Eligibility
Inclusion Criteria: All Cohorts
* 45 years of age or older
* Self-reported poor sleep quality: PSQI score greater than 5
* Within 1.5 hours driving of the Greater Boston area
* Have never used an Eight Sleep Pod (or similar device) ever
* Post-enrollment hsCRP ≤ 10 µg/mL at Preparation Period blood panel. If Preparation Period hsCRP \> 10 µg/mL: triggers clinical review on a case by case basis; hard exclusion applies only at \> 30 µg/mL Weight ≥ 88 lbs
* No MRI scheduled during the study period or within 1 week after study conclusion
* No acute illness, injury, or dental procedure/cleaning within 3 months prior to study start
* Non-smoker or previous infrequent (\<1 weekly) smoker who has ceased at least 3 months prior to study start
* Predictable bowel movements: at least 3 weekly and no more than 3 daily bowel movements
* Able to drive or be transported to a local lab facility at least three total times for blood panels
* Willing to complete 3 blood panels (3-4 tubes of blood collected at each draw): no strong aversion to needles
* Able to swallow a pill/capsule (approximately the size of the standard vitamin capsule) for internal core temperature monitoring
* Stable diet for a minimum of 3 months prior to enrollment, with no planned major dietary changes during the study period
* Stable medication regimen: no medication type or dose changes within 3 months prior to study start, and no plans to change medications during the study. This includes long-term -medication like antidepressants, statins, hormones, antihypertensives, or levothyroxine.
* Stable exercise routine for a minimum of 3 months prior to study start, with no planned changes to this routine
* Stable dietary supplement routine for a minimum of 3 months prior to the study start: includes probiotics, synbiotics, supplemental SCFA's
* Willing to receive, set-up, and use all required equipment: the Eight Sleep Pod Cover and Hub, biometric smart ring, urine-based hormone measurement kit, ambulatory blood pressure monitor, core temperature capsule, HST device, and stool collection kits for the required amount of time
* Comfortable using research accounts owned by Eight Sleep for some study devices
* Willing and able to have stool samples picked up by the research team three and up to five times during the study
* Willing to have the research team in the home for study set-up (up to 3 hours)
* Have a valid, government issued ID
Cohort A specific Inclusion: Postmenopausal women
* Assigned female at birth
* Postmenopausal: self-reported absence of menstrual period for 12 or more consecutive months prior to study start
* No change to hormone replacement therapy (HRT) use within 3 months prior to study start or plans to change HRT status during study period
* No changes to hormonal birth control use within 3 months prior to study start or plans to change birth control use during study period
Cohort B specific Inclusion: Age-Matched Men
-Assigned Male at birth
Exclusion Criteria: All Cohorts
* Currently taking any of the following medications/supplements or have changed use status (using to not using or vice versa) within 3 months before study start.
* Antibiotics (any kind), including one-time or short-term antibiotic use
* Corticosteroids (oral or injection only, topical preparations included):
* Prednisone
* Prednisolone
* Dexamethasone
* Hydrocortisone
* Methylprednisolone (Medrol)
* Budesonide
* Betamethasone
* Anti-TNF-α medications (biologics for arthritis, Crohn's disease, psoriasis, or other immune/inflammatory conditions):
* Adalimumab (Humira)
* Etanercept (Enbrel)
* Infliximab (Remicade)
* Certolizumab (Cimzia)
* Golimumab (Simponi)
* Changed use status (using to not using or vice versa) within 3 months before study start or plans to stop/start the medications during the study.
--Statins (cholesterol-lowering medications):
* Atorvastatin (Lipitor)
* Rosuvastatin (Crestor)
* Lovastatin (Mevacor)
* Fluvastatin (Lescol)
* Antihypertensive drugs (blood pressure medications):
* Angiotensoconverting enzyme (ACE) inhibitors: Lisinopril, Ramipril, Perindopril, Enalapril
* Angiotensin II receptor blockers (ARBs): Losartan, Valsartan, Candesartan
* Calcium channel blockers: Amlodipine (Norvasc), Diltiazem, Verapamil
* Beta-blockers: Metoprolol, Atenolol, Bisoprolol, Propranolol
* Diuretics: Hydrochlorothiazide, Furosemide (Lasix), Indapamide
* Changed use status (using to not using or vice versa) within 3 months before study start or plans to start/stop during the study.
* Hormonal birth control (any form):
---Combined oral contraceptives (estrogen + progestin) or progestin-only capsule
* Hormonal IUD (e.g. Mirena, Kyleena)
* Contraceptive implant (e.g. Nexplanon)
* Contraceptive injection (e.g. Depo-Provera)
* Contraceptive patch (e.g. Xulane, Evra)
* Vaginal ring (e.g. NuvaRing)
* Hormone replacement therapy (exceptions: systemic - local vaginal estrogen preparations are not excluded):
* Estrogen-based: oral tablets, patches, gel, cream, or vaginal ring
* Combined estrogen + progestogen: oral tablets or patches
* Progesterone-based: oral tablets or intrauterine device
* Testosterone: cream or gel
* Bioidentical: oral tablets, patches, gel, cream, pellets, or injections
* Currently taking any of the following medications/supplements or have changed use status (using to not using or vice versa) within 3 months before study start or plans to start/stop during the study.
--Anabolic-androgenic steroids or performance-enhancing drugs (prescribed or non-prescribed):
* Testosterone-based: testosterone enanthate, cypionate, propionate, Sustanon
* Synthetic anabolic steroids: nandrolone, stanozolol (Winstrol), oxandrolone (Anavar), methandrostenolone (Dianabol), trenbolone
* GLP-1 receptor agonists or other glucose-lowering medications:
* GLP-1s: Semaglutide (Ozempic, Wegovy), Liraglutide (Victoza, Saxenda), Dulaglutide (Trulicity), Tirzepatide (Mounjaro, Zepbound)
* Other: Metformin (Glucophage), Insulin (all types), Sitagliptin (Januvia), Empagliflozin (Jardiance), Dapagliflozin (Farxiga), Glipizide, Glyburide
* Currently taking any of the following medications/supplements or have changed use status (using to not using or vice versa) within 3 months before study start or plans to start/stop taking these drugs during the study period.
--Sleep medications: Prescription: Zolpidem (Ambien), Zopiclone (Imovane), Eszopiclone (Lunesta), Temazepam, Nitrazepam, Trazodone (when prescribed for sleep), Suvorexant (Belsomra) Over-the-counter: Diphenhydramine (Benadryl, ZzzQuil, Unisom), Doxylamine (Unisom SleepTabs, Nytol),
--Benzodiazepines (use status change within 12 months before study start): Diazepam (Valium), Lorazepam (Ativan), Clonazepam (Klonopin), Temazepam, Nitrazepam
* Antidepressant medications (change within 3 months of study start or plans to start/stop taking during the study period)
* Stimulants affecting blood pressure:
* Methylphenidate (Ritalin, Concerta)
* Amphetamine/Dextroamphetamine (Adderall)
* Lisdexamfetamine (Vyvanse)
* Modafinil (Provigil)
* Pseudoephedrine (Sudafed, including other cold/decongestant medications)
* Antipsychotics: Quetiapine (Seroquel), Olanzapine (Zyprexa), Risperidone
* Mood stabilizers: Lithium, Valproate (Depakote)
* Changed use status (using to not using or vice versa) within 3 months before study start or during the study.
--CBT-I or pharmacological treatment for insomnia disorder
* Changed use status (started or stopped using) within 3 months before study start.
* Probiotics, prebiotics, or synbiotics
* SCFAs
* Butyrate (Sodium butyrate, Calcium/magnesium butyrate, Tributyrin), Acetate, Propionate
* Multivitamins containing any of the following minerals:
* Iron, Selenium, Calcium, Zinc, Phosphorus, Magnesium Note: Stable long-term multivitamin use (unchanged for ≥3 months) is not excluded Folic Acid, Vitamin C, Vitamin A, Vitamin D, or Vitamin E supplements
* Antioxidant supplements
* Omega-3 / fish oil supplements
* Melatonin (current use excluded if unwilling to cease use during study participation)
* Current, ongoing, or history of diagnosis or changed diagnosis status (new diagnosis, revised or reversed diagnosis) within the specified timeframe.
* Metabolic Conditions
* Diabetes mellitus: Type 1
* Type 2 diabetes (within the past 3 years)
* Diagnosed prediabetes (confirmed via Preparation Period hbA1c levels. A result between 5.7-6.4% warrants exclusion from the study)
* Chronic hepatitis B/C
* Liver cirrhosis
* Alcoholic liver disease
* Non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH) (within the past 3 years)
* Hepatitis A (within the past 3 years)
* Hypothyroidism or hyperthyroidism (including Hashimoto's thyroiditis)
* Cardiovascular Conditions
* Hypertension
* Cardiovascular disease, including:
* Coronary artery disease (CAD) or ischemic heart disease
* History of myocardial infarction (heart attack)
* Heart failure (any grade)
* Atherosclerosis
* History of stroke or transient ischemic attack (TIA)
* Peripheral arterial disease (PAD)
* Atrial fibrillation or other major cardiac arrhythmias
* Vasovagal syncope: common fainting episode caused by a sudden drop in blood pressure and heart rate
* Severe anemia or significant white blood cell or platelet abnormalities
* Surgery, severe skin disease, or fistula on the upper arm (interfering with BP cuff readings; within 3 months prior to the study start)
* Autoimmune Conditions
* Rheumatoid arthritis
* Ankylosing spondylitis
* Lupus erythematosus
* Multiple sclerosis (MS)
* Any other diagnosed autoimmune condition or current use of immunosuppressive medications
* Gastrointestinal Conditions
* Inflammatory bowel disease (IBD), Crohn's disease or ulcerative colitis
* Irritable bowel syndrome (IBS)
* Celiac disease
* Gastroparesis or diverticular disease
* History of colostomy, colon cancer, or other colon-related surgeries
* Recent gastrointestinal surgery (within 6 months prior to enrollment)
* Chronic Diseases
* Renal disease (chronic kidney disease, any stage)
* Hepatic disease (beyond those listed under metabolic conditions above)
* Respiratory or chronic lung disease
* Neurological and Psychological Conditions
* Dementia
* Alzheimer's disease
* Parkinson's disease
* Schizophrenia
* Sleep-Related Conditions
* Obstructive sleep apnea (OSA)
* Central sleep apnea
* Complex sleep apnea syndrome
* Narcolepsy or hypersomnia disorders
* Restless legs syndrome (RLS) / Willis-Ekbom disease
* Periodic limb movement disorder (PLMD)
* Circadian rhythm sleep-wake disorders: shift work disorder (SWD), irregular sleep-wake rhythm disorder (ISWRD), or non-24-hour sleep-wake disorder (N24SWD) Note: Participants with delayed sleep-wake phase disorder (DSWPD) or advanced sleep-wake phase disorder (ASWPD) with chronically stable sleep timing may be included.
* Participants will be excluded if they participate in any of the following behaviors or conditions within the indicated timeframe.
* Substance Use
* Current addiction to opiates
* Excessive alcohol consumption (more than 14 standard drinks per average 1 week)
* Habitual caffeine consumption exceeding 400 mg per day (approximately 4 standard cups of coffee or equivalent)
* Recreational frequent drug use within timeframes noted prior to study start:
* Cannabis / marijuana (including edibles and oils): daily or near-daily use (defined as ≥5 days per week) within 3 months prior to study start
* Cocaine: any use within 3 months prior to study start
* MDMA / ecstasy: any use within 3 months prior to study start
* Hallucinogens (LSD, psilocybin): any use within 4 weeks prior to study start
* Ketamine or other illicit substances: any use within 3 months prior to study start
* Diet and Weight
* Planning significant changes to diet or lifestyle in the 3 months prior to study start, or had significant changes to diet or lifestyle in the 3 months prior to study start
* Starting or stopping a specialized diet (ketogenic, vegan, carnivore, elimination, intermittent fasting)
* Significant increase or decrease in exercise load or training plan (change of ≥60 minutes per week in total exercise volume, starting or stopping a structured exercise program, or injury/illness-related activity restriction) within 3 months prior to study start
* Currently enrolled in an active weight-loss program, bariatric program, or medically supervised diet, or planning to start one during the study
* Weight loss or gain within the past 1 month of 5% of body weight or greater,, or weight loss or gain within the past 6 months of 10% body weight or greater
* Health Status at Enrollment
---Acute illness or active infection at the time of recruitment or study start: includes colds, prolonged cough, fevers, etc.
* Active cancer diagnosis or receipt of chemotherapy or radiotherapy within 12 months prior to study start, or planned chemotherapy treatment during the study duration
* Hospitalization of greater than 24 hours for acute illness, major surgery, sepsis, or cardiac, pulmonary or neurological events within 6 months prior to study start
* Study Equipment Compatibility
* Unable or unwilling to swallow a standard-sized capsule (required for internal core temperature monitoring capsule)
* Currently using a pacemaker or other electromagnetic medical implant (contraindicated with core temperature capsule)
* MRI scheduled during the study period or within 1 week after study conclusion
* Have or may have a CT scan planned during the study period
* Allergic to nickel or aluminum
* Sample and Data Collection ---Unable or unwilling to
----Collect and provide at least 3, and up to 5, stool samples
----Store self-collected stool samples in a home freezer until shipment/pick-up (up to 1 week after collection)
----Complete 3 blood panels (3-4 tubes of blood each), including strong aversion to needles
----Complete required digital surveys and any requested data sharing
* Communicate with the research team within a timely manner throughout the duration of the study
* Have stool samples picked up from home
* Have research staff within home for study set-up for up to 3 hours
* Complete all data collection requirements in a timely manner
* Lifestyle and Compliance
* Travel planned during the study period
* Unstable WiFi connection at any point during the study period (to the best ability this can be predicted)
* Unwilling or unable to provide informed consent with sufficient mental wellness to understand the study
* Lived outside of the United States within 6 months prior to study start
Cohort A Exclusion Criteria: Postmenopausal women
* Hysterectomy
* Oophorectomy (single or double)
* Polyendocrine metabolic ovarian syndrome (PMOS), previously known as polycystic ovarian syndrome (PCOS)
* Diagnosed testosterone dysregulation (hyperandrogenism or androgen insufficiency) not attributable to PMOS
* Premature ovarian insufficiency (POI) or premature ovarian failure (POF)
* Endometriosis
* Change to hormone replacement therapy (HRT) use within 3 months prior to study start
* Changes to hormonal birth control use within 3 months prior to study start
Cohort B Exclusion Criteria: Age-Matched Men
-Diagnosed testosterone dysregulation (hyperandrogenism and/or androgen insufficiency)