Does Exercise Improve Sleep Quality?

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 useful exercise is at improving sleep quality. 

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HOW COULD EXERCISE HELP?

Homeostatic Pressure is one of the three primary variables that are responsible for proper 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 some 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 working 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. Rather than trying to stop exercise altogether, what I’ve decided to do is monitor my steps each day using a Misfit Ray activity tracker, and compare the 7 most active days to the 7 least active.

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 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 precisely 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 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.

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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 fewer 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, the 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 than 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 an 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 intake, staying off bright screens in the last two hours before bed, and doing things to wind down before sleep.

Thanks for reading! If you would like a personalised sleep report and the five things that you could do to best improve your sleep, please check out our services.

The Negative Impact of Spending Too Long In Bed

The eighth variable that I will be manipulating across a two week period to examine its impact on sleep is the 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 an excellent 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, higher 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 seeking 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 want 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, while 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 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 woke 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 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.

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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 the 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 bedtime.
  7. Go to bed each night around your to bedtime, 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.

My Top 20 Inspirational Quotes

20. “A Year From Now You Will Wish You Had Started Today.” — Karen Lamb

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19. “Nobody can go back and start a new beginning, but anyone can start today and make a new ending.” – Maria Robinson

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18. “Tell me and I forget. Teach me and I remember. Involve me and I learn.” – Benjamin Franklin

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17. “Instead of condemning people, let’s try to understand them. Let’s try to figure out why they do what they do. That’s a lot more profitable and intriguing than criticism; and it breeds sympathy, tolerance and kindness. ‘To know all is to forgive all.'” Dale Carnegie

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16. “Rules for Happiness: Something to do, Someone to love, Something to hope for.” – Immanuel Kant

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15. “I can’t change the direction of the wind, but I can adjust my sails to always reach my destination.” – Jimmy Dean

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14. “Though philosophers have traditionally been concerned with the pursuit of happiness, far greater wisdom would seem to lie in pursuing ways to be properly and productively unhappy. The stubborn recurrence of misery means that the development of a workable approach to it must surely outstrip the value of any utopian quest for happiness” – Alaine de Botton

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13. “In a chronically leaking boat, energy devoted to changing vessels is more productive than energy devoted to patching leaks.” – Warren Buffett

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12. “Any fool can know. The point is to understand.” – Albert Einstein

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11. “Alone we can do so little; together we can do so much.” – Helen Keller

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10. “The greatest mistake you can make in life is to be continually fearing you will make one.” – Elbert Hubbard

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9. “Find A Group Of People Who Challenge And Inspire You, Spend A Lot Of Time With Them, And It Will Change Your Life.” – Amy Poehler

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8. “It Is Not The Strongest Of The Species That Survive, Nor The Most Intelligent, But The One Most Responsive To Change.” – Charles Darwin

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7. “No act of kindness, no matter how small, is ever wasted.” – Aesop

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6. “The Ultimate Measure Of A Man Is Not Where He Stands In Moments Of Comfort And Convenience, But Where He Stands At Times Of Challenge And Controversy.” – Martin Luther King, Jr.

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5. “Never Believe That A Few Caring People Can’t Change The World. For, Indeed, That’s All Who Ever Have.” – Margaret Mead

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4. “I’ve missed more than 9000 shots in my career. I’ve lost almost 300 games. Twenty-six times I’ve been trusted to take the game winning shot and missed. I’ve failed over and over and over again in my life. And that is why I succeed.” – Michael Jordan

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3. “Be more concerned with your character than your reputation, because your character is what you really are, while your reputation is merely what others think you are!” – John Wooden

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2. “Live your questions now, and perhaps even without knowing it, you will live along some distant day into your answers.” – Rainer Maria Rilke

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1. “Two roads diverged in a wood … I took the one less travelled by, and that has made all the difference.” – Robert Frost

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Dr Damon Ashworth

Clinical Psychologist

Does Regular Meditation Lead to Better Sleep?

The seventh variable that I will be manipulating across a two week period to examine its impact on sleep is meditation. I will see 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 helpful 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, Vipassana meditation aims to help you to tune in to the knowledge and wisdom within (I think). Through meditating up to 15 hours a day while 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 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 terrific 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 intense 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 while 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 sleep onset latency dropped from 24 minutes down to 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.

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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 were 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 smartphone, 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! If you would like a personalised sleep report and the five things that you could do to best improve your sleep, please check out our services.

Can Psychologists and Psychics Read Minds?

phil-coffman-161251.jpgA question that I often get asked when I tell people that I am a Clinical Psychologist is “Are you reading my mind, right now?

The interesting thing about the question is that it really isn’t what psychologists do.

Sure, I can pick up on other people’s emotions much more than I could before I started clinical work. I’ve also become more skilled at reading people’s body language and tone of voice and what this might mean. These skills could help me to be a better poker player, but they definitely don’t make me a psychic.

Do people get a psychologist and a psychic confused?

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I’d like to hope not, but I’m also sure that I’ve never met another psychologist who has claimed to be a mind reader.

Well, maybe some of my friends and I used to during our undergraduate studies, but we weren’t psychologists yet, and we definitely weren’t psychics. Just using some silly tricks that we had read in the book ‘The Game’ by Neil Strauss, an exposé on the pick-up-artist community. When anyone asked us if we could read their minds we would say one of two things:

1. Think of a number between 1 and 10.

Go ahead, think of it.

It turns out that a surprisingly high number of people say 7. Not sure why, but when people guessed this, and we got it right, they confirmed their beliefs that we were mind readers.

2. Imagine you are driving along a road in the desert, and in the distance, you see a cube up ahead on the side of the road. What size is the cube (small, medium, big)? Is the cube opaque (see-through) or solid? What colour is the cube? Now imagine that there is a ladder in relation to this cube. Where is it? 

With each response, an “hmm, interesting” was all that we would say until all questions were answered.

We would then give generic, generally positive responses such as:

  • big cube = extraverted
  • opaque = open and easy to get to know
  • red = passionate
  • ladder on top of cube = high achiever

The funny thing was that people were generally pretty happy with their analysis, and were sufficiently impressed with our mind-reading skills.

The Problem With Horoscopes

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It often perplexes me that horoscopes written in the newspaper claim to apply to the 625 million people in the world that have that star sign. It’s also fascinating to me how many people read them each day and believe in what they say. But maybe that is typical of me as a Sagittarius to be a doubter and an unbeliever. Who knows.

In my year 11 Psychology class, I remember a little experiment that our teacher did with us. To begin with, we were all given a description of our personality based on our horoscope. To provide you with a sense of how accurate it was, I have programmed my website to figure out your character based on your horoscope. Let me know how accurate my description of you is from 0 = poor to 5 = excellent:

  1. You have a need for other people to like and admire you. 
  2. You have a tendency to be critical of yourself. 
  3. You have a great deal of unused capacity which you have not turned to your advantage. 
  4. While you have some personality weaknesses, you are generally able to compensate for them. 
  5. Disciplined and self-controlled outside, you tend to be worrisome and insecure inside. 
  6. At times you have serious doubts as to whether you have made the right decision or done the right thing. 
  7. You prefer a certain amount of change and variety and become dissatisfied when hemmed in by restrictions and limitations. 
  8. You pride yourself as an independent thinker and do not accept others’ statements without satisfactory proof. 
  9. You have found it unwise to be too frank in revealing yourself to others.
  10. At times you are extroverted, affable, sociable, while at other times you are introverted, wary, reserved. 
  11. Some of your aspirations tend to be pretty unrealistic. 
  12. Security is one of your major goals in life.

How accurate was my assessment?

When we were given this description in class, most of us rated it a 4 out of 5. It turns out that we were all given the same explanation regardless of our horoscope, and if you haven’t guessed it yet I have done the same with you.

All of these 12 items are all known as Barnum statements, which Psychologist Bertram Forer first used in his 1948 study to observe this phenomenon. He found that people tend to believe that general and mostly positive personality descriptions apply specifically to them without realising that they could also apply to many others too.

These findings have been duplicated several times since, with most results supporting the initial findings that these statements are rated at about 85% accurate at describing an individual’s personality. Now commonly known as the Forer effect, it is thought to be one of the main reasons why astrology, fortune telling, some personality tests and other forms of supposed mind reading are so popular and perceived as valid.

Well Then Explain To Me How..?

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Whenever I tell people that I doubt these types of things, most believers will come back to me with a testimony, either from one of their experiences or that of a family member or friend. They’ll tell me about a time when someone they saw was able to accurately know or predict something that they believe could not have been possibly known in any other way.

Just because I don’t believe in mind reading or fortune telling or communicating with spirits does not mean that I can know with 100% certainty that they do not exist. If anyone could prove their gifts scientifically, I would be genuinely amazed. I’d even be happy to utilise and recommend their services.

Until I see much scientific proof, however, I recommend this. If a clairvoyant, fortune teller, medium, aura reader or anyone else helps you to feel better or gain more clarity on the path that you would like to take going forward, then that is great. If they cause you to worry more about a horrible fate or not take control or action in your life, then that is not good. Especially if they are charging you a lot of money. If a psychologist is doing the same thing to you, then this would be equally as bad too.

Tricks of the Trade

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It doesn’t matter what field it is. Some people are generally warm, intuitive and empathetic, and genuinely want to help the people that they see. Other people may have less altruistic intentions and motivations for doing what they do.

I just want people to be aware of the various tricks that may be used by certain people to convince others that they have the power to read people’s minds, communicate with spirits, or predict the future.

In ‘The Full Facts book of Cold Reading’, Ian Rowland lists 38 persuasion techniques (including Barnum statements). Known as elements, they are used to extract information from clients, convince them that they know something about their character, about the facts and events of their life, and about the future. Some of my favourites are:

Elements to extract information:

  1. ‘Jargon Blitz’ with a ‘Veiled Question’: Explain the traditional meaning of a tarot card “the five of swords indicates a struggle in the affairs of the heart” then make a statement about the client’s life “I sense your personal goals are taking priority over romance at this time”, followed by “is this making sense to you?” If it is, you’ve got a hit. If not, they give you more information about their lives without realising that a question has been asked.
  2. ‘Vanishing Negative: State a negative question with ambiguous tone and phrasing, such as “you don’t work with kids, do you?“. It can be a hit whether they agree or disagree, as the negative part of the question simply vanishes if they say they do work with kids – “yes, I thought so. A strong affinity with children is indicated…

Elements about character:

  1. ‘Rainbow Ruse’: Credit the client with both a personality trait and its opposite: “sometimes you are very outgoing and confident, even the life of the party when the mood strikes you, and yet there are other times when you can retreat into your shell, preferring to keep quiet or distance yourself from others.” It sounds perceptive, but literally covers the whole scope of the personality trait.
  2. ‘Jacques Statement’: Depending on what stage of life they are at, talk about the usual crises that tend to occur around their age. Rowland shares his one for someone in their mid-thirties to early forties: “if you are honest about it, you often get to wondering about what happened to all those dreams you had when you were younger, and all those wonderful ambitions you once held dear. I suspect that deep down, there is a part of you that sometimes wants to scrap everything, get out of the rut, and start again, but this time do things YOUR way.”

Elements about facts and events:

  1. ‘Fuzzy Fact’: Ask them an apparently factual statement that is quite likely to be accepted initially, and leaves space to become something more specific with additional prompting. This can be related to geography (“I see a connection with Europe, possibly Britain, or it could be the warmer Mediterranean part”), medical (“the gentleman with me now is telling me about a problem around the chest area”), or an event (“There’s an indication here of a career in progress, or in transition. This could be your career, or it could be someone else’s career that affects you”).
  2. ‘Good chance guesses’: Ask a question that has a higher chance of being true than the other person would think, such as “I see a house with the number 2” or “I see a blue car”. If they have lived in a house with a number 2 or owned a blue car at any point in their life, it’s a hit. If not, it could be someone that was close to them or someone that they knew, or even a neighbour, which makes it unlikely to be wrong.
  3. Trivia stat: Most people have a box of old photos around their house that haven’t been sorted, or medical supplies that are years out of date, or a key that is now redundant, or books associated with a hobby or interest that is no longer pursued. Most people will have had a scar on their left knee, been involved in some sort of childhood accident that included water, have an item of clothing in their wardrobe that they can no longer fit into, and tried to learn a musical instrument as a child that they later gave up. Of course, people are not likely to realise how common these traits are, so they are also good chance guesses.

Elements about the future:

  1. ‘Pollyanna Pearls’: State that whatever has been difficult lately is likely to improve: “It’s been a bit of a bumpy ride romantically these last few years for you, but the next year or so will be a lot easier!”
  2. ‘Self-fulfilling Predictions’: When making predictions about mood or personality, these have the added bonus of potentially becoming self-fulfilling: “You will begin to adopt a more confident and optimistic disposition. You will let go of old regrets, and start being more compassionate to yourself and others. You will soon have a greater sense of connection and belonging with others!”
  3. ‘Unverifiable Predictions: These can never be verified either way, so no chance of them being wrong. Here is Rowland’s example again: “Someone you know will harbour a secret grudge against you. They will plan to put obstacles in your way, but you will overcome their plans without even realising it.”

I’ve shared my 10 favourite elements with you, but there are still another 28 in ‘The Full Facts book of Cold Reading’. Check it out if you are interested in learning more about the persuasion techniques that are typically employed in the psychic industry.

Conclusion

jonathan-simcoe-88013Some people may be able to convince you that they can read your mind. But from my experience in life so far, I have never come across any substantial scientific evidence that suggests that this is the case.

The truth is that to understand and help people, I generally have to rely on how they present in session with me, as well as what they say to me and how they say it. Communication with their partner, family members, friends or other treating doctors can also help at times too (if the client consents to this).

If you are going to see a psychologist, please do not assume that they can read your mind. If you’d like to speak about something, make sure that you say it. Especially if the session isn’t going in the way that you want it to, if you are uncomfortable, or if the treatment isn’t as helpful as you’d like it to be.

I have no doubt that a client could successfully withhold or deceive me if they wanted to, but all this would do is create a barrier in the therapeutic relationship that would then prevent me from being able to help them in the best way possible.

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A lot of people assume that others should know precisely what they need and how to give it to them. But if both psychologists and psychics can’t even read your mind, then it is unlikely that someone else will be able to either. The reality is that it is okay to ask for what you need and to teach others to support you in the ways that you find most helpful.

 

Dr Damon Ashworth

Clinical Psychologist

 

 

Can You Sleep Better By Changing What You Eat and When You Eat?

The sixth variable that I will be manipulating across a two week period to examine its impact on sleep is food. I will see 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 others maybe.

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 somewhat confusing.

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

  • whole grain bread
  • 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 higher 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 dinner or a snack before bed that was considered potentially harmful to sleep. This included:

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

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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 Sunday night,
  • Peanut butter on toast with honey on Monday night, and
  • Oats with mixed berries and milk on 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 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 lousy meal too, and my sleep quality was rated as precisely 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 lousy food than the excellent food, but that is hardly enough of an improvement to focus too much on what I eat before sleep if I want 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 quicker and stay asleep longer.

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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 weaker 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 real 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, 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 more significant 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 essential 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 poorly 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! If you would like a personalised sleep report and the five things that you could do to best improve your sleep, please check out our services.

The Importance of Winding Down Before Sleep

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 merely 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 beautiful way to end my work day with a brisk walk and lovely scenery, but the thing that always amazed me was the number 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 are 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

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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!

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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 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 bedtime, 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 long 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 was 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

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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 has 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! If you would like a personalised sleep report and the five things that you could do to best improve your sleep, please check out our services.

6 Thinking Traps That We All Fall Into

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Snow in Las Vegas – I never thought that could happen! But it did, in December 2008, when this photo was taken. Luckily an American friend warned me how cold it could get in the winter. Otherwise I would have expected it to be hot, just like the other two times that I had previously been there. It is a desert after all, and I had to drive through Death Valley, the hottest place on the planet, in order to get there each time. My past experiences had negatively impacted my ability to predict what the weather would be like in winter.

But why was this so?

Have you ever wondered why past experiences can damage judgment?

or

Why you should never accept a “free” drink?

Why we prefer a wrong map to no map at all?

Why you should forget the past when making a decision?

Why less is sometimes more?

and

Why a lame excuse is better than none?

‘The Art of Thinking Clearly’ by Rolf Dobelli answers all of these questions and more. He lists 99 cognitive biases, or thinking errors, that research has shown that the majority of us get trapped by. Each chapter is only 3-4 pages in length, and introduces a cognitive bias, gives an example of what it is, and gives some advice for how we can avoid these errors. It has sold over a Million copies, and is extremely popular in Europe. I would highly recommend it for anyone who wants to be as effective as possible at work and as happy as possible outside of it.

Here are the answers to the above questions:

1. Association Bias

As well as me expecting Las Vegas to always be hot, our past experiences can also affect our judgment through the development of superstitions. Let’s imagine that I’ve played an excellent game of Basketball. My mind may reflect on the game afterwards, and think about what it was that led to me playing so well. Even though it is unlikely to be a particular cause, I could attribute it to the bowl of pasta that I ate for lunch, or that I had the orange and not the red Powerade during the game, or that I wore my special socks that were just the right level of thickness and comfort. I then try to do these same things again the next game in precisely the same way, but I don’t play as well. Instead of breaking this association then and there, my mind is more likely to look for other reasons why I didn’t play so well, and try to avoid these things too for the next game. Pretty soon, if I’m not careful, I have 20 things that I must do to play well, and I’m still not playing any better because I’m stressed out about having all of the things go “just right”. In reality, the thing that may have allowed me to play well in the first place was that I was relaxed and engaged fully in what I was doing, without having to do anything except for play the game.

I see the same issue in individuals with insomnia, who “can’t sleep” unless they have their eye mask on and earplugs in, even though they aren’t sleeping well anyway, and they used to sleep well without these rituals in the past.

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The association bias was first discovered by the Russian Scientist Ivan Pavlov with his work on classical conditioning. He was studying the digestive system of dogs, and he realised that the dogs were able to quickly associate two previously unrelated things (bell = food) if they occurred in close enough proximity to each other. While responding to a bell that signals dinner time is helpful because the dog is better able to eat and digest their food, it may be less useful if they became hungry and started salivating each time they heard the bells of a local church. This can be applied to humans too. Not eating a poisonous berry that has previously led an individual to be sick would increase their likelihood of survival, but not being able to enjoy any berries and the antioxidant properties inherent in these may actually reduce their health over time.

The reality is that there are a lot of things in this world that are out of our control, and that sometimes things just come down to luck. Our mind doesn’t like to think this, however, and tries to develop an illusion of control by assuming that things that are merely correlated are actually causally related to each other. Just because carbon emissions and obesity have both increased since the 1950s doesn’t mean that increased carbon emissions lead to an increased risk of obesity. Many other factors are likely to explain our generally expanding waistlines much more efficiently.

The solution is to realise what is in your control and read up on what research has shown to be helpful for whatever it is that you are trying to do. Focus on what you can influence, and accept whatever you can’t. Carbohydrate loading before a big game or race could be helpful, as could electrolytes when dehydrated. It’s unlikely that the colour of the Powerade or the socks had anything to do with how well I played, however.

Don’t let one experience influence how you react to all similar situations in the future. Build up a bigger sample size of experiences before deciding if the two things that your mind is trying to create an association between are actually helpful for you to maintain. If 10 minutes of mindfulness consistently leads to a better quality of sleep for two weeks in a row, it is worth keeping up. If not, let it go, and see what else can help.

2. Reciprocity

I remember a few summers ago stopping off at a winery to do a “free wine tasting” with my brother and father on the way to a hike. Fortunately, I don’t enjoy drinking wine and declined, buying some food and a drink from the cafe instead. My brother and father participated however, and both walked out with at least two bottles of wine each from the cellar door, at what I thought was a fairly hefty price for a winery that I had never heard of.

Robert Cialdini, a Psychologist, has studied reciprocity, and has found that people struggle to be in another person’s debt. Where possible, they will naturally feel the urge to try to repay the favour, so that things seem equal or balanced again. Whilst this can lead to a collaborative and co-operative society, some people know about the pull of reciprocity all too well, including Kevin Spacey’s character in the ‘House of Cards’ TV show, and will use it to their advantage to get what they want when they want it. A lot of pharmaceutical companies used to go to extreme lengths (and may still try at times) to get doctors to use their products with patients, ranging from giving them pens or a nice bottle of alcohol to sponsoring conferences and all-inclusive weekends away at a lovely beach resort somewhere in the Caribbean. Even those Timeshare nights where you get a “free dinner” may not sound like such a good idea if you understand our natural urge to repay the debt to someone who gives us something for free.

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The solution is to think twice before saying yes to something if you really don’t want what is being offered.

3. Availability Bias

Imagine this scenario:

Your 9-year-old child comes to you and asks if they can go to the house of either of their two friends on the weekend – one family has guns in the house, and the other family has a swimming pool.

Which house would you feel safer letting your child go over to?

If you said the family with the swimming pool, you would be wrong, but I don’t blame you for thinking it. It is an availability bias, where what comes to your mind most easily is confused with what is right. We assume that guns are more dangerous than swimming pools, but don’t realise that guns are often locked away in a safe and secure spot in the house, whereas kids can drown very quickly in a swimming pool if they are left unattended, even briefly. In the US, as pointed out in a Steven Levitt article, one child under 10 drowns annually for every 11,000 pools, whereas only one child under 10 is killed by a gun for every one million guns. So swimming pools are almost 100 times more likely to kill children under 10 than guns. When we think of pools, we don’t think of them as a death trap typically, but instead think of summer and fun with family and friends.

brooklyn-morgan-390.jpgWe are much more likely to think of the risk of death and severe injury when thinking about guns. Our risk map is therefore often wrong, replacing what is right with what information comes to our mind the easiest. We tend to overestimate the risk of dying from a plane crash or by murder and underestimate the health risks associated with smoking, binge drinking, an unhealthy diet and inactivity.

The solution is to look at the statistics, and to spend time with people who think differently than you. We need external sources to understand that what is most available to us isn’t always what’s true.

4. Sunk Cost Fallacy

This problem was posed to me when I was learning about this phenomenon at University:

Let’s imagine that you have booked an upcoming holiday for yourself, and have already put down a non-refundable $500 deposit towards this trip. You still have $400 to pay. You are looking forward to this trip, but wished that you were going with some friends, as you usually don’t enjoy solo trips as much.

You speak to your friends who say that they have already booked a trip for the same week. It’s at not as lovely a place, but it will only cost you $400 a week, and you really do prefer going on a trip with friends than by yourself.

What do you do?

The sunk cost fallacy occurs when people let their past investments, whether it is time, money or emotions, influence their decision about what they should do going forward. Both trips are only going to cost you $400 from this point onwards, so the $500 that you have already spent shouldn’t factor into it. The only logical thing to do is to take the holiday that you are likely to enjoy more. I hate to waste money, so I probably would decide to say no to my friends, and try to enjoy the holiday by myself as much as possible, or see if I could get another friend to come along. This doesn’t make it the right choice, however.

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So how does this play out in your life? Should you stay in a uni course or job or relationship because of how far you have already come, even if it is quite evident that it is no longer the right choice for you and that another option would lead to higher happiness? It’s a tricky question again because we are horrible at being able to predict what will make us happy in the future, as highlighted in the book ‘Stumbling on Happiness’ by Dan Gilbert.

The solution is to use a surrogate, and find out how happy people are that have just done or are currently doing what you would like to do. If it’s a holiday, movie, show, or restaurant, check out the reviews. If everyone else likes it, there is a good chance you will too, so go for it. And if you don’t, don’t feel that you have to see it through to the end just because you have started it. Close the book you aren’t enjoying, turn off the movie, or quit the course, providing that you think there is a better option that will allow you to achieve your long-term goals. Be brave, forget the past, and do what is likely to serve you best going forward.

5. The Paradox of Choice

Ever noticed how the more of something there is, the harder it is to choose. It is the problem with online dating, cable television, potential career options, choosing what to eat for dinner, and where to go on a holiday. The more decisions we have to make, the more fatigued we become, but everywhere that we turn these days there seems to be constant need for exactly this. We used to just be able to order a coffee, but now it has to be a tall (or another size), skinny (or no milk, 1%, 2% or full cream) soy (or almond or regular cow’s milk) decaf (or caffeinated weakly, normally or extra strong) caramel (or no sugar, raw sugar, stevia, white sugar or other flavours) macchiato (or espresso, latte, flat white or cappuccino) without the cream on top (or with cream, foam or powered chocolate). No wonder people sometimes become nostalgic for a time when there were less choices and things just seemed to be easier.

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In his book ‘The Paradox of Choice’, Barry Schwartz, a Psychologist, talks about an experiment that was done at a supermarket where they offered 24 different samples of jelly to customers on day one, and only 6 different samples of jelly on day two. Which day led to more jelly being sold? Day two, by ten times the amount. Too many options led to indecision and paralysis, and most left without getting any jelly. By providing fewer choices, it became easier to choose which one they liked the best, and they bought it. So while we may always think that more potential partners, channels, dinner options, and holiday brochures equal a better final decision and outcome, this isn’t always the case. Large selections often lead to more unfortunate choices and greater discontent after a decision has been made.

The solution is to think carefully about what you want before you decide to search through the options. If you know you want to watch a recent, Australian Horror Movie set in the outback; suddenly your search is likely to be more specific with a higher likelihood of a more favourable outcome (for your watching enjoyment, not for the characters in the movie). Then once you have made your decision, stick to it, at least for a set period of time before reviewing the situation and deciding once again. Another research study found that people were actually happier with their decision when they were unable to take it back than when they were able to change their mind whenever they felt like it in the future.

6. ‘Because’ Justification

This one is great, because it just doesn’t seem like it would work, but it really does. In the 1970s, Ellen Langer, a Psychologist, did an experiment in a Harvard library where she asked to cut to the front of the line at a photocopier.

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In the first scenario, she asked “Excuse me, I have five pages. May I use the photocopier?” 60 percent of respondents agreed to it.

In the second scenario, she asked “Excuse me, I have five pages. May I use the photocopier because I’m in a rush?” 94 percent of respondents agreed to it.

In the third scenario, she asked “Excuse me, I have five pages. May I go before you because I have to make some copies?” 93 percent of respondents agreed to it.

Notice how the third scenario is asking the exact same thing as the first scenario, with no other reason apart from needing to make copies being provided, which would be the same as anyone else in the queue at the photocopier. Yet because the word ‘because’ is used, 33 percent more of the respondents agree to it. This was only 1 percent less than for those in a rush, a seemingly much better excuse, and one that you would expect people to allow more if they weren’t in a big hurry themselves.

The solution is, therefore, to justify your reason whenever you want to do something or get away with something, even if the idea isn’t convincing or logical. It may give you that extension that you really need on the assignment because you preferred to go to the party on the weekend or get you out of the speeding ticket because it was more fun to go fast. I dare you to try it next time, because it very well may work. Just remember to include the word because.

There are plenty more thinking errors that the majority of us succumb to from time to time or all the time. I am sure that I will touch on these more when talking about Cognitive Behavioural Therapy in more detail. Until then, check out ‘The Art of Thinking Clearly’, ‘Thinking Fast and Slow’ by Daniel Kahneman, or ‘Predictably Irritational’ by Dan Ariely if you are interested in learning more.

Once we realise that we are not as rational and in control of our actions as it seems, I think that it becomes a lot easier to be compassionate towards ourselves after we fall into the same trap for the 100th time. The key is to identify once you have fallen into the trap and learn the steps and the skills that you need to get yourself out.

Dr Damon Ashworth

Clinical Psychologist

Does Wearing Blue-Light Blocking Glasses Before Bed Improve Sleep?

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

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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.

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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 for people who don’t need reading glasses, and the second picture is of lenses 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, the 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:

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Blue light is present in white or natural light, as shown in red and yellow in the chart 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 the next night).

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Unfortunately, blue light is also highly prevalent in LED screens including televisions, computers, tablets and smartphones. 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 going to 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 were 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, the time taken to fall asleep, the 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.

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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 Friday and 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.

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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 a 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 smartphone 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 a 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! If you would like a personalised sleep report and the five things that you could do to best improve your sleep, please check out our services.

Trauma – What is it and what can we do about it?

A Traumatic Experience?

It was a Saturday night when I was 16 years old. I had a couple of my basketball friends stay over, and we decided to venture out around 10:30pm to meet up with some other friends a few streets away.

I grew up in what I felt was a safe neighbourhood in the North-East suburbs of Melbourne, and had been out plenty of times this late at night with my brother to go and get some food.

We didn’t think that we would be out long, so I didn’t tell my parents where we were going. We crept out the back door and meandered down the road.

When we reached the bottom of the street a shiny silver sedan with blue underlighting pulled up, and a group of older teenagers asked us if we knew of any parties in the area. We said that we didn’t, and kept walking, thinking that they were friendly enough.

They slowly started reversing the car with us as we continued down the street and said: “What do you guys think of the car?”

My taller friend, impressed with the blue lighting, replied: “Yeah, pretty sweet!”

“Do you want it?” the other guy continued.

“Wouldn’t mind a car like that,” my friend replied.

Suddenly the mood changed.

“How about this…” the guy stated, as the ignition was turned off and he and his four mates climbed out of the car. “You three versus us five, you beat us, and you can have it!”

Two of them began smacking extended cylindrical objects that looked like trolley bars into their hands as they approached us.

“We don’t want any trouble, and we definitely don’t want to fight you!” I interjected, speaking up for the first time as I tried to de-escalate the situation. “My friend was just trying to give you guys a compliment!”

That was the last thing that I remember saying before I felt my head jolt back with a thud from the force of a fist that connected with my nose and mouth. I didn’t even see it coming.

My two friends backpedalled, turned, and started to sprint back up the hill towards my house as soon as I was hit. Blood began gushing from my nose. Before the five guys could get another punch in, I ran with my friends, flew over the fence into my backyard and straight back inside where we locked the door, gasping for air while my heart beat out of my chest.

I was scared, but also relieved, because it could have been a lot worse. The bleeding eventually slowed down, and luckily my nose didn’t seem broken, and my teeth were still intact. I was sore for the next few days with a delicate nose and cut and swollen lips, but within a week, my physical appearance was back to normal.

Psychologically, I wasn’t quite the same after the incident. I was irritable and more emotional. I kept getting flashbacks of the event intruding into my mind during the day, and couldn’t believe that something like this could have happened to me in my neighbourhood. I had nightmares in the month after the incident of being jumped, attacked or chased by a group of guys in the dark.

I was annoyed that my friends hadn’t tried to back me up but understood why running was the smarter decision given the circumstances. I was also furious that the police said that there was nothing that could be done about it without any further identifying information. It didn’t seem fair, and the world no longer seemed safe, especially if I was walking at night, and especially if a car came past.

As the months went by things settled a lot more, and I was back to feeling pretty good during the day and sleeping well at night. Some lingering symptoms persisted for a while that I can now see were a direct result of this physical assault. The main ones were an elevated startle response, or being “jumpy” in response to sudden movements or loud noises and a greater sense of hypervigilance and being “on guard” when I was out at night. I also had the annoying habit of diving behind bushes or hiding behind trees whenever I saw headlights or heard a car approaching at night.

I had no idea why I did these things initially, and would even say that I was joking to my friends when I ran for cover whenever a car came by. But I still did it, and deep down feared that the same event would happen again, with an even worse outcome this time.

It was only after I started to study Psychology at university, and particularly trauma that I was able to make sense of my reactions in the aftermath of this event. I was then able to research and understand how to overcome trauma and challenged myself so that the physical assault impacted me less over time.

Through sharing this experience, I am hoping that those who have been through any traumatic experiences might be able to identify with these symptoms and experiment with the strategies that I have personally found helpful, so that they may too get long-term relief from the trauma that they have suffered.

What is Trauma?

The Diagnostic and Statistical Manual for Mental Disorders (DSM-V) describes a traumatic experience as exposure to an event that involves death, serious injury (actual or threatened), or sexual violence (actual or threatened). It usually creates intense feelings of helplessness, horror, or fear in the individual. It is mostly direct exposure to an event that causes trauma, but can also be caused by witnessing an incident that happened to someone else. Other forms of trauma include indirect exposure by hearing about a close friend or family member being exposed to trauma, or through extreme or repeated exposure to aversive details of an event, typically through professional duties, such as first responders to a fatal crash site, or repeated exposure to information of child abuse.

Trauma can create long-standing changes in the brain. Imaging studies have shown heightened brain-stem activity, which controls the fight-or-flight (or freeze) system. This is the brain’s inbuilt survival mechanism. Imaging studies also show increased amygdala activation, which floods the body with feelings of fear. Both of these changes can be quite effective in keeping people safe in times of imminent danger because they allow individuals to scan the environment and react quickly to anything that is perceived to be dangerous.

The problem is that once these areas of the brain become overreactive, they will respond to anything that is potentially similar to a traumatic experience from the past, without first trying to accurately assess the actual level of threat. This makes it more difficult to respond in a calm, rational manner in an individual’s everyday life.

The hippocampus, an area of the brain that is responsible for memory, can also be severely affected by traumatic events. The more extreme, unexpected and inconsistent an event is with previously held beliefs about themselves, the world or other people, the harder it is for the brain to fully process and integrate this experience. Some of it remains unprocessed or “stuck”, which then reduces the capacity to move on from the traumatic event and process and integrate subsequent information that is taken in by the senses.

Re-experiencing symptoms, such as flashbacks and nightmares, are thought to be the brain’s attempt to correctly process and integrate the traumatic experience. As scary as this can be, it generally does help in healing and resolving trauma symptoms over time. Unfortunately, with Post-traumatic stress disorder (PTSD), the brain continues to be unable to fully process and integrate what has taken place. This can lead to devastating consequences and severe functional impairment for the individual that is suffering from the condition, especially if they don’t understand the symptoms or what to do with them when they occur.

How to Best Respond to Each Cluster of Trauma Symptoms:

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There are four clusters of symptoms that indicate that a person is suffering from an acute stress reaction in the first month after exposure to a traumatic event or a post-traumatic stress reaction after a month. Even if you do not have all of these symptoms, it can still be helpful to know what is occurring at the time when you do experience these symptoms after trauma and what you can do about it.

A: Intrusion symptoms – This includes intrusive memories, traumatic nightmares, dissociative reactions, such as flashbacks, and marked physiological reactivity and intense or prolonged distress after exposure to trauma-related stimuli or reminders.

When these intrusive symptoms occur, our brain rushes back to the past and starts to think and feel the same way that it did when the traumatic event was taking place. The mind feels that it is in imminent danger, and the initial feelings of intense helplessness, horror or fear come rushing back in.

What I have found to be most effective when this occurs is a process called grounding, as it helps me reconnect with my senses at the moment, and brings my brain back from the past to the present.

Next time an intrusive symptom occurs, ask yourself the following:

  1. What are five things that I can see right now?
  2. What are four things that I can touch/feel right now?
  3. What are three things that I can hear right now?
  4. What are two things that I can smell right now?
  5. What is one thing that I can taste right now?

Once you are reconnected with the present, ask yourself “Am I safe right now?” If you are in danger, remove yourself from the situation. If not, then you are not at risk of harm and instead need to focus on reducing your distress and physiologic reactivity through self-soothing activities.

The more that these activities can engage you and your senses at the moment, the better, as it will help you to continue to feel present and safe. Grounding must occur first though, or the brain will want to stay in a hypervigilant state to protect you from the perceived threat, even if the danger is only a memory in your head.

B: Avoidance – Persistent avoidance of distressing external (people, places, conversations, activities, objects or situations) and/or internal (thoughts or feelings) reminders of the trauma

Avoidance of any reminders of the trauma in the first month after the incident is actually a good thing, as it can lower your arousal levels and reactivity, assisting your recovery.

Ongoing avoidance of these reminders, particularly after month, is not recommended, however, and may prevent a full recovery. Chronic avoidance prevents processing and integration of the traumatic event and sometimes means that people begin to avoid more and more things that may seem dangerous when they are logically quite safe.

Gradual exposure to the things that you fear (as long as they are relatively safe) is essential in the treatment of any anxiety disorder, including PTSD. I have gone through the steps of how to do this in my first article titled “Feel the Fear and Do It Anyway”. I personally followed these steps to challenge myself to get outside at night more and stop hiding when cars came past. It did get more comfortable with each time as I realised that my fear of being attacked was much higher than the actual probability of it occurring (it’s never happened again).

Also, remember that we cannot entirely run away from our thoughts and feelings. Acceptance and Commitment Therapy teaches Defusion and Expansion skills to help us better manage our thoughts and emotions. Research shows that these are more effective long-term strategies than continually avoiding internal reminders of trauma through drugs and alcohol, emotional eating, meaningless distractions or by keeping busy all the time (which only tires you out further and makes you more likely to feel out of control and react emotionally).

C: Negative alterations in cognitions and mood –  including inability to recall key components of the trauma, persistent and distorted negative beliefs and expectations about oneself, others or the world, or blame of self or others for causing the traumatic event or its consequences, persistent negative emotions, including anger, fear, horror, impending doom, guilt and shame, diminished ability to experience positive emotions, as well as loss of interest and engagement in previously important activities, and feeling isolated, alienated, detached or estranged from others. 

Exposure-based treatments, particularly cognitive processing therapy is essential for addressing the extreme shifts in cognition and beliefs that can take place after trauma, particularly if they are preventing you from doing the things that you used to enjoy.

If you are feeling detached or physically or emotionally numb, movement can help a lot. It doesn’t matter what type of movement, but if you enjoy it that’s an added bonus. The next time you feel this way, go for a walk or run, stretch or try yoga, play a sport or even twist and dance. They all may help to bring you back into your body more and feel a bit less distant and more connected.

Writing about how your beliefs and feelings have changed or explaining these changes to a friend that you can trust can help you feel more connected and better in time, but should be done in collaboration with a therapist if you are concerned about how you may react.

If I ever felt disconnected, which happened occasionally, I found any movement to be the best strategy to reconnect. This could be playing sport, doing yoga or Pilates, weight lifting, walking or running outside, or even dancing. Anything that helps you get out of your head and into your body or the world around you (as long as it is safe).

D: Alterations in arousal and reactivity – trouble falling asleep or staying asleep, difficulty concentrating, feeling jumpy or easily startled, and being super alert or watchful. 

Learning emotional regulation and distress tolerance skills are both critical to managing arousal levels, which then diminishes reactivity.

Emotional regulation skills include adequate rest, recovery, leisure and socialising, or ensuring that things are in the right balance. Too much work and stress without sufficient breaks will slowly increase our arousal levels over time. Ensuring that we minimise caffeine and alcohol intake, eat a healthy well-balanced diet and get a consistent 7 hours of sleep each night also help us to lower our arousal levels and better regulate our emotions.

Distress tolerance skills include relaxation and mindfulness skills, as well as a distraction at times. By practising these on a regular basis when you are feeling calmer, it then becomes easier to implement them when you are most distressed so that things do not become too overwhelming for too long and you are able to not panic and calm yourself down.

Diagnosis of PTSD and Recommended Treatments

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All four symptom clusters must be present to a significant degree and cause significant distress or functional impairment to warrant a diagnosis of PTSD.

If you are concerned that you may be suffering from PTSD from a trauma that you experienced more than a month ago, please complete the Post-traumatic Checklist for the DSM-V (PCL-5) questionnaire, which can be accessed for free online. If you score above 38 on this checklist, I encourage you to visit your GP or primary care physician to discuss the matter further and collaboratively decide on which treatment path you would like to go down.

Sometimes a referral to a Psychologist and/or Psychiatrist will be important to give you the best chance of making a full recovery.

It is important to realise that the most effective psychological therapies for trauma all include some element of exposure (imaginal and/or in vivo) to the traumatic experience. This could be though trauma-focused cognitive behavioural therapy (CBT), Cognitive Processing Therapy (CPT), or Eye Movement Desensitisation and Reprocessing (EMDR) Therapy. All are considered first-line approaches for treating PTSD in Australia (NHMRC, 2007), and should be recommended before pharmacological interventions, or alongside antidepressants (SSRIs) if sufficient benefits are yet to have been obtained through psychotherapy alone.

Even 8-12 sessions of 60-90 minutes of therapy are usually sufficient in treating PTSD. Any co-morbid issues can then be addressed in further treatment once the PTSD symptoms have subsided.

Traumatic events can change the brain and the way that we respond to situations afterwards. Often the brain can heal itself over time, especially if we are engaging in the right strategies. If it doesn’t, useful psychological help is available, and it can make a big difference in helping you to heal and grow.

You can also check out my new podcast discussing the main symptoms of PTSD and how they can be managed.

Dr Damon Ashworth

Clinical Psychologist