Is Your Insomnia Treatment Working?

I’ve struggled with insomnia all my life. I’ve probably spent more time researching methods to improve my sleep than I have anything else. But how can you tell if your sleep is improving as a result of your changes?

As a data-driven person, I turned to apps and fitness trackers. Most of them aren’t very reliable when it comes to determining the sleep quality. So, I’ve cobbled together a set of qualitative and quantitative (maybe) methods to assess my sleep. I recommend that you do a baseline assessment first. Then pick a few strategies to improve your insomnia and try them for 2-4 weeks. Redo the assessments, and see if your insomnia is improving.

The National Sleep Foundation’s Sleep Diary

The National Sleep Foundation’s Sleep Diary is a simple log of sleep and wake times, qualitative assessment of sleep quality, and a tracker for caffeine, exercise, and other behaviors that might impact sleep . The simple 1-page form covers a week’s worth of data. I highly recommend recording your sleep data based on what you’ve observed. Don’t look at a sleep tracker app or fitness watch to get this data.

The Pittsburg Sleep Quality Index (PSQI)

The Pittsburg Sleep Quality Index is a self-assessment of sleep disruptions. The survey covers the last 30 days’ worth of sleep. The first couple of questions are about sleep and wake times, hours of sleep, and other data that you will have captured when you fill out the National Sleep Foundation’s Sleep Diary. I don’t think it matters what order you do the two things. If you do the PSQI first, then I believe it can be illuminating to compare your concept of sleep times with the more accurately measured values you obtain from the Sleep Diary.

The next element of the PSQI survey asks about the frequency of different factors that disrupt sleep, such as getting up to use the bathroom at night. I think this can be the most useful section of the form. If you haven’t worked on improving your sleep hygiene, apply the Pareto principle to these results. What one or two items has caused you the most sleep disruption in the last month? Fix them and then reassess.

The PSQI is a validated tool for sleep assessment. There is a scoring algorithm, but I think for trying to hack your sleep, you probably don’t need to worry about this. If you do see a sleep specialist, they will score the survey. A score over 5 indicates sleep problems.

Your Fitness Tracker or Sleep App

I include this last because I’ve found very poor agreement between this data, my subjective experiences, and what I remember of how I slept. Generally, the most significant discrepancy comes with determining sleep onset. Lying still in bed looks the same to your watch as actually being asleep. I think these devices are more accurate when it comes to determining the number of times you wake up in the night.

I’d compare the results from the app with your sleep diary. You may find the results are quite accurate for you. Or, like me, you might find specific measures more accurate than others.

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