LAUSR

Despite being used and widely recommended since the 1970s, few studies have examined whether adherence to sleep hygiene practices affect objectively measured sleep in non-clinical populations. While individual components of sleep hygiene such as limiting caffeine and alcohol consumption are clearly related to sleep by plausible physiological and psychosocial mechanisms, the real-world evidence of overall sleep hygiene practices on sleep is surprisingly inconsistent. Here, we examined the association between self-reported sleep hygiene practices and objectively measured sleep in a general population. Responses to a survey on sleep hygiene were used and matched with objective sleep data, resulting in data from 720 users (mean age: 52.5 ± 15.9, 63.4% female). Objective sleep data across 92,808 nights were included in the analysis from the PSG-validated SleepScore Mobile Application, which uses a non-contact sonar-based method to capture sleep-related metrics and self-reported lifestyle. Self-reported sleep hygiene practices were assessed with 13-items on a 5-point scale ranging from “Never” to “Always”. Descriptive statistics and linear regressions were used for the analysis, controlling for age and gender. Overall, the top three most frequented poor sleep hygiene practices were going to bed at different times (29.7%), overthinking/worrying in bed (24.0%), and waking at different times (22.7%). Linear regressions revealed a significant negative association between composite sleep hygiene scores and objective sleep measures, whereby poorer sleep hygiene was associated with significant reductions in total sleep time (ß=-0.89, SE=0.33, p< 0.01), REM duration (ß=-0.24, SE=0.10, p< 0.05), and SleepScore (ß=-0.15, SE=0.05, p< 0.01), an objective sleep quality metric. No significant associations were observed between individual sleep hygiene factors and objectively measured sleep. While we could not identify a relationship between individual hygiene factors and sleep, poorer aggregated sleep hygiene scores were associated with poorer objectively measured sleep. Thus, sleep health may not be defined by one single behavior, but rather by the sum of its parts. Future work should examine the efficacy of personalized sleep hygiene factors in sub-clinical populations, where targeted sleep hygiene education may be preferred given it is more intuitive and less burdensome than other behavioral interventions. SleepScore Labs