People with insomnia are more likely to exacerbate or perpetuate their sleep problem by drinking alcohol to help induce sleep, smoking close to bedtime, and by “sleeping in” late in the morning, according to a study in the May 1 issue of the journal Sleep.
Results of the study show that people with insomnia do more social drinking than controls, consume alcohol more often within 30 minutes of bedtime, and 29 percent of them use alcohol to try to induce sleep.
They also regularly smoke more than controls, and among regular smokers, 45.3 percent of them smoke within five minutes of bedtime. Furthermore, people with insomnia are more likely to report “sleeping in” on days when they do not have to work, with 42.7 percent of them following this pattern.
Correcting these behaviors is a part of good sleep hygiene, which consists of practices based on an understanding of the processes of sleep that have been identified to promote quality sleep, according to background information in the article.
Most insomnia treatment programs involve overall sleep hygiene as one component of a multi-tiered approach. But little data exists that evaluates specific sleep hygiene behaviors in people with insomnia.
Catherine D. Jefferson, BS, of the Henry Ford Hospital Sleep Disorders and Research Center in Detroit, Michigan, and colleagues set out to determine if a few targeted behaviors that could potentially exacerbate or perpetuate an existing sleep disturbance are differentially practiced in people with insomnia as compared to normal sleepers.
“Good sleep hygiene practices should be an inherent part of everybody's sleep-wake function, similar to good nutrition,” says Ms. Jefferson. “These data show that it is a wise investment of clinical time to question insomniacs as to their sleep practices, as it will reveal areas where interventions can lead to better therapeutic outcome.”
While the results also show that the number of hours spent in bed do not differ between people with insomnia and a control group, those with insomnia have an average total sleep time of 5.9 hours per night that is an hour less than the controls. In contrast to drinking and smoking behaviors, the members of both the insomnia and control study groups drink a similar number of caffeine drinks per day.
The authors caution that their results do not clarify the cause and effect relationship between these behaviors and disturbed sleep. The study does not show the extent to which these behaviors cause the primary sleep disturbance, or if these practices result from attempts to cope with a sleep problem.
The authors suggest that more research is needed to see if behavioral therapy that alters these targeted behaviors improves the sleep of people with insomnia.
This population-based study is drawn from 3,283 phone interviews conducted in the Detroit tri-county area by random-digit dialing techniques. From those interviews, a representative sample of 516 individuals was selected for comparison.
A total of 258 individuals selected for the study group responded that they had experienced severe insomnia over the past three months. A group of 258 respondents without insomnia were matched to the study subjects by age and sex as a control group. All participants were between 18 and 65 years of age.
This study was supported by a grant from the National Institute of Mental Health.
Sleep is the official journal of the Associated Professional Sleep Societies, LLC, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society. Go online to www.journalsleep.org for more information.