#68 - Blue Screenlight vs Feeling Blue - Part 4

In Part 1 of this blog series we unveiled the myth that blue screenlight causes difficulties falling asleep.

In Part 2 we showed that 1.5 hours or more of bright screen use (which contains blue light) reliably reduces melatonin - even though this doesn’t lead to difficulty falling asleep!

In Part 3, we took a left turn and introduced readers to the concept of flow and how it’s more influential than the brightness from blue-enriched screenlight.

In this final part of the story, we take a second left turn.

If you know how to add ‘left turns’, two left turns make a U-turn. And that’s exactly what we’re doing this week. Instead of thinking that technology use causes sleep problems, we’re going to reverse that idea.

We’re going to look at whether technology use before sleep helps with sleep problems …

Yes. We’re asking you to open your mind to that possibility. And to help you, we’re going to provide some pieces of evidence from various studies - and also invite you into our clinic - to pull this strange concept together.

Here goes …

Those Arrows in The Model

At the beginning of the 2010s we published an explanatory model of how technology use could affect sleep.

For the first part of the 2010s I became obsessed testing the mechanisms in the middle box (eg, bright screenlight, arousal, etc.).

In 2021, I am now focusing on those arrows in the model. The arrows suggest what’s called “A Direction of Effect”. This means that the direction moves from technology use to sleep - and not the other way around.

When I get my next chance to update this model, I’ll be changing the direction of the arrows…

Taking 10 Min to Fall Asleep at 4 AM

Whilst I was obsessing about the mechanisms linking technology use and sleep in my research time, something completely different was happening during my clinical time treating teen sleep problems.

And I distinctly remember one case that was a turning point.

He was a 16 year old teenage boy who was falling asleep at 4 AM each night (and obviously wasn’t going to school).

And he was averaging about 10 minutes to fall asleep.

Although he wanted to change the timing of his body clock (so he could go for daytime jobs), he was surprisingly calm about his bedtime routine - which included a smörgåsbord of technology use.

And he said something that struck me.

“I use to lay in bed for hours tossing and turning. Thinking of everything and nothing. So one day I thought, f#ck it, I may as well do something. So I started watching movies. And it made me feel better.”

It made perfect sense to me.

For a decade before this 16-year old, I was hearing virtually every adult with insomnia state that they would lie in bed and think - and worry - and ruminate.

And a whole bunch of these insomnia patients had moved their TV out of their bedroom because “That’s what the books say you’re supposed to do” (note: this was before smartphone became a thing).

The very first time we evaluated our adult insomnia treatment back in 2004, it was incredibly insightful.

We didn’t increase their sleep, but we did decrease their time awake in bed. And we also improved their anxiety and depression - even though we only focused on their sleep behaviours.

In other words, we began reducing the opportunity for them to be awake in bed, and thus limiting their time to worry and ruminate.

“Prior To The Tone, Were You Awake Or Asleep?”

One of the jobs I did during my PhD was coding answers to the question above for another PhD student, Jeremy Mercer.

Jeremy’s thesis was investigating sleep misperception - the idea that people with insomnia are more likely to perceive light sleep as being awake.

In one of his studies, he was monitoring the sleep of people with insomnia, and would wake them up during different stages of sleep (eg, light, deep, REM sleep) with a tone.

When the tone woke the person up, a pre-recorded voice would ask them whether they were awake or asleep before the tone. If they said they were awake, the voice would ask what were they thinking prior to the tone.

My job was to categorise what they were thinking, based on the research of …

Wicklow & Espie (2003)

Prof Colin Espie is one of the Insomnia Gurus in the world, and 3 years after the Millenium Bug, he published a study recording the thoughts of people with insomnia.

His team then categorised these thoughts.

One common theme was ‘Sleep & Its Consequences’. For example, people would think about how long it’s taking them to fall asleep, how much sleep they might get, how it’s not enough sleep, and how bad they will fell tomorrow.

But the main theme was ‘Planning & Rehearsal’.

People began planning for tomorrow - even the week ahead. They would think of what tasks they needed to prioritise, and how they have so much to do. They’d even worry about an upcoming even that they felt they had no control over. Or …

They would ruminate. What happened today - especially the things that didn’t go well. What does that mean for their life, or even how people view them.

As you can imagine - these thoughts really led to the ‘Bedtime Blues’. And these themes were exactly what I heard time and time again when I was seeing people who had insomnia.

And because I was seeing adults with insomnia in the 2000s, they didn’t have technology in the bedroom.

This meant that they would spend hours, lying awake in the dark, alone with their thoughts …

But not the 16-year old teenager I later saw. He figured out what to do …

Nodding Off or Switching Off?

In 2006, Prof Jan van den bulck led a survey study where they asked teenagers whether they used certain activities - including the use of technology - as a sleep aid.

Strange hey?

Music was used the most, followed by books, watching TV and playing computer games.

What’s interesting about this study was the questions it asked. That is, the questions were getting at a behaviour (using technology) and relating it to a reason (helps me fall asleep).

The flaw with surveys is that they usually cannot determine the ‘direction of effect’ between variables (in this case the variables are technology use and sleep) - because they are measured at the same time.

A better way is to measure variables over time. That way, you can see if a change in one (technology use) sees a change in the other (sleep) later on.

Filling The Void

One of the first studies to test which variable changes first was published several years ago.

Researchers found that 19-year old University students developed sleep problems first, and then later on increased their evening technology use. Worth noting, is that changes in technology use did not see an increase in sleep problems later on.

Whilst this study did not ask the University students why they increased their technology use, I can just imagine their experience was similar to the 16-year old teenager I was treating.

They learned if they were going to be awake for hours that they may as well do something.

So they could fill the void of lying awake in the dark with their thoughts.

Because their thoughts … are really unpleasant … as highlighted in these findings from Swedish researchers last year …

I’m aware some people speed read, and others scroll past images. I really encourage you to soak in the above screenshot from Jakobsson and colleagues’ study. If you really want to understand what it is like for a teenager to fall asleep without using technology, then the above information gives you a great sense of that.

Escaping Negative Feelings

Recently, I was asked to give a ‘Year in Review’ talk for an international conference. The great thing about these reviews is that you get a chance to get stuck into the sleep science that you may have missed.

I recall scanning over titles in Google Scholar, and one title caught my attention quick smart !

Even though it was a survey study of over 1,000 Latvian teenagers, the findings - once again - resonated with the 16-year old teenager I’d been treating.

Obscure studies like this one come out when researchers ask teenagers their point-of-view.

Many teenagers experience the blues. And whilst many can feel the blues after using technology use, new research coming out shows that many teenagers use technology to distract themselves from worrying in the dark.

Do You Use Technology To Distract Yourself From Worrying?

This is a question a former research student of mine - Alex Daniels - asked several hundred teenagers.

Two out of every 3 teenagers confirmed they did.

And those teenagers who did use technology to distract themselves were more likely to report that they had a sleep problem.

It was their way to cope with the distressing worries that began entering their minds in the hour before bed.

He Wasn’t The Only One

Back to that teenager who had learned to use technology until sleep arrived around 4 AM…

He wasn’t alone.

I’ve treated so many teenagers for their sleep issues. So many of them report worrying before falling asleep. We have been listening. We’ve been learning from them. And we’ve been trying to tell their story for several years now (Hiller et al., 2014).

Teens are getting sick and tired of being sick and tired.

They’re also sick and tired of adults - even sleep experts - telling them not to use technology at night.

It’s their safety net.

I’m sure that if we were high-flying circus performers, we wouldn’t want teens to tell us to remove the safety net.

Instead, they want to be heard.

They want adults to understand what they’re going through.

And they want real solutions to their sleep problems.

We’re gonna give some of those solutions to our subscribers 15 min from now…

Because switching off their device doesn’t mean they get to switch off …

• Prof Michael Gradisar.