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.
HOW COULD WRITING HELP?
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.
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.
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.
- If you know how to fix the problem completely then write that down.
- 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.
- 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
- 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.
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:
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|
|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!
Let’s see if journalling or planning was better for my sleep…
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?
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 =
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.
Dr Damon Ashworth