Healthtech/Digital Health/Analysis/ Keeping your pillow cold and other European sleep tech Europe’s startups are tackling the $40bn sleep industry. But which are the next market leaders, and which are peddling pseudoscience? By Madeleine Taylor 8 May 2019 Irritated young woman putting her alarm clock off in the morning with soft morning light. Relaxing concept. Irritated young woman putting her alarm clock off in the morning with soft morning light. Relaxing concept. \Healthtech Will Spotify founder Daniel Ek’s all-in-one body scanner be the future of medical diagnostics? By Mimi Billing 14 December 2022 Healthtech/Digital Health/Analysis/ Keeping your pillow cold and other European sleep tech Europe’s startups are tackling the $40bn sleep industry. But which are the next market leaders, and which are peddling pseudoscience? By Madeleine Taylor 8 May 2019 Sleep used to be so simple: the body’s nightly slide into semi-consciousness, when the sun goes down and the work stops. Now, sleep tech is a global industry that’s worth up to $40bn, according to consultants at McKinsey. Bedtech’s been an overnight success, with New York mattress firm Casper recently valued at $1.1 billion, six years after its launch in 2013. The field is expanding into sleep tech though, as now we’re seeing cuddly sleep robots that breathe in time with you (Somnox); smart beds to stop you from snoring (Balluga); and a ring that monitors your pulse and body temperature so that you can inspect your sleep data in charts when you wake up (Oura). And the more we learn about our sleep, the more important it becomes. Studies now tell us that those precious eight hours protect us from a whole slew of dangers, from cardiovascular disease and car accidents to dementia and early death. And we’re worried by the risks. According to a global survey last year by Philips, over three-quarters of adults (77%) have taken action to improve their sleep. This includes trying out various drugs, soothing music, and new tech. It’s no wonder that there is a plethoras of sleep tech startups wanting to aid those in need. Tech startups and VCs are eyeballing the sleep-deprived market. Minute differences in light, noise, body position and temperature can all disrupt a peaceful snooze – and there are as many startups taking on the problem, with as many cures. For the time being, sleep tech startups are competing on often contradictory claims, and hoping to hit gold. Sifted takes a look at some of the industry’s sleep tech giants. Catching some Pzizz Rockwell Shah founded Pzizz in 2015, a London-based app which specialises in composing “psycho-acoustic” lullabies to soothe your mind. $500,000 in funding comes from investors including tech accelerator Wayra UK. The company has also benefited from a series of high-profile endorsements by J.K. Rowling, Parkinson’s UK and the NHS. “Intuitively, we know that listening to music has great power over us,” says Shah. “You go to the gym and you listen to music. Or you watch a horror movie on mute, and it’s not so scary anymore. It’s why we sing lullabies to our children. But there’s so much more advanced that you can get than Twinkle Twinkle Little Star.” Instead, Pzizz lulls you into a reverie (and wakes you up again) with “dreamscapes” that combine music and narration. Pzizz’s engineers and composers work with an in-house researcher to discover the sonic “levers that you can pull” to relax the mind, and create tracks that guide users to sleep. The app is free but offers a “pro” subscription for $9.99 per month. According to Shah, it has twice the average conversion rate for digital health and fitness products. Pzizz considers itself a “health tech firm”, but the company is starting to change its tune, with current plans to branch out into the grey-areas between health and entertainment. One goal is to release a “lucid dreaming script” on the app to help users take literal control of their dreams. Shah is keen not to overpromise though, saying: “Lucid dreaming is a hard thing to accomplish and pull off for people who are practitioners. It is possible, but it’s not going to be lucid dreaming at the push of a button.” Another project in the works is “the world’s first AI meditator,” which Shah hopes to release this year. “Part of meditation is about waking up and being aware, and we think it would be quite funny, based on how popular meditation is right now, to train an AI system to train people to wake up, even though it itself is not aware.” Turning over a fresh pillow The idea behind Parisian sleep tech startup Moona is simple: helping you sleep by keeping your pillow cold overnight. The company calls it a “revolutionary sleep device that actively improves sleep”. It’s currently selling a 2cm-thick pad that circulates cold water inside your pillow. The pad is then hooked up to a bedside hub that regulates the temperature, and a mobile app that lets you set your own preferences. Moona spokesperson Nicolas Roux, says that temperature is “one of the most important factors our body uses to know when to go to sleep”. He says that the product is particularly beneficial for groups like women in the menopause and high-level athletes who work out at night, who often have difficulty overheating at night. Research has also shown that optimal sleep occurs at 1°C lower than our regular core temperature – and Moona says you can just as easily ‘hack’ this effect. “By regulating skin temperature around the head and neck, you are able to improve the sleep quality and fall asleep faster.” But at $399 a pop, Moona is more of a luxury home-furnishing than a health necessity. The first batch is not set to ship until July this year, but Moona has already raised $859,000 from investors. SOSV is one of Moona’s lead investors, and has backed a large number of budding sleep techs, including startups Kokoon, Circadia and Sana. Partner Benjamin Joffe says that the firm makes its sleep technology investments at the prototype stage, before there have been any proper clinical studies or certification for company claims. Investments are then made based on the “credibility in the technology and the team, generally via the prototype and the background of founders.” Fun and games While not having to turn your pillow over, and learning to lucid dream might be fun novelties, there’s an important boundary between health and entertainment. “There are a lot of gimmicks in the sleep market,” Pzizz founder Shah warns. Wearable sleep monitors are all the rage, and companies selling at-home devices claim to measure your sleep quality by tracking brainwaves, bodily movement and circadian rhythms. Beddit, a Finnish startup selling $150 sleep trackers, was acquired by Apple in 2017. A recent study dismissed the device as “not a valid device to monitor sleep” when its motion-sensing sleep tracker was tested against a clinical polysomnography machine. The science of sleep tracking, whether it’s in a wearable headband (Dreem), ring (Oura) or headphones (Kokoon), is still in its infancy. But this hasn’t stopped the investors circling. “You’re not getting anywhere near accurate data,” says Shah. “I oftentimes caution people, don’t make health decisions on the data that you’re seeing from your consumer wearable. If you want to use it as a toy and play around with it, that’s great. But don’t take the data that it’s telling you about your sleep seriously.” Doctors are now diagnosing “orthosomnia” in patients obsessed with the quality of their sleep, often fuelled in by the scores given to them by dubious tracking devices: users are literally lying awake at night, unable to sleep due to worries about what their device will say about their sleep quality. “This is an example where technology has run amok,” says Shah. An alternative to sleeping pills One of the best-evidenced sleep technologies available is Cognitive Behavioural Therapy (CBT). Digital sleep therapy burst onto the UK scene in 2012 with an interactive six-week video course based on Cognitive Behavioural Therapy. Known as Sleepio, it is the online equivalent of face-to-face therapy which is clinically proven to be effective against insomnia. “We as a company see ourselves as an alternative to sleeping pills,” says Kit Fitton, Sleepio’s head of partnerships. This could be important, as the drugs (benzodiazepines) prescribed to treat insomnia are dangerously addictive, and the NHS recommends that prescriptions not be given for more than 10 days at a time. Sleepio is a subsidiary of Big Health, which has raised $15.3m in funding rounds including a $12m Series B with London-based VCs Octopus Ventures and Index Ventures. Sleepio is available on the NHS, with regional contracts based primarily in the South East of England. But the road to nationwide rollout on the NHS is long and bumpy – and not something the company expects to see anytime soon. But importantly, Sleepio doesn’t see sleep as a winner-takes-all market, because options are important in consumer sleep: “There will be some people who just won’t get on well with a digital solution,” admits Fitton. “They may be more interested in a face-to-face solution. One way to think about it is that when a new class of drug launches, there will be multiple different drugs being launched by different companies, and each one will have slightly different attributes. So for each one, they can compete on price but also on their side effect profile, or how exactly they’re effective or the mechanism that they’re using.” The city never sleeps Not getting enough sleep is especially a problem in high-tempo, high-stress environments, which is why Sweden’s challenger in CBT-therapy, Learning to Sleep, is looking to tackle the problem in startups. Founded in Malmö in 2012 by Micael Gustafsson and Peter Boye, its funding pot currently tips the balance at $1.2m. The course is already integrated into Swedish public health service Läkemedelsverket but hopes to scale within Europe, starting with the UK. Co-founder Gustafsson plans to start by reaching out to London’s tech startups. “Our main target market is people with sleeping problems, and we know that people in the tech sector are overrepresented there,” says Gustafsson. Gustafsson blames poor role models for our sleeping problems: Tesla Exec Elon Musk famously claimed to work 120-hour weeks and get by on as little as four hours per night. Unlike Sleepio, Gustafsson wants to take on private healthcare – and hopes that the results from treating just 50 to 100 patients will speak for themselves. He hopes that the tech industry will to wake up to the cost of employees to turn up to work underslept and exhausted, and pay for his programme as an employee benefit. “It’s very quick return on investment because we know that people who are less tired are 5-10% more productive. They will be more productive and they will make better decisions at work, so it’s kind of a no brainer.” Common sense, expensive technology Dr Neil Stanley, an independent sleep expert who has been working on sleep for 37 years – he is the author of ‘How to Sleep Well’ – says that tried and tested routines like reading a book and taking a bath before bed – what he calls “folk wisdom” – are being abandoned in favour of quick fixes. Even CBT, he says, runs the risk of over-promising and under-delivering. “Sleep now is just a market. There are people exploiting the market – they create this fear by saying say that if you don’t get a good night’s sleep, you’re going to die, and then they sell you the solution to this non-existent problem.” And in fact, new research is coming to light that suggests that our anxieties about our sleep might be uncalled for. A 2018 study in Journal of Sleep Research found that people in the UK are actually getting more sleep than they were forty years ago – sleeping an average of 43 minutes more every night than they did in 1974. “We’re replacing common sense with expensive technology,” says Dr Stanley: “The thing is, sleep isn’t difficult. If you ask a good sleeper how they sleep, they’ll look at you like you’re an idiot. ‘You lie down, you close your eyes.’” The big hitters in sleep tech at the moment are all tremendously optimistic about tech’s role at bedtime. It’s a land of opportunity, ‘everyone needs to sleep’, they say. But there’s still a question hanging in the air over whether the consumers have much to gain from expensive gadgets that toy with their sleep. At least some of them are fun. Related Articles 4 questions for Alan cofounder Jean-Charles Samuelian By Michael Stothard Click here to read more Impact investors to know in Europe By Connor Bilboe Click here to read more European startups push into VR healthcare despite industry gloom By Kitty Knowles Click here to read more Mentech startup Numan raises €11m to help more men tackle their health issues By Mimi Billing Click here to read more Most Read 1 \Healthtech Is Daniel Ek’s new body scanner worth the hype? Sifted tried it out 2 \Venture Capital VC diversity needs to change — and white men need to take responsibility 3 \Venture Capital New €3.75bn European Investment Fund pot to back late-stage VCs 4 \Sustainability Counteract closes £15m fund for carbon removal solutions 5 \Mobility Was the $5bn that VCs plugged into escooters worth it?