While technology like polysomnography and actigraphy has been key to helping Americans sleep better, there is an entirely different category of technology that is undoing all that progress. No longer is the television the only technology keeping Americans from getting a good night’s sleep. The advent of communications technology such as the cell phone and laptop computer and their ubiquitous use have impacted both the quantity and quality of sleep people are getting as they make their way into the bedroom. The problem, according to the National Sleep Foundation (NSF) 2011 Sleep in America poll, titled “Communications Technology in the Bedroom,” is that many Americans fail to recognize the connection between these devices and their sleepiness.
The use of communications technology in the hour before bed is pervasive, according to the poll: 95% of respondents—ranging from 13 to 64 years of age—reported use of some type of electronics, either a television, computer, video game, or cell phone, at least a few nights a week within the hour before bed. But recognizing that sleep changes across the age range, the poll dug deeper and looked at technology use among the different generation groups. Baby Boomers (46-64 year olds), generations X’ers (30-45 year olds), generation Y’ers (19-29 year olds), and generation Z’ers (13-18 year olds), in fact, reported very different technology preferences.
While television viewing in the hour before bed was more popular among Baby Boomers (67%) and generation X’ers (63%), only half of generation Z’ers (50%) and Y’ers (49%) reported watching television every night or almost every night within the hour before going to sleep. The poll found that newer, more active, and communicative technology was more likely to interrupt the presleep routine of younger generations. A higher percentage of generation Z’ers and Y’ers were to be found in front of the computer or with a cell phone in hand in that prebed hour, either surfing the Internet (55% generation Z’ers and 47% of generation Y’ers versus 26% of generation X’ers and 17% of Baby Boomers), sending or reading a text message (56% and 42% versus 15% and 5%), or using a social networking site (52% and 42% versus 16% and 9%).
The generation gap continues with video game use in the hour before bed, with generation Z’ers (36%) and generation Y’ers (28%) about twice as likely as generation X’ers (15%) and Baby Boomers (12%) to play a video game in the hour before bedtime at least a few nights a week. More than one in 10 (14%) generation Z’ers say they do so every night or almost every night before going to sleep.
“Over the last 50 years, we’ve seen how television viewing has grown to be a near constant before bed, and now we are seeing new information technologies such as laptops, cell phones, video games, and music devices rapidly gaining the same status,” says Lauren Hale, PhD, a member of the task force and assistant professor of preventive medicine at Stony Brook University Medical Center. “The higher use of these potentially more sleep-disruptive technologies among younger generations may have serious consequences for physical health, cognitive development, and other measures of well-being.”
And the interruptions to our sleep do not end once we are asleep. Of those respondents who reported using their cell phones in the bedroom in the hour before trying to go to sleep (39% of the total sample), more than half (57%) leave the ringers on when they go to sleep. One-third (33%) place their ringers on silent or vibrate. About one in 10 (9%) turn their cell phones completely off. Of those who reported using their cell phones in their bedroom in the hour before bed, one in 10 (10%) reported being awakened by their cell phones at least a few nights a week after trying to fall asleep, by either a phone call, text message, or e-mail. Generation Z’ers and Y’ers were more likely than their older counterparts to be awakened as a result at least a few nights a week (18% and 20% versus 11% generation X’ers and 3% Baby Boomers).
“We spend a lot of money to treat sleep apnea and periodic limb movements in sleep. The main reasons those two sleep disorders are so problematic is they create multiple partial awakenings throughout the night, which then contribute to inefficient sleep and excessive daytime sleepiness,” says Amy Wolfson, PhD, a task force member and professor of psychology at the College of the Holy Cross. “In a way, these generation Y’ers and generation Z’ers are basically creating a sleep problem that’s not different than a diagnosed sleep problem, but it’s self-induced. That is a serious concern to me.”
THE NATURE OF INTERACTIVE TECHNOLOGIES
So, what exactly is it about these devices that affects a person’s sleep? From the social interaction inherent in the use of cell phones for texting to the light exposure that comes from sitting inches away from a computer surfing the Internet, the design of this technology is more arousing than users may think.
“I think [these devices] tend to be more engaging because they’ve often got a social component or a gaming component; they’re inherently more arousing,” says Allison Harvey, PhD, a member of the poll task force and professor of clinical psychology at the University of California, Berkeley. “We humans like competition in games and we love social things like Facebook and Twitter. That back and forth is not passive viewing [as is found with a television].” And that distinction between interactive technologies and passive technologies is key, adds Harvey.
Michael Gradisar, PhD, another task force member from the psychology department at Flinders University, Adelaide, Australia, whose research compares how technologies that are “passively received” such as television and music versus those with more “interactive” properties like video games, cell phones, and the Internet may affect the brain, hypothesizes that the latter devices are more disruptive to sleep because they are more alerting and may delay the sleep-onset process.
While the light emitted from a computer screen is similar to the light emitted from the television screen Americans have been sitting in front of for decades, there is a difference in how these devices are used: Americans are sitting closer to their computer screens than they ever have to their television screens.
“The light that is emitted from a desktop computer or laptop screen—if you are right up on top of it—can have enough of an impact on your physiology to suppress the release of melatonin, which has a signaling effect on the rest of the brain for sleep to occur,” says Russell Rosenberg, PhD, task force member and vice chairman of the NSF, and director of The Atlanta School of Sleep Medicine and Technology, Atlanta.
THE PRICE OF INCREASED TECHNOLOGY USE
The end result of all this technology use is that Americans are sleepy—especially younger generations. While fewer Baby Boomers (9%) and generation X’ers (11%) rate as “sleepy” using a standard clinical assessment tool (included in the poll), roughly one in five generation Z’ers (22%) and generation Y’ers (16%) do.
About two-thirds (63%) of Americans report that their sleep needs are not being met during the week. Most say they need about 7 and a half hours of sleep to feel their best, but report getting about 6 hours and 55 minutes of sleep on average weeknights. About 15% of adults between 19 and 64 and 7% of 13 to 18 year olds say they sleep less than 6 hours on weeknights.
According to the poll, generation Z’ers report sleeping an average of 7 hours and 26 minutes on weeknights, about an hour and 45 minutes less than the 9 hours and 15 minutes recommended by experts. More than half of this group (54%) say they wake up between 5 am and 6:30 am on weekdays—compared to 45% of generation X’ers and Baby Boomers and 24% of generation Y’ers.
“As children develop into their teenage years, their bodies are biologically predisposed toward later bedtimes,” says Wolfson. “If they are required to get up before 6:30 to go to school, it’s impossible for teens to get the amount of sleep they need.”
Additionally, the poll found that 43% of Americans between the ages of 13 and 64 say they rarely or never get a good night’s sleep on weeknights. More than half (60%) say that they experience a sleep problem every night or almost every night, including snoring, waking in the night, waking up too early, or feeling unrefreshed when they get up in the morning.
As a result, Americans are relying on caffeine and naps to cope with their sleepiness. According to the poll, on a weekday, the average person drinks about three 12-ounce caffeinated beverages, with little difference between the age groups. Napping is also common among all the age groups; however, the two youngest groups reported slightly more napping during the week. More than half of generation Z’ers (53%) and generation Y’ers (52%) say they take at least one nap during the work week/school week compared to about four in 10 generation X’ers (38%) and Baby Boomers (41%).
“Now napping in and of itself is not a problem,” says Harvey. “I’m just concerned about the timing of the naps. If naps are before 3 pm and for short periods—20 to 30 minutes—they’re not going to get in the way of sleep for most people. But after school for teens who are already having trouble getting to sleep at night or in front of the television for older adults, that’s really going to get in the way of a good night’s sleep.”
This lack of sleep is not going unnoticed. More than eight in 10 (85%) of respondents who say their schedules do not allow for adequate sleep said it affects their mood; three-quarters (72%) said it affects their family life or responsibilities at home; and roughly two-thirds (68%) said it affects their social life.
For those who are employed and not getting adequate sleep, the effects are being felt at work and at home, with three-quarters (74%) of those over 30 years of age reporting that sleepiness affects their work and about two-thirds (61%) reporting that their intimate or sexual relations were affected by sleepiness (13-18 year olds were not asked this question).
The poll also found that sleepiness is affecting safe driving practices. Half of generation Y’ers (50%) say they drove while drowsy at least once in the last month, while 40% of generation X’ers, 30% of generation Z’ers, and 28% of Baby Boomers admit the same. Even more disturbing, about one in 10 generation X’ers (12%), Y’ers (12%), and Z’ers (8%) say they drive drowsy once or twice a week.
If sleepy Americans are to get a good night’s sleep, says Harvey, an electronic curfew might be in order. From dimmer light conditions in the 30 to 60 minutes before bedtime and bright light conditions on waking, the goal is to create a pleasant environment in the hour before bed so the body can ready for sleep. As Harvey says, “Sleep is not like a light switch. It’s more like a dimmer, so it takes time for us to wind down at night.”
And this prebed routine will be different for everyone. There is no ideal, according to Rosenberg.
“I think this is an important point. One person’s potion may be another person’s poison. Something that might relax me or unwind me might do just the opposite for you,” he says. “But in general, try to reduce the amount of light exposure from computer screens, try to engage in activities that aren’t emotionally stimulating or even cognitively stimulating in an attempt to unwind.”
Assessing these presleep behaviors, including technology use, is vital for sleep professionals treating sleep patients.
“[Clinicians] need to do an adequate environment assessment when they talk to a patient. In other words, [they] need to assess what’s in the patient’s bedroom—what’s on, what’s off—to be able to give advice. And if you don’t ask that question, you might know all about their curtains and their television and forget to ask whether they turn their cell phone off,” says Wolfson.
Harvey points out that a lot of these behaviors, especially those associated with technology, are modifiable.
“It really is simple changes to our lifestyles. And I know it’s hard to do; but I guess that’s the clinician’s role—to work with people to provide the motivation, to kind of be a cheerleader for behavioral change,” she says.
In the end, while these devices offer a tremendous upside to our waking lives, says Rosenberg, their downside must be kept in mind.
“We have to be careful. Our brains and our ability to deal with these technological advances are much slower. They take a much longer time to adapt,” he points out. “We have to be careful not to let them intrude on our normal physiologic functioning.”
Alison Werner is associate editor of Sleep Review. She can be reached at [email protected]