Sleep Revisited: Does Education Do Anything?

Sleep is a topic we’ve covered in depth before as it relates to hormones, learning, performance, health, rehabilitation, injuries, and fatigue. Bottom line: sleep is extremely important. However, this concept is common sense is it not? If we have covered sleep in such depth previously, why do we still need to address? Well, because we as a species are poor sleepers.

Here at Sparta we recently held our first annual Silicon Valley Health and Performance Summit featuring speakers looking to optimize human performance. We were lucky enough to have sleep expert Dr. Cheri Mah give an excellent presentation on the impact of sleep, body clock, and travel on performance. Dr. Mah has worked with athletes and teams in all major sports and has been putting out a ton of great research around sleep leading to many high performers re-evaluating their sleep needs and habits.

The Badge of Honor

Dr. Mah’s research and resume speaks for itself, but perhaps one of the most important things she has been pushing is a paradigm shift in how high performers need to view sleep. There are countless examples in sport, business, and politics of people taking pride in not sleeping enough.

The detriments of a lack of sleep are well documented: increased risk of injury, fatigue, cortisol levels (stress hormone), depression and anxiety, as well as decreased performance, retention of information, reaction time, immune function, and perceived well-being among many other negative effects.

With all of the information and data in the world showing us that sleep is crucial, the question then becomes how do we make this shift happen?

Knowledge is Power

The fact that sleeping is important seems like common sense. Many people argue that no matter how well educated we are, logistical limitations will continue to hold us hostage to practicing poor sleep habits. The research, however, tells us a different story.

In a recent study (1) with rugby athletes, individuals were able to significantly increase sleep quality, sleep duration, and time in bed following a simple educational intervention on the importance of sleep and sleep hygiene. Not only that, but their hormonal profiles showed a decrease in cortisol levels as well as an improvement in reaction time! These findings have been validated many times elite athletes (2), but (as athletes are also humans) applies to other populations as well. Another study (3) has shown that nurses with clinical insomnia were also able to significantly improve sleep quality and duration following only a 2-hour educational session and a brochure.

Consistency is Key

Simple educational interventions show to have at least an acute effect on improving sleep habits and thus decrease many of the detriments that come from a lack of sleep. It is important to consider the effectiveness of these interventions from a more chronic view point. As we know creating habits often takes much longer than most people think. Here, common sense actually seems to fail us as research has shown that the 30 days most people think it takes to create a habit actually is closer to 66!

Luckily, Caia et al. (4) looked into this question as well, what happens when sleep education interventions stop? The researchers found that while single interventions (and follow ups) can improve (and continue to improve) sleep habits, after about a month these sleep measures return back to baseline levels. That is, improving sleep longitudinally only works when education is consistent.

KISS

One common thread between all of these studies is the simplicity of the education presented to the individuals. Most of these interventions were very brief and basic, discussing the importance of sleep and giving simple tactics for improving sleep hygiene. Though many will look for sleep “hacks” or short cuts, as is usually the case, simplicity works best.

Using the rule of 3’s as we often do, we can break down our education on sleep into three simple categories: quantity, quality, and consistency.

Sleep Habits of High Performers

• Quantity: Are we getting enough sleep? Shoot for 8-10 hours of sleep a night, remembering 8 hours in bed may only equate to 6.5 hours of actual sleep.

• Quality: Are we getting good sleep? This often has to do with the environment and routine. Make your bedroom like a “sleep cave”, so it’s cool and dark. Limit electronics and light. Avoid alcohol.

• Consistency: Are we doing all of the above, consistently? Due to our natural circadian rhythm, our sleep quantity and quality will be much improved if we are consistent. Try to go to sleep and wake up about the same time everyday, ideally we don’t even need to use an alarm clock

Take Home

Sleep is well understood by both the scientific community as well as the layperson to be extremely critical to support health and performance. Because of this common knowledge, many people don’t think it is worth spending time on sleep. The truth is that simple and consistent education tactics work. As is the case more times than not, the simplest solution is often the best.

References

1. Swinbourne, Richard, et al. “The Effects of Sleep Extension on Sleep, Performance, Immunity and Physical Stress in Rugby Players.” Sports 6.2 (2018): 42.

2.O’Donnell, Shannon, and Matthew W. Driller. “Sleep-hygiene education improves sleep indices in elite female athletes.” International journal of exercise science 10.4 (2017): 522.

3.Yazdi, Zohreh, Shabnam Jalilolghadr, and Farid Tootoonchian. “Effect of a Sleep Hygiene Education Program on Sleep Problems in Female Nurses on Shift Work.” Journal of Sleep Sciences 2.1-2 (2018): 28-33.

4.Caia, Johnpaul, et al. “The influence of sleep hygiene education on sleep in professional rugby league athletes.” Sleep Health: Journal of the National Sleep Foundation(2018).