Improving Sleep Quality - SMART Goals, Strategy & Justification

Background

As part of the blogging assignment for PSYC1024, the positive change I will be implementing is reducing sleepiness during the day by improving quality and duration of sleep. As a result of beginning full-time work, I have found that it has been difficult to achieve quality sleep and sufficient sleep. I am quite tired during the day and have become reliant on coffee during the mornings to keep myself awake.

S.M.A.R.T Goals

• Specific:

My goal is to reduce sleepiness throughout the day by increasing my sleep quality and sleep duration by at least 30 minutes by implementing a sleep extension intervention over 4 weeks in combination with a sleep hygiene checklist. 

• Measurable:

Sleep quality and duration will be recorded in the sleep diary and supported by results of a sleep cycle app called 'Sleep Cycle Alarm Clock'.  Sleep hygiene rule check list as described by Evan et al. (2012) to ensure I am following the sleep hygiene rules. Lastly, day time sleepiness will be measured by Epworth Sleepiness Scale (ESS) by Johns (1991).

• Achievable: 

I would like to achieve an increase in sleep duration of 30 minutes by the end of the 4 week sleep extension intervention. This will be challenging as I have found it extremely difficult for me to fall asleep when I do go to bed earlier than usual. My current sleep schedule has been ineffective and additionally, I have found that its been quite difficult for me to obtain quality sleep. Because of this, I think it is fitting to implement sleep extension in combination with sleep hygiene to increase my sleep quality and duration, thus in turn achieving less sleepiness throughout the day. This goal is difficult as I will have to keep in mind various rules aligned with sleep hygiene throughout the day to ensure that I am able to achieve quality sleep, e.g. no caffeine intake. Therefore, it impacts more than just my bedtime routine. 

• Realistic:

By extending the initial intervention described by Dewald-Kaufmann et al. of 3 weeks to 4 weeks, the goal of achieving a 30 minute increase in sleep duration is realistic. This will in turn decrease day time sleepiness. Given my current circumstance, I will need make changes in my day time routine to ensure that I give myself extra time before my current bedtime to commence lights off/sleep extension. I will need to move my school and other life commitments to the weekend and ensure I am home at a reasonable time throughout the week. This is realistic as my work hours are during the day and I do not work on the weekends. 

• Time:

Sleep hygiene rules contain certain things that I will need to keep in mind throughout the day. However,  many of the rules apply specifically 3 hours before bedtime. I will also need 5 minutes to complete my sleep diary and 5 minutes to complete my sleep hygiene check list. I will need 1 hour before my current bedtime to allow for sleep extension as by the end of the intervention I lights off period should commence 1 hour before bedtime. At the end of each week I will need 15 minutes to complete the ESS questionnaire. Therefore in total, the implementation of the intervention and sleep hygiene should take 3 hours and 10 minutes a day, with an additional 15 minutes a week. By the end of the 3rd week I hope to achieve an increase in sleep duration of 13 minutes as supported by Dewald-Kaufmann et al.'s results. By the end of week 4 I hope to achieve an increase of sleep duration of 30 minutes, this has also been supported suggested by Dwald-Kaufmann et. al, Gruber et al. (2012) and Sadeh et al. (2003).

Strategy & Justification

I have chosen this goal because I have find myself becoming extremely sleepy and tired throughout the day and this lowers my productivity while at work or during study sessions. 

I will be replicating the methods from Dewald-Kaufmann et al. who found that gradually increasing lights off or bedtime by 5 minutes a night for 3 weeks in combination with sleep hygiene rules as described by Evan et al. (2012), increased sleep by 13 minutes. I have chosen this strategy because Dewald-Kaufmann has found that gradual sleep extension in combination with sleep hygiene is a successful method of increasing sleep duration and reduction in day time sleepiness. 

Dewald-Kaufmann et al. found that they were only able to increase sleep by 13 minutes. These results are different to Gruber et al. (2012) and Sadeh et al.  (2003) who were able to increase sleep duration by 30 minutes. Dewald-Kaufmann et. al. suggests that this may be the result of reaching a lights off or bedtime of 1 hour before participant's usual bedtime only during the last day of the 3 week intervention. Therefore, Dewald-Kaufmann et al. suggests that by extending the intervention to 4 weeks whereby a lights off/bedtime of 1 hour before usual bedtime is maintained throughout the last week. This should achieve similar results by Gruber et al. (2012) and Sadeh et al. (2003). Thus, although my goal sleep duration is longer than that achieved by the experiment, it should still be achievable by extending the intervention to 4 weeks as justified by Dwald-Kaufmann et al. 

ESS Sleep Scale

**Each item can be rated from 0 to 3 points (0 = would never doze, 3 = high chance of dozing), with the final score ranging from 0 to 24.

1. Sitting and reading
2. Watching TV
3. Sitting inactive in a public place (e.g., a theatre or a meeting)
4. As a passenger in a car for an hour without a break
5. Lying down to rest in the afternoon when circumstances permit
6. Sitting and talking to someone
7. Sitting quietly after a lunch without alcohol
8. In a car while stopped for a few minutes in the traffic

Sources

https://onlinelibrary-wiley-com.wwwproxy1.library.unsw.edu.au/doi/epdf/10.1111/jcpp.12157

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538572/

https://www-sciencedirect-com.wwwproxy1.library.unsw.edu.au/science/article/pii/S1389945707003061