This shows a clock and a person sleeping.
Insomnia affects between 4 and 22% of adults and is associated with long-term health problems including cardiovascular disease, diabetes and depression. Credit: Neuroscience News

Clock-Watching Worsens Insomnia

Watching the clock while trying to sleep can worsen insomnia and increase need for sleep aids.

Summary: Monitoring time while trying to sleep can exacerbate insomnia and increase the use of sleep aids.

The study involved nearly 5,000 patients from a sleep clinic, and found that the stress of estimating sleep durations significantly impeded the ability to fall asleep. Consequently, the frustration led to a higher likelihood of using sleep aids.

The study suggests a simple behavioral intervention, such as avoiding checking the time, can help alleviate insomnia.

Key Facts:

  1. The act of monitoring time while trying to fall asleep can worsen insomnia symptoms and increase the use of sleep aids.
  2. The study suggests a simple behavioral intervention, such as avoiding checking the time, can help in dealing with insomnia.
  3. Insomnia affects between 4 and 22% of adults and is associated with long-term health problems including cardiovascular disease, diabetes, and depression.

Source: Indiana University

Watching the clock while trying to fall asleep exacerbates insomnia and the use of sleep aids, according to research from an Indiana University professor — and a small change could help people sleep better.

The research, led by Spencer Dawson, clinical assistant professor and associate director of clinical training in the College of Arts and Sciences’ Department of Psychological and Brain Sciences, focuses on a sample of nearly 5,000 patients presenting for care at a sleep clinic.

Insomnia affects between 4 and 22% of adults and is associated with long-term health problems including cardiovascular disease, diabetes and depression.

Credit: Neuroscience News

Participants completed questionnaires about the severity of their insomnia, their use of sleep medication and the time they spent monitoring their own behavior while trying to fall asleep. They were also asked to report any psychiatric diagnoses. Researchers conducted mediation analyses to determine how the factors influenced each other.

“We found time monitoring behavior mainly has an effect on sleep medication use because it exacerbates insomnia symptoms,” Dawson said.

“People are concerned that they’re not getting enough sleep, then they start estimating how long it will take them to fall back asleep and when they have to be up. That is not the sort of activity that’s helpful in facilitating the ability to fall asleep — the more stressed out you are, the harder time you’re going to have falling asleep.”

As the frustration over sleeplessness grows, people are more likely to use sleep aids in an attempt to gain control over their sleep.

The results are published in The Primary Care Companion for CNS Disorders. Additional co-authors are Dr. Barry Krakow, professor of psychiatry and behavioral health in the Mercer University School of Medicine; Patricia Haynes, associate professor in the Mel and Enid Zuckerman School of Public Health at the University of Arizona and Darlynn Rojo-Wissar, a postdoctoral fellow at Alpert Medical School of Brown University.

Dawson said the research indicates a simple behavioral intervention could provide help for those struggling with insomnia. He gives the same advice to every new patient the first time they meet.

“One thing that people could do would be to turn around or cover up their clock, ditch the smart watch, get the phone away so they’re simply not checking the time,” Dawson said. “There’s not any place where watching the clock is particularly helpful.”

With 15 years of of research and clinical experience in the sleep field, Dawson is interested in comparing individuals’ sleeping experiences with what is concurrently happening in their brains. He trains and supervises doctoral students in the Department of Psychological and Brain Science’s Clinical Science Program.

About this sleep research news

Author: Barbara Brosher
Source: Indiana University
Contact: Barbara Brosher – Indiana University
Image: The image is credited to Neuroscience News

Original Research: Open access.
Use of Sleep Aids in Insomnia: The Role of Time Monitoring Behavior” by Spencer Dawson et al. The Primary Care Companion for CNS Disorders


Abstract

Use of Sleep Aids in Insomnia: The Role of Time Monitoring Behavior

Objective: Over-the-counter (OTC) and prescription sleep medications are frequently used as treatments for chronic insomnia, despite risks and limited long-term efficacy. Investigating mechanisms underlying this predilection for pharmacotherapy may uncover strategies to decrease reliance on sleep aids. The objective of this study was to determine how time monitoring behavior (TMB; clock-watching) and associated frustration may interact with insomnia symptoms to drive the use of sleep aids.

Methods: Patients (N = 4,886) presenting for care at a community-based, private sleep medical center between May 2003 and October 2013 completed the Insomnia Severity Index (ISI) and Time Monitoring Behavior-10 (TMB-10) and reported their frequency of sleep medication use (OTC and prescription, separately). Mediation analyses examined how clock-watching and related frustration could be associated with insomnia symptoms and medication use.

Results: The relationship between TMB and sleep medication use was significantly explained by ISI (P < .05), in that TMB (especially related frustration) appears to aggravate insomnia, which in turn leads to sleep aid use. Similarly, but to a lesser extent, the relationship between ISI and sleep medication use was explained by TMB, in that ISI may lead to increased TMB, which may in turn lead to sleep aid use.

Conclusions: TMB and the associated frustration it engenders may perpetuate a negative cycle of insomnia and sleep aid use. Future longitudinal and interventional research is necessary to examine the developmental course of these clinical symptoms and behaviors and to test whether decreasing frustration by limiting TMB reduces the proclivity for pharmacotherapy.

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