Clock-Watching Worsens Insomnia, Increases Reliance on Sleeping Pills

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

Summary

Aim :

Over-the-counter (OTC) and prescription sleep medications are frequently used as treatments for chronic insomnia, despite risks and limited long-term effectiveness. Investigation of the mechanisms underlying this predilection for pharmacotherapy may uncover strategies to decrease dependence on sleeping pills. The goal of this study was to determine how time-monitoring behavior (TMB ) and associated frustration may interact with insomnia symptoms to drive sleep aid use.

Methods:

Patients (N = 4,886) who presented 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 (over-the-counter and prescription, separately). Mediation analyzes examined how clock watching and related frustration might be associated with insomnia symptoms and medication use.

Results:

The relationship between TMB and sleep medication use was significantly explained by ISI (P < .05), with TMB (especially related frustration) appearing to aggravate insomnia, which in turn leads to sleeping pill use.

Similarly, but to a lesser extent, the relationship between ISI and the use of sleep medications was explained by TMB, in that ISI can lead to an increase in TMB, which in turn can lead to the use of sleep aids. for sleeping.

Conclusions:

Time monitoring (TMB) and the associated frustration it engenders can perpetuate a negative cycle of insomnia and sleeping pill use.

Future longitudinal and interventional research is needed to examine the developmental course of these clinical symptoms and behaviors and to test whether decreasing frustration by limiting BMR reduces the propensity for pharmacotherapy.

Comments

Looking at the clock while trying to fall asleep exacerbates insomnia and sleeping pill use , 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 Department of Psychology and Brain Sciences in the College of Arts and Sciences, focuses on a sample of nearly 5,000 patients who present for care at a sleep clinic.

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

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

"We found that time monitoring behavior primarily has an effect on sleep medication use because it exacerbates insomnia symptoms," Dawson said. "People worry about not getting enough sleep, so they start estimating how long it will take them to fall back asleep and when they should get up. That’s not the type of activity that is helpful in facilitating the ability to fall asleep. The more stressed you are, , the harder it will be for you to fall asleep.

As frustration with insomnia grows, people are more likely to use sleep aids in an attempt to control their sleep.

The results are published in The Primary Care Companion for CNS Disorders . Dawson said research indicates that a simple behavioral intervention could provide help to those struggling with insomnia. Give the same advice to each new patient the first time they meet.

"One thing people could do would be to flip or cover their watch, get rid of the smartwatch, take the phone away so they’re just not looking at the time," Dawson said. "There’s nowhere where looking at the clock is particularly useful."

With 15 years of research and clinical experience in the field of sleep, Dawson is interested in comparing people’s sleep experiences with what is happening simultaneously in their brains. He trains and supervises doctoral students in the Clinical Sciences Program of the Department of Psychology and Brain Sciences.