TEXT2ZZZ

A Text Message Mindfulness Sleep Study Improving Sleep Quality & Duration in Adults

By Victoria Somerville

You will spent one third of your life sleeping.

Benefits of Sleep* Enhances mental alertness and memory

*Provides optimal physical and mental health

*Increases longevity

Sleep Deprivation

- Partial Sleep Deprivation: 30 minutes of sleep lost every two weeks.

- Complete Sleep Deprivation:24 hours without sleep.

1 in 5

- Research showed that being mindful and being grateful lead to better sleep outcomes.

- Mindfulness has been found not only to be positively associated with sleep quality but also to improve pre-sleep restlessness by reducing distracting thoughts leading to deeper sleep.

Mindfulness & Sleep

Mindfulness canbedefinedaspayingattentiontothepresentmoment—observing(nonjudgmentally)butnotreactingtostimuli

Six Main Constructs of Mindfulness

(1) Clarity of Awareness(2) Nonconceptual, Nondiscriminatory Awareness(3) Flexibility of Awareness and Attention(4) Empirical Stance towards Reality(5) Present-Oriented Consciousness(6) Stability of Attention and Awareness

Target Audience1) Men and women aged 30-60 years old2) Who are either partially or completely

sleep deprived3) Who have poor sleep knowledge and habits4) Who desire to change their current sleep

cycle and habits

38% Yes62% No

Recruited Audience

8% Some college54% BA/BS38% Masters’ degree or higher

46% Northeast15% South39% West

Health Objective:To reduce the prevalence of sleep deprivation and partial sleep deprivation (as it applies) by 50% among intervention participants by the end of the intervention period.

Behavioral Objectives: To increase sleep quality and duration by 40% among intervention participants.

To increase mindfulness by 50% among intervention participants.

1) By the end of the intervention, at least 65% of participants will know three mindfulness techniques that will keep their attention in the present moment and that can help them improve their sleep duration

2) By the end of the intervention, at least 50% of participants will know how to accept and change sleep distractions—thoughts and behaviors—that keep them from getting the necessary amount of sleep.

3) By the end of the intervention, at least 70% of participants will learn how clearing their mind of judgmental thoughts affects their sleep quality.

4) By the end of the intervention, at least 50% of participants will be able to evaluate progress towards their sleep goals.

Communications Objectives:

• Goal: To improve sleep duration & quality in participants

• Pilot program n=14 enrolled, but n=13 completed

• Pilot ran for 14 days with 100% completion

• Pre-Post test survey

• Participants received a chain of the following types of messages every day:

1) Sleep Goals

2) Mindfulness Exercises

3) Eliminating Sleep Distractions (Thoughts & Behaviors)

4) Understanding Judgmental Thoughts

TEXT2ZZZ

Sample Messages

Sleep Goals Mindfulness Exercises Sleep Distractions Judgmental Thoughts

Tip Day 1 Tip Day 2 Tip Day 3 Tip Day 4 Tip Day 5

Turn off your gadgets. Using phones or TVs to get to sleep suppress melatonin production. Unplug!

Change your bright light bulbs in your bedroom for low-watt blubs instead.

Darker is better for sleep. Make sure you cover electrical displays and close the blinds for deep sleep.

Don't lie in bed awake for more than 20 minutes. If you can't sleep try a relaxing activity like light stretching, massage, or a hot bath.

Melatonin is a hormone in the body that helps you sleep. Melatonin production is controlled by the sun. Go outside and get 15 minutes of sun to sleep better.

But…Did it work?

…Mostly

Reduce the prevalence of sleep deprivation and partial sleep deprivation (as it applies) by 50% among intervention participants.

Health Objective

15%

46%

39%

0%

On average, how many hours of sleep do you get per night?

5 hours or less5-7 hours7-9 hours9 hours or more

8%

46%46%

0%

On average, how many hours of sleep do you get per night?

Pre-Test Post-Test

Behavioral Objective #1To increase sleep quality and duration by 40% among intervention participants.

Average sleep time across all participants was increased by 25 minutes!

Yes92%

No8%

Since the beginning the program, do you feel your sleep quality and duration have improved?

To increase mindfulness by 50% among intervention participants.Behavioral Objective #2

Mindfulness Attention Awareness Scale

1-3 4-6 Difference in 4-6 Pre vs. Post

#1 Listening (pre-test) 54% 46%

#1 Listening (post-test) 39% 61% 61%-46%= 15%#2 Future & Past (pre-test) 69% 31%

#2 Future & Past (post-test) 54% 46% 46%-31% =15%#3 Emotions (pre-test) 46% 54%

#3 Emotions (post-test) 23% 77% 77%-54% =23%#4 Auto Pilot (pre-test) 8% 92%

#4 Auto Pilot (post-test) 15% 85% 85%-92% = -7%#5 Pass Judgment (pre-test) 39% 61%

#5 Pass Judgment (post-test) 23% 77% 77%-61% =16%#6 Stay Focused (pre-test) 46% 54%

#6 Stay Focused (post-test) 38% 62% 62%-54% =8%#7 Focused on Goal (pre-test) 15% 85%

#7 Focused on Goal (post-test) 23% 77% 77%-85% = - 8%

The average mindfulness change was 11%.

65% of participants will know three mindfulness techniques.Communication Objective #1

All54%Most

31%

Some15%

None0%

How many of the techniques you learned would you feel confident performing by yourself?

87.2% could identify the three mindfulness techniques.

50% of participants will know how to accept and change sleep distractions—thoughts and behaviors.

Communication Objective #2

Yes8%

No92%

Do you know how to accept distracting thoughts and change your sleep distractions?

Yes92%

No8%

Do you know how to accept distracting thoughts and change your sleep distractions?

Pre-Test Post-Test

70% of participants will know how to clear their mind of judgmental thoughts.Communication Objective #3

Yes62%

No39%

Do you know how to clear your mind of judgmental thoughts?

Pre-Test Post-Test

Yes85%

No15%

Do you feel you learned how to clear your mind of judgmental thoughts?

Yes77%

No23%

Since beginning the program, do you feel you have experienced a change in your awareness of judgmental thoughts?

Communication Objective #3

50% of participants will be able to evaluate progress towards their sleep goals.Communication Objective #4

15%

31%23%

23%

8%0%

How often did you meet your sleep goal?

Almost AlwaysVery frequentlySomewhat frequentlySomewhat infrequentlyVery infrequentlyAlmost never

100%

Do you feel you were given the appropriate sleep tools to meet and evaluate your sleep

goal?

YesNo

Discussion77% reported that the program “helpful,” “very helpful,” or “extremely helpful.”

People Liked:- The structure, the tone, the sign-off, the

convenience, and the number of texts.

People Wanted:- The pilot to be longer, more open-ended responses,

and a forum.

Program Improvement:- Health Objective – need more frequent

measurement of sleep duration & longer study period.

- Behavioral Objective #2 – More time & exposure to materials. Perhaps a different scale.

Sweet Dreams!