A Sleep Hygiene Intervention With or Without a Well-Being Component Improves Sleep

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To date, studies of sleep quality and psychological distress have been of cross-sectional designs and it remains unclear whether there is a causal relationship between well-being and sleep quality.

A sleep hygiene program during the COVID-19 pandemic associated with improved sleep, according to results of a study presented at the 2022 Annual Meeting of the American Academy of Sleep Medicine and the Sleep Research Society, held from June 4 to 8, 2022, in Charlotte, North Carolina.

Sleep problems have been associated with psychological distress and recent studies have associated psychological well-being with better sleep. To date, however, studies of sleep quality and psychological distress have been of cross-sectional designs and it remains unclear whether there is a causal relationship between well-being and sleep quality.

This study, conducted by investigators at Columbia University, recruited 30 individuals to evaluate whether a 7-week well-being and sleep hygiene intervention had differing effects compared with the sleep hygiene intervention alone. Distress was evaluated using the Perceived Stress Scale (PSS) and Symptom Questionnaire, well-being using the Psychological Well-Being scales, sleep using the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index, and real-world patterns of sleep were recorded in a sleep diary. Poor sleep quality was defined as PSQI >5 and moderate distress as PSS ≥14.

Reduced perceived stress associated with improved sleep quality (β, 0.2; P =.005) and insomnia (β, 0.3; P =.02), lower depression with improved sleep quality (β, 0.2; P =.007), reduced hostility with earlier bedtime (β, 8.8; P =.008), reduced anxiety with improved insomnia (β, 0.6; P =.008) and increased total sleep time (β, -10.1; P =.009), and lower somatization with increased total sleep time (β, -10.3; P =.03).

Changes in well-being did not have an effect on sleep measures.

This pilot study was potentially biased as it was conducted during the COVID-19 pandemic which may have had effects on well-being and sleep patterns.

The study authors concluded, “Our findings suggest that reductions in distress following well-being and sleep hygiene or sleep hygiene alone interventions predict improvements in sleep. […] The association between well-being and sleep should be further delineated to determine the role of well-being in sleep promotion.”

Reference

Benasi G, St-Onge MP. Improving psychological distress for better sleep during the COVID-19 pandemic: Analyses of data from a pilot randomized controlled trial. Presented at SLEEP 2022; June 4-8; Charlotte, North Carolina. Abstract 684.