Degree In Sight

Take sleep seriously

As a psychology graduate student, you probably know that sleep is important. But did you know that skimping on your zzz's can trigger major depression (Journal of Affective Disorders, 2011)? Bouts of insomnia may even predict suicide (Combat and Operational Stress Research Quarterly (PDF, 35.4KB), 2012) and serve as a more serious harbinger of self-harm than depression or hopelessness (Journal of Affective Disorders, 2012).

Then there are the cognitive effects of poor sleep — including a decreased ability to pay attention and solve problems (The Clinical Neuropsychologist, 2012). Not convinced yet? Poor sleep can take years off your life — with one study finding that men who get fewer than six hours of sleep a night are four times more likely to die within the year (Sleep, 2010).

If you haven't heard about these links, you're not alone. Most psych students get two hours or less of training and lectures on the topic of sleep, according to an article in February's Training and Education in Professional Psychology. Meanwhile, another article in TEPP  found that psychology students average only about four hours of sleep a night.

"Psychologists rarely heed their own advice," says study author Shannon B. Myers, PhD, a postdoctoral fellow at the University of Medicine and Dentistry of New Jersey.

That's unfortunate, especially for future therapists who would do well to learn more about the importance of sleep, says Larissa Barber, PhD, a psychology professor at Northern Illinois University who studies sleep. A case in point: Helping your clients sleep better can reduce marital discord and ease symptoms of depression, researchers have found. Even if they never plan to set foot in a therapy room, science-oriented grad students should know that regular, quality sleep is key for creative thinking and productivity.

"People often think of sleep in compensatory terms, like a credit card," Barber says. "But they forget the hidden interest rates."

Sleep Interventions

When psychologists treat patients for sleep disorders, they often treat them separate from other problems, says Allison Harvey, PhD, a psychology professor at the University of California at Berkeley. That's a mistake, she says. According to a study led by Harvey and published in 2008 in Current Directions in Psychological Science, if you combine insomnia interventions with treatments for mental health problems, the effectiveness of both increases.

"Regardless of the diagnosis, if we treat insomnia directly, that results in improvement across the board," says TEPP study author John T. Peachey, a clinical psychology student at the California School of Professional Psychology in San Francisco.

Peachey's experience in teaching an introductory sleep course shows adding insomnia treatments to your therapy toolbox doesn't require intensive training. Therapists in training can start by adding these three questions to their intake evaluations, he says:

  • Are you dissatisfied with your sleep?

  • Are you excessively sleepy during the day?

  • Do others complain about your snoring, tossing and turning, or other sleep behaviors?

If a client answers yes to any of those questions, "then you should do a much more detailed sleep assessment," says Peachey. He recommends starting with a two-week sleep diary. "This can often be a helpful intervention in and of itself because people gain insight into how certain behaviors are interfering with their circadian rhythms and drive to sleep," he says.

Students may also want to explore asking clients to take formal sleep assessments, such as the Insomnia Severity Index, the STOP-BANG questionnaire (PDF, 20KB), the Sleep Disturbance Questionnaire, the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale.

Getting Your Zzz's

According to the National Heart, Lung, and Blood Institute, adults need seven to nine hours of sleep each night. However, that doesn't need to happen in one solid block, says Russell Foster, PhD, a professor of circadian neuroscience at Oxford University. One famous study found that participants who were not exposed to artificial light or forced to adhere to a modern workday schedule slipped into a "bimodal" sleep pattern of two blocks of four hours, separated by an active period (Journal of Sleep Research, 2009). In fact, people regularly slept this way before the Industrial Revolution, according to research by Virginia Tech history professor Robert Ekirch, PhD, author of "At Day's Close: Night in Times Past."

Regardless of the precise timing of your sleep, chances are that as a graduate student, you aren't getting enough, says Myers. All too often, students prioritize studying, conducting research and preparing for classes over getting to bed on time.

"The thinking is, 'I'll sleep later,' and it slowly falls down the ladder as far as importance," she says.

Psychology grad students' habits also undermine their sleep, including an ever-shifting bedtime, long daytime naps and working right up until bedtime, the TEPP study found. What's more, poor sleep contributed to students' stress more than other factors, including a lack of social support or exercise.

Grad students should also know that sleep deprivation can weaken the ability to deal with the day-to-day stresses of school, says Barber. In a 2010 study in Stress and Health, Barber and her colleagues found that consistent, sufficient sleep helped people exert greater self-control when dealing with stressful events.

"Sleep can often mean the difference between you crying after receiving negative feedback on a paper or calmly evaluating the information as constructive," Barber says.

To determine how much sleep you need, take a vacation with no set schedule or alarm clock, advises Barber. If you're sleep-deprived, you'll sleep a lot for the first day or two, but "you'll drift to your optimal sleep number after a few days."

Then, set a schedule that allows you to get the sleep you need, she says.

If you have trouble getting to sleep or staying asleep, consider whether you have any habits that may be robbing you of healthy rest, including exercising or tackling big projects near bedtime, and reading, eating or studying in bed.

What's not healthy is also very common among grad students: getting an early start on the weekdays and sleeping in and staying up late on the weekends. Barber equates it to a cycle not unlike jet lag, where students might be getting enough sleep, but they're throwing off their biological rhythms and, typically, paying for it with rough Monday mornings.

"Poor Monday always gets a bad reputation," she says, "but the reality is we set ourselves up for Monday failure through our weekend sleep habits."

People treat sleep like a luxury, she says. It isn't, and Barber points to research that shows staying up 17 to 19 consecutive hours is similar to having a blood-alcohol percentage over the legal limit (Occupational & Environmental Medicine, 2000). "Think about that for a minute," says Barber. "Late at night, you are basically writing your papers drunk. How efficient is that, given the amount of editing and reworking time you need the next day?"

Jule Banville is a writer in Missoula, Mont.

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