The Effects of Pre-Bedtime Routine on Sleep

Keywords: pre-bedtime routine, sleep characteristics, college students, professors

Abstract

Anecdotal evidence shows that activities in preparation for sleep affect certain characteristics of sleep, such as duration and quality. This study tests this evidence. According to the literature, when asking the question of whether pre-bedtime routine affects sleep characteristics, particularly of college students and professors, it was hypothesized that a structured pre-bedtime routine positively affects sleep characteristics. A web-based survey was distributed to college students and college professors to look into structure of pre-bedtime routine and sleep quality. Two Pearson r correlations and two t-tests were used to analyze the data. After completion of this study, there was no significance found between the variables of pre-bedtime routine and sleep characteristics.

Introduction

Given the rigors of college life, one would suspect that sleep quality would be an issue. There has not been much research regarding the effects of pre-bedtime routine on sleeping characteristics, especially on young and middle-aged adults. However, there has been a fair amount of research relating to sleep and children as well as sleep and the elderly. Numerous factors relate to sleep quality such as a structured routine, external stimuli, substances, cognitive strain, and daytime sleep. Among the research studies conducted thus far, some factors seem to correlate and/or affect sleeping qualities more than others, mainly structure of routine.

Sleep problems, such as trouble sleeping or a lack of sleep, are of major concern for parents of young children. Approximately 20-30 percent of infants and toddlers brought into pediatricians possibly suffer from a sleep problem. A 2008 study of 206 infants (ages 7–18 months) and 199 toddlers (18-36 months) tested the efficacy of pre-bedtime routine on sleep characteristics (Mindell, Telofski, Wiegand, & Kurtz, 2009). The mothers of the children were instructed to follow a three-step routine of preparing their child for bed including a bath, massage/lotion, and “quiet activities (e.g., cuddling, singing, lullaby) with lights out within 30 minutes of the end of the bath.” The study resulted in 94 percent effectiveness with 80 percent significant improvement, subsequently leading to less waking, shorter waking periods, increased sleep continuity, and decreased amount of time it took to fall asleep (Mindell, Telofski, Wiegand, & Kurtz, 2009).

Another study by Chrsitodulu and Durand (2004) involved four toddlers who all had developmental disabilities and sleeping difficulties. The researchers wanted to minimize sleeping problems by implementing positive bedtime routines and restrictions on sleep. Positive bedtime routines varied, but still had specific guidelines: each child’s parents constructed a routine following those guidelines. Parents also restricted sleep time by setting bedtimes and wake-times for the children based on their normal sleep duration. Similar to the Mindell et al. (2009) study, this approach reduced the number of times the children awoke during the night. Beyond these findings, the Chrsitodulu and Durand study (2004) was “successful in eliminating bedtime disturbances” as long as the routine continued for the duration of the study. Research suggests that children’s sleep quality can be positively affected by routine.

Cultural differences have implications as well. For example, in a study comparing children in China and children in the United States, Chinese children get one less hour of sleep than children in the United States. Chinese children’s sleepiness is accounted for by less sleep, and in the United States’ children’s sleepiness is accounted for by restless sleep and snoring (Liu, Liu, Owens, & Kaplan, 2005). Apart from overseas cultural differences, subcultures within a society can have vast differences as well.

Although young children need healthy sleeping habits, the same is true for the elderly. A research article authored by Lai and Good (2005) stated that half of the people they studied over the age of 65 had interrupted sleep or difficulties getting a good night’s rest. Their study looked at the impact of listening to music while falling asleep and during sleep. Lai and Good also sought to determine which factors influenced sleep quality, such as caffeine ingestion, medication, etc. This particular study found that music was greatly beneficial in many different areas related to sleep: quality, latency, efficiency, and daytime function (Lai & Good, 2005).

The middle-aged cohort is important to study as well. This cohort includes mostly people in the workforce, such as doctors, factory workers, teachers, social workers, and even professors. It could be assumed that this age group might include the idea of their having pre-bedtime routines habitualized, as well as mostly good sleeping patterns. Research suggests this may or may not be the case. One study conducted by the National Sleep Foundation said that 52 percent of women and 45 percent of men have problems sleeping/getting a good night’s rest (“Why nearly half of all adults have trouble sleeping,” 1996). The same article went on to say that stress was usually the main contributor to the problems middle-aged adults have with sleep. One of the conclusions was that relaxing bedtime routines provide for more restful sleep.

Other research investigated pair sleep versus sleeping alone for middle-aged adults. The definition given of pair sleep was “the practice of sleeping in couples in an individual bed with close contact” (Dittami, Keckeis, Machatschke, Katina, Zeitlhofer, & Kloesch, 2007). Negative impacts of lack of sleep included effects on cognition, ability to deal with stress, and immunity to diseases. The main purpose of this study was to determine whether or not pair sleeping had more negative effects on people than sleeping alone. Conclusions drawn from this study included the fact that women were more likely than men to be negatively influenced by pair sleep. Interrupted sleep induced by another person was the main culprit.

College students are a culture all their own. They have extremely high workloads, variable schedules, and a vast array of stimuli. In 1999, change in sleeping habits was the highest stressor for college students at a particular university in the United States (Ross, Nievling, & Heckert, 1999). In fact, sleep routine is one of the first habits to deviate according to Jensen (2003). It is quite likely that this trend has continued over the years since the study was conducted. A study about the effects of television on sleep-wake patterns for college students concluded that restricted amounts of television viewing led to earlier bedtimes and longer sleeps periods. Managed television viewing can also contribute positively by reinforcing “sleep-wake patterns” (Asaoka, Fukuda, Tsutsui, & Yamazaki, 2007).

The freedom of college students to make decisions on their own concerning their well-being also may contribute to sleep patterns. Although it does not focus on college students, a study concerning adolescents making their own decisions about sleep concluded that adolescents who made their own bedtimes were more sleep deprived and had more sporadic bedtimes (Teufel, Brown, & Birch, 2007). Although this study researched adolescents, decision-making power over their own bedtimes pertains to college students as well. Many college students are still biologically adolescents, and their physiology indeed affects their sleep. Specifically, this age group has delayed sleep phases, meaning they naturally fall asleep later than other age groups. According to the National Sleep Foundation, 59 percent of people from 18-19 years of age labeled themselves as night owls (Gaultney, 2010). College students also report having unsatisfactory sleep throughout the week and trying to make up for it on the weekends: 24 percent of college students claimed to be dissatisfied in 1978, and 71 percent of students reported dissatisfaction in 2000 (Jensen, 2003). These sleep patterns often have severe consequences on activities of daily living and their responsibilities (Gaultney, 2010).

Since pre-bedtime routines have the capability of influencing sleep, it is wise to consider what impacts the quality of sleep. A study was completed on the impact of reading for pleasure as a pre-bedtime activity. In the article, there were multiple reasons given for why individuals would enjoy reading for pleasure, especially pre-bedtime. A group of 223 college students were the subjects for this particular study. The researcher found a significant relationship between decreased sleep duration and increased amounts of pleasure reading (Kelly, 2009).

Another external stimulus that may have an impact on sleep is the presence of continuous white noise. Forquer and Johnson (2007) were concerned about the influence of white noise on sleep characteristics. This study of college students found that “white noise appears promising in reducing sleep problems in college students; however, like medication disturbances may return when discontinued.”

Hypothesis 1 - Because all the cohorts discussed previously seemed to respond well to routine and were affected similarly by certain stimuli, college students will most likely experience comparable effects.

Hypothesis 2 - When asking the question of whether pre-bedtime routine affects sleep characteristics, particularly of college students and professors, it is likely that pre-bedtime routine does indeed affect sleep characteristics. Specifically, a structured routine will be a major positive contributor to such characteristics, especially in the area of increased quality of sleep influenced by an increased steadiness of routine.

Method

This study surveyed the population of a midwestern private Christian university. The whole student body was invited to participate, and the whole body of professors was selected as a contrast group. There were 979 students (519 females and 460 males) and 105 professors in the potential pool of respondents. Although most of the students’ ages ranged from 18 to 23, a handful of them were older. The professors’ ages ranged from 30-70. The study gathered 213 respondents, with 17 being professors and 189 being students.

The effects of pre-bedtime activities on sleep characteristics were measured through a survey entitled the “Sleep and Pre-Bedtime Routine Survey” (Anderson, Garner, & Manges, 2011) [see Appendix A]. The survey contained nineteen questions and consisted of a variety of response-types, including multiple choice, yes/no, and matrix form. Demographic questions followed. The survey was produced using SurveyMonkey for an online response.

The questions compared each participant’s pre-bedtime activities and structure of their activities before bed to the qualities of sleep that they tended to experience. The survey examined things such as television watching, showering, reading, video gaming, exercising, and other activities that people may do before going to bed. It also examined items that participants might need, or might need to avoid, in order to sleep. These included things such as a light, a television, a fan running, and a noisemaker running. Each question was based on the participant’s average or normal tendencies.

The survey was created through SurveyMonkey, a resource specifically for making web surveys. With the permission of the university, the survey was e-mailed to the participants using the university list serv for a mass e-mail. An administrator in charge of student body and faculty e-mails sent the e-mail per request of the researchers. Through the e-mail, the participants could click on a hyperlink in order to take the survey. When the participants finished the survey, they could click “Done,” and the results would be sent to a SurveyMonkey account for further analysis.

Results

The data were analyzed using a Pearson r correlation coefficient in order to test the possible correlation between pre-bedtime routine and quality. In order to test whether a correlation existed between pre-bedtime routine and sleep quality, the researchers constructed quality and structure indexes using SPSS. All of the pre-bedtime routine question results were placed into an index labeled “Structure Index” and all of the results of the quality of sleep questions were placed into an index labeled “Quality Index.” The answers were quantified pertaining to structure and quality and ranges were created to indicate scores on the indexes. Then, using the Pearson r correlation coefficient, the two indexes were compared. No significant correlation was found between pre-bedtime routine and sleep characteristics (r = .013) (see Table 1). The results failed to reject the null hypothesis.

In order to examine individual aspects, participants’ rigidity of routine were examined and compared with how rested they felt after waking. This accounted for a relationship not between structure of routine on sleep quality but on perceived quality—how the participant felt after waking rather than his or her actual efficacy of sleep. According to the literature, one would have expected that the rigidity of the pre-bedtime routine, above all other variables, would have contributed to more perceived restfulness. However, the findings from this study were not so decisive. No significant correlation was found between a structured routine and restfulness (r = -.015) (see Table 2).

This study examined professors contrasted with college students, particularly testing whether the two cohorts differed in the rigidity of the structure of their pre-bedtime routines and in the quality of their sleep. Two t-tests were run to compare these groups. There was no significant difference found between college students and professors in the area of structure of pre-bedtime routine (t = .619) (see Table 3) and no significant difference again for their quality of sleep (t = .450) (Table 4).

Discussion

After completing our review of the literature, we hypothesized that a structured pre-bedtime routine would produce better sleep quality shown through different characteristics. Now as we look back at our literature review, we found that a structured routine can (but not always) affect sleep quality in a positive manner. As supported by the research conducted prior to this collection of data, sleep routine of college students is one of the first habits to deviate from the norm (Jensen, 2003). Another factor contributing to pre-bedtime routine is the newfound freedom that college brings to students. Because of that freedom, college students may be more likely to not have strict routines.

Upon completion of the analysis of data, we determined that a structured pre-bedtime routine has little impact on sleeping characteristics and/or quality. This finding did not support our hypothesis, because we thought that a more structured routine would lead to better sleep overall. The results from this study are important because the findings dissent from a common sense point of view.

There were also several limitations of our research. The survey distributed to the participants was probably the most problematic in that there were several ways in which some of the questions could have been interpreted, e.g., the meaning of whether the person would sleep poorly if they did not follow it or how strictly they actually follow their routine (which question three was attempting to answer; see Appendix A). Better descriptive words might have been useful, and there may have been problems of misinterpretation. In order to fix this, we could separate it into two different questions. Question eleven created an issue for participants because it did not address what we were looking for—how often a person is tired enough that they want to sleep throughout the day. Similarly, number twelve could have had better answer options. One important limitation that we considered at the beginning of this project was the population sample. College students are not representative of the general population, especially because their sleep schedules vary so much, but the research was intended to examine sleep habits of college students.

There was a very strong correlation between health-related characteristics, such as getting more sleep leads to feeling less tired throughout the day and structured routine (especially for bedtime). For future research, we would suggest that sleep habits and characteristics be studied in light of health and well-being. By doing so, future researchers may learn more about the impact of structured sleeping habits on overall daily functioning. When considering the growing academic population, sleep is an important area of research. Research projects in the future should compare the academic population with other groups of people in the general population.

References

Asaoka, S., Fukuda, K., Tsutsui, Y., & Yamazaki, K. (2007). Does television viewing cause delayed and/or irregular sleep-wake patterns? Sleep and Biological Rhythms, 5, 23-27.

Christodulu, K. V., & Durand, M. (2004). Reducing bedtime disturbance and night waking using positive bedtime routines and sleep restriction. Focus on Autism and Other Developmental Disabilities, 19, 130-139.

Dittami, J., Keckeis, M., Machatschke, I., Katina, S., Zeitlhofer, J., & Kloesch, G. (2007). Sex differences in the reactions to sleeping in pairs versus sleeping alone in humans. Sleep and Biological Rhythms, 5, 271-276.

Forquer, L., & Johnson, M. (2007). Continuous white noise to reduce sleep latency and night waking in college students. Sleep and Hypnosis, 9, 60-66.

Gaultney, J. F. (2010). The prevalence of sleep disorders in college students: Impact on academic performance. Journal of American College Health, 59, 91-97.

Jensen, D. R. (2003). Understanding sleep disorders in a college student population. Journal of College Counseling, 6, 25-34.

Kelly, W. E. (2009). To wake, to wake, perchance to read: Sleep duration and reading for pleasure. Reading Improvement, 46, 221-226.

Lai, H. L., & Good, M. (2005). Music improves sleep quality in older adults. Journal of Advanced Nursing, 49, 234-244.

Liu, X., Liu, L., Owens, J. A., & Kaplan, D. L. (2005). Sleep patterns and sleep problems among schoolchildren in the United States and China. Pediatrics, 115, 241-249.

Mindell, J. A., Telofski, L. S., Wiegand, B., & Kurtz, E. S. (2009). A nightly bedtime routine: Impact on sleep in young children and maternal mood. Sleep, 32, 599-606.

Ross, S. E., Niebling, B. C., & Heckert, T. M. (1999). Sources of stress among college students. College Student Journal, 33, 312-317.

Teufel, J. A., Brown, S. L., & Birch, D. A. (2007). Sleep among early adolescent students. American Journal of Health Studies, 22, 10-17.

Why nearly half of all adults have trouble sleeping. (1996). Jet, 89, 54-58.

Appendix A

Thank you for participating in our survey!! If you have any questions or concerns please e-mail us.