Talk:Sleep hygiene/Archive 2

Archive 1

Archive 2

Major revision an expansion again

Just a heads up! Over the next month or so I will be expanding the recommendations, and organizing by level of research support. I will additionally be adding new sections to this page. I have been reading sleep hygiene related articles for years, and look forward to integrating this knowledge on this page. Please let me know if you have any thoughts or concerns! leslierrn (talk) 16:41, 29 October 2014 (UTC)

Not a how-to (2)

We're back there again. The article is now in an unacceptable form, one which is not encyclopedic.

Quoting from the policy page What Wikipedia is not

Wikipedia articles should not read like:

1. Instruction manuals. While Wikipedia has descriptions of people, places and things, an article should not read like a "how-to" style owner's manual, advice column (legal, medical or otherwise) or suggestion box. This includes tutorials, instruction manuals, game guides, and recipes. Describing to the reader how people or things use or do something is encyclopedic; instructing the reader in the imperative mood about how to use or do something is not.

(I've bolded the words "medical" and "imperative".)

Giving orders such as "Do this" and "Avoid doing that" is clearly not allowed in a Wikipedia article. Hordaland (talk) 13:34, 28 November 2014 (UTC)

Better now, I think. Hordaland (talk) 15:34, 28 November 2014 (UTC)

Y Done. I have better tried to balance being comprehensive with maintaining your less instructional language. Thank you for your efforts here. I had intended to add a controversy section (working on it today) that notes the importance of realizing that recommendations have been researched to different extents, so in the mean time, the article did indeed read problematically more like a "how to" - leslierrn (talk) 19:53, 28 November 2014 (UTC)

Hi, leslierrn. I wonder how your comment got dated in October!

I became aware that I was messing up your non-sentence points by changing some of them to sentences. But I got too tired to continue.  :(

I'm glad you left the sentence "Clinicians choose which item(s) to recommend for each individual patient..." just under the main heading Recommendations, where I put it. I think that that is a very important point that shouldn't be hidden far down. However, I also left the very similar sentence far down where it was. It's probably important enough to be in there twice.

The last point under Engaging in advisable activities seems out of place to me. It's important, but is there a better place for it?

I think this is what Wikipedia calls collaboration! --Hordaland (talk) 11:42, 29 November 2014 (UTC)

Yes, I really appreciate your investment in this! I made a revision based on your last point. As for stressing the importance of individuals seeking professionals' help for self-application, I now have that mentioned in the intro section, the recommendations section, the controversies section, and the counseling section. Hopefully this will sufficiently make clear that this article is not intended to be a "how to" on its own. --leslierrn (talk) 21:47, 30 November 2014 (UTC)

Could the following sentence be rewritten for clarity?

• "In general, there has been less research on sleep hygiene principles in non-clinical samples."

For example (if this is what really is meant):

• "In general, most research on sleep hygiene principles has been done in clinical settings." --Hordaland (talk) 22:35, 11 December 2014 (UTC)

GA Review

This review is transcluded from Talk:Sleep hygiene/GA1. The edit link for this section can be used to add comments to the review.

Reviewer: Melody Lavender (talk · contribs) 17:43, 8 December 2014 (UTC)

Hi! I will be reviewing this article. First, it is still very much a how-to article. This could be solved by writing the text more like you are writing about scientific findings from therapist to therapist, not so much an advice article for patients. The heading could be changed from 'recommendations' to something like 'aspects of sleep hygiene'. Also the bullet point format is not the usual style format for Wikipedia articles. It should be in paragraphs. I also noted that an excessive amount (about half) of the references is to a single source.--^Melody _Lavender 17:43, 8 December 2014 (UTC)

Hi Melody, Thanks so much for taking this on! I liked your suggested new header, and I will work today on re-formatting the recommendations in a new way other than bullets. As for the most frequent reference I use, I'm a little torn. I have had a few classmates that were told by their reviewers that they should not cite as many original journal articles, and that review articles are preferred. The Hauri chapter that I cite the most was a review of many sleep hygiene studies and findings, so it seemed like a perfect source. I can add original journal article citations more throughout the page though, in addition to the Hauri chapter. Please let me know if this would be preferred. -- Leslierrn (talk) 15:45, 9 December 2014 (UTC)

The assessment section, by the way, can stay in bullet point form. The sources should ideally all be secondary, the guidelines for this are at WP:MEDRS. One possibility to find such sources is typing in "Sleep hygiene" review. You'll usually get some results that live up to MedRS. I just found these sources, for example, on google scholar:

• Benca, Ruth M. Diagnosis and Treatment of Chronic Insomnia: A Review In: Psychiatric Services Volume 56 Issue 3, March 2005, pp. 332-343.
• Lewandowski, Amy S., Marisol Toliver-Sokol, and Tonya M. Palermo. Evidence-Based Review of Subjective Pediatric Sleep Measures In: Journal of Pediatric Psychology Volume 36, Issue 7, pp. 780-793.

These are just two papers I picked because the full text is available online, which is very useful to our readers. There are several others, they don't all have to have the full text online, of course. I'm afraid medical editors here at Wikipedia are particularly picky about sources.--^Melody _Lavender 17:51, 9 December 2014 (UTC)

Hi Melody, I have updated the formatting of the recommendations section - it is now more appropriately avoiding a "how-to" presentation. I will continue the last of my edits through tomorrow, adding in some supplemental citations per your advice. Thank you for your feedback and advice on this! -- Leslierrn (talk) 5:05, 11 December 2014 (UTC)

Hi again, I have identified a number of other review articles related to the various topics, and have accordingly replaced repetitive citations with these. I am happy to do more still to make this article better quality for our wikipedia readers. Thank you again for volunteering your time to review this sleep hygiene article!-- Leslierrn (talk) 19:50, 11 December 2014 (UTC)

Hi Leslierrn! All 6 Good Article criteria are met and I will pass the article. Thank you for your great work!--^Melody _Lavender 20:13, 12 December 2014 (UTC)

• Well-written  Done
• Verifiable  Done
• Broad in its coverage  Done
• Neutral  Done
• Stable  Done
• Illustrated - criterion doesn't apply.

Hi Melody, This is fantastic news! Thank you so much for taking the time to provide feedback and review the article - it was truly a collaborate effort. I'm glad wikipedia readers will now be able to learn about sleep hygiene in a informed and balanced way. Thank you! -- Leslierrn (talk) 22:05, 12 December 2014 (UTC — Preceding unsigned comment added by 76.170.129.6 (talk)

Moved

This text (if it can be sourced to secondary reviews), belongs at sleep deprivation, with a brief link worked into this article. (comment above by — Preceding unsigned comment added by SandyGeorgia (talk • contribs) 01:36, 13 December 2014 (UTC) )

Results of poor sleep hygiene

Cognitively, sleep deprivation has been associated with diminished logical reasoning abilities, slower reaction time, decreased attention and concentration, difficulties with memory, decreased work efficiency, and high rates of mistakes and omissions. Emotionally, restricted sleep has been associated with high levels of perceived stress, increased irritability, and decreased motivation. Physically, sleep deprivation has been associated with weakened muscles, disrupted visual perception, increased appetite, and weakened immune system.

Okay, instead of going back and forth on these edits. Let me approve this here. I would like to add the below text in as an article section again. That review paper referred to results OF sleep hygiene, so it is not off topic now. — Preceding unsigned comment added by Leslierrn (talk • contribs) 21:36, December 13, 2014

Results of poor sleep hygiene : Knowledge of sleep hygiene practices has been found to relate to actual use of sleep hygiene practices. In turn, adhering to sleep hygiene practices has been associated with increased total sleep time, increased sleep efficiency, and decreased subjective sleepiness. There are correspondingly a number of detrimental cognitive, emotional, and physical consequences of the resulting sleep deprivation and poor sleep quality.

The Brown source has MEDRS tag in the article; it is not good. Only the last sentence actually discusses "results of poor sleep hygiene" and is nonspecific. What is the source for that statement? Thanks. Jytdog (talk) 21:39, 13 December 2014 (UTC)

What I am trying to say, is that if you really want a section on "Results of poor sleep hygiene" then please generate well-sourced content that actually discusses that. If you cannot find sources that directly discuss it, please just say nothing. My sense is that you couldn't find sources and were trying to kind of back into it, but that is WP:SYN. This is a pretty interesting topic. For people who present with insomnia, clinicians look at how good their sleep hygiene is. If they find behaviors that are are not good sleep hygiene, they recommend that the person with insomnia change those behaviors. The whole paradigm is kind of a companion diagnostic or theranostic. The clinician runs the checklist, checks off behaviors that are poor hygiene, and recommends behavior changes to the good hygiene practices. It is strange to discuss "results of poor hygiene" in the abstract - outside the context of somebody with poor sleep. I don't know if somebody who has "poor sleep hygiene" necessarily will have bad sleep and therefore have the problems that come with sleep deprivation. do you see what I mean? I am not sure the section is conceptually valid. Jytdog (talk) 22:07, 13 December 2014 (UTC)

The result of bad sleep hygiene is bad sleep. That is a result, and if it is not included and cited in a section of the article, then we are losing those facts. I have found new citations that are reviews of multiple studies that support each claim. It is absolutely not the case that I "couldn't find sources" and was "trying to kind of back into it." I think that we will have more productive collaboration if we are not trying to assume negative intentions. If you look at the archived sleep hygiene article from yesterday, you will see that there were many citations. The content was just deleted, so I tried to revise my approach. I understand that the citations I did use are not preferred, so I found others now. These are such robust findings, that many articles say the same thing. That is how I learned about these aspects of sleep hygiene - by reading them, and then adding them to the wikipedia article I was expanding. Hopefully that provides insight into my process. leslierrn (talk) 22:33, 13 December 2014 (UTC)

I do understand that you are assuming that "the result of bad sleep hygiene is bad sleep.". Really I understand that. You just have not had a source for that, and seem to be just be assuming that. Jytdog (talk) 23:13, 13 December 2014 (UTC)

Updated proposed content:

Results of poor sleep hygiene : Knowledge of sleep hygiene practices has been found to relate to actual use of sleep hygiene practices. In turn, adhering to sleep hygiene practices has been shown to result in increased total sleep time, increased sleep efficiency, and decreased subjective sleepiness. Good sleep hygiene has also been associated with earlier bedtimes and shorter sleep onset latency. There are correspondingly a number of detrimental cognitive, emotional, and physical consequences of the resulting sleep deprivation and poor sleep quality.

Would you please tell me what "Knowledge of sleep hygiene practices has been found to relate to actual use of sleep hygiene practices" has to do with "results of poor sleep hygiene"? More to say, but you have not spoken to this so am asking this one question. Thanks. Jytdog (talk) 22:39, 13 December 2014 (UTC)

Follow on questions:

• The sentence "In turn, adhering to sleep hygiene practices has been shown to result in increased total sleep time, increased sleep efficiency, and decreased subjective sleepiness" doesn't specify a population. The source you use there, Irish, says "lthough research has demonstrated links between individual sleep hygiene components and subsequent sleep, evidence for the efficacy of sleep hygiene education as a treatment for insomnia has been limited and inconclusive." So you are not talking about people diagnosed with sleep problems. The article goes on to addressing the general population - its use in public health. What it says about that, is; "Though the utility of sleep hygiene education may be limited in clinical settings, there are several reasons to consider its potential to improve sleep and promote health in the general population." In other words, 'we don't know if it works in that population. And please see the "Practice points" in the box at the top of page 11. So... where in Irish is support for your 2nd sentence? Jytdog (talk) 22:55, 13 December 2014 (UTC)
• your source for the last sentence doesn't even mention "hygiene". it is about sleep restriction. again, you are assuming that poor sleep hygiene necessarily causes sleep deprivation. i don't think you have any support for that. This is like many diagnostic tests or risk factors. You know what percentage of smokers get lung cancer? 25%. Not 100%. Or think about Human body temperature. If you have a temperature of 100 degrees are you definitely' sick? No. You seem to be thinking that poor sleep hygiene is necessary and sufficient to cause bad sleep (with its subsequent problems), and as far as I know, this is not true and you have not brought any source saying it is true. It is pretty straightforward. Jytdog (talk) 23:12, 13 December 2014 (UTC)

The new source PMID 25444442 is great. Great find. Please use it respectfully! First, it is limited to adolescents. Second, it cautions quite clearly that it found correlations, and is not drawing causation; it notes that there are tons of confounders. 10,000 foot view - you would expect happy kids in happy stable homes to have better sleep, and better sleep hygiene. What causes what in that scene? Formally what the article says is: "Importantly, due to the correlational nature, no cause or effect could be determined, and future experiments will need to ascertain the direction of effect."{p 12). So this also does not support that poor sleep hygiene causes bad sleep, which appears to be the argument you are trying to make. But great source, yes. Its key conclusion (among others, which are important to also include) is that "Good sleep hygiene appears to be a protective factor" for adolescent quality sleep. Again, not causation. A protective factor. (like quitting smoking decreases, but doesn't eliminate, the risk of lung cancer and smoking increases the risk of getting lung cancer, but is not 100% predictive). Jytdog (talk) 23:28, 13 December 2014 (UTC)

I can delete that first sentence, rephrase it, or put it elsewhere in the article. When good information about sleep hygiene exists in the world, it would be a shame to not include it in this article. Seems like you're issue is with the placement of this. Would you like to make a suggestion?

Regarding the Irish article, it is pretty long with lots of relevant content, so I'll provide some of the other quotes that support the sentence:

• "To maximize its relevance to the general population, when possible, the present review is focused on adults who were not specifically recruited because they suffered from clinically diagnosed sleep disorders."
• "Several studies of nonclinical adult populations have examined the association between sleep timing regularity and sleep. Though not entirely consistent [102], these data typically suggest that irregular sleep schedules are associated with greater daytime sleepiness [103] and worse self-reported sleep quality [104] and [105]."
• "In sum, the evidence demonstrates a clear association between sleep schedule irregularity and sleep problems, though the data in nonclinical samples are somewhat limited by their self-report nature."
• "Epidemiologic and laboratory research provide some support for the relationships between individual sleep hygiene components and sleep, and each recommendation is supported by plausible physiological and psychosocial mechanisms."

So yes, they acknowledge that findings are occasionally inconsistent, but support exists for the relationship. I have acknowledged in my "research" section of the sleep hygiene these limitations of existing sleep hygiene research. Perhaps you would like me to move all this content to that sub-section of the sleep hygiene article? I imagine that could resolve our disagreement over this content. leslierrn (talk) 23:25, 13 December 2014 (UTC)

Yes, great, you are dealing with the messiness - that Irish doesn't support the content you propose and probably no source will, because we don't know. I think you are getting that now, which is great. I don't know if you looked at my user page, but i have a thing with what i call somewhat coarsely, "bullshit" - namely "speech intended to persuade, without regard for the truth". and what I say there is "Where things are not fully explainable, and we are dealing with uncertainties, that has to be clearly acknowledged. (Much bullshit is generated in claims of certainty, in cases where none can be had.)". In many, many MANY health related topics, there is a LOT we don't know and it is a bad thing to write content as though we do. So communicate what we know, accurately. Please.

about that first sentence - it could go any number of places in the article. It just has nothing to do with the section you created and put it in. However, a) the new source does not support it - in fact the source contradicts it. It starts out by saying that "there is limited research to support the notion that knowledge of healthy sleep practices improves an individual’s sleep quality" and its conclusion is "The present study provided only minimal support for the notion that sleep education for the general public leads to improved sleep quality." (!) Very very different from the content. disappointingly different. :( and again :( and b) this is a primary source that is 7 years old - not much better than the Brown source. Jytdog (talk) 23:41, 13 December 2014 (UTC)

Just as a request, I would be so much more willing to work on this if you attempted to be less condescending. When you say things like "you are getting that now" and referring to content that I've work on for weeks as "bullshit" it really reduces my motivation to collaborate. Especially when your attention seems selective, as I have had that note about research inconsistencies in the sleep hygiene article since two weeks ago. Expecting that sources should be less than 7 years is pretty extreme, considering that researchers may not publish an updated review every few years. Research does not become less valid in 7 years. Your feedback has been less constructive in providing solutions. Getting a little burnt out. leslierrn (talk) 00:55, 14 December 2014 (UTC)

Sorry you are getting burnt. I don't understand what it is driving you. in any case, I have told you exactly what is wrong with the content and with the proposed section altogether. I will say it again - a section broadly talking about "results of poor sleep hygiene" is based on an assumption of causality that the literature doesn't support, as far as I can see. I have looked. Instead of listening and adapting, you just keep going after the same thing - this assumption you have that there is causality. And you still have not found a source that could support such a section. I reckon that would be exhausting. More importantly to our collaboration, you didn't acknowledge that you have proposed content that was not only not-supported by the source, but directly contradicted by it. (This is what often happens when editors bring an assumption to the table and try to shove it in, instead of reading the best sources they can find and listening to them) This is all about content and sources, not about ego. I fuck up all the time, and I acknowledge it and apologize. Anyway, good luck. Jytdog (talk) 01:31, 14 December 2014 (UTC)

Some examples of being condescending still would be "And you still have not found a source that could support such a section. I reckon that would be exhausting" and "I fuck up all the time, and I acknowledge it and apologize." And yet you did not apologize. You said you were sorry that I was having an experience - not the same thing. If this conversation should not be about ego, then please do not put me down while you talk yourself up. I proposed above that I move all this content to the research controversies section, to resolve the issue of findings being inconsistent. For some reason you did not respond to that suggestion. Also, I had prepared a response to your claim that my source contradict my content, but deleted it, thinking that I am wasting my time getting in a battle with you. I will re-type it now. leslierrn (talk) 02:00, 14 December 2014 (UTC)

please discuss content and not contributors as much as possible. It is not about you or me, but the content. Thanks. Jytdog (talk) 02:04, 14 December 2014 (UTC)

Perfect, that's exactly what I was asking you to do. This will be much easier if we can discuss what is wrong with the content, instead of what is wrong with the person writing the content. Glad we agree. leslierrn (talk) 02:08, 14 December 2014 (UTC)

The first sentence: "Knowledge of sleep hygiene practices has been found to relate to actual use of sleep hygiene practices". The source "there is limited research to support the notion that knowledge of healthy sleep practices improves an individual’s sleep quality" and its conclusion is "The present study provided only minimal support for the notion that sleep education for the general public leads to improved sleep quality." Direct contradiction. Jytdog (talk) 02:06, 14 December 2014 (UTC)

Your quote is actually different than what I am writing in the content. Your quote is saying Sleep Hygiene Knowledge --> Good Sleep Quality. I'm saying Sleep Hygiene Knowledge --> Sleep Hygiene Practice. Separately, Sleep Hygiene Practice --> Better quality sleep. A paragraph in the discussion section: 1) "For the entire sample, significant relationships were found between global measures of sleep knowledge and practice, as well as with sleep quality." Supporting first sentence I wrote. 2) "Further analyses revealed that sleep practice (i.e. practice of both sleep hygiene and behavioral therapy techniques) mediated the relationship between global sleep knowledge (i.e. knowledge of sleep hygiene and behavioral sleep practices) and sleep quality." Supporting the second sentence I wrote. So it's good that I never said that sleep hygiene awareness was sufficient to produce positive results, because yes, that is where the findings in the study got complicated. In the conclusion of that paragraph, the authors still maintain that "This suggests that sleep practice is an important factor affecting sleep quality, above that of age and gender." SO, since my content never was in contradiction with these findings, let's shift our focus on how to re-write it so that this distinction could be more clear. I would also appreciate it if you could respond to my suggestion about moving this content to the "research" section of the article, so that I can make the changes. leslierrn (talk) 02:22, 14 December 2014 (UTC)

I will deal with the contradiction thing in a bit.. but whoa i am catching you now. you did say something about moving this to a "research" section - one of the strongest things I have been reacting to, is the section title which is "Results of poor sleep hygiene" and I have said that the content is not about that. Let me ask you - moving this to a research section, what is this talking about - what will the point be? The proposed content doesn't mention "research". so i am not following you. thx Jytdog (talk) 02:54, 14 December 2014 (UTC)

I don't understand what you mean by the catching me thing. But I'll explain what my plan would be. Also, I'm probably not going to respond to another statement about the contradiction thing. I'm pretty content with my explanation, and don't see continuing that thread as the best use of our time. I agree with you about the "results" and causation thing, which is why I proposed moving it to the "research" section as an easy fix. I think a lot of this back and forth has been unnecessary, if we go with this suggestion that I made hours ago. Here is what I would have in mind: Move the content I have into the result section (maybe after all exisiting content), with an intro line about how "there has been some research on the results of SH awareness and practices, but findings here have also been inconsistent." (then bring in paragraph of content). Then finish with" However, these findings vary depending on the population being studied." something like that. leslierrn (talk) 03:08, 14 December 2014 (UTC)

i didn't grasp that you were proposing making this into something else. I have been thinking we are talking about "results of poor sleep hygiene" in this whole conversation. I have no idea what you want the to be about now nor what you want to say. I am open. It just needs to be based on what the sources actually say. propose away! but just had a thought -- maybe what you have had in your mind the whole time, is an "Efficacy" section. hm! is it? If so, I think that would be fine, and you have the 2014 Irish reference for content. Which I already cited in the lead, and really should be discussed in the body. Jytdog (talk) 03:21, 14 December 2014 (UTC)

Sorry for the confusion. I'll have to consider if it will be easier to fit it into the "research" subsection or a new "efficacy" section. I'm exhausted and behind on other work for the day. I will think on it, and come back to it once I have a better idea of how I can write this in a way that reflects both our sentiments. leslierrn (talk) 03:58, 14 December 2014 (UTC)

References

DYK

Template:Did you know nominations/Sleep Hygiene Chris Troutman (talk) 04:29, 14 December 2014 (UTC)

Sources

• Lavigne, G. (2003). Sleep and Pain. “sleepmatters”

What is that? It is not a complete citation. SandyGeorgia (Talk) 02:18, 13 December 2014 (UTC)

 Done, now gone. SandyGeorgia (Talk) 13:37, 14 December 2014 (UTC)

• Other sourcing cleanup; some primary sources need attention. I also removed "Further reading", as everything listed there was already used as a source. SandyGeorgia (Talk) 02:36, 13 December 2014 (UTC)

Dated

• Driver, Helen S.; Taylor, Sheila R. (August 2000). "Exercise and sleep". Sleep Medicine Reviews. 4 (4): 387–402. doi:10.1053/smrv.2000.0110. PMID 12531177.

This review is 15-years old; can it be replaced with a recent source? SandyGeorgia (Talk) 13:24, 14 December 2014 (UTC)

Removal of Counseling and resources section

Jytdog,

I see that your reason for removing this entire section was because of wikipedia "how to rules". While I can see the need to delete the second paragraph, I have reviewed the first paragraph of this section, and compared it to the NOTHOWTO page. I cannot identify which of the types of incorrect "Encyclopedic content" (sections 2.1-2.11) you believe this article was creating. If you could be specific, that would help address the concern. Below is the new content I am proposing. I would like to have this content appear somewhere in the article, but am open to suggestions of how else to incorporate it. Thanks. leslierrn (Talk) 22:56, 13 December 2014 (UTC)

Clinicians who advise sleep hygiene strategies for individuals and families have lists of suggestions which may include advice about timing of sleep and food intake in relationship to it, exercise, sleeping environment, etc. Which items are suggested for which people are selected by the clinician, depending on knowledge of the individual situation; the counselling is presented as a form of patient education. As attention to the role of sleep hygiene in promoting public health has grown, there has been an increase in the number public sleep hygiene resources available in printed materials and on the internet.

This is an improvement. I think the section head this is moving into is something like "Clinical and public health implementation" and the section could include content about what kind of clinicians are using this concept (a friend's therapist actually discussed sleep hygiene with her) - so psychologists, primary care, sleep doctors? And who is implementing public health initiatives, and how? And how prevalent is it? are boatloads of clinicans using it, or is it a kind of fringey idea? (I don't think it is fringey at all, but because the article doesn't discuss this, the reader doesn't have the facts to know) All of that would be encylopedic, non-howto content that would tell us more about this ... paradigm. that's interesting. just not doing public health outreach itself, which was where the former content was going. Jytdog (talk) 23:50, 13 December 2014 (UTC)

When you say we should include "who is implementing public health initiatives, and how" that confuses me, because that is the exact information that you deleted. "As sleep hygiene has become more popular, a number of sleep hygiene resources have been made available online to the public. The websites of the National Sleep Foundation and the Division of Sleep Medicine at Harvard Medical School have published tips for sleep hygiene, instructional videos, sleep hygiene self-assessments, poll statistics on sleep hygiene, and tools to find sleep professionals." I imagine the phrasing was more of the issue, which can be changed. But in that case, editing the text would have addressed this, instead of deleting the whole section. I'll edit it now.leslierrn (Talk) 1:14, 14 December 2014 (UTC)

No, you misunderstood me. A random listing of where to find information goes right back to the HOWTO thing. You missed the point. Jytdog (talk) 01:53, 14 December 2014 (UTC)

The point was never made. I didn't miss it. What other public health initiatives would I list? Other than those that I had listed? I understand that the style of the content needs to re-written, as I stated above. Which is why I have spent the last 45 minutes re-writing the content to be in non-HOWTO format. If you would be willing to provide a suggestion or example of what you mean, instead of having me mind read, that would help so much. leslierrn (talk) 02:04, 14 December 2014 (UTC)

The new proposed content is below. I did not add in the "kind of clinicians are using this concept" because this type of information is not included in the review sources I've been using, and I don't want to cite something that is considered a bad source. I did try and spent time on this, but you have spent more time on identifying appropriate sources. If you have any suggestions, that could help make this article more informative. — Preceding unsigned comment added by Leslierrn (talk • contribs) 02:32, December 14, 2014

Clinical and public health implementation

Clinicians who advise sleep hygiene strategies for individuals and families have lists of suggestions which may include advice about timing of sleep and food intake in relationship to it, exercise, sleeping environment, etc. Which items are suggested for which people are selected by the clinician, depending on knowledge of the individual situation; the counselling is presented as a form of patient education. As attention to the role of sleep hygiene in promoting public health has grown, there has been an increase in the number public sleep hygiene resources available in printed materials and on the internet. Example organizations running such public health initiatives include the National Sleep Foundation and the Division of Sleep Medicine at Harvard Medical School, both of which have created public websites with sleep hygiene resources, such as tips for sleep hygiene, instructional videos, sleep hygiene self-assessments, poll statistics on sleep hygiene, and tools to find sleep professionals. A cooperative agreement between the Center for Disease Control and the American Academy of Sleep Medicine was established for 2013-2018 in order to coordinate the National Healthy Sleep Awareness Project, with one of their aims being to promote sleep hygiene awareness.

you have external links in the body text. please don't do that - use refs instead. please see Wikipedia:External links. Otherwise, that is pretty good as far as I am concerned, yes. other people may think differently, of course. Jytdog (talk) 02:44, 14 December 2014 (UTC)

 Done leslierrn (talk) 03:48, 14 December 2014 (UTC)

I have problems with this new section, noted above on this page under prose. SandyGeorgia (Talk) 14:19, 14 December 2014 (UTC)

References

Some copyedit

See copyedits to reduce redundancy; more of same would be helpful. SandyGeorgia (Talk) 01:40, 13 December 2014 (UTC)

Prose query

• Sleep hygiene is a central component of treatment for insomnia. Sleep hygiene recommendations have been shown to reduce or eliminate the symptoms of insomnia. Specific sleep disorders may require additional treatment approaches. Continuing difficulties with sleep may require additional assistance from healthcare providers.

This prose could use some massaging. First, the link to cognitive behavioral therapy as a treatment is hidden in an easter egg link. CBT should be better discussed for broad coverage of the topic as required by GA. Second, some of the sentences don't say anything. Third some of the sentences could be merged for better flow. SandyGeorgia (Talk) 13:31, 14 December 2014 (UTC)

Prose sample from "Implementation"

Leslierrn, here is a sample of some of my concerns about prose redundancy; not that you need to agree with every wording change, but I hope it is illustrative.

Section headings are typically kept short on Wikipedia so as not to be overly restrictive in terms of future text (and for a number of other reasons).

Now, moving on to the rest of that paragraph, how did you decide which organizations/entities to include in the list? We have to take care with original research and what Wikipedia is not (a support group, an indiscriminate list, etc). Are those specific entities singled out in secondary sources? Also, what happens outside of the USA? SandyGeorgia (Talk) 14:21, 14 December 2014 (UTC)

References

Self-cited

• The term sleep hygiene was coined in 1977 by psychologist Peter Hauri, who published a list of behaviors intended to promote improved sleep.

We can't cite Hauri saying that Hauri coined a term; that kind of statement should be sourced to a third-party. That is, we can't take Hauri's word for it that someone else didn't coin the term before him. SandyGeorgia (Talk) 13:21, 14 December 2014 (UTC)

•  Done SandyGeorgia (Talk) 22:11, 16 December 2014 (UTC)

HI jytdog I see that our edits were just posted at conflicting time. The edits you made were not quite accurate, but I can revise my section according to any feedback. Re: Michael Perlis, in the 2011 Hauri chapter, the open with a quote from the Perlis article, and go on to state "How can we change our behaviors, our environment, and other factors to make us sleep better? Answers to these questions have been sought throughout the ages (see the preceding quote from 1894)"Leslierrn (talk) 22:41, 16 December 2014 (UTC)

yes i read the hauri chapter. they offer that as a random example of the kind of advice that was given about sleep back then. they don't say that there was anything special about it. hauri writes: "What can we do consciously to improve our sleep? How can we change our behaviors, our environment, and other factors to make us sleep better? Answers to these questions have been sought throughout the ages (see the preceding quote from 1894), but they have acquired more “authority” now, ever since sleep has become an object of intense scientific study during the past half century." Jytdog (talk) 22:50, 16 December 2014 (UTC)

So including the Perlis contribution is factual accurate, and reaffirms that there were more people than Paola M who were considering this concept before 1977. I think that still provides article readers with more context.Leslierrn (talk) 22:57, 16 December 2014 (UTC)

No. Houri is explicit that it is a random example. There is zero basis for making a random example seem important, as the text formerly did. Jytdog (talk) 23:05, 16 December 2014 (UTC)

Incorrectly sourced

• Practice of sleep hygiene and knowledge of sleep hygiene practices can be assessed with measures such as the Sleep Hygiene Index, Sleep Hygiene Awareness and Practice Scale, or the Sleep Hygiene Practice Scale. For younger individuals, sleep hygiene can be assessed by the Adolescent Sleep Hygiene Scale or the Children’s Sleep Hygiene Scale.

References

We can't use primary sources or primary source validation studies to claim validity for certain assessment tools; we need secondary-source mention that these various tools are validated as accurate, and widely used in practice. SandyGeorgia (Talk) 15:43, 14 December 2014 (UTC)

I actually looked a bit for a review or textbook covering these instruments and I didn't find one... maybe lesliern knows, as she has expertise in this field. Jytdog (talk) 15:09, 15 December 2014 (UTC)

As an example of correct sourcing, Lewandowski is a review. But curiously, all of the instruments reviewed did not make it into the article, so ... ??? SandyGeorgia (Talk) 15:30, 15 December 2014 (UTC)

ISDR

The ISDR used in the article dates from 2001. The current version was updated in 2014 - link is here: http://www.aasmnet.org/store/product.aspx?pid=849 More importantly. the version in our article, was linked from the esst.com website. It is not clear that ESST has permission to host this document, although it is still up on their website, even though other resources have been taken down from there (they have notices that the postings infringed copyright. See here http://www.esst.org/resources.htm. Because of the risk of COPYVIO and the outdatedness of the source, we shouldn't use it. Jytdog (talk) 02:25, 14 December 2014 (UTC)

I propose the following update:

While the second edition of the International Classification of Sleep Disorders (ICSD) classified Inadequate Sleep Hygiene as its own disorder, the ICSD-III encompasses Inadequate Sleep Hygiene within Chronic Insomnia Disorder. To assess for inadequate sleep hygiene within a Chronic Insomnia Disorder, clinicians have patients complete sleep logs in order to identify presence of napping or invariable sleep-wake times.

leslierrn (talk) 03:35, 14 December 2014 (UTC)

page? please never cite a book without giving a page... Jytdog (talk) 03:43, 14 December 2014 (UTC)

 Done with pages leslierrn (talk) 02:04, 14 December 2014 (UTC)

my connection to the library isn't working. will verify Monday. fingers crossed. Jytdog (talk) 04:03, 14 December 2014 (UTC)

leslierrn sorry to you mean "variable" sleep/wake times? Jytdog (talk) 04:06, 14 December 2014 (UTC)

Yes, thanks.  Done leslierrn (talk) 05:28, 14 December 2014 (UTC)

References

ok i was able to check this source. In the chapter called "A Patient with Insomnia and an Irregular Sleep Pattern", p595-597, on p 596 says "Inadequate Sleep Hygiene is not a diagnostic category in the International Classification of Sleep Disorders, edition 3 (ICSD-3). However, in the ICSD-2, one of the diagnostic categories for insomnia was “Inadequate Sleep Hygiene.”" so that part is verified. It is also says, and I think this would be super useful information to include in the article, "Although education about good sleep hygiene is a part of most behavioral treatment programs for insomnia, no evidence suggests that education about sleep hygiene alone is effective treatment for the insomnia syndromes. Insomnia caused by poor sleep hygiene occurs in approximately 5% to 10% of insomnia cases evaluated in a sleep center. The condition is present in 1% to 2% of adolescents and young adults."

That page also mentions "sleep logs" but does not say that "clinicans have patients complete sleep logs..."

I did not find in this source, verification for "the ICSD-III encompasses Inadequate Sleep Hygiene within Chronic Insomnia Disorder" The chapter "A 30-Year-Old Woman Having Difficulty Falling and Staying Asleep, in pp 593-594, defines CID and later says "Patients with this disorder frequently have a history of being “light sleepers” for many years. Inadequate sleep hygiene also may be present, but the problem persists even after correction." that is the not what our article content says. I also checked this PMID 25367475 and it doesn't verify that content either. Jytdog (talk) 18:25, 15 December 2014 (UTC)

 Done Jytdog (talk) 23:41, 16 December 2014 (UTC)

Lead

Hi. I actually think this is a pretty good article. (I'll hold off from saying for the moment whether or not it should be a Good Article.) But I was looking at the lead, and think it should be rewritten and expanded. In the first instance, it should reflect better what follows. In the second place, it is unclear, in part because it is rather full of jargon. To take but one example, I for one am rather mystified by what is mean by "variable research support across recommendations." Can someone help out? --jbmurray (talk • contribs) 06:19, 14 December 2014 (UTC)

yes that was bugging me too. There was jargony language elsewhere. I just worked on the lead and some of the body. Jytdog (talk) 06:35, 14 December 2014 (UTC)

Yes (and the article is certainly much improved already from the version that passed GA.) I'm still catching up on cleaning up the talk page, and looking at the trivial MOS-y stuff in the article. On that score, the article could benefit from better Wikilinking. I, too, am holding off on opining on the GA reassessment, because good work is underway. SandyGeorgia (Talk) 13:17, 14 December 2014 (UTC)

• Came across this at DYK. Slightly concerned that this GA begins with a quote. Shouldn't the first sentence be a standard factual definition on the medical subject? Fuebaey (talk) 01:12, 18 December 2014 (UTC)

 Done Leslierrn (talk) 17:38, 22 December 2014 (UTC)

Hi jytdog, I have read this article and I am going to insist on the removal of "weak" in the lead. The phrases you are referring to are actually quoted as:

• "Although research has demonstrated links between individual sleep hygiene components and subsequent sleep, evidence for the efficacy of sleep hygiene education as a treatment for insomnia has been limited and inconclusive" - "Limited" is different than "weak" - in clinical research, limited generally implies that significant findings exist, but must be considered within methodology, or that they vary across settings/populations.
• "First, direct evaluation of the effects of following sleep hygiene recommendations is scant and inconclusive for many individual recommendations." - this is pointing out this limited support for individual recommendations, not sleep hygiene recommendations as a set.

In this same article, authors also state:

• "Epidemiologic and laboratory research provide some support for the relationships between individual sleep hygiene components and sleep, and each recommendation is supported by plausible physiological and psychosocial mechanisms."
• "Overall, the limited support for individual sleep hygiene recommendations in the general adult population is not the result of null effects, but rather the substantial need for replication and extension of current work."
• "Overall, though epidemiologic and experimental research generally supported an association between individual sleep hygiene recommendations and nocturnal sleep, the direct effects of individual recommendations on sleep remains largely untested in the general population."
• "Overall, this work has provided some preliminary support for the use of sleep hygiene education in nonclinical populations, but the findings are inconsistent."
• "Taken together with findings in clinical samples, these data raise an interesting question. If it is known that, individually, each specific component of sleep hygiene is related to sleep, why wouldn't addressing multiple individual components (i.e., sleep hygiene education) result in improved sleep? Inconsistent and uncompelling findings may be due, in large part, to the lack of a standardized approach in the application of sleep hygiene principles to clinical practice and research."

So in the spirit of accurately representing this source, calling findings "weak" is problematic, as the authors never once use that word. Research is much more complicated than that. The authors are actually supporting a belief in the effectiveness of sleep hygiene recommendations, but encouraging the field to consider how we can better the research to reduce inconsistent findings. In general, "weak" is a value judgement that relates to determined thresholds of evidence, which neither your nor I have established. Therefore it would be in the best interest of good scientific language to avoid it. Leslierrn (talk) 19:45, 22 December 2014 (UTC)

the source is crystal clear- and as you describe above, the evidence is weak. I am sorry that displeases you but that is not relevant here. We reflect what the source says. Jytdog (talk) 04:27, 23 December 2014 (UTC)

It doesn't displease me, it's just not what the source says! Are you reading the explanation I wrote above, or just holding doggedly onto your edits? The word "weak" is never used - scientific language usually avoids using "weak" as a qualifier, unless it's statistical. This is ridiculous - what I had written made it absolutely clear that evidence is limited. It would be mis-informing readers to use the word "weak" in the lead and then go on to talk about all the parts of sleep hygiene that have indeed been supported. How can we get a third party to resolve this? Leslierrn (talk) 03:53, 24 December 2014 (UTC)

yes after 30 years of testing the paradigm remains unvalidated, which means it is pretty much time to say "it doesn't work". this article originally made it sound like sleep hygiene was the greatest thing since sliced bread. the article is moving closer and closer to being in tune with the sources, which is great. Jytdog (talk) 06:20, 24 December 2014 (UTC)

Ah, okay. It sounds like you have a pretty strong opinion on the matter, and I don't think that a wikipedia article is the place to say for the first time "it doesn't work." If authors of an article are pushing to continue sleep hygiene research so that it can be improved enough for public use, they would not agree with you. Let's keep the lead void of personal agendas. We'll compromise at the quote, it's much better than forcing the word "weak". Leslierrn (talk) 16:57, 24 December 2014 (UTC)

ahhh i knew little about sleep hygiene before starting to work on this. my stance that "it doesn't work" is based 100% on the sources you have brought. the 2014 review is especially trenchant on this, if you read it with clear eyes. i have quoted relevant bits above. Jytdog (talk) 17:14, 24 December 2014 (UTC)

Junk sleep

See Wikipedia:Articles for deletion/Junk sleep. See also this source for a different (medical) use of the term, which shows that the term was used to describe Stage 2 sleep BEFORE the students allegedly introduced the term in 2010. It was also used in a 1991 journal article about newborns, but I cannot access that article.

The source (of dubious reliability) says the term was "popularized" (not introduced) by the students. The BBC source is about a survey. The very limited sources which discuss the term refer to a survey. There is no good sourcing for this term, and I do not understand why a merge was advocated over deletion.

The merged text[1] uses lay sources and contains dubious info. I've removed this content to talk for discussion of proper sourcing, prose evaluation, and where to place it in the article if it is to be included. @Doc James: SandyGeorgia (Talk) 13:43, 6 February 2015 (UTC)

• The term junk sleep is used to refer to low-quality sleep, usually when fueled by switched-on electrical devices. The term is coined by an analogy with junk food. It was introduced in 2010 by several students at Wee Kim Wee School of Communication and Information in Singapore. They published an article, where it was told that "using electronic devices right before bed would affect sleep in a negative way". The sleeper cannot get to a normal REM sleep and thereby does not get proper rest. To avoid junk sleep, one should break off usage of digital devices in at least half of hour before sleeping.

agreed, I just searched pubmed and there are no pubmed articles with the term. search is here. Jytdog (talk) 14:07, 6 February 2015 (UTC)

AGREED. I wouldn't necessarily say that the term "Junk sleep" never should be used in Wikipedia, but that paragraph as quoted here is just wrong in several ways. Off with its head. --Hordaland (talk) 19:27, 6 February 2015 (UTC)

References

References

sleep duration

this dif improved things by removing yet another sloppy drawing of causality between "poor sleep hygiene" and negative outcomes, but the statement is still too strong and too global. Based on reviews I have read to date, kids, adults, and older people generally (very generally) have different "needs" with regard to sleep duration, and even in those broad groups there are subgroups and big error bars due to wide variability. Even in the source provided, it is clear that ~20% of people get only 6 hours regularly and that is far bigger percentage than people who have sleep-deprivation-like morbidities. Am continuing to look for sources on this and will make some suggestions about content and sourcing later. Jytdog (talk) 17:26, 24 December 2014 (UTC)

so PMID 22633283 is a 2012 review of sleep duration and obesity in adolescents, and found that the research is poor and inconclusive for any causation. PMID 25306538 finds that in postpartum women, research on sleep duration, depression, and weight gain is limited and inconclusive. PMID 25295652 is a recent review. It cites the DSM-V definition of insomnia, which does not define any recommended sleep duration but instead defines insomnia functionally as "A predominant complaint of dissatisfaction with sleep quantity or quality, associated with ≥ 1 of the following symptoms:" which again are functional. I don't buy that there is any reasonable-to-define numbers that one can put on sleep duration. Jytdog (talk) 16:20, 25 December 2014 (UTC)

I agree that the section isn't satisfactory. The recommendation "allowing enough time for sleep" should definitely be included. But that can mean finding out how much sleep an individual needs and allowing that much time for sleeping. I don't think numbers of hours need be mentioned here.

BTW, The National Sleep Foundation in the USA has just revised its table of suggested optimal sleep duration by age groups. I've made the corrections in the table in our article Sleep. The source itself also allows for less strict guidelines.

The words "schedule" and "the timing of sleep" do not mean the same thing as "duration". (The timing/scheduling of our sleep is also important: Some will sleep very well 10 p.m. to 6 a.m., others midnight to 8, etc. Some are quite flexible in this regard, others are "hard-wired". But society isn't ready to acknowledge this. Yet.)

The recommendations about napping are one-sided. A good deal of research by, among others, Robert Stickgold and Sara Mednick is showing benefits (the when, how and why) of napping. --Hordaland (talk) 20:15, 6 February 2015 (UTC)