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Cognitive Shuffling for Health & Longevity

Evidence Review created on 10/24/2026 using AI4L / Opus 5.5

Also known as: Cognitive Shuffle, Serial Diverse Imagining, SDI, Serial Diverse Kinesthetic Imagining, SDKI, mySleepButton

Motivation

Cognitive shuffling (also called serial diverse imagining) is a mental technique for falling asleep. Lying in bed, a person picks a neutral word and, letter by letter, pictures a stream of unrelated everyday objects for a few seconds each, without linking them into a story. The idea is that scattered, dream-like images resemble the natural drift of thought as a person falls asleep and leave little room for worry or planning.

The technique was proposed more than a decade ago by a Canadian cognitive scientist, whose company also sells a phone app built around it. It spread widely on social media and in newspapers from 2025 onward, often described as science-backed. Interest among health-focused adults reflects a broader concern: difficulty falling asleep is common, and sleep is treated as a foundation of long-term health alongside exercise and diet.

This review examines what is actually known about cognitive shuffling: how it is supposed to work, what studies of it and of closely related bedtime imagery techniques have measured, what downsides and trade-offs exist, and how it compares with established non-drug treatments for sleeplessness.

Benefits - Risks - Protocol - Conclusion

The following items give a high-level overview of cognitive shuffling and of the bedtime imagery and refocusing research it builds on.

No directly relevant content on cognitive shuffling was found from Rhonda Patrick, Peter Attia, Andrew Huberman, Chris Kresser, Life Extension Magazine, or Lifespan.io; web searches and on-site searches of each platform returned no matching articles, episodes or newsletters.

Grokipedia

Cognitive shuffle

An AI-written encyclopedia overview of the technique’s definition, history and proposed mechanism; its statements on effectiveness rest on preliminary and largely unpublished data.

Examine

No Examine article on cognitive shuffling exists.

ConsumerLab

No ConsumerLab article on cognitive shuffling exists.

Systematic Reviews

The following systematic reviews and meta-analyses cover bedtime mental strategies related to cognitive shuffling and the established treatment it would otherwise compete with.

No systematic review or meta-analysis covers the risks of cognitive shuffling; the principal trade-off, delayed use of established insomnia therapy, is represented by the two therapy meta-analyses above.

Mechanism of Action

Cognitive shuffling targets pre-sleep cognitive arousal (effortful, racing thought at bedtime), a recognized maintaining factor in difficulty falling asleep.

  • Somnolent information-processing (SIP) theory: Beaudoin proposes a sleep-onset control system (SOCS, a hypothesized brain process weighing signals for and against sleep). Coherent, goal-directed thought signals that wakefulness is still needed; fragmented, story-less imagery signals readiness for sleep (Beaudoin, 2014).
  • Mimicking hypnagogia: The technique supplies a new, unrelated, neutral image every few seconds, resembling hypnagogic imagery (the disconnected pictures of the wake-to-sleep transition). Good sleepers report more random, non-connected pre-sleep images than people with insomnia (Nelson & Harvey, 2003).
  • Occupying working memory: Working memory (the limited mental workspace holding current thoughts) has little spare capacity; a vivid imagery task may leave too little room to re-engage worries (Harvey & Payne, 2002), the rationale also behind articulatory suppression (silently repeating a word to block verbal thought) (Levey et al., 1991).

Competing explanations exist. The SOCS has no confirmation from brain imaging or polysomnography (overnight brain-wave recording), so effects may reduce to generic distraction, expectancy, or the calming structure of a routine. Imagery is not uniformly calming: imagining a stressor in pictures raised short-term distress (Nelson & Harvey, 2002).

Historical Context & Evolution

  • Original intended use: Beaudoin, a cognitive scientist at Simon Fraser University, began exploring the idea in 1989 to address his own occasional sleeplessness (SFU, 2025).
  • Precursors: Articulatory suppression (Levey et al., 1991), imagery distraction (Harvey & Payne, 2002) and cognitive refocusing (Gellis et al., 2013) established the idea of displacing worry at bedtime.
  • Formalization and commercialization: Beaudoin set out the theory in 2013–2014 papers and released the mySleepButton app through his company, CogSci Apps Corp., in 2014 (SFU, 2025).
  • First data: A 2015 conference poster found improvement with both serial diverse imagining and structured problem-solving (writing down worries and solution steps earlier in the evening), without a significant difference between them; 78% of students receiving both rated the app more helpful (Beaudoin’s 2015 blog report of the Digdon & Beaudoin poster). A 2016 abstract of 154 students followed (Beaudoin et al., 2016); neither appeared as a peer-reviewed paper.
  • Health-optimization interest: Cohort data (groups followed over time) linking difficulty falling asleep to higher mortality (Ge et al., 2019) and the technique’s zero cost drew longevity-minded adults.
  • Evolution of opinion: Popular use grew sharply in 2025 without a matching increase in published trials. What changed was visibility, not evidence; the technique has been neither confirmed nor refuted by controlled testing.

Expected Benefits

High 🟩 🟩 🟩

No benefit reaches High: no trial of cognitive shuffling itself has been published in a peer-reviewed journal, and the controlled trials available concern related imagery and refocusing techniques.

Medium 🟩 🟩

No benefit reaches Medium: the only randomized study of the technique is an unpublished conference abstract without an untreated comparison group, and controlled trials of related techniques are indirect evidence.

Low 🟩

Faster Sleep Onset

Faster sleep onset is the core claim. In a one-night controlled trial of 41 people with insomnia, single-scene imagery distraction shortened sleep onset latency (time taken to fall asleep) versus no instructions (Harvey & Payne, 2002). This is indirect: one engaging scene, not serial unrelated images.

Magnitude: Shorter self-reported sleep onset latency with imagery distraction than with no instructions on a single night; the literature available to this review reports no outcome figure for this comparison.

Lower Pre-Sleep Cognitive Arousal

In Beaudoin’s unpublished 154-student trial, cognitive pre-sleep arousal fell from baseline equally with serial diverse imagining and structured problem-solving, without an untreated group (Beaudoin et al., 2016). Controlled data come from related techniques, imagery distraction (Harvey & Payne, 2002) and cognitive refocusing (Goodhines et al., 2024), making the evidence indirect.

Magnitude: Pre-sleep cognitive arousal improved within groups by d = 0.94 after single-session cognitive refocusing and d = 0.75 after an awareness control (d, Cohen’s d, a standardized change where 0.8 is conventionally large), not compared between groups (Goodhines et al., 2024).

Reduced Insomnia Severity

Two randomized trials from Gellis’s Syracuse group found greater improvement in insomnia severity with cognitive refocusing, which fills bedtime with absorbing neutral content (Gellis et al., 2013; Goodhines et al., 2024). The evidence is indirect for cognitive shuffling and limited to university students.

Magnitude: The Insomnia Severity Index (ISI, a 0–28 symptom questionnaire) improved within groups by d = 1.13 after cognitive refocusing and d = 0.90 after an awareness control, not compared between groups (Goodhines et al., 2024).

Return to Sleep After Night-Time Awakening

Beaudoin designed the technique for resettling after awakenings too. The only related data are an uncontrolled case series and a single-case experiment suggesting articulatory suppression may particularly help sleep maintenance (staying asleep through the night) (Levey et al., 1991). No study of cognitive shuffling measured night-time awakenings.

Magnitude: Not quantified in available studies. Only a small uncontrolled case series and a single-case experiment of a related technique exist, and they report no outcome figure.

Speculative 🟨

Downstream Mood and Anxiety Benefits

A meta-analysis of 65 trials found that interventions improving sleep also improved depression and anxiety (Scott et al., 2021). No study links cognitive shuffling to mental-health outcomes; the basis is inferential only.

Longevity Relevance Through Easier Sleep Onset

In prospective cohorts, difficulty falling asleep was associated with higher all-cause mortality (Ge et al., 2019). Whether shortening sleep onset with this technique changes such risk is untested; the basis is associative only.

Less Reliance on Sleep Medication

A university profile of Beaudoin describes the technique’s appeal to people seeking non-pharmaceutical sleep solutions (SFU, 2025). No study has measured use of hypnotics (sleep-inducing medications) among people practicing it; the basis is conceptual only.

Benefit-Modifying Factors

  • Genetic polymorphisms: No genetic variant has been studied as a modifier of response to cognitive shuffling or related imagery techniques.
  • Visual imagery ability: About 3.9% of people have aphantasia (absent or markedly impaired voluntary visual imagery) (Dance et al., 2022); an imagery-based technique may offer them little, though audio-prompted or kinesthetic (movement-based) variants exist.
  • Baseline cognitive arousal: The 2016 trial enrolled students selected for excessive cognitive pre-sleep arousal; benefit is plausibly greatest where racing thoughts, rather than circadian (body-clock) timing or pain, drive sleeplessness.
  • Baseline insomnia severity: An ISI score of 10 or higher marked insomnia cases in validation work (Morin et al., 2011); severe chronic insomnia may need the fuller established therapy rather than a single technique.
  • Sex: Insomnia is more common in women (risk ratio 1.41, meaning 41% more likely) (Zhang & Wing, 2006); the 2016 sample was 89% female, so response in men is less characterized.
  • Pre-existing conditions: Obstructive sleep apnea (repeated breathing pauses in sleep), pain, depression or circadian rhythm disorders cause sleeplessness that bedtime mental techniques do not address.
  • Age: Trial participants were mostly young adults (mean age about 20 in 2016); older adults, who have more sleep-maintenance problems, are unstudied.

Potential Risks & Side Effects

High 🟥 🟥 🟥

No risk reaches High: no trial of the technique has systematically recorded adverse events, and no replicated human harm data exist.

Medium 🟥 🟥

No risk reaches Medium: the human data bearing on possible harms come from experiments with related tasks and from opportunity-cost inference, both indirect.

Low 🟥

Paradoxical Delay From Effortful Use

Trying hard to fall asleep during a mentally demanding task, including word generation treated as a puzzle, can backfire. In normal sleepers under high mental load, instructions to fall asleep quickly lengthened sleep onset (Ansfield et al., 1996). Indirect evidence: the load was marching music, not imagery.

Magnitude: Longer sleep onset latency when trying to fall asleep fast under high mental load than without that intention; the literature available to this review reports no outcome figure, and no adverse-event rate or comparison-group rate exists for cognitive shuffling.

Delayed Treatment of Insomnia or Other Sleep Disorders

Relying on a self-help technique can postpone cognitive behavioral therapy for insomnia (CBT-I, a structured multi-session program) or assessment for obstructive sleep apnea. CBT-I has meta-analytic support (Trauer et al., 2015). No study measured delayed care among technique users; this is inferred opportunity cost.

Magnitude: The forgone benefit is CBT-I shortening sleep onset latency by 19.03 minutes (95% CI, confidence interval, the range likely to contain the true value: 14.12 to 23.93) more than inactive comparators (Trauer et al., 2015); no adverse-event or comparison-group rate for delayed care has been reported.

Distress From Emotionally Charged Imagery

Imagery carries strong emotion. In people with insomnia, thinking about a stressor in images produced more short-term distress and arousal than verbal thinking (Nelson & Harvey, 2002). This matters where shuffled words trigger intrusive or traumatic images; the evidence is indirect.

Magnitude: Higher short-term distress and arousal in the imagery group (14 people) than the verbal group (17 people), with faster estimated sleep onset later; the literature available to this review reports no outcome figure, and no adverse-event rate or comparison-group rate exists for cognitive shuffling.

Speculative 🟨

Frustration in People With Weak Visual Imagery

People with aphantasia may find picturing objects impossible (Dance et al., 2022), which could add sleep-related frustration. The basis is mechanistic only; no controlled data exist.

Risk-Modifying Factors

  • Genetic polymorphisms: No genetic variant is known to modify the risks of cognitive shuffling or related imagery techniques.
  • Trauma history: People with post-traumatic stress disorder or nightmare disorder carry intrusive imagery; emotionally charged images raised short-term distress in an insomnia experiment (Nelson & Harvey, 2002).
  • Baseline insomnia severity: An ISI score of 10 or more identified insomnia cases (Morin et al., 2011); above that level, the opportunity cost of relying on a single technique rises.
  • Sleep apnea risk markers: Snoring, observed breathing pauses, daytime tiredness and high blood pressure, the items of the STOP questionnaire (named for Snoring, Tiredness, Observed apnea, blood Pressure) (Chung et al., 2008), raise the risk that a missed breathing disorder underlies poor sleep.
  • Sex: No sex difference in risk has been studied; women’s higher insomnia prevalence (Zhang & Wing, 2006) means more women face the delayed-treatment trade-off.
  • Age: Older adults have higher rates of sleep apnea and medical causes of sleeplessness, raising the cost of delayed assessment; no older-adult data exist for the technique.
  • Imagery ability: Aphantasia (Dance et al., 2022) may turn the task into a source of frustration.

Key Interactions & Contraindications

Cognitive shuffling is a mental technique with no pharmacology; no human interaction or pharmacokinetic study exists.

  • Prescription hypnotics, sleep-inducing drugs (zolpidem, eszopiclone, temazepam): Monitor (theoretical). Possible additive sleep-onset effect; no study tested combined use, and the technique does not alter drug levels or next-day sedation.
  • Prescription stimulants taken late in the day (methylphenidate, modafinil): Caution (theoretical). Drug-driven alertness may override a mental technique, producing longer time awake in bed and frustration; timing earlier in the day addresses the drug, not the technique.
  • Over-the-counter sedating antihistamines (allergy drugs that cause drowsiness; diphenhydramine, doxylamine): Monitor (theoretical). Possible additive sleep-onset effect with no known harmful interaction; next-day grogginess stems from the drug alone.
  • Over-the-counter decongestants (pseudoephedrine): Caution (theoretical). Evening doses can cause wakefulness that bedtime imagery is unlikely to overcome, with longer sleep onset as the consequence.
  • Supplements promoted for sleep (melatonin, magnesium, L-theanine, valerian): Monitor (theoretical). Additive sleep-onset effect is plausible but untested; no harmful interaction is expected.
  • Additive mental techniques (guided imagery, sleep stories, progressive muscle relaxation): Monitor (theoretical). These share the aim of displacing worry; combining them may be redundant rather than harmful.
  • Established insomnia therapy (CBT-I; stimulus control, using the bed only for sleep): Compatible, complementary (theoretical); no conflict expected. The American Academy of Sleep Medicine (AASM), whose members bill for these therapies, recommends CBT-I and suggests stimulus control (Edinger et al., 2021).

Populations who should avoid Cognitive Shuffling:

  • None identified

Risk Mitigation Strategies

Durations and timings below follow common practice unless cited.

  • Neutral seed words: Choosing words without personal or emotional associations, and moving on from any image that turns distressing, limits the risk of emotionally charged imagery (Nelson & Harvey, 2002).
  • Low-effort stance: Treating the exercise as idle play rather than a race to sleep reduces the paradoxical delay seen when people try hard to sleep under mental load (Ansfield et al., 1996).
  • Leaving bed when awake (stimulus control): Getting up after roughly 20 minutes awake and returning when sleepy prevents bed-wakefulness association and frustration; stimulus control has guideline support from AASM, whose members bill for it (Edinger et al., 2021).
  • Insomnia severity threshold: An ISI score of 10 or more, the case-detection cutoff (Morin et al., 2011), is the point at which formal insomnia assessment and CBT-I avoid delayed treatment.
  • Sleep apnea screening: Answering the four STOP questions on snoring, tiredness, observed pauses and blood pressure (Chung et al., 2008) flags a missed breathing disorder for sleep testing.
  • Audio-prompted version: An app presenting concrete words at 8-second intervals (Beaudoin et al., 2016) removes word-generation effort, limiting over-engagement and frustration.

Therapeutic Protocol

Timings are cited to their source; other parameters (seed-word length, session structure, how long to persist) reflect common practice.

  • Self-directed serial diverse imagining: The person picks an emotionally neutral seed word and, letter by letter, pictures unrelated concrete items, switching to a new target every 5–15 seconds without linking them (Beaudoin, quoted by Jackson & Kavaliotis, 2025).
  • Technology-assisted version: The research app presented a recorded concrete word every 8 seconds for the user to picture (Beaudoin et al., 2016); its commercial form, mySleepButton, is sold by Beaudoin’s company.
  • Kinesthetic variant: Serial diverse kinesthetic imagining pictures actions or movements instead of objects, “a bit like playing Pictionary in your mind” (SFU, 2025).
  • Alternative — single-scene imagery distraction: Elaborating one interesting, engaging imagined scene throughout the pre-sleep period, tested by Harvey’s Oxford group (Harvey & Payne, 2002).
  • Alternative — cognitive refocusing: A single session teaching people to replace arousing pre-sleep thoughts with absorbing, non-arousing mental content, developed by Gellis (Gellis et al., 2013).
  • Alternative — structured problem-solving: Writing worries and solution steps about 15 minutes, earlier in the evening rather than at bedtime (Carney & Waters, 2006; Beaudoin et al., 2016).
  • Time of day: Used at lights-out and again after night-time awakenings; it has no role during the day.
  • Duration of effect (half-life equivalent): As a mental activity, it has no half-life; any effect lasts only while practiced.
  • Single versus repeated sessions: One continuous session per attempt to sleep, restarted with a new seed word if the first runs out.
  • Genetic polymorphisms: No variant is known to alter protocol choice; aphantasia, not genetics, is the main reason to prefer audio prompts or kinesthetic imagery.
  • Sex: No sex-specific protocol exists; tested samples were predominantly female.
  • Age: Older adults may favor the audio-prompted version if word generation feels effortful; no age-specific data exist.
  • Baseline status: Pre-sleep arousal and ISI scores help distinguish worry-driven sleeplessness, the technique’s target, from other causes.
  • Pre-existing conditions: Trauma-related intrusive imagery favors verbal techniques or refocusing on non-visual content; suspected sleep apnea calls for sleep testing rather than technique changes.

Discontinuation & Cycling

  • Duration of use: Used as needed, from single nights to indefinitely; it is not a course with a defined end.
  • Withdrawal effects: None are known or plausible; stopping simply removes the bedtime activity.
  • Tapering: Not applicable; there is no dependence or rebound to manage.
  • Cycling: No cycling is described or needed; whether repeated use maintains effectiveness or builds a conditioned sleep cue is untested.

Sourcing and Quality

  • Applicability: Sourcing largely does not apply; the technique needs no product, only instructions.
  • Do-it-yourself versus app: The self-directed method is free; mySleepButton is the original commercial app, made by the developer’s company.
  • What to look for in apps: Audio-only delivery, random concrete words, and adjustable intervals; screen use at bedtime adds light exposure.
  • Instruction quality: Beaudoin’s own papers and the developer site describe the method directly; social-media versions vary and sometimes omit the emphasis on unrelated, emotionally neutral images.

Practical Considerations

  • Time to effect: Proponents describe effects within a single night; the 2016 trial measured outcomes after one week and one month of use.
  • Common pitfalls: Choosing emotionally loaded words, building stories between images, clock-watching, and treating failure to sleep quickly as a personal failing all work against the technique’s premise.
  • Regulatory status: Not applicable; a self-administered mental exercise involves no product, prescription or clinical supervision.
  • Cost and access: Free and immediately available; no exceptional cost or access barrier exists.
  • Research funding asymmetry: A free, unpatentable technique gives no manufacturer a reason to fund trials; insurers, who pay for CBT-I sessions, could favor it on cost, a potential structural bias in guideline formation and research funding that helps explain the thin evidence base.

Interaction with Foundational Habits

  • Sleep: Direct and potentiating. The technique targets sleep onset and fits within stimulus control and consistent sleep timing, both backed by AASM, whose members bill for these therapies (Edinger et al., 2021); it cannot offset a bedtime set too early for the body clock or excessive time in bed.
  • Nutrition: No direct interaction. Late caffeine or alcohol drives arousal or fragmented sleep that a mental technique cannot override; their timing is a separate lever.
  • Exercise: None direct; potentially complementary. Regular exercise has small-to-medium benefits on sleep onset latency (Kredlow et al., 2015), acting on physiology, whereas the technique acts on bedtime thought.
  • Stress management: Direct overlap. Both target worry; structured problem-solving earlier in the evening reduced pre-sleep cognitive arousal (Carney & Waters, 2006) and performed similarly to serial diverse imagining in the 2016 trial.

Monitoring Protocol & Defining Success

No laboratory tests are needed for a mental technique; monitoring relies on validated questionnaires and sleep records.

Before starting, baseline assessment consists of one to two weeks of sleep diary entries (bedtime, estimated time to fall asleep, night awakenings, wake time), an ISI score, and the cognitive subscale of the Pre-Sleep Arousal Scale (PSAS, a questionnaire rating racing thoughts at bedtime). A STOP questionnaire screens for possible sleep apnea, which would redirect attention to sleep testing.

Ongoing monitoring repeats the diary for a week and the ISI and PSAS at 1 week and 4 weeks, matching the 2016 trial’s follow-up points, then every 3–6 months while the technique is in regular use. Success is defined against the individual’s own baseline: shorter estimated sleep onset, fewer nights with prolonged wakefulness, and lower questionnaire scores. A persistently high ISI score signals the need for formal insomnia assessment rather than further self-experimentation.

Biomarker Optimal Functional Range Why Measure It? Context/Notes
Insomnia Severity Index (ISI) No established target; track change from own baseline Expected to change; also a safety check (persistently high score prompts formal assessment) 7-item questionnaire, 0–28; a score of 10 detected insomnia cases and a drop of 8.4 points matched moderate improvement (Morin et al., 2011); no fasting or time-of-day requirement
Sleep onset latency (sleep diary) No established target; track change from own baseline Expected to change Self-estimated minutes from lights-out to sleep; average over 7 nights; pair with ISI; wearable estimates can supplement but are less accurate for wake time
Pre-Sleep Arousal Scale, cognitive subscale (PSAS) No established target; track change from own baseline Expected to change Measures racing thoughts and worry at bedtime (Nicassio et al., 1985); the 2016 trial’s main outcome; complete in the morning about the previous night
STOP questionnaire (sleep apnea screen) No established target; a positive screen prompts sleep testing Safety check Four yes/no items on snoring, tiredness, observed apnea and blood pressure (Chung et al., 2008); baseline and if symptoms appear

Qualitative markers:

  • Perceived ease of falling asleep and sense of effort at bedtime
  • Frequency of intrusive worries or replayed conversations in bed
  • Ability to resettle after night awakenings
  • Daytime energy, mood and concentration
  • Frustration or distress during the exercise, a sign to switch variant

Emerging Research

  • No registered trial of the technique: ClinicalTrials.gov lists no trial of cognitive shuffling or serial diverse imagining; the evidence will not change until one is run with an untreated or placebo-like comparison group and objective sleep measures.
  • Imagery rescripting trial (Geneva): NCT06335784 randomizes 120 adults with insomnia to imagery rescripting (reshaping distressing images into positive ones, in bed), with or without odor cues, versus sleep hygiene; primary endpoint ISI; estimated completion August 2027. A positive result would raise confidence in the imagery-based benefits graded Low here; a null result would lower it.
  • Bedtime mindfulness app pilot (Boston): NCT06972303 randomizes 30 adults with sleep-onset insomnia to bedtime app-guided mindfulness, daytime practice, or sleep hygiene; primary endpoints are feasibility and acceptability; estimated completion December 2028. As a feasibility pilot, a positive result would not change the conclusion; a null result would weaken the case for app-delivered bedtime techniques.
  • Theory development: Beaudoin and Guloy’s chapter on somnolent information-processing theory for a Cambridge handbook is in press (SFU, 2025); testable predictions could support or falsify the sleep-onset control system idea.
  • Mechanism research: Lemyre et al. call for studies of how specific kinds of pre-sleep thought affect sleep onset latency (Lemyre et al., 2020); recordings during the technique could show whether it truly induces sleep-like thinking.
  • Scalable delivery: Brief, electronic, peer-led refocusing proved feasible in students (Goodhines et al., 2024), a model for testing app-delivered cognitive shuffling; failure to beat stimulus control would weaken its case as a stand-alone tool.

Conclusion

Cognitive shuffling is a free, drug-free mental exercise for falling asleep: picturing a stream of unrelated, emotionally neutral objects so that worry and planning have no room to take hold. Its rationale is coherent and fits what is known about how thinking loosens as people drift off, and about the worry-filled thinking of people who sleep poorly.

The evidence, however, is thin. The technique itself has been tested only in student samples reported at conferences, without an untreated comparison group, and the researcher who developed it also sells an app built on it; the professional body backing the established insomnia therapy has members who are paid to deliver it. Support for its benefits — falling asleep faster, calmer thinking at bedtime, milder sleeplessness — comes mainly from related imagery and refocusing techniques, so all benefits rest on low-grade or indirect evidence. Links to mood and long-term health remain inference.

Risks are small and mostly indirect: trying too hard can keep the mind busy, vivid images can stir distress in people with trauma, and the most consequential downside is relying on a home technique while an established talk-and-behavior therapy for insomnia, or a missed breathing disorder during sleep, goes unaddressed.

For health-focused adults, the technique costs nothing and carries little risk, but its value is uncertain, and its evidence base is far thinner than that of the better-studied approaches to persistent sleeplessness.

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