Draft:Sleep Reset

Insomnia is a common sleep disorder affecting approximately 10–30% of the global population, with chronic cases often leading to cognitive impairment, increased risk of cardiovascular disease, and other health issues.{{cite journal |last1=Bhaskar |first1=S. |title=Prevalence and correlates of insomnia symptoms in the general population: Findings from the National Health and Nutrition Examination Survey (NHANES) |journal=Journal of Clinical Sleep Medicine |date=2022 |volume=17 |issue=11 |pages=2283–2306 |doi=10.5664/jcsm.9512|pmid=34666885 |pmc=8636361 }} Cognitive Behavioral Therapy for Insomnia (CBT-I) is recognized as the first-line treatment for chronic insomnia by the American Academy of Sleep Medicine (AASM) and other health organizations.{{cite web |title=AASM Clinical Practice Guidelines for Chronic Insomnia Treatment |url=https://www.aasm.org/insomnia-treatment-guidelines/}} However, access to in-person CBT-I therapy is limited, leading to the development of digital and app-based solutions like Sleep Reset.

In a research study titled "[https://pubmed.ncbi.nlm.nih.gov/37860823/ CBT-I-Based Sleep Coaching Program: Implications for Sleep Duration and Sleep Quality]" presented at the AASM 2023 Sleep Conference, Dr. Michael Grandner and Dr. Suzanne Gorovoy showed that [https://thesleepreset.com/ Sleep Reset] demonstrated significant improvements in sleep continuity, sleep duration, and reduced use of sleep aids.

Data were obtained from Sleep Reset, a 12-week consumer product that offers app-based sleep education and monitoring, along with personalized text-based sleep coaching provided by live coaches. 564 completers were included in the study. Pre-post changes for sleep latency (SL), wake after sleep onset (WASO), number of awakenings (NWAK), total sleep time (TST), sleep efficiency (SE%) and use of “sleep aids” were evaluated. To evaluate whether the program produced meaningful results, the proportion of participants who demonstrated reductions in SL, WASO, and NWAK, and increases in TST and SE% were examined.

Mean SL was reduced by 11 minutes, mean WASO was reduced by 28 minutes, mean SE% increased by 6.6%, and mean TST increased by about 44 minutes. Of those who reported using “sleep aids” during Week 1, 41% no longer used them by week 12. Those with low SE% at baseline demonstrated greater improvements in SL (16.2 vs 5.7mins), WASO (47.3 vs 7.2mins), SE% (11.2% vs 1.6%), and TST (65.3 vs 31.2mins). Those with ≤6 hours of sleep at baseline demonstrated greater improvements in WASO (36.8 vs 22.3mins), SE% (10.1% vs 4.3%), and TST (85.1 vs 25.5mins).

In conclusion, participants that completed the app-based, personalized text supported coaching intervention reported subjective improvements in sleep duration and quality that suggest more beneficial effects particularly in those with lower sleep efficiency or sleep duration at baseline. An effective sleep coaching program that utilizes trained sleep coaches with access to board-certified providers, may provide a valuable resource for subclinical populations [https://www.frontiersin.org/journals/sleep/articles/10.3389/frsle.2023.1156844/full (Frontiers paper)].

Sleep Reset is structured as a multi-week, [https://www.neurologylive.com/view/role-sleep-coaching-sleep-reset-care-sleep-problems personalized sleep coaching program] designed to address the behavioral and cognitive aspects of insomnia. The program follows the core principles of CBT-I.

Sleep has long played a critical role in workforce productivity, influencing everything from cognitive performance and decision-making to creativity, mood, and overall health. Numerous studies have shown that inadequate sleep can lead to decreased efficiency, increased errors, and higher rates of absenteeism, while well-rested employees are more alert, engaged, and resilient in their work. Programs like Sleep Reset are now being adopted by employers to address these challenges and improve sleep health across organizations — a trend highlighted in [https://sleepreviewmag.com/sleep-health/demographics/career/sleep-reset-program-improve-sleep-health-workplace/ this article by Sleep Review Magazine].

SRT is a technique aimed at increasing sleep efficiency by initially reducing time spent in bed and gradually extending it as sleep improves.{{cite journal |last1=Kyle |first1=S. |title=Sleep restriction therapy for insomnia: Systematic review and meta-analysis |journal=Sleep Medicine Reviews |date=2014 |volume=18 |issue=4 |pages=299–310 |doi=10.1016/j.smrv.2013.06.002|pmid=23907095 }}

Stimulus Control Therapy (SCT) is a core component of cognitive behavioral therapy for insomnia (CBT-I) that targets the learned associations between the bed and wakefulness. Over time, individuals with insomnia may come to associate their bed with frustration, worry, or wakeful activities like watching TV or scrolling on a phone, rather than sleep. SCT works to break these negative associations and reestablish the bed as a strong cue for sleep.{{cite journal |last1=Harvey |first1=A. |title=Behavioral treatment of insomnia: A clinical review |journal=Psychological Bulletin |date=2002 |doi=10.1037/0033-2909.128.5.753|doi-broken-date=15 February 2025 }}

Relaxation techniques include guided relaxation, deep breathing exercises, and mindfulness meditation to reduce sleep-disrupting arousal.{{cite journal |last1=Ong |first1=J. |title=Mindfulness-based therapy for insomnia |journal=Sleep |date=2014 |doi=10.5665/sleep.3542|doi-broken-date=15 February 2025 }}

This includes guidelines on optimizing sleep environments and behaviors, such as limiting caffeine intake, avoiding screen exposure before bedtime, and maintaining a consistent sleep schedule.{{cite journal |last1=Irish |first1=L. |title=The role of sleep hygiene in the treatment of insomnia |journal=Sleep Medicine Clinics |date=2015 |volume=10 |issue=2 |pages=169–179 |doi=10.1016/j.jsmc.2015.02.005|pmid=26055865 }}

Participants in Sleep Reset undergo an initial sleep assessment, followed by a tailored intervention plan. Sleep logs and real-time progress tracking are used to refine strategies over time.

CBT-I-based digital interventions have been widely studied and found to be effective for insomnia treatment. Sleep Reset follows methodologies similar to those validated in clinical trials. A meta-analysis of digital CBT-I programs found that they led to significant improvements in sleep onset latency, total sleep time, and sleep efficiency, comparable to in-person therapy.{{cite journal |last1=Zachariae |first1=R. |title=Efficacy of internet-delivered cognitive behavioral therapy for insomnia |journal=Journal of Medical Internet Research |date=2016 |volume=18 |issue=3 |pages=e49 |doi=10.2196/jmir.5069|doi-access=free |pmid=26935646 |pmc=4795321 }}

Specific outcomes reported for Sleep Reset users include an average increase of 85 minutes in total sleep time per night, a 50% reduction in the time taken to fall asleep and the frequency of nighttime awakenings.{{cite journal |last1=Grandner |first1=M. |title=App-supported sleep coaching: Implications for sleep duration and sleep quality |journal=Journal of Sleep Research |date=2023 |volume=2 |doi=10.1093/sleep/zsad077.0931 |pmid=37860823 |pmc=10586750 }}

These findings align with broader research demonstrating the long-term benefits of CBT-I, with sustained sleep improvements lasting beyond the treatment period.{{cite journal |last1=Espie |first1=C. |title=The clinical effectiveness of CBT-I: A systematic review |journal=Sleep |date=2019 |volume=42 |issue=4 |doi=10.1093/sleep/zsz007|pmid=30649500 |pmc=6448286 }}

The Sleep Reset program has been used by over hundreds of thousands of participants and is endorsed by sleep specialists ([https://sleepreviewmag.com/sleep-diagnostics/screeners/smart-phone/digital-sleep-program-increases-sleep-over-one-hour-short-sleepers/ Sleep Review]) and healthcare providers ([https://www.dentistrytoday.com/new-research-shows-sleep-reset-increases-total-sleep-time-by-over-one-hour-for-short-sleepers/ Dentistry Today]). It is particularly recommended for individuals seeking an alternative to pharmacological sleep aids, which can have side effects such as dependency, cognitive impairment, and increased risk of dementia in older adults.{{cite journal |last1=Billiard |first1=M. |title=Risks and benefits of hypnotics in the treatment of chronic insomnia |journal=Journal of Clinical Sleep Medicine |date=2019 |volume=16 |issue=1 |pages=137–141 |doi=10.5664/jcsm.8138|pmid=31957641 |pmc=7053001 }}

In another research study published in Oxford Academic titled [https://academic.oup.com/sleep/article/46/Supplement%201/A414/7182270 Reductions in Use of Sleep Aids Following an App-Based Sleep Coaching Platform], science researchers found that Sleep Reset was able to reduce use of sleeping aids by 71.1% by the end of the 12-week period, with the largest reductions in the first week.

Data were obtained from N=563 individuals who participated in the 12-week Sleep Reset program. The Sleep Reset program (Sleep Reset, Inc.) includes ongoing text-based communication with coaches trained to support sleep behavior change, and a mobile app that includes a sleep diary, educational modules, mindfulness exercises, and progress tracking. Potential users are screened prior to entry and if they demonstrate a contraindicated medical or psychiatric problem, they were not admitted to the coaching program. If they demonstrate a likely sleep disorder (including insomnia disorder) they are referred for additional support. The coaching communications included information about basic sleep and circadian principles (e.g., sleep hygiene, behavioral scheduling, light exposure, relaxation) and techniques based on CBTI (e.g., stimulus control). Participants were asked if they used any “sleep aids” (which could include medications or melatonin/supplements) daily while in the program. Type of substance was not assessed. Data were binned by week, dichotomized as yes/no regarding any use in that week.

Among participants, 54.96% reported using sleep aids at least once during the first week of participation. This was reduced to 40.6% by week 12. Among those that did not use sleep aids at baseline, 81.89% continued to avoid them at week 12 while 18.11% had begun using them during the study period. Among those who used sleep aids at baseline, 59.03% were still using them at week 12 while 40.97% had stopped. A chi-square test was statistically significant (X2(1)=96.9, p=-8.88 x 10-16), and a post-hoc t-test showed that sleep aid use was reduced overall pre-post (t(563)=-6.37, p=3.93 x 10-10) ([https://www.researchgate.net/publication/371127235%200940%20Reductions%20in%20Use%20of%20Sleep%20Aids%20Following%20an%20App-Based%20Sleep%20Coaching%20Platform research gate]).

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