and Circling From Above The band's current lineup, including Lawrence Gowan, and its 2025 studio album. Styx official band page Styx official music page Crash of the Crown — Styx The 2021 album discussed extensively in Neil's conversation with Gowan. Styx discography Rock & Roll Hall of Fame — 2026 The official nominee and inductee lists; Styx does not appear on either. 2026 performer nominees 2026 inductees Dr. Mark Boulos — University of Toronto Current academic and clinical profile, including his roles with the Sunnybrook Sleep Laboratory and Sleep Neurology Fellowship. University of Toronto profile AASM clinical practice guideline for RLS and PLMD The current guideline on iron assessment, exacerbating factors and treatment, including the shift away from standard dopamine-agonist use because of augmentation risk. Read the guideline on PubMed TRINTELLIX / vortioxetine prescribing information Current drug labeling describing vortioxetine's indication and serotonergic mechanism. DailyMed prescribing information Antidepressants, RLS and periodic limb movements — systematic review A review finding that antidepressant-associated RLS worsening is possible but appears uncommon overall, with meaningful differences among medications. Read the systematic review Vortioxetine and RLS — conflicting case literature A 2019 case report linked vortioxetine to RLS; later reports described improvement in some patients. These small reports are useful mainly because they show why a single simple rule is not justified. 2019 case report 2023 case series Bupropion and RLS A small randomized trial found that bupropion did not exacerbate RLS and may have improved symptoms short term. Current AASM guidance nevertheless recommends against using bupropion as a treatment for RLS itself — a different question from choosing an antidepressant in someone who also has RLS. Read the randomized trial

In this episode Why sex and sleep are surprisingly difficult to study in a laboratory How at-home sleep technology may make naturalistic research more practical The difference between association, mechanism and an actual sleep intervention Why trying too hard can interfere with both sleep and sexual function Performance anxiety and the danger of turning intimacy into another sleep obligation Why "good sex" does not automatically mean orgasm Jade Wu on embodied attention, mindfulness and getting out of the insomnia thought loop Wendy Troxel on relationship safety, vigilance and sleep as a social behavior Michael Grandner on conditioned arousal and why the bed should not become "the dentist chair" Cheryl Carroll on "bed dread" and making the bedroom feel safe rather than threatening How fertility-related performance pressure can affect both sex and sleep Why sleeping apart does not automatically mean relationship trouble Possible psychological and physiological pathways linking intimacy with sleep What later research found about partnered sex, orgasm, masturbation and sleep The 2025 pilot study that measured sexual activity and sleep with at-home polysomnography What newer research says about insomnia, sexual satisfaction and sexual dysfunction A 2026 correction to the episode's statement about sleep deprivation and testosterone Why the panel ultimately resists turning sex into a standardized sleep prescription About the panel Dr. Michael Grandner is a licensed clinical psychologist certified in behavioral sleep medicine and a professor at the University of Arizona. He directs the Sleep and Health Research Program and the Behavioral Sleep Medicine Clinic. His research examines sleep health, insufficient sleep, sleep disparities and the relationship between sleep and cardiometabolic and daytime functioning. University of Arizona profile Dr. Jade Wu is a board-certified sleep psychologist, researcher and author of Hello Sleep: The Science and Art of Overcoming Insomnia Without Medications. Her current research at Duke University School of Medicine focuses on treating sleep disorders in people with chronic illness. Duke University profile Dr. Wendy Troxel is a senior behavioral and social scientist at RAND, a licensed clinical psychologist specializing in behavioral sleep medicine, and an adjunct professor at the University of Pittsburgh and University of Utah. She is the author of Sharing the Covers: Every Couple's Guide to Better Sleep and is internationally recognized for research on sleep in couples and relationships. RAND profile Cheryl Carroll, DNP, CNM, PMHNP-BC, PMHCNS-BC, CST, is a women's-health and mental-health clinician and an AASECT-certified sex therapist with more than thirty years of experience. She now owns StrongTower Counseling and Education in Durham, North Carolina, where she works with individuals, couples and families. StrongTower Counseling and Education MENTIONED Congresswoman Stacey Plaskett and Her Surprising Sleep Routine The earlier Snooze Button episode that started the sleep-and-sex question. Listen / read the episode Please Don't Make Us Call It a Sleep Divorce Neil's earlier conversation with Wendy Troxel about couples who sleep separately and what that choice does — and does not — say about a relationship. Listen / read the episode Hello Sleep — Jade Wu Wu's book on insomnia, behavioral sleep medicine and building a healthier relationship with sleep. Duke University on Hello Sleep Sharing the Covers — Wendy Troxel Troxel's book on sleep in couples and the intersection of sleep, relationships and health. Wendy Troxel at RAND Sex and Sleep: Perceptions of Sex as a Sleep Promoting Behavior in the General Adult Population The 2019 survey study showing that many adults perceive sexual activity involving orgasm as helpful for subsequent sleep. Read the study The influence of sexual activity on sleep: A diary study The 2023 study that followed sexual activity and subjective sleep across fourteen days. Read the study Sleep on it: A pilot study exploring the impact of sexual activity on sleep outcomes in cohabiting couples The 2025 pilot study using portable polysomnography in participants' homes — a practical answer to one of the methodological problems debated in this episode. Read the study Relationship of insomnia to sexual function and sexual satisfaction: Findings from the Sleep and Sex Survey II A 2023 study of 1,266 adults examining insomnia severity, sexual function and sexual satisfaction. Read the study Effect of partial and total sleep deprivation on serum testosterone in healthy males The systematic review and meta-analysis used for the archive correction to the episode's testosterone discussion.