Sleepio blog

Do Americans sleep better than the British?

Rosie — Fri, 18 Nov 2011 14:22:49 +0000

This morning Sleepio co-founder Peter Hames was invited back onto BBC World Service for an update on the response to the World Sleep Survey following Tuesday’s World Update. We saw a fantastic reaction to the survey all the way from Afganistan to Zambia, with the greatest number of responses from North America. Although these are not scientifically-selected samples (and therefore we should be wary of generalisations) this has allowed us to make some initial comparisons between the British and American responses so far.

An initial look suggests the Brits who answered the survey are worse sleepers, with an average Sleep Score of 5/10 compared to the North Americans’ 6.5. There were many similarities between samples: both wake up on average twice each night. Both are most often kept awake by the same type of thoughts – worries about the next day or unresolved problems. However, despite sleeping for a similar total length of time each night, the Brits spent an hour longer in bed than the US contingent – suggesting more frustrating lying awake.

How does your sleep compare? Take 5 minutes to complete the World Sleep Survey, get your own tailored Sleep Report designed by Professor Espie, and help us grow the global sleep database!

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ITN Tonight goes “inside insomnia”

Rosie — Thu, 17 Nov 2011 17:15:24 +0000

This evening’s ITN’s Tonight program will be focusing on the “urgent need” to address insomnia, the most common sleep disorder affecting around 10% of the population. The program will explore the varying forms of help which may be offered to those experiencing the problem and the availability of such treatments on the National Health Service across the UK.

Having teamed up with Sleepio expert and director of the University of Glasgow Sleep Centre, Professor Colin Espie, the program will also feature interim results from the Great British Sleep Survey. Over 12,000 people have taken part in the survey so far and the data confirm the terrible impact that poor sleep can have on all aspects of life – from energy to productivity at work to mood to relationships.

Tune in to ITV tonight at 7:30pm to catch ‘Waking Up to Insomnia’ and join in now by taking part in the Great British Sleep Survey for your own tailored sleep report designed by Prof Espie.

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The World Sleep Survey on the BBC World Service

Rosie — Tue, 15 Nov 2011 19:13:13 +0000

This morning Sleepio’s co-founder, Peter Hames, was lucky enough to be invited onto BBC World Service’s ‘World Update’ as a guest, to talk about the World Sleep Survey.

The World Sleep Survey, which aims to be the largest ever survey of the world’s sleep, was launched by Sleepio following the success of the Great British Sleep Survey. In just 5 minutes anyone can complete the survey and get their own free sleep report designed by world sleep expert Professor Colin Espie.

We’ve had a brilliant reaction with visitors from Costa Rica, Israel and Singapore becoming part of the 13,000 people that have completed the survey so far and received their free sleep report. It’s great to see interest in the world’s sleep rising and we hope this trend continues.

Take the World Sleep Survey now for your own free, tailored sleep report, join the Sleepio Community to access expert articles from Professor Espie or visit BBC iPlayer to hear the interview for yourself.

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Sleepio teams up with Channel 4’s Food Hospital

Rosie — Tue, 15 Nov 2011 15:13:39 +0000

Channel 4’s new series, ‘The Food Hospital’ focuses on “using food as medicine” and we are proud to have been involved in the episode dealing with insomnia.

As part of the series, the ‘Big Food Trial’ looks into the possible effects of food on medical conditions with a series of nationwide experiments that the public can get involved in. These will investigate the theory that specific nutrients or food-types may actually have the potential to improve the condition of the nation’s health.

The third episode of the series will investigate the sleep disorder insomnia, and launch a trial comparing the sleep of participants drinking warm milk in the morning and before bed to that of those drinking tart cherry juice over a two week period. See the Channel 4 website if you would like to take part in the insomnia trial or complete the Great British Sleep Survey for an in-depth report on your sleep designed by world sleep expert Professor Espie.

Find out more about the impact food has on your sleep when the episode on insomnia airs on Tuesday 15th November at 8pm on Channel 4, or if you miss that on 4OD.

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Nation’s health at risk due to poor sleep?

Rosie — Mon, 14 Nov 2011 15:48:57 +0000

Last weekend The Observer ran a couple of great articles which we hope will help to further raise the profile of the Nation’s sleep problems and the need for evidence-based solutions. However we wanted to clarify and expand on some of the statistics quoted from the Great British Sleep Survey and Sleepio’s co-founder and world sleep expert, Prof Espie.

During the period of the survey reported, 25% of the respondents were male and 75% female (rather than those percentages being the proportion of each gender who suffered sleep problems). This ‘response bias’ may reflect the documented higher prevalence of (and therefore interest in) sleep problems in women compared to men, or some other factor that differs between men and women (such as type of help-seeking behaviour).

Just over half of the people who completed the survey reported having trouble sleeping – however this is much higher than the prevalence of sleep problems in the general population; the literature suggests that around 10% of the population suffer from insomnia at any one time. This can be accounted for by a ‘response bias’ towards people with sleep problems – in short the hypothesis that you are more likely to respond to a questionnaire about sleep (and find value in a sleep report) if you have a sleep problem yourself.

However this response bias does not affect the comparison between the daytime functioning of normal sleepers with those suffering from a sleep problems; The survey has so far revealed that 77% of poor sleepers asked reported problems concentrating and 63% experienced problems with their mood as a result of their poor sleep.

Final word from Professor Espie:

“Insomnia affects people’s quality of life during the day, not just their sleep at night. Indeed the survey data show significant effects across different aspects of personal functioning. Living with poor sleep and it’s consequences is not only very common, but it is in all likelihood degrading Britain’s health.

This is not a trivial matter. It’s time for the NHS needs to pay attention to the scientific evidence that persistent poor sleep elevates the risk of developing new illnesses. This has been shown in disorders such as diabetes, but also very convincingly in depression.

Of course we also have to consider the evidence that sleeping pills don’t work very well for persistent insomnia and they are only licensed for short courses of prescription. The evidence is that cognitive behavioural therapy (CBT) is very effective and CBT for insomnia really must be provided on the NHS. It is available if you’re anxious or depressed; why would it not be for insomnia? Especially given that insomnia usually predates depression and is such a risk factor door poor mental health.”

Help us collect even more information on the nation’s sleep – take 5 minutes to complete the Great British Sleep Survey.

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Bye bye British Summertime: Why the clocks go back and the effect on your sleep

Rosie — Fri, 04 Nov 2011 16:34:25 +0000

It’s that time of year again – as the nights draw in, like an early Christmas present, we get an extra glorious hour in bed. But what many regard as a welcome lie-in has, once more, provoked heated debate.

The idea behind Daylight Saving Time (DST) (otherwise known as British Summertime) is to make the most of the hours of sunlight during the summer months by advancing the clock by an hour. It was first put into place during World War I and has since been credited with aiding productivity in the evenings, reducing the number of road accidents in the mornings and saving energy, particularly in northern areas.

Almost a century later and the annual shift back to Greenwich Mean Time (GMT) on 30th October has once more caused controversy. Complaints range from the nuisance of having to wind clocks back to the irrelevance of the time shift to the modern work and school days, as well as reported increases in crime. Insurer Aviva, for example, found the highest increase in reported burglaries in Strathclyde, where police saw a rise of 57% during the first week of November 2010, compared with the weekly average for the rest of the year.

As Simon Jenkins, a self-reported ‘dissatisfied sleeper’, asked in an article for The Guardian last month “why does government make things worse by constantly shortening the pleasure or prolonging the pain…keep[ing] the nation in a state of perpetual jet lag?”

Many of those against the changing of the clocks support a shift to Central European Time (CET) throughout the year. This would result in the UK’s clocks being set to GMT+1 in winter and GMT+2 during the summer months, following the example of Russian President Dmitry Medvedev. This year he decided that the country would not be putting their clocks back this year, increasing the amount of daylight they will have in the afternoons.

But what effect does this have on your sleep? When a third of the population at any one time experiences difficulty sleeping, should this time shift be added to the list of factors with the potential to make sleep problems worse?

Our resident sleep expert Dr Kyle’s view is ”Similar to the politics of DST, there also pros and cons in relation to the effects on sleep. Abrupt shifts in clock time mean our internal biological clock also needs to re-synchronise, and this doesn’t happen straight away. It can usually take up to three days for our brains and bodies to adjust to the 1 hour shift, which can alter the quality of our sleep, leaving some of us feeling more tired during the day. On a positive note, however, it has been shown that the number of heart attacks actually decrease in the acute period following the clock change in October, and this has been attributed to the positive effects of increased sleep duration. Again, however, there are drawbacks, the reverse pattern is found when we get an hour’s less sleep in march – heart attacks appear to increase”

Anecdotal reports from the Sleepio Community suggest that some of our members did indeed feel that they slept less easily following the shift whereas others reported no change.

However there may be a light at the end of the summer with news that ministers are considering moving the clocks forward an hour for a three-year trial, maintaining DST throughout the year.

Although we do, of course, support anything which aids good sleep the Sleepio team can’t help revelling in that ‘extra hour’…particularly when it’s spent in bed. Will you miss it when it’s gone?

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Poor Sleep, Poor Health

Rosie — Tue, 06 Sep 2011 07:56:30 +0000

We all know that a night’s poor sleep can leave us feeling less than perky the next day, but now it seems that a bad night may have more serious implications for our general health.

Research published by the American Heart Association suggests that consistently poor sleep may cause significant increases in blood pressure. The findings imply that participants getting the least deep sleep, particularly ‘slow wave sleep’ (SWS), have a 83% greater chance of hypertension than the group getting the most SWS. The smaller the period of time spent in SWS the higher blood pressure rose, leading the researchers to conclude that deprivation of SWS may contribute to unhealthy bloody pressure.

The research focused on men over the age of 65, an age group known to be more likely to suffer from sleep problems, but the researchers are confident that the results will also generalise to women.

Prof Espie says ‘This is yet another high quality research report that adds to the mounting evidence that sleep is associated with every aspect of our health and well-being. As this study shows, even when we are in our retirement years, deep sleep is really important … and not enough places us at risk of hypertension and maybe even heart attack’.

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Reduced sleep duration linked to increased likelihood of future obesity in young children

Dr_Kyle — Fri, 03 Jun 2011 15:40:33 +0000

A recent study published in the prestigious British Medical Journal reports that children who do not get enough sleep have an increased likelihood of becoming overweight and obese.

Many previous cross-sectional and prospective studies have reported that sleeping less is associated with elevations in Body Mass Index (BMI), in both children and adolescents. These reports, however, have several limitations; often not taking into account important confounding factors (like parental size, physical activity, early-life weight etc.) and failing to use objective, reliable measures of both sleep and fat distribution.

Addressing these limitations, researchers from New Zealand assessed 244 children over a four year period – from when they were 3 through to 7 yrs of age. Sleep was assessed with an accelerometer waist-band, for five days, at ages 3, 4, and 5 yrs. BMI and measures of fat distribution (biochemical impedance analysis to gauge fat mass and fat-free mass) were also collected and used as the main outcome variables, being assessed annually between 3 and 7 years of age. It was found that longer sleep duration at ages 3-5 was linked to a reduction in BMI – 0.48 for each hour of sleep – as well as a 61% reduction in the risk of being overweight at age 7. Crucially, this association between sleep duration and BMI reflected changes in fat mass (as compared to fat-free mass, like muscle tissue) and was found after controlling for several factors that are known to influence obesity, such as physical activity, diet and parental variables.

This study provides strong evidence that reduced sleep duration plays a causal role in contributing to future obesity. Although the mechanism(s) behind how sleep loss may have an ‘obesogenic effect’, the authors suggest several possibilities: including alterations to hormones that regulate appetite, which may impact snacking behaviour; and reduced energy expenditure due to sleep-loss induced fatigue. Professor Colin Espie, Clinical & Scientific Director of Sleepio comments ‘this could be an influential piece of research. We already know just how important obesity is in explaining poor health. Now we see that good sleep predicts a healthy weight whereas insufficient sleep risks being overweight. Perhaps if young people see that protecting your sleep is an investment in your body shape and your weight, then they will be more likely to value a good night’s sleep’.

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Email-delivered Cognitive Behavioural Therapy for insomnia effective at improving sleep quality and depression symptoms in college students

Dr_Kyle — Wed, 18 May 2011 22:28:07 +0000

A new study, published online in the Journal of Clinical Sleep Medicine, reports findings from a trial of email-delivered cognitive behavioural therapy (CBT) for poor sleep in college students. The authors focussed on college students since they are known to have erratic sleep schedules and poor sleep quality, which could increase the likelihood of developing chronic insomnia and possibly future depression.

First year-college students from two halls of residence were assigned to either an eight-week programme called ‘Refresh’, or a programme called ‘Breathe’. The ‘Refresh’ programme involved the delivery of email PDF files to participants each week for eight weeks, covering the following main CBT components: education on sleep regulation; time in bed-restriction; relaxation training; mindfulness training; stimulus control strategies; and cognitive techniques. Each week, participants practiced the strategies described in the files. The participants in the ‘Breathe’ group received an intervention that was in equal in length but that, instead of covering sleep, targeted low mood and general stress. Baseline and post-treatment assessments of sleep quality and depression were conducted.

When looking at those reporting poor sleep quality at baseline, it was found that those in the ‘Refresh’ group (n=19) experienced a significantly greater improvement in sleep quality compared with the ‘Breathe’ group (n=15). Intriguingly, it was also found that the sleep-focussed ‘Refresh’ programme produced greater reductions in depressive symptoms compared with the ‘Breathe’ programme (where there was specific emphasis on mood and stress!). It is worth pointing out, however, that those in the ‘Refresh’ group had more severe depression scores at baseline relative to the ‘Breathe’ group, perhaps indicating that regression to the mean (when scores on first measurement are extreme, they tend to be closer to the average on second measurement) could partially explain this finding.

Such work complements other published literature demonstrating that self-help CBT for insomnia can effectively ameliorate core insomnia symptoms. If the depression result can be replicated, showing positive improvement in depressive symptoms through a sleep-focussed intervention, then this study also supports preliminary research demonstrating that improving sleep in depressed patients with insomnia disorder can also help improve the anti-depressant response.

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Insomnia is the most common residual symptom after positive response to anti-depressant medication

Dr_Kyle — Wed, 18 May 2011 22:24:32 +0000

A new study has systematically investigated the frequency and nature of depressive symptoms that remain in individuals with Major Depressive Disorder, despite responding favourably to the anti-depressant, Citalopram. It has been well documented that residual depressive symptoms, even for those who go into remission, increase the likelihood of future relapse. Less is known, however, about the nature of residual symptoms in individuals who respond to anti-depressant therapy (i.e. a 50% reduction in depression severity) but don’t fully remit. Such information could be used to guide interventions targeting specific residual depressive symptoms, at an early stage, to help enhance rates of remission.

Dr. Shawn McClintock, lead author of the study, and colleagues assessed 428 responders to Citalopram treatment (i.e. those showing a 50% decrease in depression symptoms as measured by the Quick Inventory of Depressive Symptomatology questionnaire). Repeat assessments with this questionnaire at 12 weeks were conducted to determine anti-depressant response (‘responders’) and residual symptoms. It was found that the two most common residual symptom domains, rated as moderately severe in nature, were insomnia (75.5% of the sample) and appetite/weight change (20.1%). It was also found that, out of those symptoms rated as mild by responders at follow-up, insomnia (94.6%), sad mood (70.8%), decreased concentration/decision making (69.6%), and psychomotor disturbance (69.9%) were the most common residual symptom domains.

When looking at subtypes of insomnia, it was found that middle-of-the-night insomnia (problems waking up during the night) was the most common complaint of sleep disturbance, and the most common residual depressive symptom in general. The team also assessed depressive symptoms that emerged during Citalopram treatment, and which remained at follow-up. Middle-of-the-night insomnia was the most common symptom which emerged during treatment (in 51.4% of individuals that did not report it at baseline), with decreased general interest being a close second (40%).

This work, published in the May edition of the Journal of Clinical Psychopharmacology, indicates that insomnia is the most frequent, persistent residual depressive symptom, as well as the most common treatment-emergent symptom in those who respond to anti-depressant medication. Professor Colin Espie, Clinical & Scientific Director of Sleepio comments “This is important work, because it emphasises that insomnia is a distressing, persistent and perhaps crucial problem when it comes to treating depression. Insomnia needs to be taken much more seriously than has been done in the past. There is also evidence from other research that people with insomnia are at much greater risk of relapsing back into depression, and that treating insomnia alongside depression may be the most therapeutic approach”’