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Sound Sleep Guru

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Sound Sleep Guru

Boutique Sleep Telehealth Services including home sleep apnea testing, actigraphy, CPAP help, CBT-I, sleep wellness and optimization plans, and behavioral sleep medicine.

02/23/2026

🌘BEDTIME FADING

-My go-to tactic for back to school is a simple tactic called bedtime fading. The way it works is by “fading” the bedtime back 15-30 minutes each night until you reach the desired bedtime.

-This tactic can be enhanced with a small dose (0.5 mg) of melatonin in more difficult or extreme cases, usually short term. I really try to avoid gummies at all costs since the dosing is highly variable in them. I use a pharmaceutical grade product and hide the capsule in food. Please check with your child’s pediatrician to make sure they approve.

-So let’s say your child is going to bed at 9:00 PM and you’d like them to go to bed at 8:00 PM in order to get enough sleep for their school wake time.

-If you have three days until school starts you could fade the bedtime back to 8:40, the 8:20, and then 8:00 PM.

-You would also fade back all of the pre-sleep routine including the bath, bedtime, books, no electronics.

-By the way, this also works for parents who might have shifted a bit later over summer as well.

-Have you heard of bedtime fading? Share this with a friend who might need it.

02/23/2026

🦵🏻🦵🦵🏾We are entering a new era in restless legs management.

-For years, we’ve focused on dopamine medications that can worsen symptoms over time. Meanwhile, we may have overlooked the root cause: brain iron deficiency.

-Peripheral ferritin levels do not reliably reflect brain iron. And new data suggest patients can benefit from IV iron even when ferritin appears “normal.”

-This is a mindset shift — from treating only the obviously deficient to recognizing who is safe to treat.

-Because sometimes “normal” labs don’t mean optimal physiology.

Reference Article: Spector AR. “When Normal Isn’t Good Enough.” J Clin Sleep Med, 2025

02/22/2026

This memory popped up in my email today. “CG” a prolific researcher who coined “obstructive sleep apnea syndrome” and was the first to describe “upper airway resistance syndrome” and was steadfast about recognizing and treating obstructive sleep apnea in childhood as a precursor to what later in life becomes a treatable but incurable neurological disorder.

It’s impossible to describe how special he was if you didn’t meet him. He was a rockstar, he was not here to be liked, but he was almost unanimously loved.

Fierce. Disruptive. Unapologetic.

The kind of mentor who immediately enlisted you to join his mission. Training under his guidance at the Stanford Sleep Clinic changed my life.

He made rooms shift.

He made institutions uncomfortable.

And underneath it all — he cared immensely.

CG helped me negotiate my first job contract. He told me not to take the job unless they offered me a title of assistant professor rather than clinical instructor, knowing I’d only be able to apply for NIH funding with an academic appointment. He helped me negotiate with the chairs of the neurology department Robert Daroff and Anthony Furlan to get that appointment and I did indeed apply for an R01 grant in the first year of my career.

I also called him when I was flailing in my first job, unable to practice the way I’d been trained. And he spent hours on the phone with me and emailed me back within minutes anytime I contacted him about a case or career advice. It wasn’t special treatment, he was like that with everyone.

What a force. What a gift.

People say his spirit lives on in the Stanford Sleep Clinic, the candy drawer rattles periodically reminding everyone he was the first person to arrive in the sleep lab and the last to leave.

Legends like this never truly die.

Drop a ❤️ below if CG left his mark in your career

02/22/2026

😴A mantra for insomnia

-A few weeks ago I was talking with one of my patients in CBT for insomnia and they told me one of the helpful suggestions I made was to imagine you are waiting for a train to arrive.

-You have a choice. You can look at the clock every second, get upset it isn’t there yet and you have to wait, or you can choose to pas the time in a more constructive and less stressful way. There’s nothing you can do to make the train come sooner and you can’t force sleep.

-My patient told me she visualized being in a memorable train station in another country and that felt like a better way of passing the time (rather than checking the clock or getting annoyed it wasn’t happening yet). I can’t remeber where I read this analogy but I think it’s a great way to reframe insomnia.

-When I heard this audio it felt like it hit the perfect note for an insomnia mantra.

-Share this post with someone who needs it.

02/21/2026

⌚️Asking which sleep tracker a person should buy is similar to asking which scale a person should buy to lose weight. It isn’t that the scale isn’t a helpful tool. It simply isn’t a diagnostic or treatment tool.

-One of the biggest pain points in my day is helping people understand I really don’t care how much or how little deep or REM sleep they are getting on their sleep tracker. It’s one data point in a very complex and multifaceted aspect of sleep, that might not even be accurate.

🚫A scale is not a weight loss program.

🚫A sleep tracker is not a sleep health program

-Data is helpful, data is good but it needs to be applied within a context to be useful.

-What do you think, do you agree?

02/20/2026

👩🏻‍⚕️Sleep Myths

-It almost seems bizarre to write but sleep trackers have become so common and marketed in such a way that has led people to think they can diagnose and help treat sleep disorders.

-The simple fact is that sleep trackers don’t help us diagnose or treat chronic insomnia, which is a common reason people buy them.

-I think trackers are going in the right direction for being able to flag the people who need to be formally screened for obstructive sleep apnea but there is a blue ocean to do more.

-The current paradox is they are being designed and marketed as an at home sleep study, but in real medical practice we don’t use sleep studies for diagnosis or management of insomnia. At least yet anyway.

02/20/2026

🎉My New Year’s resolution was to learn to do a pull-up.

-A few days ago when I reached the thinnest band I asked ChatGPT how long it would take me to get my first UNassisted one.

-It said 3–6 weeks.

-My inner child, the one who always got picked last in gym class feels this achievement so deeply.

-Next goal -> 10 reps and chin ups (did I reverse these?)

02/19/2026

🧠Why Brains Need Friends by Ben Rein📚

-In the words of the great neurologist Oliver Sacks, “we are living through a neurological catastrophe of gigantic scale.”

-That’s why it’s incredible to see and read .benrein new book on the neuroscience of social connection. Absolutely love it, what a fascinating topic and so fun to see his personality shine through. What a gift to communicate neuroscience in an accessible way to share with the world why we all fell in love with it and pursued it as a profession.

-I’ll link in my stories to purchase, I promise you won’t be disappointed! Congrats .benrein on your book and for the important work you’re doing to help people keep their brains healthy. And thank you for sending to me to read!

02/18/2026

Why trazodone is the most prescribed drug for sleep in the US — even though it’s not FDA-approved for insomnia and isn’t recommended in guidelines for treatment of chronic insomnia👇

Trazodone has quietly become America’s default sleep prescription. And the reason is complicated.

Here’s what a 2025 systematic review + meta-analysis (Hameed et al.) found:

1) It works — especially when insomnia overlaps with depression. Across randomized trials, trazodone significantly improved subjective sleep quality.

2) It’s best used as a “bridge,” not a destination.
The authors essentially describe trazodone as a short-term stabilizer: something that can help people sleep while you build the real foundation — CBT-I.

3) It’s not benign. Compared to placebo, trazodone had much higher odds of:

daytime sleepiness (somnolence)

heavy sedation

dizziness

even blurred vision

In other words: it can “fix” sleep by creating a new daytime problem.

4) The reason it’s popular is structural — not scientific.
CBT-I is the gold standard. But it’s hard to access, not always covered, and takes time. So clinicians are left with the pressure to do what the system rewards: fix problems fast.

✨ The takeaway: trazodone isn’t snake oil.
But it’s also not a completely benign long-term insomnia solution.

02/18/2026

🙋🏻‍♀️Hi! Sleep medicine is a real field and a sub-speciality of neurology, internal medicine, pediatrics, and psychiatry! There’s a better way to live than dependency on Unisom and Benadryl.

02/17/2026

🔥🔥🔥Hot Take

Lately there’s been a lot of conversation about credentials — who finished residencies, who didn’t, and what that actually means.

Here’s what I’ll say as someone who has spent years in exam rooms:

Medicine is learned in the presence of patients.

Not because textbooks aren’t important.

Not because mentors don’t matter.

But because the real world teaches you what theory can’t:

The exceptions.

The subtle clues.

The longitudinal story.

Over time, patients teach you more than your teachers ever could — because they show you the truth, repeatedly, in infinite variations. They teach you what actually works in the real world.

That’s why training matters.

And that’s why experience matters.

02/17/2026

🍫Melatonin & Chocolate Candy 🍭

-This is a new one, a combination I saw on my favorite health food website. Wow, this is wrong on so many levels. I sent this to some of my favorite sleep docs on insta and got a unanimous thumbs down.

-Sleep is a learned behavior and we don’t want to teach our kids they way to sleep is by taking pills or even worse, overdose on them because they mistaken them for candy.

-Melatonin has a time and place, this is not then.

-Are you as disgusted as I am?

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