Headphones offer a compromise

Allyson Chiu

THE WASHINGTON POST – Natasha Smith couldn’t sleep.

The coronavirus pandemic was “this big, scary monster” turning her life upside down. Her work hours were cut. Her four children were home from school. Her husband, an essential worker, was constantly being called away from the safety of their home in Fredericksburg, Virginia.

“I just started to get major panic and anxiety over everything,” said Smith, 45, who has long blamed her “very loud mind” for disrupting her sleep. With the pandemic’s added stressors, her thoughts only became louder, and her go-to combination of a prescription medication to help her sleep and mindfulness practices wasn’t working anymore. But then, Smith said, she found a solution: listening to an audiobook on headphones.

“At first, I was like, ‘Oh, it’s just a way for me to have my alone time’, but it just started to become a crutch,” Smith said. Now, “I am unable to lay down and go to bed without some noise.”

Smith is one of many people who say listening to books or podcasts, rather than music, helps them fall asleep and get better rest.

Listening to someone’s voice narrating an audiobook or talking on a podcast can be an effective sleep aid, experts said. “Some people, when they’re alone in bed at night, they’re kind of alone with their thoughts, and they have circulating thoughts a lot. They’re thinking about this or that,” said a clinical professor at Stanford University’s School of Medicine in the sleep medicine division Rafael Pelayo. “They’ll listen to a podcast, or listen to music or something, or turn the TV on to block out their thoughts.”

Soft headband styles may be less intrusive and more likely to stay in place than ear buds, said Director of the Behavioral Sleep Medicine Programme at Johns Hopkins Luis Buenaver. PHOTO: THE WASHINGTON POST

The podcast market has adapted to capitalise on this effect, and sleep- or relaxation-focussed programmes have steadily racked up millions of downloads. Last year, Drew Ackerman’s popular narrative sleep podcast, Sleep With Me, had more than 42 million downloads, Ackerman wrote in an email to The Washington Post. Likewise, Nothing Much Happens, another popular bedtime-story podcast for adults, had almost 19 million total downloads in the past year, marking a 52-per-cent increase in growth over the previous year, according to analytics data from the Curiouscast podcast network/Corus Entertainment, home of the show. And Get Sleepy, which launched in November 2019, has since amassed more than 23 million downloads, creator Michael Brandon wrote in an email.

If sounds are familiar, there’s less of a chance they will disturb your sleep, said Pelayo, author of How to Sleep: The New Science-Based Solutions for Sleeping Through the Night.

“Your brain will learn to ignore the sound, or even better, to equate the sound with safety,” which may help enhance sleep, he said.

One of the keys to falling asleep is to bore your brain, said a sleep medicine specialist at Ohio State University’s Wexner Medical Center Steven Holfinger.

“Anything that’s going to potentially be interesting to your brain could be something that wakes it up,” he said. “The more boring the environment is when you’re asleep, the more likely you are to stay asleep.”

But because not all partners or roommates prefer the same – or any – sleep-inducing sounds, some insomniacs have started wearing headphones to bed, which raises questions about safety, comfort and sleep quality. Although the effect of sleeping in headphones has not been well-studied, said Chief of Sleep Medicine at Northwestern University’s Feinberg School of Medicine Phyllis Zee, she and other experts believe it is generally safe. Here are their recommendations for addressing your relaxation needs while protecting your hearing and your quality of sleep.

“Although the headphones may seem like they’re all targetting everybody the same, people falling asleep really have different issues, usually, that they’re trying to address,” Holfinger said.

For people such as Smith, whose anxiety or racing minds make falling asleep difficult, for example, Holfinger said the focus should be on the content of what they’re listening to. But if the priority is drowning out traffic sounds or noisy neighbours, certain headphone features “could make a big difference”, he said.

Headphones marketed for sleep come in a variety of styles, and they can range in price from less than USD20 to more than USD200. Some companies also are promoting models that have more advanced technological features designed to change or shut off sound when they sense you’re in different stages of sleep, said Zee, who served as a consultant for Philips, which sells a high-tech sleep headband. But in the absence of large-scale studies assessing different styles and technology, Zee and other experts said, users should prioritise comfort.

“Provided that the intensity levels (of sound) are similar, there probably isn’t a clear ‘safest’ choice for headphones,” an audiologist at George Washington University Medical Faculty Associates Ashley King wrote in an email. “The best style is probably the one that is most comfortable for you.”

Director of the Behavioural Sleep Medicine Programme at Johns Hopkins Luis Buenaver, said he generally doesn’t suggest people fall asleep with headphones on. “Having something like physically in your ear or wrapped around your forehead can be disruptive,” he said. “Then you also have the other concern of this noise being kind of pumped into your ear all night.”

If people really need headphones to cope with sleep problems, he suggested avoiding bulkier headphones. “If it’s very prominent or if it protrudes, then the likelihood of it disrupting the continuity of your sleep goes up,” he said. Wired headphones may pose safety risks if the cords get tangled during sleep.

Experts noted that ear buds might not be suitable for those with sensitive ear canals, and some styles can fall out during sleep. Soft headband styles with built-in headphones that sit outside the ear may be less intrusive and more likely to stay in place, Buenaver said.

Abby Ntalamu, 24, of Washington, DC, regularly uses headphones for sleep, and she said she prefers the headband style over her Apple AirPods.

“It’s a lot easier to sleep in,” said Ntalamu of her Bluetooth-enabled headband. “With the AirPods, they can fall out of my ears and then get lost in the bed, and then I have to search for them.”

Ntalamu said she often drifts off listening to ASMR videos, typically a combination of whispering and quiet sounds, such as gentle tapping or flipping pages, which can also induce sleep.

A 2017 paper reported that pink noise, a repetitive whooshing-like sound, increased deep sleep and improved memory in older adults when it was delivered in bursts aligned with the brain waves of the study’s subjects as they were sleeping. Music therapy has also been shown to have an effect on relaxation and sleep, Zee said.

Another emerging area of interest in sleep sounds is the use of binaural beats, which involves playing a slightly different sound frequency into each ear through headphones to create the perception of a single new tone, Buenaver said. Although existing research on binaural beats and sleep have not produced conclusive evidence of benefits over other types of sounds, Buenaver said, some studies have found that they may help with anxiety reduction and could be an option to try if you’re a headphone user.

Regardless of what you decide to listen to, experts suggest keeping the volume low, which is probably more conducive to sleep and will help prevent hearing damage.

“Listening at half the available volume is typically safe for most headphones,” King, the audiologist, wrote in an email. “Listening at a higher volume for an extended period of time can damage hair cells in the cochlea. These hair cells typically respond to different frequencies and can become less sensitive if damaged with prolonged exposure to high levels of sound.”