"Hacking" your sleep

Yet another article discussing sleep hygiene, but changing the verbiage to make it seem like new information. Using the word "hacks" makes it sound like you can break the sleep "code" and improve sleep quality. Almost all of the items listed are part of good sleep hygiene, and have been around for decades. With that said, I actually think this article is really good, providing useful information in a succinct format that may steer individuals in the right direction to better sleep.

Improving sleep in children

Normally, articles like this don't impress me. At least the ones written to help adults sleep. But this one for kids is packed full of great advice to help kids sleep better. It's not as applicable for infants...more for toddlers and older children / adolescents.

Sleep duration and sleep hygiene differences in homeschooled vs public / private school students

Adolescents tend to be a sleep-deprived bunch. I know I was when I was in high school. Adolescents tend to stay up late, in part because of a biological shift in circadian rhythm. Plus, high school starts earliest, which deprives adolescents of sleep as well. On the weekends, some adolescents try to make up for lost sleep by sleeping in, but this does not erase 5 days of partial sleep deprivation. Advocates have requested later school start times to help, but this is not done in most schools.

This study is about kids that are homeschooled. In this population, these kids can sleep in later, offsetting the daytime sleepiness from sleep deprivation as seen in public / private school kids. Also, kids that are homeschooled have a parent with them more often and thus may have better sleep hygiene than public / private school kids - meaning less TV / screen time in bed, less caffeine in evening, etc.

Study participants were surveyed about their sleep patterns and sleep hygiene via internet. Mean age of the sample was 13.6 years old. The results showed that kids in public / private school went to bed somewhat earlier on weekdays, but got up much earlier, resulting in 49 less minutes of sleep than homeschooled kids. Also, public/private school kids tended to sleep in more on weekends than homeschooled children. Using the National Sleep Foundation’s categories of “optimal sleep” (>9 hours) 28.2% of public/private school students obtained optimal sleep on weekday nights compared to 58.0% of homeschooled students. Public/private school kids tended to have "poorer" sleep hygiene than homeschooled kids.

The authors concluded that later school start times would allow private / public school kids to get more sleep.

Sleeping with your phone

This article discusses survey data about cell phone use. The results showed that 71% of those surveyed sleep with their cell phone near them. Most have it on their nightstand, but some have it on the bed or even in their hand. The article reports that only 24% of those surveyed keep their phone in a separate room, which is consistent with good sleep hygiene.

I don't agree that keeping your cell phone out of your bedroom is good sleep hygiene. I keep mine next to my nightstand every night. For me, my phone serves as my pager for when I am on call but also as my alarm. The problem with having a cell phone in your bedroom occurs when you use the phone to help you fall asleep, rather than learning to fall asleep on your own. Or if you get texts, email alerts, or calls all night from friends and family - this will disturb your sleep. But just having the phone next to you is not necessarily a problem.

Cognitive behavioral therapy for insomnia in fibromyalgia

Cognitive behavioral therapy (CBT) is a type of psychotherapy used to treat insomnia. I use it in my practice almost daily. Here is an article about a study of CBT vs sleep hygiene education in patients with fibromyalgia. The results showed that sleep hygiene education did improve subjective sleep quality, but that was it. CBT improved several sleep variables, fatigue, daily functioning, pain catastrophizing, anxiety and depression.

Sleep Hygiene Education and College Students

I saw an abstract in the Journal of American College Health where researchers did online surveys of students about their sleep quality and quantity. The students were mostly freshman and many reported problems with sleep that were related to sleep environments that were not conducive to sleep - the room has too much light, too warm, or too noisy. Also, the students had a difficult time winding down before bed and went to bed feeling unprepared for the next day.

The researchers did an educational campaign on campus that included information in the campus newspaper and posters placed in dorms about sleep hygiene. The sleep hygiene tips are the ones commonly presented in other sources of media and include topics like sleep-wake schedule, caffeine, exercise, and sleep environment. The students were then surveyed again and some reported an improvement in sleep quality / quantity after the sleep hygiene educational campaign.

This study does have some limitations (in the way it was carried out) and other studies have not shown that sleep hygiene by itself helps chronic insomnia, but these students were not diagnosed with that disorder. Despite its limitations, this study points out that simple interventions like sleep education can be helpful in improving the sleep habits of college students. And better sleep could improve academic performance.

Sleep and Your Local Paper

There was an article in today's local paper about the importance of sleep and the usual list of tips for dealing with sleep issues - mainly insomnia. The tips are the standard good sleep hygiene practices advocated by the sleep community and regurgitated by every newspaper and magazine that deals with health topics. Most people I meet have heard of these proper sleep practices, but rarely does anyone practice them on a regular basis. Since many of those people I meet are my patients, we usually spend some time discussing the importance of good sleep habits.

One word of caution - studies do not support sleep hygiene measures as stand alone therapy for the treatment of chronic insomnia. However, that does not mean they should be ignored. On the contrary, they should be part of a more comprehensive treatment treatment program.

For a list of good sleep habits, click on the link to the American Academy of Sleep Medicine's Sleep Education page.