Ryan McLean : Slightly Unconventional

#44 On Ending Night Terrors With Varun From Lully

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[youtube id=”ouMUg28noJk” align=”left” mode=”normal” maxwidth=”400″]Night terrors occur when your child has a tantrum but isn’t actually awake. Today I talk about Lully, a product that stops night terrors in children.

Hey guys, Ryan here from Instructions Not Included. Today is a great episode because I actually interview another startup founder. This guy’s name is Varun and he started a company called Lully or Lully, depending on how you pronounce it; tomato, tomato. But this is a really cool company. They solved the problem of night terrors in young children. Now, if you don’t know what a night terror is, then consider yourself lucky.

A night terror happens when your child – they wake up but they don’t actually wake up. And generally, it results in them having a tantrum but they’re not actually awake. And so, you can’t console your child, you can’t fix the tantrum. Often, when you go to try and help them or hold them down to stop them hurting themselves or something, they don’t respond to you and, in fact, they get worse. So, night terrors are a really serious issue for parents because it’s very traumatic as a parent.

I have a child who gets night terrors. It’s very traumatic as a parent to watch your child go through these traumas, to go through these nightmares where they don’t wake up, but there’s nothing you can do about it.

Varun created a company with his co-founders that solves this problem. Basically, they created a product which is like this disc that goes under your child’s bed and vibrates. Along with software, it’s an app on your phone, that tells you when to turn it on. We talk about how they started the company, a whole bunch of stuff around night terrors and how they ended up going through and getting this product created.

This was someone that I really wanted to interview because I really love this product. It solves the problem of night terrors for my child and I hope that by creating this, some people out there will learn about night terrors and learn about how to fix it for their children as well. So, here’s the interview with Varun from lullysleep.com.

Ryan: My kid had night terrors and I actually found out about you through This Week in Startups. Do you listen to that podcast at all? Jason Calacanis.

Varun: Oh! Yeah.

Ryan: Yeah. So, anyway, he was interviewing a VC and they were talk about, “Oh, yeah, we invested in this company that helps people whose kids wake up screaming in the night.” I was like, “Oh my god! That’s my kid!” I didn’t even know what a night terror was. And then, I heard that and so I went on a Google spree to find you. Because they had mentioned, “Oh, they were from MIT or something” so then, I’m googling “MIT night terrors”. Eventually, I found it and I was able to get one and ship it out to me.

How did you even start to think, “Oh, I know, we’ll deal with this issue that’s like night terrors and we’ll just put like vibrating disc under kids’ beds and that’ll fix the problem.” Because there seems to be no other solution out there. It’s just so random solution. What happened?

Varun: Stepping back a little bit, it sort of started because my co-founder grew up with a sister who had night terrors and more recently, his nephew had started experiencing night terrors. Both of us were at Stanford at the time doing a healthcare innovation fellowship. It’s a program that essentially helps you find ideas what’s [inaudible 3:28] and a lot of the times, it results in companies being spun out. Anyway, so, we met as a part of that program and he brought up night terrors as an interesting area.

He’s a clinician by training. It was sort of an interesting insight where the clinical community looked at night terrors and really thought they were benign. They’re something that kids will eventually grow out of. There were really no terrible adverse outcomes from night terrors. And so, the clinical community had said it’s not a problem. But in reality, for a parent dealing with night terrors and specially a family with consistent night terrors, it’s pretty draining. And it’s pretty emotional to see a child in that state. As we were looking at the problem, we thought it’s something that definitely warrants solving. So, that’s sort of how we got started working on night terrors.

Ryan: I think that’s interesting because night terror, for people who don’t know, is like your kid wakes up screaming in the night sometimes throwing a tantrum but they’re not actually awake. And if you try and console them and try and calm them down, usually, it makes things worse. Super frustrating as a parent because there’s nothing you can do.

But I can see clinically why people have ignored it because my child doesn’t even remember having them in the morning. So it’s really stressful as a parent, but as a child, I don’t even know if that registers for them that these things are happening.

Varun: Exactly. The kid doesn’t know. I think another part of it is pediatricians really didn’t have a tool. If they did start seeing night terrors was a problem, their hands are still tied because they can’t really offer you a solution to it. Part of it is that playing out as well.

Ryan: Yeah. Do we know what causes night terrors? Like, why does this happen?

Varun: Yeah. So, we don’t know exactly what causes night terrors. When you do overnight sleep studies or polysomnograms with children who experience night terrors, they tend to have a lot more spontaneous partial awakenings from their deep sleep – a lot more frequently than other children.

Ryan: Does this mean they don’t have a standard sleep cycle where they go into REM sleep and then come out and go back in?

Varun: Overall, their sleep architecture remains the same. But most kids, they’d go in a deep sleep. During a continuous period of deep sleep, they may partially awaken once or twice very, very briefly but they’re in deep sleep for majority of that time. Children who have night terrors have multiple – significantly more of these partial awakenings from their deep sleep. What people believe is those are triggers of night terrors.

Ryan: So what is a partial awakening? Is that like, when you kind of wake up and you roll over and pull the covers on yourself or something like those sort of moments?

Varun: That’s one type of partial awakening. The clinical definition of a partial awakening or non-sustained awakening is, I believe it’s less than 3 seconds. There’s no recollection of the event in the morning. You may do something that you typically do when you’re awake, like, yeah, roll over and pull the covers over. But you really haven’t fully woken up from sleep and you really don’t remember ever doing it.

With nigh terrors, what tends to happen is during some of those partial awakenings, the brain enters a dissociative state. And what that means is, part of the brain is awake while the rest of it is asleep. With night terrors, the part that’s responsible for motor activity is awake but the parts of the brain that are responsible for processing external stimuli and for laying down memories is asleep. So, they act like they’re awake but they can’t process any input. So, if you’re trying to hold them, you’re trying to control what they’re doing, trying to keep them in bed, they tend to fight you off.

Ryan: Yeah. So, why does it result in a tantrum? They can move around but they can’t respond to input. So, they don’t know you’re there or they don’t know that someone’s touching them or something. Why is a night terror not just like the kid stands up and walks around the room or something like that? Why is it so severe in terms of a tantrum?

Varun: Yeah, yeah. It’s interesting. We’ve gotten a couple of questions along that [inaudible 8:45]. There are actually a spectrum of sleep disorders called disorders of arousal and night terrors is probably the most intense. And then, the middle of the road is sleep walking. So, your child is still appears to be awake, they walk around the room but there’s no yelling, there’s on screaming, there’s no crying. And the mildest form of disorders of arousal is called confusional arousal. So, your child usually is still in bed. They may mumble a little bit, they’ll toss and turn, they may moan a little bit, but nothing…

Ryan: Is this like sleep talking?

Varun: Yeah, a little bit. So, they all fall under the same umbrella of sleep disorders and they’re all tied to the same dissociative state in the brain. They’re all very, very similar.

Ryan: So, with Lully, so it’s a vibrating disc under your bed that you, as a parent, turn on at a certain point in time. You get an app on your iPhone that connects to it and you turn it on and it vibrates for 3 minutes or you turn it off when your kid starts moving.

How did you guys come up with the idea, “Let’s use vibration to interrupt like a sleep pattern”? I think it’s genius because I don’t have to medicate my child. I hardly have to do anything. I let the app know when my kid goes to bed and then it notifies me and says it’s time for Lully and I do it when it’s time and that’s all I have to do. How did you come up with the idea, like, “Let’s skip medication, let’s just try vibration?” Did you try a bunch of things or was it just…

Varun: Yeah. It was sort of 2 parts to it. The program we were in at Stanford, called “Biodesign”, it teaches a very specific philosophy to innovation. You really identify the problem that you’re trying to solve and then you build a set of criteria that the solution to that problem needs to meet. This is way before you even start thinking about whether you can solve the problem or not or how you’re going to solve it.

Ryan: So you just say, “Here’s our problem. In order for this problem to met, we need to meet certain criteria.” And that’s kind of how you start.

Varun: Exactly. One of our most important criteria was it shouldn’t be drug-based. Criteria like that are things we gather talking to customers. So, we talked to moms and dads who are dealing with night terrors and try to understand what are the most important aspects that a solution needs to meet for it to be adopted by a parent dealing with this problem.

So, it not being something that was drug-based was really important. It not being something that interrupted with sleep routine or the sleep environment was really important. It not being something that they’d have to wear was important from a compliance standpoint. So, we put together this list of 8 to 10 requirements that are really important for a solution to meet. That’s sort of phase 1 of coming out with a solution.

Then, phase 2 was really clinical-research-driven. Spend a lot of time looking back at early literature about night terrors. Honestly, there isn’t a lot about night terrors, but…

Ryan: Yeah. It must be hard if clinically, they think it’s benign so let’s not worry about it.

Varun: Exactly. So no one wants to study it. No one gives you a grant to study night terrors. But we did find a handful of papers – they were just case reports. So, 2-3 kids being studied back in the ‘80s and some clinicians describing a technique called  “Scheduled Awakenings” where they suggested keeping a track of your child’s night terrors and then walking into the room at some point in the night fully waking up your child, keeping them up for 5 minutes and then putting them back to bed. It was a small sample size in terms of clinical studies, but the results look really compelling.

These were families that were dealing with night terrors for years on end and all of a sudden, they do this for a couple of weeks and in 12 months of follow up, these children didn’t have their night terrors come back.

Ryan: Was this something that parents would do every night?

Varun: Yeah. Parents would do it every night for up to 7 weeks. So, there was some clinical data which said, “Hey, there’s something about interrupting sleep cycles that looks like it may make sense.” So that was sort of data point number 1. The second was, we were at Stanford and we were really lucky to be at Stanford because sleep medicine as a field was created at Stanford by Bill Dement and Christian Guilleminault back in the ‘60s and ‘70s and Dr. Guilleminault still practices there. So, we went and started working with him and he’s sort of a walking encyclopedia about sleep.

We’d walk into his office on a Friday afternoon and just rattle off questions and he’d just answer them off the top of his head.

Ryan: So it’s like Google, but for sleep disorders and stuff.

Varun: Yes! Exactly! For a very, very specific space [inaudible 14:26]. We were also lucky because there was a clinician from the University of Minnesota who used to come to Stanford once a month only to run their parasomnia clinic and nigh terrors are considered a parasomnia. He’s someone who’s being invited to Stanford only to run a parasomnia clinic because he is one of the best in the world. So we had tremendous resources at Stanford, 2 clinicians who understood what was going on.

And then, the third bit was talking to pediatricians, talking to the sleep community about why scheduled awakenings hadn’t caught on. The data looked so compelling.

Ryan: Yeah. That’s what I’m thinking, if it was done in the ‘80s, why has no one picked up on it?

Varun: Yeah. So no one practiced it. That was always curious for us. What we learnt through talking to both clinicians who recommended it and parents who had tried it was your clinicians would talk to you about scheduled awakening in a 15-minute appointment and tell you, “Keep a track of your child’s night terrors and then at some point before that, go into the room and wake your child up.” So, this has a bunch of problems once you get back home.

One, you never know when you should be waking up your child because no one really told you when to wake up your child. The second is you’re breaking a cardinal rule of parenting, which is wake up your child once you’ve put them to bed.

Ryan: Yeah. Never wake a sleeping baby, isn’t that the rule?

Varun: Exactly. So, you’re stuck as a parent with not having enough information to implement it and being really worried about implementing it because it took you an hour to put your child to bed and now they’re telling you to wake them up. So we sort of looked at that and said, “Compliance, education, automation and awakening were the big problems with scheduled awakening as a therapy as it existed.” We looked at it, can all of this be automated? And technology is a great way to automate things that have compliance problems.

Technology is a great place when you have a compliance problem. And so, we looked at this entire problem and said, “Okay, is there a way to reduce this technique to something that can be taken home with someone and implement it without really needing to know anything more than, ‘put this under your child’s bed and start using it’?”

So that’s sort of how we learnt about this being an effective solution and started defining and designing the product. This is a long, withered answer to your original question of, “How we thought about the vibrating pod under the bed?” It sort of came back to some of those really important criteria that we set out for a solution. We wanted it to be something that wasn’t wearable and outside of the – that didn’t disturb the environment of the bed, didn’t disturb bedtime routine; which is why it went under the bed.

We also learned that about 40% of children share a bedroom with a sibling.

Ryan: Yup. That’s true for my children. They share a bedroom.

Varun: Okay. Yeah. And so, we didn’t want, you know, if you think of other ways to partially awaken a child, it’s light, sound, vibrations and light and sound could potentially wake up someone else in the room as well. Whereas, vibrations is very personalised. And so we picked that as an intervention mechanism.

Ryan: Was your original goal that we use these vibrations to actually wake the child up?

Varun: That was the other key bit that we learnt working with the clinicians at Stanford. A big hypothesis we had was – all the studies previously had said you have to wake up your child and keep them awake for 3-5 minutes. We said, if that was required, we couldn’t productise this. No one’s going to do that.

So, we instead tried to understand why waking up your child worked. And the reason was it sort of resets the sleep cycle. It gets the entire brain into the same state so that you don’t end up with part of the brain being awake and part of it being asleep. So we sort of speculated…

Ryan: Is that because the whole brain wakes up? Or, does it take you out of REM sleep and put you back to the start of the sleep cycle, what does it do?

Varun: Right. When you wake up someone, you take them out of whatever stage of sleep they’re in. You bring the brain entirely to the awake state. And then, if they nod back to off, they’d into light sleep and back into deep sleep. So that’s why fully waking them up works.

We were looking at whether we could do the same thing without fully waking up someone. So we came up with this concept of partial awakenings where you get the child, you bring them very, very briefly out of the deep sleep state that they are in, but don’t keep them in the awake state long enough that they fully wake up but let the body go back to sleep.

What the vibrations does is very briefly bring them out of deep sleep. And as soon as the brain sees that trigger, it tries to put the child back to sleep without ever letting them fully wake up. That was sort of a critical insight for us to be able to translate this technique into something that’s actually a product.

It was a hypothesis that we came up with while we were still at Stanford and then we ran a scientific study to validate it. We had children who had night terrors enrol in the study and we practiced this partial awakenings technique on them for a period of 3-7 weeks and saw comparable results to what was published in the previous studies back from the ’80s.

That was sort of our aha moment of, okay, we know how to build a device that doesn’t wake up the child but is enough to reset their sleep cycle. We can do it from under the mattress without preturbing their sleep and without interfering with their sleep. Now we have something that met all the criteria that we initially set out.

Ryan: Yeah. That’s awesome. Can I ask you, sometimes when I do the Lully, my child doesn’t move. So it goes for the 3 minutes and they don’t move at all. Does that mean they’re not getting that partial awakening? Or, are still getting it but their body is not responding?

Varun: Yes. It’s the latter. Because the brain can still be activated and have a partial awakening without the physical manifestation of a movement. But without having a bunch of leads on a kid’s head, you really can’t pick those up. When we see a movement, there’s a guarantee of a partial awakening, but once the vibrations are on, there could be a partial awakening that doesn’t result in a movement.

Ryan: This is so good for me to know. It makes so much sense now why you turn the vibrations off once your child starts moving, because they’ve obviously achieved that partial awakening state. I didn’t know that. I didn’t know why do you turn it off when they started moving. I thought it was just so you didn’t wake them up fully. So, yeah, that’s cool to know.

Varun: Yeah. That’s a good point. That’s probably something we need to spend some time educating our users about.

Ryan: The way it happened for me, my child would only have night terrors maybe once a week or twice a week to once a month, it really varied. So, we didn’t really know what it was. We didn’t know what a night terror was. We didn’t even know we really had a problem. We just had a kid who woke up screaming who you couldn’t fix.

We would fix it, we would have to put on a TV show like Peppa Pig and wake him up to get him out of that state. That was a solution we had come up with and it wasn’t until I heard about, oh, there’s this startup company that’s done this thing. And I was like, “Oh my goodness! That’s the problem that we have.” I didn’t know.

So, you did all the studies. You came up with the idea. Talk to me about how hard was it to start a company like this and to get a product created to be able to sell it? I sell information products, but I’ve never had to create something physical.

Varun: It’s definitely it’s own set of challenges. Today, all physical products have a software component, so I almost fell like we’re taking on the challenges of both the software and the hardware world when you build physical products these days. It’s definitely a journey. It takes a lot longer to develop physical products.

Rewinding the clock a little bit. So, we wrapped up at Stanford June-July of last year. We spent the rest of the year doing our clinical study to show that what we claimed was an effective way to help with night terrors was in fact effective.

Ryan: Is this so you could market the product as effective for night terrors? Because otherwise it could potentially be…

Varun: It sort of had 3 different reasons for doing that. One was to prove to ourselves that this was a product worth developing. And it actually solved the problem we were going after.

Ryan: Yeah. It’s not snake oil or something that you just think it helps but it doesn’t actually.

Varun: Right. Exactly, exactly. That, as a company, as founders, was really important to us. The second was to be able to make the claims that we do. We needed to have data backing it up. The third, honestly, was to get investor buy-in.

We were talking about a problem that isn’t talked about a lot and talking about a solution to a problem that hadn’t ever existed. So, there was definitely skepticism behind both whether this problem really existed and whether this problem could be solved the way we claimed it could be. That clinical study was definitely played a very big part in getting us across that hurdle.

We raised a little bit of money towards the end of 2014. We were fortunate enough to apply and get accepted in Y Combinator, which is Bay Area-based accelerate incubator now fund.

Ryan: Yeah. I didn’t know you guys were in YC.

Varun: Yeah. We were in winner 15.

Ryan: Okay. Cool. To get the product made, did you guys do – I think I pre-purchased the product or you had sold out and I purchased it before the next run. Did you go through YC and then do a Kickstarter or something like that to get it funded, to create it?

Varun: Yeah. We didn’t go down the Kickstarter approach because this really was problem that parents wanted solved today and not 9 months from today. It felt like something we needed – when we took someone’s money, we need to promise them a solution to it. So, what we did, we sort of did in 2 parts. During YC, we did 100-family beta.

This was to show that we could put a product in the hand of the lay consumer and they could use it and see comparable results to our clinical study. So, that was 100-person beta we did. And then, starting July this year, we started selling the full commercial product.

Ryan: Yup. I think that’s when I bought it. It was in July or maybe even a little bit before that. I don’t know if you did a pre-sale, did you?

Varun: Yeah. So we were taking pre-sales before our launch for a couple of weeks, that’s right.

Ryan: Okay. So I got in on the official launch, did I?

Varun: Yeah. You did.

Ryan: Awesome!

Varun: You’re an early adopter.

Ryan: The reason that I committed was just the sheer fact that there’s nothing out there. Once I realised I had this problem, you do some googling about it and really, there’s no solution out there that’s, like, this is actually going to fix my problem. And then, I think it was your sales video as well. When I saw the parents’ experience in that sales video, it’s like your kid isn’t waking up and then when you said you try and help them and they get worse.

I’m like, “Yes. That is me.” I’m like, if this is going to cost me $200 in terms of Australian money, then that’s totally worth it for me.

It’s so funny. As a parent, you’re willing to spend money on this even though your child doesn’t remember it and you’re child’s going to grow out of it. It’s such a traumatic experience that you’re like, “I will pay almost anything to not have to deal with this.” It’s just too much.

Varun: Honestly, it’s a combination of the trauma, the unknown, the heartbreak and the sleep deprivation. We have families that have 3-4 night terrors a night and it’s been going on for 3 years. I don’t know they’re functional.

Ryan: Yeah. I can’t imagine doing that. I have 1 every week or so and that was hard enough. I can’t imagine having a couple a night.

Varun: Right. It’s hard to deal with as a parent, each one is really hard.

Ryan: Yup. So, what do you guys think your plans will be from here? Is it just really get more distribution of the product and get it out there?

Varun: Yeah. Right now, we’re definitely focused on getting the product out there, helping as many families as we can. Both in terms of educating them about night terrors and then offering a solution if that’s warranted. Ultimately, our goal as a company is to be the children sleep company.

One of the things that struck us as really odd or struck us as a really good opportunity was the fact that technology had helped parents in so many different ways and it helped make parenting so much easier. But the one guarantee as a parent today is you’re going to be sleep-deprived for the next 2-3 years. It was sort of shocking.

Ryan: Yeah. I’ve got 3 kids a the moment and I’ve got a 6-month old who’s sick at the moment. And he is up all night with sickness. Yeah. I’m very sleep-deprived.

Varun: It was sort of shocking to us that in today’s day and age, with all the technology we have that was an area that hadn’t seen much of improvement and saw an opportunity to come at it from the medical, the clinical or the scientific side of things. A lot of products in the children and baby space are more consumer-driven products.

Ryan: Yeah. Like toys and colourful things and stuff like that? Cots and beds and that sort of stuff? Yeah.

Varun: Right.

Ryan: I know. I mean it. [inaudible 31:21]

When I shared this with my friends and stuff like that, one of the things that I was asked; I’ve got a friend who has – I can’t remember what the condition is called, but they had nightmares but while they were awake and they can’t move their body. Do you know what I’m talking about?

Varun: Sleep paralysis?

Ryan: Yes. Sleep paralysis. I was just wondering, can something like this or something you guys work on, will that ever help with sleep paralysis? Because that seems like one of those things that there’s just no solution and it’s just really bad.

Varun: Yeah. And that’s really scary for the kids themselves because in sleep paralysis, you’re actually fully awake and you know what’s going on and you have memory of the event.

Ryan: It kind of sounds like the opposite to night terrors. Like, night terrors your motor functions work but you’re not awake.

Varun: Yeah. They are. Right, right.

Ryan: Yeah. So they were asking me, can Lully be used for sleep paralysis? I’m guessing the answer is “No”.

Varun: Not the product we have. The product we have in the market right now is really for night terrors. But as we work through our product pipeline and get more and more products out there that are able to help with sleep, hopefully, one day, we are able to find a way to solve sleep paralysis.

Ryan: Are you able to tell me what other problems you are working on? In terms of what other sleep issues?

Varun: I can tell you broadly that it’s still within the infant-toddler-pre-schooler sleep space. I’m not sure I can get necessarily into much more detail, but we’re staying very focused. We’re not going into the adult sleep space. We’re not going into the clinical sleep space. We’re sort of focused at helping babies, infants, toddlers sleep better.

Ryan: Cool. I’ll definitely be monitoring you guys and finding what’s coming next. Because I still got toddlers and I still got young kids. And that’s the thing, I never knew I had a problem and so, if you’re saying the things that you’re creating can help parents with sleep deprivation, dude, I am all on board with that! That sounds great for me. I’ve been running off 4 hours sleep a night sort of thing for this week. Because I’ve got a sick kid and I’m like, “Oh! I just can’t do this anymore!” I can’t work. I struggle to focus. So, yeah, it’s really, really exciting.

Thanks for coming on. Thanks for telling me the story. This is a product I am pretty passionate about because it deals with such an intense issue that I have in my family and I hope that by creating this, some people will find it as well and will realise that there’s a solution to their problem. Where can people go to check you out and to find out any information that you guys have, whether it be your product or your educational stuff on night terrors?

Varun: They can go to lullysleep.com. We have a ton of information about the product. We’re constantly creating more and more content about night terrors as well. Hopefully, we’ll be the go-to resource for education on night terrors soon.

Ryan: Yeah. I hope so, too. I hope there’s a lot of parents out there who can find a solution. Because we don’t want them to have to deal with that.

Alright. Thanks, Varun. I really appreciate you coming on and I wish you the best with your company and fixing sleep deprivation for parents.

Varun: Thanks again and it was my pleasure sharing the story. It’s always really exciting to hear from parents and users of the product. So, really appreciate you reaching out as well.

Ryan: I hope you enjoyed that interview, guys. If you have kids with night terrors or if you want to check out Lully at all, go to lullysleep.com, L-U-L-L-Y sleep.com and you can check it out.

Just so you know, they currently only ship the product to the US. And this was something that I had a problem with. They couldn’t ship it out to Australia because I think they weren’t sure about the compliance and stuff like that. So, to get around this issue, what I did was I setup an account with I think it’s myus.com. Let me just go ahead and check that, myus.com. But basically, this is a US company that receives shipments on your behalf and then forwards it on to you.

So, obviously, there’s a bit of an extra cost there in order to get it shipped out to you. But you can purchase the Lully, MyUS gives you an address, you can give them the address, get it shipped out to you and you can then get myus.com to forward it on to you.

I think, also Lully is now available on amazon.com. Just going to check it for you. Let me just check for you. It’s called Lully Sleep Guardian – Proven to Stop Night Terrors. It’s on amazon.com for $129 at the moment.

I think I paid $169 plus all the postage, it ended up being over $200 Australian for it. But it was absolutely worth it for me and I totally recommend it if anyone has children who have night terrors. Absolutely, 100% works. I hope that you go ahead, check it out. And if you need it, go ahead and buy it. And if you don’t need it, I hope that you enjoyed this episode nonetheless to learn about someone else’s journey and how they came up with this idea.

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