Partnering with Harvard Medical School on Project SANDMAN

Partnership letter for Project SANDMAN from Harvard Medical School.

Take healthy adults, restrict them to six hours in bed a night, and after two weeks their performance on attention tasks has degraded to roughly what you would see in someone who had been awake for two straight nights. The deficits accumulate and can even become deadly.

Everybody knows that fatigue can be dangerous. The problem with treating sleep as a quantity are the usual mitigations (especially ones that are pharmaceutical) are unsatisfying or have side effects. Stimulants borrow wakefulness against later recovery. Better scheduling helps and is frequently unavailable, since the whole reason people are short on sleep is that something else was more urgent.

What has not existed is a way to get more out of the sleep a person actually gets.

That possibility rests on a shift in how researchers think about what sleep is for. Sleep is not a uniform block of downtime whose value scales with its length, but is a sequence of distinct electrical states, and the restorative work appears to be tied to specific events inside those states.

The event of interest is the slow oscillation, a rhythm of roughly one cycle per second that dominates the deepest stage of non-REM sleep. It is the largest, slowest thing the sleeping brain does. Work over the past decade has connected it to the physical clearance of metabolic waste from brain tissue, with human imaging showing that these slow electrical waves are coupled to the pulsing flow of cerebrospinal fluid through the brain. Rodent work established that this clearance runs faster during sleep than during waking.

The careful way to state it is that this is a candidate pathway rather than a closed case. The suggestive part is that the slow oscillation is measurable, it is measurable from the forehead, and it can be measured while it is happening.

In 2013 a group in Germany published the result that this entire field runs on - they played short tones to sleeping subjects, timed to arrive at a particular moment in the slow oscillation, at the peak of the wave rather than at random. The oscillation grew stronger. Related activity coupled to it increased. Memory for material learned before sleep improved.

Several laboratories have reproduced the physiological effect. It has been demonstrated in older adults, in home settings, and on portable dry-electrode hardware. The effect on the brain wave itself is not in dispute. Building this into something a person would actually use runs into a pair of engineering constraints that do not yield to enthusiasm.

The first is that you cannot react to the wave or window by which a person can be nudged to sleep. You have to predict it. The window that one would aim for with biofeedback modulation are aiming for lasts a few hundred milliseconds, and by the time a device has detected the peak, the peak is over. The device has to track the ongoing rhythm, forecast where the next peak will fall, and fire early enough that the sound arrives on time. The rhythm also drifts through the night, so a fixed delay that works at midnight is wrong by three in the morning.

This is a control loop with a hard timing budget, which is a well-understood category of engineering problem. The second constraint is the one that actually governs whether any of this is fieldable. Before the device can push the swing, it has to know the swing is there. It has to know, continuously and in real time, which stage of sleep the person is in, and it has to do that from a small number of dry electrodes on the forehead rather than from the twenty-odd wired sensors of a clinical sleep study.

The standard for that judgment is agreement with human experts, measured on a scale where 1.0 means perfect agreement and around 0.75 is considered strong. Clinical-grade automated systems now reach human-level agreement on full sensor sets. Comfortable wearables do not. A well-validated five-electrode headband landed near 0.62. A dry-contact ear sensor reached 0.73 across eighty nights.

Some studies report memory gains. At least one enhanced the oscillation cleanly and beautifully and found no behavioral improvement at all. A 2023 review of the literature concluded that memory effects remain variable and are most reliable in young healthy subjects, which is a polite way of saying the effect is not yet dependable in the populations that would benefit most.

Aviation crews, submarine watch rotations, and late night staff all run on compressed sleep and all care about cognitive performance in ways that are measurable and consequential. The commercial cases follow from the same device with no redesign. Shift work in aviation, rail, trucking, and hospital medicine is already a regulated fatigue-management problem with existing budgets and existing compliance obligations, which means a buyer who is already spending money on the problem. Elite athletics is an early-adopter market with a high tolerance for research-grade hardware and an unusual willingness to pay for marginal recovery. Clinical sleep medicine is the largest opportunity and the slowest, gated behind regulatory work that takes years.

This is not a bet on whether you can amplify a brain rhythm with a quiet sound at the right moment. That works, it has been reproduced, and the physics of it is about as complicated as pushing a swing. The bet is that amplifying it produces something a person would notice the next day, in the population and under the conditions where it would matter, and that you can build a device comfortable enough to sleep in that knows the wave well enough to push it correctly.