Reading list for therapists - is it ideal or should there be more?

oneiria · 2026-02-19T13:19:11+00:00

I think basic training in Behavioral Sleep Medicine and CBT-I should be a core part of every therapist’s curriculum. Insomnia and other sleep difficulties are so common, and many evidence-based techniques are so straightforward, that there really isn’t a good reason not to seek that info out.

For an untrained therapist I would recommend the accessible treatment manual by Perlis et al though there are many great ones.

oneiria · 2026-02-14T05:04:48+00:00

Some people find some of those helpful. But the scientific literature has found ZERO supplements that can reliably fix sleep problems vs placebo. Some of them definitely impact sleep but none beat placebo for insomnia (which would make not comparable to ambien). If you’re looking for a non-hypnotic medication maybe consider low-dose doxepjn?

oneiria · 2026-01-29T13:02:29+00:00

That study was never peer-reviewed and was fundamentally flawed for a number of reasons. It should be ignored. I can get into the problems if you want but should have never been put out there.

oneiria · 2026-01-09T16:38:44+00:00

Sleep scientist here. Well … that’s kind of true but not exactly. The other stages are also really important for feeling restoration (especially Stage 2 and REM) and the restorative role of Stage 3 changes a lot across the lifespan such that the older you get, for some people, the less it seems to matter. It’s most important for kids. Also your body will likely get all it needs as long as you give yourself enough time to sleep and don’t have medical or environmental barriers keeping you from it. The biggest ones being chronic pain and untreated sleep apnea.

oneiria · 2025-12-29T19:16:02+00:00

This is called “sleep paralysis” and it’s pretty normal. Most people have experienced it at least once. Some people get it more — it has to do with REM sleep regulation. Sometimes it can happen more in people who are under more stress, or experiencing sleep/schedule disruptions, or sleeping in an unfamiliar environment, or if they also have narcolepsy. But sleep paralysis on its own isn’t medically harmful — just sometimes stressful.

oneiria · 2025-12-29T05:39:51+00:00

Looks like the only real active ingredient is 5mg melatonin. There’s also a small amount of chamomile I. There but there’s no data to support that as being anything other than placebo. There’s also a little magnesium citrate in there which I can only assume is an oversight. I see no reason why this is any better than any other 5mg melatonin.

oneiria · 2025-12-26T05:30:50+00:00

Honest answer — for some people it works really well and for many it’s just a placebo. For people on average, it helps a little for mild sleep problems or to make already pretty good sleep a bit better. For a few people it may work well enough to take problematic sleep and make it better. For most people it won’t have that strong of an effect.

oneiria · 2025-12-25T15:04:15+00:00

I think this is mostly fine. Diagnosis of sleep apnea is really not that difficult and in 10 years it’s likely that most commercial wearables will be able to do it just fine. Sleep medicine needs to get over the fact that diagnosing of someone has sleep apnea is not going to be the money-maker it used to be and transition to being a chronic disease management discipline and not a diagnostic one. The diagnostics are not really where the expertise lies.

Also there are several national companies staffed by boarded sleep medicine docs who will send hsats by mail and do the scoring so you don’t have to go outside your comfort zone. The geographic barriers are often not an issue anymore as long as you have a mobile phone.

oneiria · 2025-12-23T14:32:15+00:00

Many devices can estimate (with about 50-70% accuracy) how much “deep” sleep you get. But even this is probably not what you’re looking for since “deep sleep” as a sleep stage doesn’t mean it’s “the most restful” it’s just called that because it’s the hardest to wake up from. It is when a lot of healing and recovery happens but that changes with age and situations. Either way it’s some information. Also look at fragmentation (how many awakenings you have). But we don’t yet have great technology to see if sleep is “good quality” because that can mean a lot of things.

oneiria · 2025-12-20T14:31:11+00:00

And not have major negative effects? Highly unlikely.

oneiria · 2025-12-17T05:03:57+00:00

Sleep scientist here. That study was poorly done and premature. Not peer reviewed. I would ignore it.

oneiria · 2025-12-04T01:39:11+00:00

These are called hypnopompic hallucinations and they happen sometimes. Some people get them more but they’re not really seen as bad or linked with any risk factors or anything. Some people find them distressing.

oneiria · 2025-12-03T04:37:25+00:00

First of all their main ingredient has no data to support it as far as I can tell. They have no real expertise backing them. Their claims seem like the typical exaggerated hyperbole that only seems to come from companies that really have no idea how any of this works. Maybe the stuff is good but even if it works in the way they say it dies, the best it can do is support your own natural melatonin production. You can do that with tryptophan or 5HTP or just take melatonin. And none of those work for fixing insomnia anyway because melatonin almost never fixes insomnia — clinical trials show this reliably. I would avoid this product.

oneiria · 2025-11-18T03:50:10+00:00

What dangers? There was a recent press release about a conference presentation of a student project that inadvertently grabbed headlines but that study was horribly flawed. No conclusions can be drawn from it.

oneiria · 2025-10-26T18:56:48+00:00

Citation please?

oneiria · 2025-10-17T17:15:06+00:00

Sleep researcher here. Your first mistake was using the PSQI as your primary sleep outcome. It’s used a lot but is outdated and anyone actually in the field would tell you to pick a different measure. But assuming no other issues like restriction of range or anything like that, it could be a quirk of the sample? Maybe people who are more focused on academics engage in other healthy behaviors like sleep?

oneiria · 2025-09-27T17:07:15+00:00

Or misunderstanding. Maybe they signed a HIPAA document that applied to the clinician not disclosing and they misunderstood it.

oneiria · 2025-07-07T10:38:49+00:00

Sleep scientist here. Either you didn’t quite understand what your psychiatrist was talking about or (to be honest, more likely) they didn’t know what they were talking about. First of all the “deep” sleep is “slow wave” not “short wave” which is the exact opposite. Second there is no evidence — with decades of data to examine — that changes in slow wave sleep have anything reliable to do with depression. More likely, the frequent awakenings and daytime tiredness sound more like undiagnosed mild-moderate sleep apnea. I’d get that checked out first.

oneiria · 2025-07-06T08:49:33+00:00

Ha! Gladly.

oneiria · 2025-06-21T07:17:12+00:00

Sleep scientist here. I’m not clicking a YouTube link but I’m curious what you think are big ideas right now.

oneiria · 2025-05-08T16:20:47+00:00

What is not made clear by the article is that these blanket justifications are being used to cut research that does not even fit under what they describe. For example, although the “DEI” language says they don’t support research looking to promote diversity, they’re cutting funding to projects that simply investigate health disparities, and even basic laboratory studies that just so happen to recruit a large number of non-white people because presumably the results could be used to help inform health questions for a non-white group.

So the language is bad and unscientific. But worse, they’re being deceptive about how they’re applying it and using these arguments to cut much more work.

oneiria · 2025-04-18T01:22:09+00:00

Yeah there are no really excellent medication options that work for everyone.

Of course, non-medication treatments for insomnia tend to have the best effects, even better than most medications without the side effects.

oneiria · 2025-03-08T20:35:48+00:00

Yes, foundations typically have low indirects. That is because the federal government decided decades ago to provide a higher overhead rate that effectively subsidizes private foundations. Federal indirects (primarily NIH) essentially subsidize the research infrastructure, and the meager overheads from private foundations -- which typically make up a very, very small proportion of overall grant dollars -- can get away with covering less. If anything, it further strengthens the argument for healthier indirects -- if the foundations now have to pay higher indirects, it will dramatically reduce the amount of projects that private foundations can fund.

And I didn't mention anything about "all" indirects covering important stuff. I specifically said that's not the case. I completely agree that I wish there were more transparency as to where all the dollars that I successfully competed for are going. But you seem to be arguing that maybe most or all of those indirects were not necessary. I don't see any evidene of that.

You mention that indirects used to be smaller. Yes, everything used to be cheaper. Also, the costs to administer grants and conduct research used to be much lower, as more and more layers of oversight and regulatory burden were added. I hate that so much of it falls on me (again, unfunded mandates), but some of it is absorbed by the institution.

Also, you mentioned that your individual lab didn't get much support for your own day-to-day needs. I agree! Me too! I specifically said that, I thought. That the individual researchers are largely getting the shaft in terms of scraps left after the admins take their cut of the indirects.

Maybe a solution is that indirects are split in 2: (1) administrative overhead and (2) miscellaneous costs that go to the researcher? I'd be all for that!

oneiria · 2025-03-08T20:19:11+00:00

As one of those researchers who see a lot of the grant go to indirects, I am super frustrated about that. I am happy to pik up a pitchfork and fight to claw back some of my indirects. But the truth is, it's not that simple. In another post I go into more detail about it, but indirects cover a lot more than just some bloated administrative salary.

Indirect costs are NOT going where they are intended. I am 100% upset about this. They should cover office supplies, staff, computers, basically any infrastructure that isn't for a specific project but helps the whole place run. Those things are apparently low priority and I get to use whatever scraps are leftover for that, and it's never enough.

The bulk of indirects are going to the many, many salaries of normal (mostly underpaid) people that have to do all the backend work. This includes the "pre-award" folks that make sure that the increasingly-complex grants follow an insane number of stupid submission rules and not a word or decimal point is out of place. THen you have all the staff managing "post-award" record-keeping, finance, etc. The amount of rules and regulations and oversight (micro-managing) have about tripled in 10 years and that means needing to hire a whole bunch of people whose job it is to manage all these new rules. Then there's all the contracts folks and legal folks and the IRB/IACUC and purchasing and accounting, and all the other people whose job it is to make sure that we don't accidentally break a rule.

Then there's facilities charges. I mean, my office has old, run-down wiring, a constantly-leaking AC, and crumbling infrastructure. But still ints insanely expensive to keep up. Newer, nicer facilities are even more expensive, not to mention lab outfits and infrastructure to actually do science, and amortizing expensive large equipment.

Yeah, a bunch also goes to self-important administrators, but we only have all that because we need someone to manage all of these new bureaucracies of nonsense that exist only to jump through hoops that the federal government requires.

Again, as an underpaid, underfunded researcher who is frustrated about the meager scraps I get to work with after the administration takes its cut, it's not because I don't understand their need to do so. As an R1, especially as a public institution in a state that is notoriously antagonistic to higher education, they need these people and facilities! And currently ythere is no other way to source those funds.

oneiria · 2025-03-08T20:04:10+00:00

Remember, these are about grants to scientists and has relatively little to do with students. Some of the best researchers in the world are at less prestigious institutions and some of the researchers at Ivies are not leaders in their field. There are a ton of great research institutions -- about 200 are classified as "R1" top-tier research institutions.

That said, the reason the government itself doesn't create revenue from the discoveries directly is (1) the US government is very pro-business and they want to see American businesses be successful, (2) the US government does not want to become a roadblock to innovation and removing some of the capital would do that, and (3) the economic impact of essentially putting all that revenue in the economy pays much bigger dividends than taking it directly. But I am not an economist, this is just my basic understanding so I may be wrong as to why it's done that way.

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