The twelfth variable that I will be manipulating across a two week period to examine its impact on sleep is relaxation. I will be seeing if abdominal breathing, progressive muscle relaxation or imagery have a positive impact on sleep quality. 

I will discuss what my data shows, how easy or difficult I found this strategy to implement, and what previous research says. These three factors will be combined for an overall score and grade on how effective relaxation strategies are at improving sleep.

HOW COULD RELAXATION STRATEGIES HELP?

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As I’ve previously mentioned, hyper-arousal is one of the main problems for people with sleep difficulties. It can be especially problematic for individuals who are suffering from insomnia, parasomnias, bruxism, restless legs and periodic limb movement issues.

Anything that helps us to lower these arousal levels both during the day and before we go to bed at night will improve our chances of falling asleep quickly, sleeping more, and having a great quality of sleep. Learning relaxation strategies is therefore definitely worthwhile if you have ever felt “tired but wired” and were unable to get a good night’s sleep even though you were exhausted before you went to bed.

Abdominal breathing

Abdominal, or diaphragmatic breathing is the simplest relaxation strategy to learn. It is also something that is helpful to work on first before trying any other relaxation strategies because most of these will also incorporate the breath to some degree for them to be beneficial.

If you are interested in trying this out, then there are three things that are important to focus on:

  1. rate of breath – if you breathe too quickly it will lead to you feeling more anxious and worked up. By actively trying to slow it down, it can help you to feel more calm and relaxed. Some people try the 4-7-8 breathing pattern and breathe in for 4 seconds, hold for 7 seconds then breathe out for 8 seconds. Personally I find this too long, and tend to breathe in for about 3 seconds, pause for 1 or 2 seconds, and then breathe out for about 4 seconds. Anything slower than 10 breaths per minute is thought to be potentially relaxing, so experiment with what is comfortable and what works best for you.
  2. depth of breath – if you breathe too shallowly it can make you feel more anxious and worked up. To see if this is you, place one hand on your chest and one hand on your stomach and take in a nice big breath. If the hand on your chest moved more than the one on your stomach, you are probably not breathing deeply. To breathe more deeply, you want to actively engage your diaphragm and push out your stomach as you breathe in. The deeper it is, the more calming and relaxing it should be for you.
  3. the exhale – when people first start to practice breathing deeply, they will often try to take nice deep breaths in, and not worry about breathing out. This is the quickest pathway to hyperventilating, which can even bring on a panic attack if you do it long enough. Focus on breathing out all of the air with each breath first, which will balance out the oxygen to carbon dioxide ratio, and help you to feel more calm and relaxed.
Progressive muscle relaxation

Progressive muscle relaxation (PMR) is a really good strategy to do in the last hour or so before bed if you notice that you are particularly tense in your body. It may be that you have had a stressful day, have been on your feet all day or have been sitting at a computer screen for too long. If this is the case, or you just notice that you are tense in your shoulders, neck, jaw, back, stomach or legs, then this strategy would be worth a try.

It goes as following:

  1. start with your arms. Clench them as tightly as you can, bringing your forearms up to your biceps so that they are clenched too. Really notice the tension. Then, whilst still clenching, take in a nice deep breath. pause. then exhale all of the air, and as you do release the tension in your arms and let them drop down, hanging loosely by your side. Notice the difference between when they were tensed and how relaxed they feel now. Repeat one more time.
  2. move to your face and jaw. raise your forehead, furrow your brow, shut your eyes tightly, scrunch your nose and clench your jaw. Really notice the tension. Then, whilst still clenching, take in a nice deep breath. pause. then exhale all of the air, and as you do release the tension in your face and let your jaw hang loose with your mouth slightly open. Notice the difference between when you were tense and how relaxed you feel now. Repeat one more time.
  3. move to your shoulders. raise them up to your neck, pushing them up as highs you can whilst pushing your head and neck down. Then, whilst still clenching, take in a nice deep breath. pause. then exhale all of the air, and as you do release the tension, let you shoulders be as loose as possible and let your head droop down, no longer using your neck to support it. Really observe the difference between how you felt when you were tensed and how relaxed you feel now. Repeat one more time.
  4. move to your stomach. tense. breathe in. pause. breathe out. relax the stomach. repeat.
  5. move to your upper legs and buttocks. tense. breathe in. pause. breathe out. relax the stomach. repeat.
  6. move to your calves and feet.  tense. breathe in. pause. breathe out. relax the stomach. repeat.
Imagery

Sometimes known as visualisation, this strategy is based on the neuroimaging findings that the same areas of our brain light up when we are actually tapping our fingers as when we are only imagining ourselves tapping our fingers. What this means is that our thoughts can have a huge impact on how we feel emotionally and physically, and what we then do behaviourally. If you are worried about sleeping and imagining yourself not sleeping, this can raise your arousal levels. But if you are instead imagining yourself lying on a nice hammock on a tropical island on a warm sunny day, it could help you to feel calm and relaxed instead. I like to do this in bed at times, but if you haven’t tried it yet I would encourage you to practice it outside of bed first.

The instructions are as follows:

  1. Find somewhere nice and quiet to sit or lie down where you are unlikely to be disturbed for the next 5-10 minutes.
  2. Take a few deep breaths to centre yourself in the here and now.
  3. Then close your eyes and try to picture yourself in the most calming, peaceful and relaxing environment that you can imagine. It can be a place from your childhood, from a favourite holiday, or a place that is entirely made up. A lot of people find a beach, forest, lake or mountain to be especially relaxing, but it can be a nice and cosy room too. Just wherever you feel safe, calm and relaxed.
  4. Try to engage as many of your senses as possible in the place that you are. If you are on the beach, feel your feet on the sand or the sun on your skin, hear the waves crashing in or the seagulls chirping as they fly overhead. Smell the salty water or the coconut in your sun lotion, or sip on a nice refreshing drink.
  5. Walk around and explore the area, or find a nice place to sit and look out, taking in the scenery around you.
  6. Once the 5-10 minutes is up, open your eyes, ground yourself in the present and take that sense of calm with you.

 

THE EXPERIMENT

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For the first five nights, I practiced PMR for 10-15 minutes each night in the last hour before going to bed. Generally this was done whilst watching the TV.

For the middle five nights, I practiced abdominal breathing for 10-15 minutes in the last hour before going to bed. I also continued to focus on my breath once in bed, exhaling all the air with each breath, as well as breathing slowly and deeply until I was asleep.

For the last four nights, I practiced imagery for 10-15 minutes in the last hour before going to bed. The TV was always off when I did this. Once in bed, I would continue to practice imagery until I was asleep.

Let’s see which relaxation strategy was best for my sleep…

THE OUTCOME

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Comparison: PMR vs Abdominal breathing vs Imagery

Based on my sleep diary data, the abdominal breathing relaxation strategy was the most effective for me, followed by imagery, and then progressive muscle relaxation. Here were the findings:

  • Number of awakenings:
    1. Abdominal breathing – 0.4 per night
    2. Imagery – 0.75 per night
    3. PMR – 1.2 per night
  • Time in bed:
    1. Abdominal breathing – 8 hours
    2. PMR – 7 hours 44 minutes
    3. Imagery 7 hours 30 minutes
  • Time to bed:
    1. PMR – 11:48pm
    2. Abdominal breathing – 12:06am
    3. Imagery – 12:15am
  • Total sleep time:
    1. Abdominal breathing – 7 hours 47 minutes
    2. PMR – 7 hours 16 minutes
    3. Imagery – 7 hours 6 minutes
  • Sleep onset latency:
    1. Imagery – 6.75 minutes
    2. Abdominal breathing – 9 minutes
    3. PMR – 11 minutes
  • Wake after sleep onset:
    1. Abdominal breathing – 4 minutes
    2. Imagery – 15 minutes
    3. PMR – 17 minutes
  • Rise time:
    1. PMR – 7:32am
    2. Imagery – 7:45am
    3. Abdominal breathing – 8:06am
  • Sleep quality:
    1. Abdominal breathing – 4.8/5
    2. Imagery – 4.25/5
    3. PMR – 4/5
  • Sleep efficiency:
    1. Abdominal breathing – 97.29%
    2. Imagery – 94.72%
    3. PMR – 93.97%

 

IS PRACTICING RELAXATION STRATEGIES BEFORE BEDTIME A GOOD SLEEP STRATEGY?

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IS IT EFFECTIVE?

Yes. Depending on what your problem is, different relaxation strategies are thought to be better. For a busy mind, imagery is thought to be good. For a tense body, progressive muscle relaxation is thought to be good. For me, simple deep and slow breathing was the most effective, with an excellent sleep quality and sleep efficiency and 7 hours and 47 minutes of sleep per night.

I therefore give the effectiveness of this strategy a 22/25.

CAN IT BE APPLIED?

Yes. Each strategy requires a little bit of training during the day first for it to be effective. Once you feel that it helps you to relax when your arousal levels are high you can then try to add it into your pre-bed wind down strategy. If that is helping it can then be utilised in bed. No technology is needed for any of the strategies either, which means it can be done anywhere.

I therefore give the applicability of this strategy a 22/25. 

IS IT SCIENTIFIC?

Progressive Muscle Relaxation (PMR) is the most commonly used relaxation technique in CBT-I, and is efficacious as a stand-alone treatment for insomnia (Morin et al., 2006).

In comparison to autogenic training and biofeedback training, PMR was not significantly different (Freedman & Papsdorf, 1976; Simeit et al., 2004). However, cognitive relaxation techniques such as imagery were found to be more effective for reducing time taken to get to sleep (Morin, Culbert, et al., 1994).

Relaxation has been found to be the most effective when initially practiced during the daytime, so that the participant can practice reducing their arousal levels rather than using the techniques to help them fall asleep (Harsora & Kessmann, 2009). Once arousal levels are being effectively reduced when using relaxation strategies, these strategies can reduce the time taken to get to sleep more than sleep hygiene education or the combination of stimulus control plus sleep restriction (Waters et al., 2003).

Cognitive behavioural therapy for insomnia (CBT-I) is typically superior to relaxation alone for improving insomnia severity (Edinger et al., 2001a). However, the additional benefits that relaxation can have on depression (Jorm et al., 2008), stress (Kaspereen, 2012) and anxiety (Manzoni, Pagnini, Castelnuovo, & Molinari, 2008) warrant it being used to help people sleep better. Training in relaxation strategies can also be used alongside a CBT-I intervention for people with insomnia.

I therefore give the science of this strategy a 37/50.

Overall, regularly practicing relaxation strategies before bed as a way to sleep better gets a score of 22/25 + 22/25 + 37/50 =

81/100: High Distinction

 

WHAT I RECOMMEND

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If you feel tense and stressed often, or struggle to switch off, unwind and relax at night, this could be one of the main reasons that you are having difficulties sleeping. Try to find a relaxation strategy that helps you to lower your arousal levels whenever you are feeling stressed or wound up. This could be abdominal breathing, PMR or imagery, or it could be yoga or meditation even.

Practice relaxation strategies during the day first so that you can see if they help you to calm down and relax. If they are working during the day, then trial them for a week or two in the last hour before bed. Even 10-15 minutes each night can help. Only use these relaxation strategies in bed if you feel confident that they are a helpful strategy for you.

Lastly, remember that the aim of any relaxation strategy is to lower your arousal level and to keep it low, not to get you to sleep. If you are using something to get you to sleep, it will often backfire and not work, because sleep is an involuntary process that is out of our control. The more we try to get to sleep, the harder it will be.

By winding down before sleep, going to bed once you are sleepy and keeping your focus on something relaxing once you are in bed, you are giving yourself the best chance of having a good night’s sleep.

Thanks for reading! Stay tuned for my next episode on if being too hot or too cold can impact the quality of your sleep. If you would like some individualised help on improving your sleep, please check out my CBT-I and Personalised Sleep Reports services.

The eleventh variable that I will be manipulating across a two week period to examine its impact on sleep is writing. I will be seeing if journalling or writing down plans at least two hours before bedtime has a positive impact on sleep quality. 

I will discuss what my data shows, how easy or difficult I found this strategy to implement, and what previous research says. These three factors will be combined for an overall score and grade on how effective writing is at improving sleep.

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HOW COULD WRITING HELP?

Journalling

In modern society we have so many distractions and so many tasks to keep us busy that we often forget to stop, tune in, reflect on what we have done, and clarify what we would like to do next.

After a busy work day, the last thing that most people want to do is take the time to reflect or write things down, but what if it helped you to learn more about about yourself, switch off from work more, feel more focused on whatever it is that you are doing, and sleep better?

Journalling is something that is extremely common and has been in practice for hundreds of years. One of the main benefits I see to journalling is that it helps us to stop and reflect on our days and how we have felt about them. If no one is reading what we are writing it also helps us to be truly honest with ourselves about what we did and what we want.

Most people know about the importance of goal setting, but trying something new or challenging ourselves to do something differently is only one part of the equation to long-term behavioural improvement. The second part is a reflective process, where we can review how things have gone, look at what was positive and negative, and get feedback from objective measures or other people if possible. These reflective insights help to inform our new goals and plans, as we can then determine if we would like to do things differently the next time that we are in a similar situation in the future.

Planning

Writing down our plans is thought to be useful because of two concepts known as the ‘Zeigarnik effect’ and the ‘Ovsiankina effect’. The Zeigarnik effect says that we are more likely to remember things that are incomplete, and the Ovsiankina effect says that we will have intrusive thoughts when a task is interrupted or incomplete that will encourage us to take up the task until it is completed. These effects are very useful from an evolutionary point of view because we are less likely to forget what is important to us and more likely to achieve what we have set out to do.

Where it becomes problematic is when people start to worry about things that they can’t actually do anything about in that moment. Let’s say that you have to buy a new light globe, but you are in bed trying to sleep and the store is not open during the middle of the night. Little things like this can keep people with insomnia awake all night. Even though they know that it really isn’t that big of a deal, they struggle to stop thinking about it or quieten their mind.

Fortunately, the Zeigarnik and Ovsiankina effects can also be exploited to solve this dilemma. By writing down a plan to address the unfinished task and stating when you will do it, your brain will treat the written plan as being almost identical to the task having already been completed. The business book ‘Getting Things Done’ by David Allen further highlighted the benefits to me of actually writing down our plans (rather than just thinking about them) and having a system and daily routine to clear all the mental clutter that accumulates each day.

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People that want to be productive will often write to-do-lists, and this can be good for helping us prioritise things during the day. Writing a to-do-list at the end of the day or at night is less helpful however, as often this just reminds our brain of all the incomplete tasks that we still need to do and therefore think about. A much better approach that is commonly used in the sleep field is called ‘Constructive Worry’ by Edinger and Carney (2008). The Constructive Worry strategy should be completed either at the end of the workday or in the early evening at least 2 hours before bed. Their instructions are as follows:

  • Write down the problem(s) facing you that has the greatest chance of keeping you awake at bedtime, and list them in a ‘concerns’ column on the left half of your page.
  • Then, think of the next step that might help fix it.  Write it down in a ‘solutions’ column on the right half of your page. This need not to be the final solution to the problem, since most problems have to be solved by taking steps anyhow, and you will be doing this again tomorrow night and the night after until you finally get to the best solution.
    1. If you know how to fix the problem completely then write that down.
    2. If you decide that this is not really a big problem, and you will just deal with it when the time comes, then write that down.
    3. If you decide that you simply do not know what to do about it, and need to ask someone to help you, write that down
    4. If you decide that it is a problem, but there seems to be no good solution at all, and that you will just have to live with it, write that down, with a note that maybe sometime soon you or someone that you speak with will give you a clue that will lead you to a solution.
  • Repeat this for any other concerns you may have
  • Fold the page or close the book and change your focus to enjoying your night or winding down until bedtime.
  • At bedtime, if you begin to worry about any of these concerns again actually tell yourself that you have already dealt with your problems in the best way you know how, and when you were at your problem-solving best.  Remind yourself that you will be working on them again tomorrow evening and that nothing you can do while you are so tired can help you any more than what you have already done; more effort will only make matters worse. Then change your focus to whatever will help you to stay calm and relaxed until you fall asleep.

Reproduced from: Edinger & Carney (2008). Overcoming Insomnia: A cognitive-behavioral therapy approach workbook. Oxford University Press, pp. 28-31.

THE EXPERIMENT

For the first week, I decided to journal using the online website 750 words. The reason that I like this website as opposed to journalling in a book is that it takes up less space and can be accessed online from wherever I am. This was done each night when I first arrived home from work, and would typically take me about 15 minutes to reach 750 words. It also gives me stats on what my writing content is focused on each day, which helps even more with my reflection process. Here’s an example from one of my days:

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For the second week, I created my own Constructive Worry worksheet template in a word document on my computer, and did this exercise as soon as I arrived home from work. On most days it only took about 5 minutes to complete. Here’s an example:

Name: Damon Day/Date:  14/06/2017
CONCERNS SOLUTIONS
1. TV presenter course tomorrow night – how will I go with the filming of my piece? I keep getting the same feedback that I need to be more energetic and expressive!

2. Supervision training – the two-day workshop is coming up soon and I need to complete the first component readings and tests before then. 

3. Feel tired – having something on every night this week is really tiring me out!

  1. Practice during my lunch break tomorrow and after work until the course starts. I can’t expect to be great at something that I haven’t done a lot of. Just try my best and be receptive to the suggestions that are given.
  2. Start supervision training Saturday morning after doing grocery shopping and then finish whatever I don’t do next Monday.
  3. Rest until Basketball tonight and schedule some down time for this Sunday afternoon to rest and recuperate.

Let’s see if journalling or planning was better for my sleep…

THE OUTCOME

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Comparison: Journalling vs Constructive Worry

Based on my sleep diary data, which came out a bit crooked in the scan, planning using the Constructive Worry strategy was more effective at improving my sleep than journalling. After journalling, I:

  • woke up 0.29 more times per night,
  • went to bed 49 minutes later each night,
  • spent 19 minutes less time in bed each night,
  • got out of bed 20 minutes later each morning,
  • slept 19 minutes less per night,
  • was awake for 2.86 more minutes during the night
  • had poorer sleep quality (4.14/5 vs 4.29/5)
  • had reduced sleep efficiency (96.15% vs 96.60%)

Journalling did seem to help me feel better and process my emotions more, but the only element of my sleep that was better in comparison to planning was my sleep onset. I fell asleep in 7.86 minutes on average the first week, 1.43 minutes faster than I did the second week using the Constructive Worry strategy.

Based on the Misfit Ray data, both journalling and planning were helpful for my objective sleep quality, with journalling actually coming out slightly better.

Comparing Jun 6 (5/6/2017 on the sleep diary data) to Jun 13 (12/6/2017 on the sleep diary data) you can see that on both Monday nights I was able to obtain over 8 hours of sleep, with a restful:light sleep ratio of 2.12 for journalling and 1.74 for Constructive Worry.

IS WRITING DOWN YOUR THOUGHTS, FEELINGS OR PLANS IN THE EARLY EVENING A GOOD SLEEP STRATEGY?

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IS IT EFFECTIVE?

Yes. Planning seemed to quieten my mind a bit and meant that I went to bed earlier, fell asleep within 10 minutes, awoke less than once per night, and slept 7 hours and 47 minutes per night. Journalling improved my misfit quality of sleep more and helped me to fall asleep quicker, but planning was generally more effective for me.

I therefore give the effectiveness of this strategy a 20/25.

CAN IT BE APPLIED?

Yes. Planning can be done on the computer, in a journal, or on any scrap bit of paper, and takes no more than 5-15 minutes per night. Journalling is a bit more labour intensive, and the website 750words.com costs $5 per month to use, but has the added benefit of giving you feedback on what might be troubling you.

I therefore give the applicability of this strategy a 21/25. 

IS IT SCIENTIFIC?

The reliability of the Zeigarnik effect has been brought into question in subsequent papers on the topic (Butterfield, 1964; Goschke & Kuhl, 1993; Marsh, Hicks, & Bink, 1998), If people rapidly forget their intentions in demanding situations (Einstein, McDaniel, Williford, Pagan & Dislikes, 2003), then Constructive Worry could be helpful by ensuring that we don’t forget something important that we want to do at a later date. Either way, writing important things down seems to help.

Constructive worry has been found to reduce worry and pre-sleep arousal in university students who were suffering from sleep problems due to an overactive mind (Digdon & Koble, 2011). More importantly, it also improved sleep after only one week of the intervention, although not significantly more than a gratitude intervention (Digdon & Koble, 2011).

When added to a stimulus control and sleep restriction intervention, a constructive worry intervention resulted in a larger reduction in insomnia severity and level of worry by the end of a 4-week period in comparison to just a stimulus control and sleep restriction intervention(Jansson-Frojmark, Lind & Sunnhed, 2011).

For journalling to be most effective, it should incorporate both cognitive and emotional processing elements rather than just stating the facts of the day or describing how you felt (Ullrich & Lutgendorf, 2002). By trying to make sense of events and how you would like to manage them going forward, journalling can reduce compassion fatigue and burnout (in registered nurses), and help people to make more reasonable decisions (Dimitroff, Sliwoski, O’Brien & Nichols, 2017)

I therefore give the science of this strategy a 30/50.

Overall, writing down your thoughts, feelings and plans as a way to sleep better gets a score of 20/25 + 21/25 + 30/50 =

71/100: Distinction

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WHAT I RECOMMEND

If a racing mind or worrying thoughts are keeping you awake at night, then writing down your plans for when you will address these issues and the first step that you will take (the Constructive Worry strategy) is definitely worth a try. Experiment a bit with the right timing for you, but it is preferable to do it at least two hours before bed.

Journalling may not be as helpful for sleep, but is definitely worth doing from an emotional processing and reflection point of view. Even something like a gratitude journal where you write down 3 things that you are grateful for or appreciate each day has been shown to be quite effective for reducing depression severity, and is a nice way to reflect on the positives and counterbalance most people’s general inclination to look at what went wrong rather than what went well.

You should be able to get a sense of whether or not these strategies are helping you within a week or two. If it doesn’t, please check out my other blog posts for helpful tips on getting a good night’s sleep.

Thanks for reading! Stay tuned for my next episode on the three most common relaxation exercises that are recommended in the treatment of insomnia. If you would like some individualised help on improving your sleep, please check out my CBT-I and Personalised Sleep Reports services.

The tenth variable that I will be manipulating across a two week period to examine its impact on sleep is reading. I will be seeing if reading a physical book or if listening to an audiobook before bed is a helpful way to improve sleep quality. 

I will discuss what my data shows, how easy or difficult I found this strategy to implement, and what previous research says. These three factors will be combined for an overall score and grade on how effective books are at improving sleep.

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HOW COULD READING HELP?

When you were younger, how did your parents help you to transition into sleep?

For many people, the answer is that they were given a bedtime story. This could have been a made up story, a folk lore, or something read from a book, but it is an extremely common strategy. For this practice to be so widespread and prolific, surely it must make a difference, right?

I love reading, and do typically find that it does help me to wind down and relax before sleep. It also tends to bring on sleepiness for me earlier than if I am on the computer or watching TV.

Not everyone reports these positive benefits however. Some of the clients that I see report that their minds become more active when they are reading, as they get so engrossed in the story and want to keep turning the pages to find out what is going to happen next. As a result, they really struggle to switch off and get to sleep afterwards.

THE EXPERIMENT

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For the first week, I decided to spend at least an hour before bed winding down by reading a book. My book of choice was a non-fiction book by Michael Bond titled ‘The Power of Others: Peer Pressure, Groupthink, and How the People Around Us Shape Everything We Do’. It was an interesting book, but not so engaging or exhilarating that I expected it to be a page turner that was going to keep me up all night.

For the second week I decided to spend at least an hour before bed winding down by listening to the audiobook ‘The Village Effect’ by Susan Pinker. Once again, this book has some fascinating information, but it wasn’t likely to get me too amped up before bed. Considering that both books were in the general area of social psychology also helped me to feel that the topic of the book wasn’t going to confound the results.

Let’s see if reading or listening to stories was better for sleep…

THE OUTCOME

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Comparison: Reading a book vs Listening to an audio book

Based on my sleep diary data, listening to audiobooks for at least an hour before sleep seemed to be better than reading a physical book. I went to bed over an hour earlier by lying down on the couch and listening to an audiobook than I did when I read a book. This was quite a surprising finding to me, as I thought that reading physical books may make my eyes more tired sooner.

I also slept 30 minutes longer per night after the audiobook, woke up less per night, had less time awake during the night, got out of bed 37 minutes earlier in the morning, and had a better sleep efficiency (96.62% vs 96.18%).

The one thing that was rated higher after reading in comparison to the audiobook was sleep quality, but both were pretty good (4.43/5 for reading vs 4.29/5 for listening). My average time to fall asleep in both weeks was 7.86 minutes per night, which is excellent too.

Based on the Misfit Ray data, both reading and listening to audiobooks before bedtime helped with my sleep quality.

Comparing May 24 (23/5/2017 on the sleep diary data) to Jun 1 (31/5/2017 on the sleep diary data) you can see that both nights have much more restful sleep than light sleep. Listening to audiobooks comes out slightly on top again, with a restful:light sleep ratio of 1.90, slightly ahead of the reading restful:light sleep ratio of 1.80.

This means that either listening to a story or reading one before bed is helpful, but listening to an audiobook may be even better, especially if you are wanting to go to sleep earlier.

IS READING BEFORE BED A GOOD SLEEP STRATEGY?

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IS IT EFFECTIVE?

Yes. It was not the best sleep that I’ve had all year, but it was very good. I slept more than 7 hours per night each week, didn’t take more than 10 minutes to fall asleep once in bed, woke up less than once per night for less than 10 minutes each time, and had a sleep efficiency of over 96% on both weeks.

I therefore give the effectiveness of this strategy a 21/25.

CAN IT BE APPLIED?

Yes, but it does require a bit of time. If you are wanting to go to bed on the earlier side, definitely try out audiobooks or take turns with your partner reading to each other before bed. An hour does seem like a bit of time, and would definitely require a bit of discipline in the beginning to switch off the bright screens, but as soon as you begin to feel sleepy around your bedtime you can close the book or switch it off.

I therefore give the applicability of this strategy a 17/25. 

IS IT SCIENTIFIC?

There doesn’t appear to be too much research on this specific question.

A 2008 study on Nigerian university pharmacy students found that habitual night reading was significantly associated with poorer sleep quality, which was then negatively associated with poor academic performance (Adeosun, Asa, Babalola & Akanmu, 2008). For this study, they considered habitual night reading to be between the hours of 8pm and 5am however. The benefits of reading relaxing material before sleep versus continuing to study pharmacy readings through the night were not separated, nor was reading before bedtime versus reading in bed (Adeosun et al., 2008).

I would never recommend going to bed before you are sleepy, or spending more than 30 minutes awake reading in bed each night, so it is tough to determine if these results are indicative of what I am trying to figure out. What is similar is that both their study and my personal experience found shorter sleep times when people read more after 8pm.

Another 2008 study compared participants who listened to audiobooks for 45 minutes at bedtime to those who listened to classical music for 45 minutes and those who had no intervention (Harmat, Takacs & Bodizs, 2008). They found that audiobooks had no significant benefit to people’s sleep quality over those who had no intervention. What did make a significant difference to not only sleep quality but depressive symptoms over (Harmat, Takacs & Bodizs, 2008).

This still doesn’t look at the benefits of listening to audiobooks before sleep, but the findings suggest that listening to classical music might be an even better option than either reading or listening to audiobooks.

 I therefore give the science of this strategy a 25/50.

Overall, reading or listening to stories before bed as a way to sleep better gets a score of 21/25 + 17/25 + 25/50 =

63/100: Credit

 

WHAT I RECOMMEND

Whether you read, listen to an audiobook or do something else such as socialising or listening to classical music in that last hour before bed, the key is to find something to help you to lower your arousal levels. If your arousal levels are low and you are going to bed at the right time for your body clock, you will tend to feel sleepy before going to bed, fall asleep quickly, and have a good night’s sleep.

Please do try each of these strategies for at least a week to see if they benefit you if you are interested. If there is something else that helps you wind down before sleep in a more effective way than reading or audiobooks then that is fine too.

Thanks for reading! Stay tuned for my next episode on writing down our thoughts and if journalling or planning can help with sleep quality. If you would like some individualised help on improving your sleep, please check out my CBT-I and Personalised Sleep Reports services.

The ninth variable that I will be manipulating across a two week period to examine its impact on sleep is exercise. Using my Misfit Ray data, I will be seeing if doing over 10,000 steps a day will be better for sleep than doing less than 10,000 steps. 

I will discuss what my data shows, how easy or difficult I found this strategy to implement, and what previous research says. These three factors will be combined for an overall score and grade on how effective exercise is at improving sleep quality. 

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HOW COULD EXERCISE HELP?

Homeostatic Pressure is one of the three main variables that are responsible for good sleep quality. It is also known as sleep debt, and it is something that builds up during the day regardless of what we do unless we have a nap during the day or fall asleep at night. It is what TAC talks about in their latest ad ‘Drowsy Driving – You Can’t Fight Sleep’:

I have a number of clients with insomnia who would disagree with this ad, because they manage to fight sleep every night. The difference with falling asleep on the road and in bed is the intent though. A driver who is trying to stay awake will drift off to sleep, and a person who is trying hard to fall asleep in bed will stay awake. The reason that most people with insomnia can’t sleep is due to hyper-arousal rather than sleep pressure, and they are more likely to benefit from winding down before sleep or meditating rather than exercising more.

Exercise, as long as it isn’t done in the 3 hours before sleep, is meant to be great for our health, stress levels and sleep pressure. Essentially doing anything cognitively or physically demanding during the day can increase our sleep pressure at a faster rate, because it creates a greater need for restoration and recovery. Exercise can therefore potentially help us to feel sleepy earlier, and have a better night’s sleep.

I’ve definitely had days where I have been extremely active, either from hiking all day to Mt Feathertop, or playing a Beach Volleyball tournament. On these rare occasions I’ve been extremely exhausted and have subsequently crashed before 10pm and slept over 9 hours. It will be interesting to see if these are one offs however, or if doing a bit more exercise each day really could help.

THE EXPERIMENT

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I’m generally pretty active, and also play organised sport three times a week, so what I’ve  decided to do rather than split it into a week of inactivity followed by a week of activity is monitor my steps each day using a Misfit Ray activity tracker, and compare the 7 most active days to the 7 least active days.

If I wanted to be even more thorough I could look at the data for the entire year, but I’ll just keep it to these two weeks for now and compare it to what the scientific research and literature says about sleep and exercise.

THE OUTCOME

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Comparison: Over 10,000 steps to under 10,000 steps

Based on my sleep diary data, the average of the more exercise week was 11,985 steps in comparison to the less exercise week average of 5852 steps. This means I did more than twice the amount of steps on the active days than the non-active days, which should be enough to see if more exercise makes a difference.

In spite of this, doing more exercise actually led to more awakenings per night, less time in bed, 30 minutes less sleep per night, and a bedtime that was 33 minutes later than when I exercised less.

What exercise did seem to help with was time awake in bed, as I fell asleep 4 minutes quicker, spent 2 minutes less awake during the night, and had a better sleep efficiency.

My sleep quality was rated as exactly the same (4.14/5) regardless of how much exercise I did, with both a 3,552 step and a 15,180 step day obtaining a sleep quality rating of 5/5, and both a 4,456 step and a 10,486 step day obtaining a sleep quality rating of 3/5. It appears that other things are more important to sleep quality than exercise.

Based on the Misfit Ray data, the depth of my sleep had no real relationship with the amount of exercise that I did.

Let’s compare the Sunday night from the first week (May 08 on the Misfit data – 7/5/17 on the sleep diary), where I did 13,410 steps the day before, to the Friday night of the first week (May 13 on the Misfit data – 12/5/17 on the sleep diary), where I did 4,456 steps the day before. If you were to look just at this, you could say exercise improves objective sleep quality.

However, my best night of sleep for the two week period was the Thursday of the second week (May 19 on the Misfit data – 18/5/17 on the sleep diary), where I only did 3,552 steps. This was the least steps on any day for the entire two weeks, and the best objective sleep, with a restful:light sleep quality ratio of 4.01:1. This is one of my best sleeps for the year, and all I could put it down to was an exhausting day at work.

IS EXERCISING MORE A GOOD SLEEP STRATEGY?

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IS IT EFFECTIVE?

Maybe. I didn’t compare it to no exercise at all, and I still slept fairly well for the whole two week period, but doing more exercise than normal didn’t really seem to have much of an additional benefit for me.

I therefore give the effectiveness of this strategy a 16/25.

CAN IT BE APPLIED?

Yes, but with how time poor we all are these days, mostly thanks to our increased screen time in red in the graph below by Adam Alter, it might be hard to justify spending more time exercising if your only reason to do it is so that you can get better sleep.

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If you are exercising with others for social interaction or for better overall health than that is a different story, but it is still important for each of us to determine how we’d like to spend the minimal personal time that we have, as indicated by the white and yellow in the graph above.

Only 30 minutes five times per week is enough to have a positive benefit on mood, so I’ll give the applicability of this strategy a 15/25. 

IS IT SCIENTIFIC?

A 1996 Meta-Analytic review of the effects of exercise on sleep by Kubitz and colleagues said that a lot of the research has conflicting results and interpretations. With their re-analysis, they found that both acute and chronic exercise can help people to fall asleep faster, sleep longer and obtain more deep sleep. The negative of exercise is that is reduces rapid eye movement (REM) sleep, which is useful for emotional processing and learning.

Another review by Taylor and Driver (2000) indicated that exercise “can be beneficial to general well-being but may also stress the body”, which means that it shouldn’t be done too close to bedtime. They also said that even though some modest effect sizes have been found, “the sleep-promoting efficacy of exercise in normal and clinical populations has yet to established empirically” (Taylor & Driver, 2000).

A 2008 study by King and colleagues found that a 12-month moderate-intensity endurance exercise program in older adults reduced their amount of stage 1 sleep, increased their stage 2 sleep and reduced their awakenings during the first third of a polysomnography study. Participants in this study also subjectively reported falling asleep quicker each night, having less sleep disturbances, and feeling more rested in the morning (King et al., 2008).

A 2010 study by Reid and colleagues also found that sedentary adults over 55 with insomnia who began exercising aerobically for 16 weeks improved their subjective sleep quality, time taken to get to sleep, total sleep time and sleep efficiency. Furthermore, they also experienced less daytime dysfunction and sleepiness, and rated themselves as being less depressed and having more vitality then before they began the exercise program (Reid et al., 2010).

Because of all of the scientific benefits of exercise on health in general, as well as the modest benefits of regular exercise on sleep, I therefore give the science of this strategy a 30/50.

Overall, exercising more as a way to sleep better gets a score of 16/25 + 15/25 + 30/50 =

61/100: Credit

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WHAT I RECOMMEND

A moderate exercise regime of both cardio and strength training is going to be good for your health, but do see a doctor for a check-up first before beginning any intensive program. In the long run, regular exercise could lead to better sleep for you too. Just try not to engage in vigorous exercise in the last three hours before bed too often, as this can raise your arousal levels and make it harder to get to sleep at the start of the night.

If you are currently experiencing severe insomnia, increasing your exercise is probably not the first step that I would recommend taking, especially if you are already quite active and feeling exhausted before you go to bed each night. A better approach would be not spending too much time in bed, minimising your alcohol intakestaying off bright screens in the last two hours before bed, and doing things to wind down before sleep.

Thanks for reading! Stay tuned for my next episode on if reading before bed can improve your sleep. If you would like some individualised help on improving your sleep, please check out my CBT-I and Personalised Sleep Reports services.

The eighth variable that I will be manipulating across a two week period to examine its impact on sleep is length of time in bed. I will be seeing if spending too long in bed is harmful to sleep quality, and if restricting time in bed is a good way to improve it. 

I will discuss what my data shows, how easy or difficult I found this strategy to implement, and what previous research says. These three factors will be combined for an overall score and grade on how effective sleep restriction is at improving the quality of our sleep. 

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IF I AM ALREADY TIRED, SHOULDN’T I SPEND MORE TIME IN BED?

It’s all over the media these days: The majority of people are sleep deprived. They say that we need to prioritise sleep, and get more of it. They also say that we used to sleep more, and blame our lack of sleep for a multitude of problems, from more accidents, our lack of productivity, greater rates of depression and anxiety, and even weight gain.

What they don’t tell you is how to get more sleep. The obvious answer would be to spend more time in bed, or get to bed earlier. This may help for some people, especially those who do not experience any difficulties in getting to sleep at the start of the night or staying asleep during the night.

For people with insomnia however, spending more time in bed awake is potentially the worst thing that they can do, especially if it leads to them becoming more worried or frustrated about their sleep difficulties. People with insomnia are already focusing on sleep too much, and are also usually going to bed before their body is ready for sleep each night.

If you are having difficulties with getting to sleep at the start of the night, even though it is quite counter-intuitive, waiting up until you feel sleepy before going to bed is one of the best ways to ensure that you will fall asleep quickly once you are in bed.

If you are having difficulties with waking up during the night, one of the quickest ways to reduce the amount of time that you spend awake during the night is to reduce your time in bed.

WHAT IS SLEEP RESTRICTION?

It sounds pretty scary to people that are already not sleeping enough, but sleep restriction doesn’t aim to reduce the amount of time that you sleep each night at all. What it is actually aiming to do is reduce the amount of time that you spend in bed awake each night. For this reason, at the Melbourne Sleep Disorders Centre where I work we call it bed restriction, not sleep restriction.

Let’s say that you feel that you need 7 hours of sleep on average, but are currently only getting 6 hours of sleep per night. You are wanting to get that extra hour, so you start spending 9 hours in bed instead of your usual 8 hours. By doing this, you expect your total sleep time to improve, but instead it stays about the same. Worse still, you are now spending nearly 3 hours in bed awake each night rather than the 2 hours that you were previously. Your sleep efficiency (percentage of time in bed spent sleeping) has decreased from 75% to 66.67% and now the nights seem to be dragging on for ages!

With sleep restriction what we want to do is the opposite. 85-90% is considered an ideal sleep efficiency to aim for, so if you are currently sleeping 6 hours per night we would actually want to cut down your time in bed to between 6.5 and 7 hours per night. This will make you more tired initially, but very quickly your sleep efficiency would reach the desired 85-90% range, whilst still obtaining 6 hours of sleep per night. Even better, you are now only awake for 30-60 minutes in bed per night, rather than 2-3 hours, which will help make the night go quicker and give you a better quality sleep.

Once you are sleeping better and spending less time in bed awake each night, we can then slowly increase your time in bed again, by 15 minutes per night every 1-2 weeks. As long as your sleep quality remains high, you might even be able to increase your total sleep time until you are reaching that 7 hours of sleep per night.

THE EXPERIMENT

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For the first week, I tried to show the negative impact of spending longer than usual in bed. Because I had to get up for work and am so used to waiting until I feel sleepy before going to bed this was actually quite hard, but I managed to spend nine hours in bed on average. 7 hours and 45 minutes was the shortest time in bed the first week, and 9 hours and 30 minutes was the longest.

For the second week, I tried to implement a sleep restriction routine. I managed to restricted my average time in bed to under 7 hours. The longest time in bed on any night for the second week was 8 hours and 10 minutes, and the shortest was 5 hours.

THE OUTCOME

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Comparison: Too much time in bed vs Sleep restriction

Based on my sleep diary data, I managed to sleep 8 hours a night the first week, which was an hour and 28 minutes more than the second week. I also managed to get to bed by 11:01pm during the first week, which is more suitable to my work week than the 12:39am bedtime the second week. This is where the good news stops however.

By implementing sleep restriction during the second week I fell asleep in under 10 minutes, 13.5 minutes quicker than the first week. I only awoke once per night rather than twice, and spent 12 minutes awake each night, rather than 38 minutes the first week. My sleep quality was a full point higher (4.29/5) during sleep restriction than it was when I was spending too long in bed (3.29/5). My sleep efficiency was also 6% higher with sleep restriction (94.81%) than it was the first week (88.78%).

Based on my data, after only a week of sleep restriction, my sleep was getting right back on track to where it was before the silent meditation retreat. I was feeling more tired by the end of the work week, especially after only 4 hours and 40 minutes of sleep on the Wednesday night, and this was evident by my turning to caffeine on the Wednesday, Thursday and Friday morning. The Thursday night was potentially the best sleep that I’d had in a month though, thanks to the positive impact of increased sleep pressure.

Based on the Misfit Ray data, the depth of my sleep was way better the second week during sleep restriction than it was the first week when I was spending too long in bed.

Let’s compare the Thursday night from the first week to the Thursday night from the second week. Even though the Misfit Ray didn’t pick up on any awakenings during the first Thursday (Apr 28 – 27/4/17 on the sleep diary), my restful:light sleep ratio was 0.83. The following week (May 05 – 4/5/17 on the sleep diary) I didn’t have any awakenings on the sleep diary or the Misfit data, and my objective restful:light sleep ratio was 2.69, which is incredible.

Even though I was in bed for 35 minutes less the second Thursday night, I was able to obtain nearly 2 hours more restful sleep than during the first Thursday night. Sleep restriction = better objective sleep quality.

IS SLEEP RESTRICTION A GOOD SLEEP STRATEGY?

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IS IT EFFECTIVE?

Yes. Only being in bed for the amount of time that I need to sleep is one of the most effective ways for me to improve my sleep quality and ensure that it remains good over time. As long as I am going to bed at the right time for my body clock, keeping these times fairly consistent from night to night and that I am trying to wind down and relax before sleep, this strategy is one of most effective for me.

I therefore give the effectiveness of this strategy a 23/25.

CAN IT BE APPLIED?

For me, yes. But the downside of sleep restriction is that it temporarily increases daytime somnolence and reduces vigilance in the initial phases of treatment (Kyle et al., 2014). Adherence to sleep restriction may also be difficult to obtain from individuals who are already concerned about daytime consequences of insomnia (Riedel & Lichstein, 2001).

If there is excessive daytime sleepiness, caution should be given regarding driving or operating machinery, and some time off work may be required. However, this increase in sleepiness prevents individuals with insomnia from lying in bed ruminating or worrying, and it has been shown to significantly improve sleep initiation and increase overall sleep quality (Lieberman & Neubauer, 2007).

I therefore give the applicability of this strategy a 13/25. 

IS IT SCIENTIFIC?

Sleep restriction is considered a highly efficacious and effective treatment for insomnia (Morin et al., 2006). It was initially conceived of in the 1980s and involves limiting the time in bed to an individual’s average subjective daily amount of sleep (Spielman et al., 1987). By only spending enough time in bed for sleep, sleep restriction temporarily induces sleep deprivation, which increases the homeostatic drive for sleep, decreases sleep fragmentation and consequently improves sleep efficiency (Vitiello, 2007). However, it is important to prescribe the sleep at a constant time that is in line with an individual’s circadian rhythms and lifestyle (Ebben & Spielman, 2009).

Sleep restriction is similar to relaxation in reducing time taken to get to sleep and time awake during the night across the treatment period, and more effective in maintaining these improvements by a 3-month follow-up assessment (Friedman et al., 1991). After 12 months follow-up in another study, time awake during the night had gotten worse since post-treatment with relaxation but continued to improve with sleep restriction (Lichstein et al., 2001). Another study of CBT-I found that sleep restriction adherence was one of the two best predictors of ongoing sleep improvements 12 months later (Harvey, 2002). Consequently, as long as adherence issues are addressed, sleep restriction can produce dramatic and robust improvements in insomnia symptoms.

I therefore give the science of this strategy a 45/50.

Overall, sleep restriction as a way to sleep better gets a score of 23/25 + 13/25 + 45/50 =

81/100: High Distinction

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WHAT I RECOMMEND

  1. Complete a two week sleep diary or use an activity tracker to get a baseline measure of your sleep.
  2. Figure out your average total sleep time.
  3. If this is under 5 hours per night, try to spend 5 hours and 30 minutes in bed per night.
  4. If it is over 5 hours, add 30 minutes to your total sleep time for your initial time in bed prescription.
  5. Figure out what time you would like to get out of bed each morning. Set your alarm for this time each day for the next 1-2 weeks.
  6. Minus your time in bed prescription from your wake time to figure out your to bed time.
  7. Go to bed each night around your to bed time, as long as you are feeling sleepy. If you are not sleepy yet, do something to try to wind down and relax, and then go to bed once sleepy.
  8. After 1-2 weeks, if your sleep efficiency is:
    • less than 85% = cut down your time in bed by an extra 15 minutes the following week.
    • between 85-90% – keep your time in bed the same
    • over 90% – increase your time in bed by 15-30 minutes the following week.

This is the most scientific way that you can figure out what is the right amount of time in bed for you. If these recommendations are too general or confusing, you can always send me your two weeks of sleep data, and I will score up your sleep and give you some specific and tailored recommendations for what you can do to improve it. For more information, check out my Personalised Sleep Reports services.

Thanks for reading! Stay tuned for my next episode on the impact of exercise on sleep. 

The seventh variable that I will be manipulating across a two week period to examine its impact on sleep is meditation. I will be seeing if regular meditation can improve our sleep, and if doing a lot of meditation is better than a little or none at all.

I will discuss what my data shows, how easy or difficult I found this strategy to implement, and what previous research says. These three factors will be combined for an overall score and grade on how effective meditation is at improving our quality of sleep.

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How Would You Cope?

Back in January I decided to sign up for a Vipassana meditation retreat. I’d seen the Australian comedian Judith Lucy go there in her 2011 TV series ‘Judith Lucy’s Spiritual Journey’ and thought that looks like a fun challenge.

It wasn’t.

Ten days. No technology. No reading. No writing. No hobbies. No exercise apart from walking. Complete celibacy and abstinence from any drugs (herbal, prescription or other), caffeine, alcohol, meat and sugar. Only 2 pieces of fruit for dinner. No socialising. No speaking. No eye contact. Not even head nods or gestures.

Just a lot of meditation. And sitting. And looking out onto the horizon. And lying down. And worrying about being attacked by the spiders that we weren’t allowed to kill. And bad sleep!

By removing all external pleasures and temptations and distractions, the aim of Vipassana meditation is to help you to tune in to the knowledge and wisdom within (I think). Through meditating up to 15 hours a day whilst observing noble silence, you are also meant to develop insights about yourself and the universal laws and truths that exist in our world (I think). In his book ‘Waking Up’, Sam Harris said that it is the most reliable method to reach an experience of transcendence, followed closely by taking LSD.

Before the retreat, the longest I had ever meditated for was 45 minutes, and that was a guided body scan meditation by Jon Kabat-Zinn. Even that has felt too long at times, but for some reason I thought that 10 days of it wouldn’t be too bad.

It was.

I was bored. Like really bored. Time has not gone that slowly since I was in primary (elementary) school. Sure, I developed some really good insights, such as I want meditation to help me live my life more mindfully, not take me away from it. I was able to rest and relax a lot. I also did get to strengthen my meditation skills, including noticing more subtle sensations in different parts of my body and reducing my reactivity.

I was even able to meditate for an entire hour with my legs crossed and arms in my lap without moving at all on four or five occasions. Learning and observing that I didn’t have to scratch an itch or move in response to strong back pain was pretty cool. However, so was leaving early after eight days to go and spend Easter with my family.

THE EXPERIMENT

For the first week, I was on the Vipassana meditation retreat for the first four nights. For the three nights after that I did a 15-20 minute meditation before going to bed using the app ‘Calm’.

For the second week, I did no formal meditation at all, and tried to see if I could get back into a better sleep pattern after spending too long in bed whilst at the meditation retreat.

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THE OUTCOME

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Comparison 1: Meditation vs No Meditation

Subjectively, I had a slightly better sleep quality in the first week (3.57/5) when I was meditating in comparison to the second week (3.42/5) when I wasn’t, but both were bad. Partly because I was going to bed too early, and partly because I was spending too long in bed and hadn’t been active during the day, my sleep efficiency (percentage of time in bed asleep) was less than 90% for the first time all year.

I did manage to sleep an extra 22 minutes per night on the week when I meditated, and 7 hours and 26 minutes per night on average. However, I also spent 18 minutes getting to sleep each night, woke up 2 times per night, and spent over 30 minutes awake during the night for the first time this year.

Without meditating at all, I woke up less, fell asleep quicker, spent less time awake during the night, and had a sleep efficiency that was 2.5% better than the meditation week. Not exactly what I had expected before doing this experiment.

Comparison 2: Meditation retreat (10+ hours of meditation) vs Calm meditation app before bed (15-20 minutes of meditation)

My sleep quality rose from a 3.25/5 during the retreat to a 4/5 once I left it and started doing only 15-20 minutes per night before bed. My time taken to get to sleep dropped from 24 minutes down to only 10 minutes. Instead of waking up 2.5 times per night it was only 1.33 times, and my time awake during the night decreased from 43 minutes to 18 minutes.

I went to bed a lot later and woke up later too once I left the retreat, but still got 7 hours and 10 minutes of sleep per night and increased my sleep efficiency to 93.82%. Essentially, adding 15-20 minutes of mindfulness to my normal day and routine without all of the other restrictions was better for my sleep in every possible way to the sleep that I had in the second half of my time at the silent meditation retreat.

Objectively, the depth of my sleep was the best after 15-20 minutes of meditation before bed (Apr 15 – 14/4/17 on the sleep diary). The next best was when I was at the meditation retreat (Apr 11 (10/4/17 on the sleep diary). The worst was when I did no meditation during the day or before bed at night.

Based on the objective data, meditation is good for depth or quality of sleep. However, 10 hours of meditating a day was actually worse for my sleep than only 15-20 minutes before bed.

IS PRACTICING MEDITATION A GOOD SLEEP STRATEGY?

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IS IT EFFECTIVE?

A little bit. I do not recommend going on a 10-day silent meditation retreat if you are wanting to improve your sleep. It negatively impacted my sleep and reduced my sleep quality to as low as it was the week where I was consuming alcohol every night before bed. That means just meditation was not an effective sleep strategy. It also needs to be combined with the other strategies for effective sleep. Only 15-20 minutes per night of meditation in the last hour before bed was good however, and better than no meditation. I therefore give the effectiveness of this strategy a 15/25.

CAN IT BE APPLIED?

For me, the flexibility of a meditation retreat gets a score of 2/25. It required giving up essentially everything, and could not really be replicated at home. Switching off from technology and multitasking at night is a bit easier and more effective too.

Doing 10-20 minutes of meditation using an app such as headspace, calm, smiling mind or buddhify in the last hour before bed is pretty non taxing however. I therefore give the applicability of this strategy a 22/25. All you have to do is have a smart phone, download an app, set a reminder for yourself each night, and follow what it says. Meditating without the use of an app is even easier to apply, and with a little bit of practice using the apps you may prefer to just do a body scan or mindfulness of the breath exercise by yourself rather than being guided by someone else.

IS IT SCIENTIFIC?

This article summarises the 30 Evidence-Based Health Benefits of Meditation. As they state, meditation has been shown to boost the immune system and heart health, lower blood pressure, help manage chronic pain and headaches, improve energy, decrease stress and anxiety, improve emotional intelligence, reactivity and resiliency, reduce depression and addiction relapse rates, relieve symptoms of PTSD, BPD and binge eating, and improve relationships, concentration and overall well-being.

These benefits alone should have a positive impact on sleep and insomnia, but other studies have found that meditation can directly improve sleep too. Two early studies found modest improvements when meditation is used by itself as an intervention for sleep (Britton, Shapiro, Penn, & Bootzin, 2003; Heidenreich, Tuin, Pflug, Michal, & Michalak, 2006). Brown and colleagues (2015) also found that a 6-week meditation intervention was significantly better than a sleep hygiene education intervention at improving sleep quality in older adults.

When meditation is combined with other sleep interventions such as CBT-I it has been shown to be especially effective (Ong et al., 2008; Ong, Shapiro, & Manber, 2009). Another study also found that meditation improved self-regulation of sleep by allowing it to occur more naturally (Howell, Digdon, & Buro, 2010).

I therefore give the science of this strategy a 40/50.

Overall, meditating for 10-20 minutes before bed as a way to sleep better gets a score of 15/25 + 22/25 + 40/50 =

77/100: Distinction

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WHAT I RECOMMEND

The silent meditation retreat experience really did teach me once again about the importance of balance. It showed me that even something that has an impressive amount of scientific evidence backing it can be harmful if we do too much of it at the expense of all the other things in our life that we get a sense of joy, engagement, purpose, connection and achievement from.

Social connection, relationship warmth and a sense of belonging really are important to well-being, and social isolation and loneliness really can be harmful to our long-term health and happiness. Freedom, independence and autonomy are also really important to me, as I am sure they are to others, and it’s important for people to be able to choose what they can and cannot do each day.

If mindfulness or any other form of meditation gives you the skills to live a better life with less suffering then that is awesome. Just make sure that however much you are doing is the right amount for you. For me it is 15-20 minutes in the last hour before sleep. A lot of other people prefer to do it first thing in the morning. Find what works for you, and then stick to it for a month or so if you can to get a true sense of what benefits it may bring for you.

Thanks for reading! My next episode on the impact of spending too long in bed is now up. If you are wanting some individualised feedback on how to improve your sleep, please check out my CBT-I and personalised sleep reports services.  

The sixth variable that I will be manipulating across a two week period to examine its impact on sleep is food. I will be seeing if the type of food that we eat and the timing of our eating can impact our sleep quality. 

dan-gold-105699.jpgI will discuss what my data shows, how easy or difficult I found this strategy to implement, and what previous research says. These three factors will be combined for an overall score and grade on how effective manipulating our diet can be at improving our quality of sleep.

 

The Relationship Between Food and Sleep

Now I am not a dietician, nutritionist, naturopath, medical doctor or personal trainer, so my understanding of how food could help sleep and the brain is not as in depth as other people’s may be.

Food is not something I generally focus on too much in my treatment of insomnia either, but I am aware that being too hungry or too full can both have a detrimental impact on our sleep quality and how quickly it can take to get to sleep.

When breaking it down further to look at the type of food and its relationship with sleep, a brief google search on this topic was fairly confusing.

There are a lot of foods that are meant to have a potential benefit on sleep, including:

  • whole grain breads
  • crackers and pretzels
  • cereals, including oats
  • rice (white or jasmine)
  • spinach, lettuce or kale
  • sweet potato
  • nuts, including walnut, pistachios and almonds
  • peanut butter
  • dairy, including milk, cheese and yoghurt
  • cherries, bananas and watery fruits
  • prunes
  • honey
  • hummus
  • turkey
  • elk
  • seafood, including shrimp, lobster and tuna

The reason given for these benefits include that they are high in tryptophan (which metabolises into melatonin and serotonin), melatonin, magnesium or potassium and therefore help us to feel sleepy or relax our muscles. Watery fruits are the exception to this, and are thought to help us to fight dehydration.

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There are also other foods that are meant to have a detrimental effect, including:

  • A bacon cheeseburger or greasy, heavy meals
  • processed meats
  • orange juice
  • anything with caffeine, including chocolate
  • curries or things with heavy spices
  • tomato based foods
  • Meals high in protein

The reason given for avoiding these foods include a greater risk for an upset stomach, heartburn, indigestion, elevated arousal levels and too much energy needed to break down these foods in our digestive system.

 

The Experiment

For the first week, I tried to eat healthily during the day, but then have a dinner or snack before bed that was considered potentially harmful for sleep. This included:

  • A burger and chips on the Sunday night
  • Orange juice on the Monday night
  • Pepperoni and Olive pizza on the Tuesday night
  • A creamy tomato pappardelle pasta with chilli on the Wednesday night
  • A Thai green curry on the Thursday night
  • Honey mustard chicken breast on the Friday night
  • A double chocolate sundae from the Lindt cafe on the Saturday night

For the second week, I tried to have as many healthy meals as possible, and had a light snack before bed on the Sunday, Monday and Tuesday night about 30 minutes before bed. This consisted of:

  • Cheese and crackers on the Sunday night,
  • Peanut butter on toast with honey on the Monday night, and
  • Oats with mixed berries and milk on the Tuesday night.

From the Wednesday through to the Sunday I was on a Vipassana silent meditation retreat, and was unable to modify my food intake from what was being served to us. I ate:

  • Oats, banana and yoghurt for breakfast at 6:30am every morning,
  • A simple vegetarian lunch consisting of vegetables, salad and brown rice at 11am, and
  • Two pieces of fruit for dinner at 5pm.

We were not able to eat past 5pm, so it makes for a nice comparison to view the effects of timing of food on sleep plus no processed foods and no meat.

 

The Outcome

Episode 6- food and sleep

Comparison 1 – Type of food: “bad” for sleep vs “good” for sleep

Subjectively, I woke up less each night with the food that was meant to be bad for my sleep, and also spent much less time awake per night. My sleep efficiency was better after the bad food too, and my sleep quality was rated as exactly the same (4.42/5) in comparison to the week where I ate foods that were meant to be good for my sleep.

It took 1.5 minutes longer to fall asleep after the bad food than the good food, but that is hardly enough of an improvement to focus too much on what I eat before sleep if I am wanting a good night’s sleep in the future.

Comparison 2 – Timing of eating: week 1 vs week 2

Subjectively, by eating earlier in the day and at night it did seem to have an impact on my internal body clock, or circadian rhythm. I was able to get to bed the second week by 10:15pm on average, which is the earliest it has been all year, and I still fell asleep within 8 minutes each night.

By getting to bed earlier, I was able to stretch my time in bed to 8 hours and 16 minutes per night, and obtain 7 hours and 54 minutes of sleep each night, which is also a personal best for me for the year.

My sleep efficiency and sleep quality were both excellent too, so eating earlier in the day does seem to help me to fall asleep earlier and stay asleep longer.

Objectively, the depth of my sleep was better during the first week when I was eating foods that were meant to be bad for sleep than it was during the second week when I ate earlier and less food at night.

Let’s compare Mar 31 (30/3/17 on the sleep diary) to Apr 06 (05/4/17 on the sleep diary data). I obtained more sleep on Apr 06, but it had two visible awakenings during the night, more time awake during the night, and a poorer ratio of restful:light sleep.

This means that objectively my sleep quality was a little worse during the second week – the exact opposite of what I would have expected before conducting this experiment. 

 

IS MANIPULATING YOUR FOOD CONSUMPTION A GOOD SLEEP STRATEGY?

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IS IT EFFECTIVE?

Maybe. The type of food didn’t seem to make too much of a difference to my sleep at all, although I may need to change my diet for a lot longer period of time to see the true impact of food on sleep. I also didn’t eat seafood or turkey or elk, so the wonder sleep food may still be out there for those who are willing to give these a go. Eating earlier did seem to help me to get to sleep earlier and sleep longer, but not necessarily better. Based on my data, I give the effectiveness of this strategy a 15/25.

CAN IT BE APPLIED?

Yes. For me, the flexibility of this strategy isn’t too bad, as there are plenty of options that you could still choose from, whether it is for dinner or a pre-bed snack. Eating earlier consistently might be tough, especially if you are trying to fit in with family or friends or have a late dinner reservation, but it might be worth the sacrifice if you are trying to get to sleep earlier. I therefore give the applicability of this strategy a 17/25. 

IS IT SCIENTIFIC?

Not exactly. A 2017 study by Kleiser and colleagues looked at 1050 participants between 13 and 81 years of age and found a significantly shorter sleep duration was present with higher alcohol consumption, higher coffee or black tea consumption and higher carbonated beverages consumption. No significant association were found for other dietary intake and sleep duration or quality (Kleiser et al., 2017).

Eating your main meal earlier in the day can lead to greater weight loss than eating later in the day, but it does not significantly impact sleep duration (Ruiz-Lozano, Vidal, de Hollanda, Scheer, Garaulet & Izquierdo-Pulido, 2016).

For individuals with obstructive sleep apnea (OSA), there does seem to be some benefits to increasing whole grain and legume consumption (Lamprou et al., 2017). It is also important that they try to reduce refined grain, red meat and soft drink consumption, as too much of these foods can lead to insulin resistance (Lamprou et al., 2017).

I therefore give the science of this strategy a 25/50.

Overall, reducing work-time and winding down in the two hours before bed as a way to sleep better gets a score of 15/25 + 17/25 + 25/50 =

57/100: Pass

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WHAT I RECOMMEND

In my session one handout that I give to clients I include Sleep Hygiene recommendations from Perlis and Youngstead (2000). They have this to say about food:

“Eat regular meals and do not go to bed hungry. Hunger may disturb sleep. A light snack at bedtime (especially carbohydrates) may help sleep, but avoid greasy or heavy foods.”

–Perlis & Youngstead (2000).

The National Sleep foundation recommends that a small snack consisting of both protein and carbohydrates in the last hour before bed is generally the best, such as peanut butter on toast or cheese and crackers.

Even if what we eat doesn’t help sleep too much I have no doubt that eating less processed foods and more fresh vegetables would be good for our overall health and vitality.

If you aren’t sleeping well and want to improve it, changing your diet is unlikely to be the most effective thing that you can do. If you eat badly on one night, it’s unlikely to lead to a horrible night’s sleep. A more important factor might be how much you begin to worry about what you ate, and how much you then worry about not sleeping well.

As with most things, try to relax and wind down at night, wait until you feel sleepy before going to bed, and try not to force yourself to sleep once you are in bed. The more you try to sleep, the less likely it is to come. If you can keep your focus on something peaceful, calming or relaxing instead, you will drift off when the time is right.

Thanks for reading! My next episode on the benefits of meditation before sleep is now up. If you are wanting some individualised feedback on how to improve your sleep, please check out my CBT-I and personalised sleep reports services. 

The fifth variable that I will be manipulating across a two week period to examine its impact on sleep is the importance of giving ourselves time to relax and wind down before sleep. 

I will discuss what my data shows, how easy or difficult I found this strategy to implement, and what previous research says. These three factors will be combined for an overall score and grade on how effective winding down and relaxing before bedtime is at helping people to improve their sleep.

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How much time do you take each day to do nothing? To simply be, rather than always having to do something? To put your feet up and just relax?

For me, the answer is a lot more than I used to. I remember back when I was completing my Doctorate in Clinical Psychology, I would finish up my day of placement at Peter MacCallum Cancer Centre and walk through the Fitzroy Gardens on the way to Jolimont train station. It was a nice way to end my work day with a brisk walk and lovely scenery, but the thing that always amazed me was the amount of people that were laying around, reading a book or chatting with friends. “Where do they find the time?” I would ask myself in amazement, as I checked my phone to make sure that I wouldn’t be late for the next train.rob-bye-141864.jpg

A Doctorate is a great way to become more self-disciplined and efficient, as it involves trying to juggle coursework with research, writing a thesis and clinical placement. It isn’t great for a work/life balance however, as even after a full day of work and study it always felt like there was a copious amount of work that still needed to be done.

Once my thesis was finally accepted in February 2014 I remember walking through those same gardens after a day of work at the Melbourne Sleep Disorders Centre, and noticed that there were still people out and about, exploring the garden paths with their kids or having a picnic under a tree. “Where do they find the time?” I asked myself again.

I was now working full-time in private practice as a Clinical Psychologist, and in general I was feeling more relaxed and less rushed, but always felt like there were more things that needed to be done that were more important than lying around in the park on a weekday afternoon.

Now I’m only working four days a week and I finally get it. It’s a trap to keep waiting until we find the time to do something. We have to make the time to do it. Just ask time management expert Laura Vanderkam:

So last Monday, on my usual day off, I decided to go back to Fitzroy Gardens again. Instead of walking briskly like I used to do I now strolled, found a nice spot, and laid back on the grass, staring up at the sky. Thoughts of lying back on my trampoline when I was younger and trying to make out shapes in the clouds came rushing back to me, and I began to just take in my surroundings and relax even though I was only five minutes away from all the hustle and bustle of the city.

ilham-rahmansyah-102After 30 minutes of relaxing, I carried on with my day, much less frantic and hurried than I used to be only a few years before.

Hyper-Arousal

There are three main things that I look at during an assessment of a client with sleeping difficulties. Firstly, their sleep pressure and if this is high enough each night when they are going to bed. Secondly, their circadian rhythms and if they are in bed at the right times based on their internal body clock. The last factor is hyper-arousal, or how active their brains are during the day and at night.

Hyper-arousal tends to be the main problem for the majority of individuals that I see with chronic insomnia. By the time they come to see me they have generally tried as many of the sleep hygiene instructions that they can and are getting more and more frustrated and worried that their sleep isn’t improving. What they often don’t realise is that this frustration and worry is only further elevating their nocturnal hyper-arousal, and it is preventing them from getting the very thing that they desire – a nice, deep, restful and restorative sleep.

Cognitive arousal, or a busy mind, is ten times more likely to be rated as the reason for sleep difficulties by patients with insomnia than physical arousal, or a tense and restless body. Given how much information people are exposed to these days, and how little they tend to move, this doesn’t surprise me at all. Just think about how many people you see on their phones wherever you go. I even saw someone checking their phone whilst skateboarding the other day.

What would happen if we all decided to do less? If we took some time out during the day to power down, do nothing and just be? If we all stopped trying to work and achieve for at least the last hour before bed each night and focused instead on winding down, relaxing and preparing our mind and body for sleep?

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The Experiment

For the first week, I stopped doing any form of “work” at least two hours before bed. This meant four nights of watching Netflix on TV (with blue-light blocking glasses on), one night of reading, and two nights of guided meditation using the phone app calm.

For the second week, I made sure that I didn’t do anything specific to wind down, and did work on the computer (with f.lux on) on the five weeknights (Sun-Thur). On the weekend I didn’t have the chance to do work as I was away at a Bachelor or Buck’s Party, but did socialise right up to bedtime without actively trying to do anything to wind down.

 

The Outcome

wind down sleep diary.jpg

Comparison: Working right up until bedtime vs winding down and relaxing before bed

Subjectively, I woke up nearly three times as much by working right up until bedtime. I still managed to get 7 hours of sleep per night and fell asleep in under 10 minutes once in bed. I also had a sleep efficiency of 96.55%, which is excellent, but I went to bed 18 minutes later, took longer to fall asleep, and spent more time awake during the night. The only thing that was better on the week where I worked right up to bedtime was my rising time in the morning, as I got out of bed 8 minutes earlier each day.

By taking the time to wind down and relax before sleep my sleep quality was the second best it has been all year (no alcohol was better) and I slept 31 minutes more per night. The 7 hours and 31 minutes of sleep that I obtained on average in the week that I stopped working and relaxed before sleep was 15 minutes more than I had obtained in any other week this year!

Objectively, the depth of my sleep was much better during the first week when I was winding down than when I was working right up until bedtime.

Let’s compare Mar 17 (16/3/17 on the sleep diary) to March 20 (19/3/17 on the sleep diary data). Granted, I did have to run an all-day workshop on sleep on the Monday, which I was a bit nervous about. This did seem to make my sleep more restless, and I slept an hour less than the Thursday before when I had meditated before bed.

Even though I was only in bed for an extra hour after meditating, I obtained 2.5 hours more restful sleep, as you can see for yourself on the Misfit Ray data above. The objective difference in sleep quality is important for daytime functioning, mood and energy levels, and it suggests that mindfulness meditation is worth exploring further.

IS STOPPING WORK AND WINDING DOWN BEFORE BED A GOOD SLEEP STRATEGY?

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EFFECTIVENESS

Yes. Notice how with this technique I mixed up how I wound down and also mixed up the work that I did, but in general taking some time out before sleep to relax was very effective in improving my sleep, especially my sleep quality and total sleep time. I therefore give the effectiveness of this strategy a 22/25.

APPLICABILITY

For me, the flexibility of this strategy is great, as I don’t have to do exactly the same thing every night and can fit in with others too (as long as I find it relaxing). I therefore give the applicability of this strategy a 23/25. All you have to do is stop trying to be productive right up to bed time, and actually give your mind a chance to wind down in the last hour before bed.

SCIENCE

In Perlis and colleagues’ (1997) neurocognitive model of insomnia, they say that hyper-arousal interferes with both sleep initiation and sleep maintenance. They also say that people with insomnia develop conditioned cortical (mental) arousal from the association of sleep related stimuli and sleep difficulties (Perlis et al., 1997).

In Espie’s (2002) psychobiological model of insomnia, he says that normal sleep processes are disrupted, resulting in difficulties disengaging from active wake processes. This leads to higher cortical arousal and lack of inhibition of arousal (Espie, 2002).

Kleiner and Pavalko (2010) have found that individuals who work over 41 hours a week report worse mental and physical health. Other studies have found a link between longer working hours and stress, poor sleep, depression, anxiety, increased alcohol use, coronary heart disease and potentially even cancer (Heikkila et al., 2016).

By reducing the working hours of medical interns, Lockley and colleagues (2004) found that weekly sleep times increased by 5.8 hours and the rate of attentional failures during night shifts were more than halved.

I therefore give the science of this strategy a 40/50.

Overall, reducing work-time and winding down in the two hours before bed as a way to sleep better gets a score of 22/25 + 23/25 + 40/50 =

85/100: High Distinction

WHAT I RECOMMEND

clem-onojeghuo-175917

 

Hyper-arousal, especially an active mind, is the #1 reason that individuals with insomnia cannot sleep.

It doesn’t matter how this arousal level is lowered, or how you choose to wind down and relax, but preferably you don’t want it to disrupt your circadian rhythms, so minimising bright screen use in the last two hours before bed is advisable.

Apart from that, experiment a bit. Socialising with others is okay, as is reading, listening to music, doing some light stretching, engaging in a relaxing hobby, having a hot bath (30-60 minutes before bedtime) or meditating. Find what works for you, and then try to develop a bit of a wind-down routine each night to see if this helps your sleep.

It is also important to make sure that you are not working too much (if this is possible). Anything more than 9 hours per day or 48 hours per week is likely to lead to poorer self-care and poorer health, and it is also likely to reduce your productivity whilst working. Sweden have dropped down to 6-hour work days, and in time we’ll hopefully see the health benefits that this brings.

Lastly, try not to focus too much on sleep, or worry about the negative impacts of not sleeping. The more attention that we have on it, the greater effort that we put into it and the greater intent that we have towards getting to sleep, the less likely it is to come. Sleep is an involuntary process, which means that there will never be a strategy that offers a 100% guarantee that you will sleep well tonight. It’s much better to focus on relaxing and lowering our arousal before bed, waiting until we feel sleepy before going to bed, and then allowing sleep to come.

Thanks for reading! My next episode on whether the type of food and the timing of eating can impact our sleep quality is now up. If you are wanting some individualised feedback on how to improve your sleep, please check out my CBT-I and personalised sleep reports services.  

The fourth variable that I will be manipulating across a two week period to examine its impact on sleep is blue-light blocking glasses.

Blue_Light_Blocker_Glasses_Australia_grande

I will discuss what my data shows, how easy or difficult I found this strategy to implement, and what previous research says. These three factors will be combined for an overall score and grade on how effective wearing blue-light blocking glasses in the last two hours before bedtime is at helping people to improve their sleep.

glasses2_grande

The Technology

I bought a pair of UVEX Blue-light blocking glasses for $22AUD with free delivery from the website www.optimoz.com.au. As you can see, the first picture above is of glasses for people who don’t need reading glasses, and the second picture is of glasses that can be worn over the top of reading glasses. Here is their description on the product:

UVEX have produced a set of eyewear designed for use by dental or medical practitioners while working under strong UV lamps. These are orange lensed glasses, but there is more to them than just the orange colour. These glasses use UVEX’s patented “Spectrum Control Technology” to filter out specific colours of the light spectrum.

The light that is going to hurt your sleep performance is any blue light with a wavelength below 520nm  (however 440-480 is a particularly critical range). This eyewear will selectively block out any light less than 550nm while allowing 80%-90%  of all other light through. Wear these for a couple hours before bed and you will eliminate the impacts of blue light on your sleep!

Why Blue Light?

For a long time, scientists thought that the only receptors in our eyes were rods and cones. However, in 2001, a third lot of receptors were discovered, whose only role was to determine whether it was light or dark outside (Brainard, 2001).

Interestingly, these light/dark receptors only respond to blue wavelengths of light, as shown by the effective bandwidth in the graph below:

BlueLi1

Blue light is present in white or natural light, as shown in red and yellow in the graph above. Given the intensity of these wavelengths outside during the day, our light/dark receptors will tell our brain that it is light, and help us to feel energetic and alert. For this reason it is actually considered helpful to get 30-minutes of exposure to sunlight in the morning.

Blue light boxes or glasses with blue lights on them can even be bought online and used by people with Delayed Sleep Phase Disorder (DSPD) to help them wake up and get going at an earlier time than they usually would (as well as get to sleep earlier that next night).

 

Unfortunately, blue light is also highly prevalent in LED screens including televisions, computers, tablets and smart phones. Whilst this isn’t a problem during the day, it can quickly become one at night.

The most important hormone for sleep is melatonin, which responds to signals of darkness from our light/dark receptors, and usually begins to be released about 2 hours before our usual bedtime. If we are exposed to high levels of blue-light wavelengths during this time, our light/dark receptors will tell our internal body clock that it is still daytime, and our melatonin production will be suppressed. This can then contribute to more difficulties in falling asleep and staying asleep, as well as poorer sleep quality and a shorter sleep duration (Cajochen, Krauchi & Wirz-Justice, 2003).

 

The Experiment

My reason for trialling blue-light blocking glasses builds upon what I discovered in episode 3 on Sleep and TV. Across this two week period, I found that not watching TV in the last two hours before bed was more helpful than watching TV for my sleep.

What I don’t know is if it was purely the bright light or blue light from the TV that led to my sleep being worse (by suppressing melatonin), or if the meditation and reading that I did before sleep on the no TV week was more relaxing than watching TV? In order to answer this question, I needed to ask another:

What if I could watch TV or use the computer before bed without it negatively impacting my sleep?

Blue-light blocking glasses are the best way to find out. 

For a two-week period, I decided to use bright-screen technology for the last two hours each night before bed. On each week I used the computer on 4 nights, and either my phone or the TV on 3 nights.

For the first week, I did not use any programs or glasses to reduce the amount of blue-light I was exposed to.

For the second week, I put on blue-light blocking glasses, and didn’t take them off until I was in bed with the lights off.

The Outcome

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Comparison 1: Blue-blocking Glasses vs Bright Screens

Subjectively, My sleep efficiency, sleep quality, time taken to fall asleep, number of awakenings during the night and time awake during the night were all better with the blue blocking glasses on in comparison to being on bright screens in the last two hours before bed without them on. My wake time during the week was also much more consistent.

Surprisingly, I actually went to bed 5 minutes later per night with the blue-blocking glasses on, spent less time in bed, and slept 20 minutes less per night. This may have been due to the better sleep quality that I was getting, as I wasn’t any more tired during the day, but I was no longer getting the recommended 7 to 8 hours of sleep per night.

Objectively, the depth of my sleep was much better during the second week when I was wearing the blue-light blocking glasses. Let’s compare Feb 27 (26/2/17 on the sleep diary) to March 06 (5/3/17 on the sleep diary data). Both were Sunday nights. I had gone for a swim in the morning on both days. I didn’t have any alcohol or caffeine. I spent at least two hours on the computer before bed on both of the nights. The only difference was that I didn’t wear the glasses the first week, but did on the second.

Even though I spent two hours less in bed the second week, I was still able to attain 8 minutes more restful sleep, with a restful:light sleep ratio of 2.45:1 in comparison to 1.11:1.  This meant that I felt quite refreshed and energetic the next day after wearing the blue-blocking glasses, even though I slept less than the ideal 7 to 8 hours.

Comparison 2: Blue-blocking glasses vs No Screens

Another interesting comparison is comparing wearing blue-blocking glasses and staying on bright screens in comparison to staying off bright screens altogether (the second week of the sleep and TV episode).

Subjectively, I spent 18 minutes less in bed each night with the glasses on, slept 13 minutes less, went to bed 11 minutes later and woke up 7 minutes earlier. This means that blue blocking glasses didn’t get me to sleep earlier or help me to get more sleep each night in comparison to reading and meditation before bed.

What the glasses do seem to help with is improving my sleep efficiency (1.06% higher) by helping me to fall asleep quicker (by 2.15 minutes) and spend less time awake in bed (by 50%) each night. They also improved my subjective sleep quality (by 0.13 points), although the quality was artificially lowered on the no screens week by alcohol consumption on the Friday and the Saturday night. Alcohol tends to impact sleep quality more than anything else I’ve measured so far, so those wanting to feel more refreshed during the day would benefit from minimising their alcohol consumption.

Objectively, both blue-light blocking glasses (see Mar 08) and no screens (Feb 23) in the 2 hours before bed contribute to a restful night’s sleep. The restful:light sleep ratio produced by the blue-light blocking glasses was 2.68:1, in comparison to the no screens ratio of 2.09:1.

IS WEARING BLUE-LIGHT BLOCKING GLASSES BEFORE BED A GOOD SLEEP STRATEGY?

EFFECTIVENESS

Yes. I still didn’t find wearing the glasses to be quite as effective as avoiding alcohol, but better than avoiding caffeine and slightly better at improving sleep quality over not watching TV. It beat bright screens and no TV before bed on 5 to 6 out of the 9 categories that I measured on the sleep diary, so I give the effectiveness of this strategy a 20/25.

APPLICABILITY

For me, it was bit annoying to have to wear the glasses whilst on my computer or the phone, but watching TV I got used to wearing the glasses pretty quickly, and felt like I could enjoy the programs just as much. The times when it might be tough are if you are going on holiday somewhere, having friends over, or staying over at someone’s house. I therefore give the applicability of this strategy a 17/25. It is pretty easy to forget to put them on, and they do look a little silly, but if used consistently they really can help.

SCIENCE

A 2017 study found that playing games on a blue-light emitting smart-phone between 7:30pm and 10:00pm significantly decreased sleepiness and delayed melatonin onset by .24hours (as well as increased cortisol levels and body temperature) in comparison to the same subjects who played these games on a smart phone with the blue-light wavelengths removed (Heo et al., 2017).

What we don’t know enough about is if the blue-light blocking glasses are as effective as their product graph shows:

SCT_photometrics_large If blue-wavelengths are predominantly between 440-480nm, and the glasses block out all wavelengths below 550nm, then they will essentially have the same positive effect on our melatonin release as being in complete darkness for the last two hours before bed.

In 2016, Esaki and colleagues had eight patients with delayed sleep-phase disorder (DSPD) wear blue-light blocking glasses from 9pm onwards for a two-week period. It brought their melatonin onset forward by 78 minutes on average, and their sleep onset time was over two-hours earlier after the treatment than before it (Esaki et al., 2016).

I therefore give the science of this strategy a 38/50.

Overall, avoiding watching TV in the two hours before bed as a way to sleep better gets a score of 20/25 + 17/25 + 38/50 =

75/100: Distinction

 

WHAT I RECOMMEND

 

If you can avoid bright screens in the last two hours before bed, it will help with your sleep. If you don’t want to avoid bright screens during this time, or have tried but found it too difficult to stop, do yourself a favour and get a pair of blue-light blocking glasses. For a very small investment ($22), you can watch as much TV or be on your tablet for as long as you want before bed without having to worry about the impact that it is having on your sleep.

I still don’t recommend being on your computer or phone in bed but if you are using them late at night, do download f.lux and install it on your computer, or go to settings on your iPhone and then go to display & brightness and turn on night shift starting so that it starts at least two hours before you normally go to bed.

Going forward I will be using f.lux on my computer, night shift on my phone, and blue-blocking glasses when I am watching TV at home.

Thanks for reading! My next episode on the importance of giving ourselves time to relax and wind down before sleep is now up. If you are wanting some individualised feedback on how to improve your sleep, please check out my CBT-I and personalised sleep reports services. 

The third variable that I will be manipulating across a two week period to examine its impact on sleep is TV – specifically watching it in the last two hours before bedtime.

I will discuss what my data shows, how easy or difficult I found this strategy to implement, and what previous research says. These three factors will be combined for an overall score and grade on how effective avoiding TV before bedtime is at helping people to improve their sleep.

jens-kreuter-85328

TV or bright screen usage is not something that I have been keeping track of this year, but the reason I want to study it is that I know that:

  1. A lot of people watch TV in the last two hours before bedtime.
  2. A lot of my clients say that it helps them to wind down before bedtime.
  3. I do not recommend using bright screens in the last two hours before bed.

I generally don’t include TV in with other bright screen use, as computers, tablets and phones are generally closer to people’s eyes and therefore their light receptors than a TV is. Having said that, it might still be having an impact, especially with how big some TVs are these days.

I also know that people who like to watch TV before bed probably aren’t going to stop this, especially if it has become a long engrained pattern. Surely we should see if it has a big negative impact on sleep before recommending that it needs to be cut out alongside computer, tablet or phone usage.

The Experiment

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In order to explore the impact of TV on sleep, I decided to once again be a little bit more extreme than I normally am.

For the first week I watched:

  • One hour of TV before bed on the Sunday and the Wednesday
  • One and a half hours of TV before bed on the Tuesday and Friday
  • Two hours of TV before bed on the Monday, Thursday and Saturday

For the second week, if I watched any TV it had to wrap up at least 2 hours before bed. What this meant is that I had to be creative with what else I could do before bed that didn’t involve bright screens. This meant talking to my partner more, journalling, reading or meditating.

If you decide to try this at home and switch off your TV in the two hours before bed, just focus on doing something that isn’t too physically demanding or emotionally intense, as the key is to try to relax and lower your arousal levels, and then go to bed once you feel sleepy.

Other ideas that don’t involve bright screen time include playing board games or card games, playing a musical instrument or listening to music, colouring, drawing, painting, knitting, cross-stitching or any other hobby really.

The Outcome

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Comparison 1: No TV vs baseline data

With no TV in the last two hours before bed, my sleep efficiency was at 96.84%, 0.64% higher than the baseline data, but not as high as the no alcohol data and just below the no caffeine data. If you take out the Friday where I caught up with old friends and Saturday night where I went to a wedding, this increases to 97.7%, higher than no caffeine, but still not better than the week where I had no alcohol.

My time to get to sleep was nearly 2 minutes longer than baseline, but my time awake during the night was half of what it was during the baseline period, with awakenings only being recalled on the two nights that I’d consumed alcohol. My to bed time was still 17 minutes later than at baseline, but was earlier than all of the caffeine and alcohol data, and is definitely trending in the right direction again. My time in bed was 2 minutes less than baseline, and I was getting out of bed 15 minutes later in the mornings.

My sleep quality was rated as a 4.29, equal to caffeine, better than alcohol and no caffeine, but not as good as the no alcohol data. Take out the last two nights where I did drink alcohol, and my sleep quality with no TV rises to a 4.8 – the best rating so far!

Objectively, There were 3 nights where my sleep had a restful:light sleep ratio of more than 2:1, which is excellent. The Feb 21 Misfit data (20/2/17 on the sleep diary) was the best, with a really solid block of deep sleep and a ratio of 2.15:1.

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The worst objective sleep was the Friday night, with a ratio of 0.75:1. More evidence that alcohol has a large impact on objective sleep quality!

Comparison 2: TV vs No TV

Looking at the sleep diary data, I woke up 0.28 less times per night when I didn’t watch TV than when I did, went to bed 12 minutes earlier, fell asleep 3.57 min quicker, awoke for 1.43 minutes less, and had better sleep efficiency and subjective sleep quality.

I did sleep 7 minutes more per night on the week that I watched TV, but I was within the recommended 7-8 hours of sleep on both weeks.

I also spent 12 minutes less in bed and was able to get out of bed 24 minutes earlier on the week when I didn’t watch TV before bed.

By remaining away from TV and other bright screens in that last two hours before sleep, my body clock (or circadian rhythm) really did seem to start to shift forward to an earlier sleep and rise time, which is really important for someone like me with a tendency towards having a delayed circadian phase.

Objectively, even with watching 2 hours of TV before sleep my sleep wasn’t too bad. Like the no TV week, my worst night of sleep objectively was on Feb 18 (17/2/17 on the sleep diary), where I caught up with some volleyball friends for dinner and had some alcoholic drinks. My restful:light sleep ratio was 0.97:1 on this night – better than when I avoided TV the week after.

My best sleep objectively was Feb 13 (12/2/17 on the sleep diary), where I watched 1 hour of TV before bed. The restful:light sleep ratio on this night of 2.14:1 was nearly as good as my best night on the week with no TV. The 6 hours and 13 minutes of restful sleep that I obtained on this night was the most that I have had on any night this year!

IS AVOIDING TV BEFORE BED A GOOD SLEEP STRATEGY?

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EFFECTIVENESS

For me, yes. Not as effective as avoiding alcohol, but better than avoiding caffeine. It beat watching TV before bed on 7 out of the 9 categories that I measured on the sleep diary, so I give the effectiveness of this strategy a 19/25.

APPLICABILITY

For me, not watching TV was fun, as the other things that I did instead are more in line with my values and who I’d like to be, especially talking more with my partner, meditating and reading regularly. Journalling is good too, but I generally don’t recommend doing this in the last two hours before bed either for the challenging emotions that it may bring up at times.

For others, especially if their housemate or partner really enjoys watching TV together with them I imagine that it would be a lot harder. I give the applicability of this strategy a 17/25, as I’m not saying that you have to stop watching TV altogether. Just not in the last two hours before you go to sleep.

SCIENCE

Data from Project Viva has found that for every 1 hour of increased TV viewing per day, a child’s sleep decreased by 7 minutes each night. Having a TV in their bedroom was even worse, and was associated with 8-31 minutes of less sleep per night (Cespedes et al., 2014).

Data from the GECKO Drench cohort has supported these findings, and found that more televisions at home or in the bedroom led to more television watching for children, which was significantly associated with a reduced sleep duration and higher BMI (Sijtsma, Koller, Sauer & Corpeleijn, 2015).

A systematic review by Hale and Guan (2015) found 67 studies that looked at the relationship between screen time and sleep in children and adolescents, and found adverse sleep consequences in 90% of the studies. They did say that a causal link is not yet confirmed, but recommended that we:

limit or reduce screen time exposure, especially before or during bedtime hours to minimise any harmful effects of screen time on sleep and well-being

— Hale and Guan (2015).

I’m still not sure if TV is less problematic than other bright screen use where the screens are closer to the eyes, but McIntyre and colleagues (1989) did find that more intense light exposure led to a greater suppression of melatonin. 1 hour of light exposure at midnight suppressed melatonin by 71% with 3,000 lux, 67% with 1,000 lux, 44% with 500 lux, 38% with 350 lux, and 16% with 200 lux (McIntyre, Norman, Burrows & Armstrong, 1989).

If you can download a lux meter app and then look at what it says where you normally sit to watch TV, it might give you an estimate of how problematic the behaviour is. Using the LightMeter App, sitting in my office with the lights on is 98 lux, and looking at the computer is 1287 lux. The TV reading would probably be somewhere in between.

I therefore give the science of this strategy a 33/50.

Overall, avoiding watching TV in the two hours before bed as a way to sleep better gets a score of 19/25 + 17/25 + 33/50 =

69/100: Credit

Watching TV for the 1-2 hours before going to sleep did mean that I went to bed later, took longer to fall asleep, woke up more during the night, spent more time awake during the night, and got out of bed later in the morning.

By avoiding TV and other bright screens in the last 2 hours, I was able to engage in other more beneficial activities that helped to reduce my arousal levels more. I also obtained 3 nights of sleep that objectively had a restful:light sleep ratio of more than 2:1 for the first time this year. It also seemed to helped bring my body clock forward a bit, so that I was feeling sleepy earlier, getting to bed earlier and getting up at a more desirable time in the morning, which helped me to do more exercise before work and be more active during the day.

WHAT I RECOMMEND

I know that TV is enjoyable to watch for many people, but there is some data that suggests that the more we watch, the less sleep we get. If you really want to watch your favourite show and it is within 2 hours of going to bed, go for it, just try not to make it a nightly habit. It would be even better if you could record your favourite late night programs and then watch them earlier the next day – that way you’d know that it won’t impact your sleep.

The 2016 Sleep Healthy Survey of Australian Adults showed that our sleep problems are 5-10% worse than they were in 2010, with 33 to 45% not sleeping enough or sleeping poorly. Of the 44% who surf the internet just before bed every night, the percentage of people having sleep difficulties climbs to nearly 60%.

Reading, meditation and even listening to music all have studies supporting their efficacy in reducing stress levels more than what watching TV does, and they all have the added benefit of not including bright light. Removing TV from bedrooms and pre-sleep routines is unlikely to be harmful, and could be beneficial.

CONCLUSION

If you have sleep problems and watch TV before bed, it’s definitely a variable that is worth experimenting with. Try watching your normal amount of TV one week, then switch it off in the last two hours the next week, and see what it does for you.

If nothing, at least you know that you don’t have to feel bad about watching TV pre-bed. If it is having an impact, surely it’s worth switching it off a bit earlier if it means better sleep for you, and all of the other benefits that come with this.

Thanks for reading! My next episode exploring the use of blue blocking glasses before bed is now up. If you are wanting some individualised feedback on how to improve your sleep, please check out my CBT-I and personalised sleep reports services.