Sh*t That Works, Part 2: Sleep!
May 14, 2023
We wanted to create Consensus to make getting good information easy. There is so much information in the world, yet so little of it is based on real evidence.
For many subjects and debates, the evidence exists, its just hard to find, and even harder to consume.
This series will take a variety of important topics and discuss we actually can conclude based on real, research-backed evidence. We’re calling it: “Sh*t That Works”.
Of course, this will all be done with the help of Consensus.
Disclaimer: I am not a trained a medical professional. I just read lots of studies for my job
Sleep Interventions That Aren’t Bulls–t
Interventions with “solid” evidence:
Sleep has no magic bullets – these interventions have modest effect sizes, but they help!
Interventions with “emerging” evidence:
Still early, some promising studies/outcomes...
Popular interventions that have “meh” evidence:
Interventions that definitely DON’T help:
Outside of eating, drinking and breathing, sleep is the single most important physiological process for our health. It quite literally impacts every single part of our well-being.
In the United States alone, up to 70 million people suffer from a sleep disorder, and millions more deal with periodic sleep issues.
Unfortunately, despite this, popular media continues to churn out click-bait-y content focused on interventions that lack any real evidence of efficacy.
Let’s dive a little deeper into the three top interventions that actually have been shown to help improve sleep outcomes.
Disclaimer: I am not a trained medical professional. I just read lots of studies for my job.
Melatonin study to care about #1: 2013 Meta-Analysis
TLDR; this meta-analysis looked across 19 controlled trials and found that melatonin improves multiple different sleep outcomes (latency, total sleep time, and overall quality) but the effect was relatively modest.
Melatonin study to care about #2: 2014 Randomized Controlled Trial
TLDR; this RCT on patients with breast cancer found that melatonin improved subjective sleep quality (again moderate effects) without any adverse side effects
Melatonin takeaway:
Melatonin has the most evidence of any supplement for improving sleep. However, the effect sizes found in high-quality studies are mild. Melatonin is not a magic bullet, but given its lack of side effects and the evidence of some positive impact, melatonin is a relatively safe choice to help with sleep issues.
Mindfulness-therapy study to care about #1: 2019 Meta-Analysis
TLDR; this massive meta-analysis of over 1,600 participants found ‘moderate strength’ of evidence for mindfulness meditation in improving sleep quality against non-specific controls – but found little effect compared to specific active controls.
Mindfulness-therapy study to care about #2: 2007 Systematic Review
TLDR; very similar to the above study, this study found some modest evidence across seven studies that mindfulness-based therapy can improve sleep by causing a reduction in ‘sleep-interfering cognitive processes’ like worry.
Mindfulness-therapy takeaway:
Mindfulness-based therapies like meditation are certainly not a cure-all and many controlled studies have found very modest effects. But, considering the lack of downside and the evidence of improvement in some aspects of the sleep process, mindfulness-based therapies are a worthwhile intervention to improve your sleep!
Exercise study to care about #1: 2018 Meta Analysis
TLDR; this meta-analysis of over 550 patients found that exercise improved sleep quality but found little impact on sleep efficiency (time in bed spent sleeping), with very minimal adverse effects. The effect size was low.
Exercise study to care about #2: 2020 Systematic Review
TLDR; this systematic review looked across 14 studies (6 RCTs and 8 pre-post test) and found that 13 of the 14 studies showed at least one significant improvement in sleep outcomes from exercise.
Exercise takeaway:
If the effects of exercise could be put into a pill, it would be the most effective supplement in the history of supplements across multiple outcomes. Sleep is yet another on the long list of outcomes that exercise can improve!
