Test your sleep

Making a self-assessment is the first tangible step towards accountability and better sleep. And even if you go to meet doctor/expert, you are required to make a proper self-assessment before diagnosis and treatment choices can be made. It’s very valuable learning our sleep patterns, identifying (unhealthy) thoughts and habits causing insomnia and seeing if other problems and/or disorders contribute to our insomnia. You can start with a 1 minute test:

1-minute sleep test

In this test, ticking even one box indicates you have a problem with sleep.

By conducting our own insomnia self-assessment we will increase our knowledge and understanding of the thoughts and behaviour causing our insomnia. As a consequence, we start to feel more empowered, and probably start to sleep better. However, it’s also good not to get obsessed with diaries and follow-up and rather concentrate on finding bigger patterns than going nuts with every small detail.

There are many different templates for tracking sleep. We have collected here some that we find most useful and clear.

Your sleep profile

Please find attached a link to The BBC Sleep Profiler. It takes about 10 minutes and includes the Epworth Test – an assessment tool used by sleep experts worldwide. The test gives you a little report with a short overview whether you are lark or owl, how to boost your alertness, about your environment and lifestyle challenges & tips and also a psychological angle. We liked this one.

Sleep disorder index

This questionnaire helps you to understand the severity of your insomnia. Rate every question from 0-4 and then add every answer together for the result.

1. Difficulty to fall asleep                  

0             1             2             3             4

2. Difficulty to stay asleep

0             1             2             3             4

3. Too early awakening

0             1             2             3             4

(0=no problem, 1=slight problem, 2=moderate problem, 3=serious problem, 4= very serious problem)

4. Satisfaction with your current sleep

0             1             2             3             4

(0=very happy, 1=happy, 2=neutral, 3=dissatisfied, 4=very dissatisfied)

5. How much to you think your sleep problem disturbs your daily functioning (for example fatigue, concentration, memory, mood, etc)

0             1             2             3             4

6. Do you think other people notice the effect of your poor sleep onto your quality of life

0             1             2             3             4

7. How worried are you about your sleep

0             1             2             3             4

(0=not at all, 1= slightly, 2=moderately, 3= quite a lot, 4=very much)

Then add on all answers from 1-7.

0-7=No remarkable insomnia

8-14= Mild insomnia

15-21=Moderate insomnia

22-28=Severe insomnia

Sleep diary

A sleep diary helps you to understand causes for your insomnia. This ‘template’ does not give a diagnosis but it provides more insight into the key issues and patterns that require attention. The information contained in a typical sleep diary includes some or all of the following points:

  1. The time the person had wanted or intended to wake up
  2. The time the person woke up
  3. Whether the person woke up spontaneously, by an alarm clock, or because of another (specified) disturbance
  4. The time the person got out of bed
  5. A few words about how the person felt during the day (mood, drowsiness, etc.), often on a scale from 1 to 5 and the major cause
  6. The start and end times of any daytime naps and exercises
  7. The name, dosage and time of any drugs used including medication, sleep aids, caffeine and alcohol
  8. The time and type/ heaviness of evening meal
  9. Activities the last hour before bedtime, such as meditation, watching TV, playing PC-games
  10. Stress level before bedtime, often on a scale from 1 to 5 and the major cause
  11. The time the person tried to fall asleep
  12. The time the person thinks sleep onset occurred
  13. Activity during aforementioned two moments (remaining eyes closed, meditating…)
  14. The presumed cause, number, time, and length of any nighttime awakenings and activities during these moments
  15. Quality of sleep
  16. Level of comfortableness of any recalled good or bad dreams

There are several ready-to-go templates for sleep diary.

NHS sleep diary

Patient.co.uk sleep diary

Or you can download a sleep diary app .

Measuring sleep efficiency

Sleep efficiency is the percentage of sleep of total time spent in bed. For example, I might go to sleep 11.00 but I won’t fall asleep until 12.30. Then I sleep 6 hours (06.30) and wake up 07.00. I have spent in bed 8 hours and slept 6 hours.

Sleep efficiency calculation:

Time slept (hours) x 100 / time spent in bed. In the above case this goes: 6,0h x 100/8,0h = 75%.

The experts aim to get sleep efficiency around 85-95%. If you fall asleep immediately and wake up to the noise or an alarm clock your sleep efficiency is 100%.

Experts say that you should start increasing your amount of sleep when sleep efficiency is about 90% which means you sleep 90% of the time your time spent in the bed. Then you can go to bed 15 minutes earlier or sleep 15 minutes later in the morning. If sleep efficiency remains 90% you can then add another 15 minutes per week but so that sleep efficiency will always remains at 85-95% level.

Note: If the increased amount of time spent in bed does not increase the amount of sleep you should content yourself with the amount of sleep that gives 85-90% sleep efficiency. More so, not everyone needs the ~8 hour sleep every night which is a myth itself. As we age, less can do the trick. It’s also wise to follow up energy levels after different nights. Several things impact our energy levels.

The dilemma here is that we are all very aware of the importance of sleep. Yet one of the biggest enemies is over-trying. If we spend too much time in bed (without sleeping 90% of that time) it almost inevitably means that we start worrying and stressing about sleep leading to further worries and poorer sleep.

Stress test

We face multitude of stresses in our lives on a daily basis covering work, family and personal aspects. Although some people cope well with daily stress (even very high levels!), others experience negative emotional and physical responses that can disturb sleep and overall well-being.

Why do some people lose sleep during periods of stress, while others seem to “sleep like a baby”? Research suggests that the difference may be explained by the ways people cope.

At Tel Aviv University, Dr. Avi Sadeh conducted a study of students. He found that those “who tended to focus on their emotions and anxiety during the high-stress period were more likely to shorten their sleep, while those who tended to ignore emotions and focus on tasks extended their sleep and shut themselves off from stress.”

When we are under stress we might get blind to our own situation. Alternatively, it might also be that our lives are so stressful so long that we forget what ‘normal’ life is and as time goes by our stress management skills get weaker and we become exposed to its harmful side effects such as poor sleep.

In order to understand whether or not stress plays a role in our lives a following stress test is useful to do. This is a fast test with tips in case you are approaching or already are in the danger zone.

Depression, anxiety

Sometimes insomnia is related to mental diseases. In case you suspect that this is possible, do a test for example in here:

Am I depressed test (Depressed test)

Depressed? A test. (WebMD)

Depression screening test (Psych Central)

More information in here:

Understanding depression (Mind.org)

How do I know if I am depressed (Councelling-Directory.org)

Sleep disorders

The reason for poor sleep can also be related disorder. Find more information on sleep disorders in here.

 

References & Disclaimer

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