#61 - From Clinic to Classroom: Sleep Education that Works!
Lyn Moseley had been a high school teacher for decades.
Like many people, she desired a sea change.
Psychology was to be the new career.
Only thing was - she had to do a thesis.
And one day she knocked on my door.
Tomato and Basil
Like ‘tomato-and-basil’ or ‘raspberries-and-dark-chocolate’, I saw the match straight away…
“Well if you’re a teacher, why not teach sleep to teenagers in schools?”
To cut a long story short, Lyn’s thesis ended up being published in the best sleep journal in the world …
And even got a lot of press around the world …
To be honest, it feels like a fluke that we got published in SLEEP. But I guess it was the novelty of the study. A few people had been trying to do sleep education in schools in 2000s, but they weren’t getting published. And if they were, they were in lower-ranked journals.
We just made sure we had a strong study design (eg, control group, follow-up measures) and a theory.
And the theory driving this 1st Sleep Education Program (SEP) was cognitive-behaviour therapy (CBT).
You see, between 2005-2010, we were also running our clinical trials in our Child & Adolescent Sleep Clinic - for instance, using CBT for insomnia for kids and teens.
But clinical trials take time before you get to see the results (these initial trials took 5 years).
So we thought we’d move CBT out of the clinic, and into the classroom.
There Was Just One Problem
The ‘C’ in CBT stands for cognitive - which means teaching teens to be aware of their thoughts that enter their mind when trying to fall asleep. Once identified, they can learn skills to deal with these thoughts.
But when you can only squeeze one class of cognitive therapy into a school curriculum, what happens is that teenagers say this:
““Great. I’m now aware of all these thoughts and I don’t know what to do with them!””
It seemed that CBT didn’t lend itself well to the classroom - because there is A LOT of content to teach. And you cannot teach all the skills in 1 lesson.
But we did learn something else.
The teens told us that they wanted to get more sleep - but they weren’t convinced of our methods to change their behaviour.
So ‘behaviour’ is what we focused on in our 2nd Sleep Education Program …
Motivated the Unmotivated
In our clinic, we were getting the impression that it was our work changing teens’ sleep behaviours that was the key ingredient to their success.
So we completely changed our theory from CBT to Motivational Interviewing (MI).
MI had been traditionally used to change people’s behaviours around alcohol and other drugs - as well as gambling.
Yet in the 2000s, there were other fields that were adopting MI.
It was being used for a whole range of reasons, including:
safe sex education
increasing physical activity
eating more healthy food.
reducing the risk of skin cancer.
As yet, no one had applied it to sleep (let alone teen sleep).
So we thought like a teenager (ie, f#ck it! let’s do it!).
And it worked!
Well - it half worked.
The teens really liked the MI-version of our Sleep Education Program. And the teachers told us this version was better than the CBT version.
But There Was One Big Problem
The MI version didn’t completely work.
Despite all the planning and effort; despite how much more the teens and teachers liked it; the MI-version did no better than the control group (who just went to regular classes).
Again - we learned something new.
We did manage to convince teens to make changes to their behaviours - and they did this - but it was temporary. In the end, they said they needed support to help them maintain behavioural changes.
So we thought like a teenager …
F#ck It - Let’s Do It Again
In 2015, with our revised MI-version of the Sleep Education Program (yes, version 3) - we nailed it!
What do we mean by nailing it?
Every sleep education performed on virtually every continent has managed to increase teens’ sleep knowledge.
None had managed to convert this knowledge into actual improvements in the teenagers’ sleep.
Until now!
In fact, none have improved sleep since our program - not even the well-funded Oxford University trial.
But … you guessed it …
There Was Another Problem
Our Sleep Education Program consisted of 4 classes, spread over 4 weeks. And it was delivered by individuals who were formally teachers, but were now psychologists (like Lyn Moseley). Professionals who knew how to handle a class - but also knew how to exact change in teenagers’ behaviours.
This limits how many schools can access our program.
So we started working on a training program, where we teach teachers how to teach our sleep education program (that’s a lot of teaching!).
Guess what?
There Were A Further 2 Problems
You’d think by now we would have given up with all these problems to overcome, right?
Teachers said they were too busy to learn more content. They wanted someone to come in and teach it.
And around this time, the ‘positive psychology’ movement turned into the ‘wellbeing movement’. And sleep was consistently identified as one of the ‘cornerstones’ or ‘pillars’ of wellbeing.
And schools would have a ‘wellbeing series’ or a ‘wellbeing’ day.
But they only wanted 1 class on sleep. Not 4 classes spread over 4 weeks.
What they didn’t get was that our research showed that change doesn’t happen in one day.
Actually, did I say there were 2 problems? I forgot one …
Our University was not able to commercialise our Sleep Education Program. For them they told us the case was closed.
Nah, F#ck It - Let’s Keep Going …
We were either dumb or stubborn (or both).
Or perhaps we were adaptive?
You see, from 2005-2015 we were developing clinical treatments and a sleep education program that were composed of multiple techniques.
Our sleep education program worked - as did our treatments.
But which techniques were the best?
Given the fact that I’m becoming more inattentive as I age (like some Benjamin Button curse), I wanted to see how much ‘bang you could get for a buck’.
2015-2021
Here’s the short story:
We did it. And we’re still doing it.
We managed to find a way to deliver a sleep education program into a single class.
And the techniques in this new program improve sleep in teens:
They have less negative thoughts when trying to fall asleep.
They fall asleep faster.
They get about 100 minutes extra sleep per school week.
We’ve delivered so many presentations in schools; collected so much data from teens; helped so many teens in our sleep clinic; that we know just about everything about what causes their sleep to worsen, and how to make it better.
We’re creating our new Sleep Education Program for release in 2021.
We’ve got the tagline (it’s the heading of this blog).
We just need a name for it.
Coz I don’t think “Unf#cking Your Sleep” is gonna fly …
Or will it?
In any case - the morale of this story is “F#ck it - keep going!”
Prof Michael Gradisar