Sunday, December 21, 2014

Go to Bed Early and Cure Your Negative Ruminations!

Source: Alyssa L. Miller, Flickr.

For nearly 9 years, this blog has been harping on the blight of overblown press releases, with posts like:

Irresponsible Press Release Gives False Hope to People With Tourette's, OCD, and Schizophrenia

Press Release: Press Releases Are Prestidigitation

New research provides fresh evidence that bogus press releases may depend largely on our biological make-up

Save Us From Misleading Press Releases


So it was heartening to see a team of UK researchers formally evaluate the content of 462 heath-related press releases issued by leading universities in 2011 (Sumner et al., 2014). They classified three types of exaggerated claims and found that 40% of the press releases contained exaggerated health advice, 33% made causal statements based on correlational results, and 36% extrapolated from animal research to humans.

A fine duo of exaggerated health advice and causal statements based on correlational results recently caught my eye. Here's a press release issued by Springer, the company that publishes Cognitive Therapy and Research:

Don’t worry, be happy: just go to bed earlier

When you go to bed, and how long you sleep at a time, might actually make it difficult for you to stop worrying. So say Jacob Nota and Meredith Coles of Binghamton University in the US, who found that people who sleep for shorter periods of time and go to bed very late at night are often overwhelmed with more negative thoughts than those who keep more regular sleeping hours.

The PR issues health advice (“just go to bed earlier”) based on correlational data: “people who sleep for shorter periods of time and go to bed very late at night are often overwhelmed with more negative thoughts.” But does staying up late cause you to worry, or do worries keep you awake at night? A survey can't distinguish between the two.

The study by Nota and Coles (2014) recruited 100 teenagers (or near-teenagers, mean age = 19.4 + 1.9) from the local undergraduate research pool. They filled out a number of self-report questionnaires that assessed negative affect, sleep quality, chronotype (morning person vs. evening person), and aspects of repetitive negative thinking (RNT).

RNT is a transdiagnostic construct that encompasses symptoms typical of depression (rumination), anxiety (worry), and obsessive-compulsive disorder (obsessions). Thus, the process of RNT is considered similar across the disorders, but the content may differ. The undergraduates were not clinically evaluated so we don't know if any of them actually had the diagnoses of depression, anxiety, and/or OCD. But one can look at whether the types of symptoms that are endorsed (whether clinically relevant or not) are related to sleep duration and timing. Which is what the authors did.

Shorter sleep duration and a later bedtime were indeed associated with more RNT. However, when accounting for levels of negative affect, the sleep variables no longer showed a significant correlation.Not a completely overwhelming relationship, then.

But as expected, the night owls reported more RNT than the non-night owls. 

Here's how the findings were interpreted in the Springer press release and conspicuously, by the authors themselves (the study of Sumner et al., 2014 also observed this pattern). Note the exaggerated health advice and causal statements based on correlational results.

“Making sure that sleep is obtained during the right time of day may be an inexpensive and easily disseminable intervention for individuals who are bothered by intrusive thoughts,” remarks Nota.

The findings also suggest that sleep disruption may be linked to the development of repetitive negative thinking. Nota and Coles therefore believe that it might benefit people who are at risk of developing a disorder characterized by such intrusive thoughts to focus on getting enough sleep.

“If further findings support the relation between sleep timing and repetitive negative thinking, this could one day lead to a new avenue for treatment of individuals with internalizing disorders,” adds Coles. “Studying the relation between reductions in sleep duration and psychopathology has already demonstrated that focusing on sleep in the clinic also leads to reductions in symptoms of psychopathology.”

As they mentioned, we already know that many psychiatric disorders are associated with problematic sleep, and that improved sleep is helpful in these conditions. Recommending that people suffering with debilitating and uncontrollable intrusive thoughts to “just go to bed earlier” isn't particularly helpful. Not only that, such advice can be downright irritating.

Here's a news story from Yahoo that plays up the “sleep reduces worry” causal relationship even more:
This Sleep Tweak Could Help You Worry Less

Can the time you hit the hay actually influence the types of thoughts you have? Science says yes.

Are you a chronic worrier? The hour you’re going to sleep, and how much sleep you’re getting overall, may exacerbate your anxiety, according to a new study published in the journal Cognitive Therapy and Research.

The great news here? By tweaking your sleep habits you could actually help yourself worry less. Really.

Great! So internal monologues of self-loathing (“I'm a complete failure”, “No one likes me”) and deep anxiety about the future (“My career prospects are dismal”, “I worry about my partner's terrible diagnosis”) can be cured by going to bed earlier!

Even if you could forcibly alter your chronotype (and I don't know if this is possible), what do you do when you wake up in the middle of the night haunted by your repetitive negative thoughts?

Further Reading

Alexis Delanoir on the RNT paper and much more in Depression And Stress/Mood Disorders: Causes Of Repetitive Negative Thinking And Ruminations

Scicurious, with an amusingly titled piece: This study of hype in press releases will change journalism


Chronotype was dichotomously classified as evening type vs. moderately morning-type / neither type (not a lot of early birds, I guess). And only 75 students completed questionnaires in this part of the study.

2 It's notable that the significance level for these correlations was not corrected for multiple comparisons in the first place.


Nota, J., & Coles, M. (2014). Duration and Timing of Sleep are Associated with Repetitive Negative Thinking. Cognitive Therapy and Research DOI: 10.1007/s10608-014-9651-7

Sumner, P., Vivian-Griffiths, S., Boivin, J., Williams, A., Venetis, C., Davies, A., Ogden, J., Whelan, L., Hughes, B., Dalton, B., Boy, F., & Chambers, C. (2014). The association between exaggeration in health related science news and academic press releases: retrospective observational study, BMJ, 349 (dec09 7) DOI: 10.1136/bmj.g7015

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