Watching the clock while trying to fall asleep exacerbates insomnia and the use of sleep aids, according to research from an Indiana University professor—and a small change could help people sleep better.

The research, led by Spencer Dawson, clinical assistant professor and associate director of clinical training in the College of Arts and Sciences' Department of Psychological and Brain Sciences, focuses on a sample of nearly 5,000 patients presenting for care at a sleep clinic.

Insomnia affects between 4 and 22% of adults and is associated with long-term health problems including cardiovascular disease, diabetes and depression.

Participants completed questionnaires about the severity of their insomnia, their use of sleep medication and the time they spent monitoring their own behavior while trying to fall asleep. They were also asked to report any psychiatric diagnoses. Researchers conducted mediation analyzes to determine how the factors influenced each other.

"We found time monitoring behavior mainly has an effect on sleep medication use because it exacerbates insomnia symptoms," Dawson said.

"People are concerned that they're not getting enough sleep, then they start estimating how long it will take them to fall back asleep and when they have to be up. That is not the sort of activity that's helpful in facilitating the ability to fall asleep—the more stressed out you are, the harder time you're going to have falling asleep."

As the frustration over sleeplessness grows, people are more likely to use sleep aids in an attempt to gain control over their sleep.

The results are published in The Primary Care Companion for CNS Disorders. Additional co-authors are Dr. Barry Krakow, professor of psychiatry and behavioral health in the Mercer University School of Medicine; Patricia Haynes, associate professor in the Mel and Enid Zuckerman School of Public Health at the University of Arizona and Darlynn Rojo-Wissar, a postdoctoral fellow at Alpert Medical School of Brown University.

Dawson said the research indicates a simple behavioral intervention could provide help for those struggling with insomnia. He gives the same advice to every new patient the first time they meet.

"One thing that people could do would be to turn around or cover up their clock, ditch the smart watch, get the phone away so they're simply not checking the time," Dawson said. "There's not any place where watching the clock is particularly helpful."

With 15 years of of research and clinical experience in the sleep field, Dawson is interested in comparing individuals' sleeping experiences with what is concurrently happening in their brains. He trains and supervises doctoral students in the Department of Psychological and Brain Science's Clinical Science Program.