The irony of using our phones to get better sleep

Device screens are one of the worst contributors to poor sleep hygiene. Yet, our phones are so ingrained in our everyday lives it is difficult to physically and mentally separate ourselves from the temptation they provide. Often, they are with us from the moment we wake up to the moment we go to sleep.

We use them to check we have not accidentally missed an important work email or Facebook comment as we wind down to sleep. As we wake, overnight FOMO takes hold and the muscle memory of swiping and tapping to see what we might have missed while we slept can be irresistible. We know that blue light from screens is bad for us; indeed, Apple and Android systems now have ‘night mode’ specifically to reduce its effect, and you can even buy glasses that reduce eye fatigue from looking at blue screens. Yet we still scroll and tap right up until our brains rudely interrupt our subconscious that it really is sleep time. (Hands up if you’ve ever dropped your phone on your face because you fell asleep while scrolling… just me?)

We then wonder why we sleep poorly… and once again, we turn to our phones for the solution.

Companies and developers have tapped into a lucrative market, and have managed to convince us that they can help us reach that beautiful nirvana of 7-8 hours sleep… using our phones. The exact thing that contributes to our terrible sleep habits. How did this cycle of irony happen?

The first question asked of exhausted parents, “Is your baby sleeping through yet?” suggests that achieving quality sleep is a standard marker of success. But, sometimes it almost feels like a  badge of honour to have sleep issues now, because it ‘proves’ how full our lives are, how busy we are with our day jobs, our side hustles, our hobbies, our families. Why are we so obsessed with sleep?

SO MANY APPS!

 Even just a quick search for ‘sleep’ in the App Store or Google Play will turn up hundreds of results.

There are apps that integrate with wearables to monitor your sleep using heart rate, accelerometer and audio technology to give you detailed information about your sleep cycles, whether you stop breathing, when you move, when you talk, even when you break wind, all to tell us about our sleep cycles, if we are going to sleep on time, if we’re getting too little or too much sleep, or sleeping at the wrong times.

There are apps that lull you to sleep with relaxing music or a story (Calm is probably the most well-known for this).

My personal favourite – apps that use binaural beats and isochronic tones to give a meditative induced slumber.

Even our kids are feeling the pressures of daily life and have their own subset of storytime and white noise apps to help them sleep.

Do any of these really work? Is too much insight just stressing us out? Certainly, most people will have tried a number of different apps before settling on something that works, but is there anything on the market that’s proven to work?

CBT-I APPS

One subset of apps we haven’t yet covered above are Cognitive Behavioural Therapy for Insomnia (CBT-i) apps, for those with clinically diagnosed insomnia. Although the method itself is proven, less is promoted about the benefits and effectiveness of digital CBTI (or dCBT) despite the research that proves this to be the case. This likely comes down to the fact that there are relatively few commercial apps on the market that fully utilise the technique and even fewer that can market themselves as ‘proven’ given the complexity of the technique and funding challenges to undertake the research.

However, there are organisations that are actively pursuing digital CBTI solutions both in a research and commercial capacity, so you can expect to start seeing more products in the market within this rather specific space. The Australian Sleep and Alertness Consortium, which is made up of The Woolcock Institute, Monash University and the University of Sydney, among others, is leading the charge in Australia when it comes to research; for example, The Woolcock Institute is researching both online insomnia programs and solutions for people with irregular sleep patterns (i.e. shift workers). ResMed, a leading sleep and respiratory device manufacturer has enjoyed enormous growth in the last two years, and Philips is actively building its Sleep & Respiratory Care market by including consumer-targeted solutions into its suite of products.

When it comes to developing digital CBTI tools, developers have to be fairly tactful about how to use the wealth of technology available to them to deliver programs. We can of course offer the same tracking as that of the more mainstream tracking apps (e.g. Sleepscore, Pillow), we can add meditations and calming music such as those found in Headspace and Calm, we can include smart alarms like that which is found in Sleepscore. However, throwing tools and information at people is one thing, making them meaningful is another. Additionally, acknowledging the irony that using your phone is probably not the best way to promote healthy sleep hygiene presents an interesting challenge, and one which we had to consider carefully when developing CBTI apps for our clients.

To get around this, the apps we have chosen to focus on in this space are those with a specific purpose or audience in mind. To date, we have built two such apps and I’d like to talk a little about their challenges and how we approached them from a UX and technical standpoint that contributes to better sleep outcomes.

The first app delivers a short, sharp CBTI program that focuses on sleep consolidation only and is designed to be completed within a couple of weeks. The only tracking it uses is sleep and wake times as delivered by its Fitbit integration (user can manually enter this information also) in order to calculate the total sleep time. We avoid confusing the user with detailed sleep cycle data altogether, and there are no fancy tools to encourage better sleep beyond the simple program’s sleep/wake time instructions. The app actively promotes educational content that was designed to be read during the day with explicit instructions about what to do with the phone overnight. In fact, if the user attempts to use the app overnight, all functionality is blocked and the information presented instructs the user to put the phone in another room. The app is currently in its second round of research and we have already moved it into a commercialisation phase, hopefully, to be released in 2022.

The second app we created was a small pilot app to trial with shift workers, which uses an algorithm to work out optimum sleep schedules based on a user’s work shifts. The challenge here was to ensure the algorithm was considerate of a person’s personal preferences when it came to events and obligations outside of work; we couldn’t just suggest people go to sleep when they would normally need to pick up their kids! So the algorithm takes into account both work and personal schedules to ensure that people with unusual sleep patterns were still getting the optimum amount of healthy sleep.

IN SUMMARY

Sleep and the associated wellness apps are experiencing a huge swell in popularity at the moment and it’s understandable in this day and age of busy lives (even when there isn’t a pandemic on…). When it comes to solving our sleep problems, it is clear that digital tools can help, but truly understanding WHY we don’t sleep can show us what method may be best for us. Be wary of the apps that can promise you perfect sleep, but merely overload you with information that doesn’t give personalised help. Try a few things, but be wary that a digital tool might not be best at all – simply putting away the blue light and reading may be all we need to improve our sleep quality.