Skip to main content
SpringerLink
Log in

Self-Monitoring vs. Implementation Intentions: a Comparison of Behaviour Change Techniques to Improve Sleep Hygiene and Sleep Outcomes in Students

  • Published:
International Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Purpose

This study seeks to investigate and compare the efficacy of self-monitoring and implementation intentions—two post-intentional behaviour change techniques—for improving sleep hygiene behaviours and sleep outcomes in university students.

Method

Seventy-two undergraduate students completed baseline measures of four sleep hygiene behaviours (making the sleep environment restful, avoiding going to bed hungry/thirsty, avoiding stress/anxiety-provoking activities near bed time and avoiding caffeine in the evening), as well as the Pittsburgh sleep quality index (PSQI) and the insomnia severity index (ISI). Participants were randomly assigned to an active-control diary-keeping, self-monitoring condition or completed implementation intentions for each behaviour. Post-intervention measurement was completed 2 weeks after baseline.

Results

Repeated measures analyses of variance found significant main effects of time for improvements in making the sleep environment restful and avoiding going to bed hungry or thirsty, as well as PSQI and ISI scores. Non-significant interactions suggested no group differences on any variable, except for increasing avoidance of stress and anxiety-provoking activities before bed time, for which only implementation intentions were found to be effective. Attrition was higher amongst self-monitoring participants.

Conclusion

Both self-monitoring and implementation intentions appear to be promising behaviour change techniques for improving sleep hygiene and sleep. Future research should examine the acceptability of the two behaviour change techniques and the relationship with differential attrition, as well as effect size variations according to behaviour and technique. Researchers should investigate potential additive or interactive effects of the techniques, as they could be utilised in a complementary manner to target different processes in effecting behaviour change.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Mastin DF, Bryson J, Corwyn R. Assessment of sleep hygiene using the sleep hygiene index. J Behav Med. 2006;29:223–7.

    Article  PubMed  Google Scholar 

  2. Stepanski EJ, Wyatt JK. Use of sleep hygiene in the treatment of insomnia. Sleep Med Rev. 2003;7:215–25.

    Article  PubMed  Google Scholar 

  3. Pilcher JJ, Ginter DR, Sadowsky V. Sleep quality versus sleep quantity: relationships between sleep and measures of health, well being and sleepiness in college students. J Psychosom Res. 1997;42:583–96.

    Article  CAS  PubMed  Google Scholar 

  4. Medeiros A, Mendes D, Lima P, Araujo J. The relationships between sleep-wake cycle and academic performance in medical students. Biol Rhythm Res. 2001;32:263–70.

    Article  Google Scholar 

  5. Wolfson AR, Carskadon MA. Sleep schedules and daytime functioning in adolescents. Child Dev. 1998;69:875–87.

    Article  CAS  PubMed  Google Scholar 

  6. Brown F, Buboltz WC, Soper B. Relationship of sleep hygiene awareness, sleep hygiene practices, and sleep quality in university students. Behav Med. 2002;28:33–8.

    Article  PubMed  Google Scholar 

  7. Medeiros ALD, Mendes DB, Lima PF, Araujo JF. The relationships between sleep-wake cycle and academic performance in medical students. Biol Rhythm Res. 2001;32:263–70.

    Article  Google Scholar 

  8. Kor K, Mullan B. Sleep hygiene behaviours: an application of the theory of planned behaviour and the investigation of perceived autonomy support, past behaviour and response inhibition. Psychol Health. 2011;26:1208–24.

    Article  PubMed  Google Scholar 

  9. Dahl RE, Lewin DS. Pathways to adolescent health sleep regulation and behavior. J Adolesc Health. 2002;31:175–84.

    Article  PubMed  Google Scholar 

  10. Abraham C, Kok G, Schaalma H, Luszczynska A. Health promotion. In: Martin PR, Cheung F, Kyrios M, Littlefield L, Knowles L, Overmier M, et al., editors. The international association of applied psychology handbook of applied psychology. Oxford: Wiley-Blackwell; 2010.

    Google Scholar 

  11. Abraham C, Michie S. A taxonomy of behavior change techniques used in interventions. Health Psychol. 2008;27:379–87.

    Article  PubMed  Google Scholar 

  12. Michie S, Johnston M, Francis J, Hardeman W, Eccles M. From theory to intervention: mapping theoretically derived behavioural determinants to behaviour change techniques. Appl Psychol Int Rev. 2008;57:660–80.

    Article  Google Scholar 

  13. Michie S, Johnston M, Abraham C, Francis J, Eccles MP. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: Building an international consensus for the reporting of behavior change interventions. Ann Behav Med. 2013;46:81–95.

    Article  PubMed  Google Scholar 

  14. Michie S, Abraham C. Interventions to change health behaviours: evidence-based or evidence-inspired? Psychol Health. 2004;19:29–49.

    Article  Google Scholar 

  15. Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new medical research council guidance. Int J Nurs Stud. 2013;50:587–92.

    Article  PubMed  Google Scholar 

  16. Peters G-JY, de Bruin M, Crutzen R. Everything should be as simple as possible, but no simpler: towards a protocol for accumulating evidence regarding the active content of health behaviour change interventions. Health Psychol Rev. 2013. doi:10.1080/17437199.2013.848409.

    Google Scholar 

  17. Todd J, Mullan B. The role of self-monitoring and response inhibition in improving sleep behaviours. Int J Behav Med. 2014;21:470–7.

    Article  PubMed  Google Scholar 

  18. Carver CS, Scheier MF. Control theory: a useful conceptual framework for personality-social, clinical, and health psychology. Psychol Bull. 1982;92:111–35.

    Article  CAS  PubMed  Google Scholar 

  19. Burke LE, Wang J, Sevick MA. Self-monitoring in weight loss: a systematic review of the literature. J Am Diet Assoc. 2011;111:92–102.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Bandura A. Health promotion from the perspective of social cognitive theory. Psychol Health. 1998;13:623–49.

    Article  Google Scholar 

  21. Adachi Y, Sato C, Kunitsuka K, Hayama J. A brief behavior therapy administered by correspondence improves sleep and sleep-related behavior in poor sleepers. Sleep Biol Rythms. 2008;6:16–21.

    Article  Google Scholar 

  22. Yamatsu K, Adachi Y, Kunitsuka K, Yamagami T. Self-monitoring and bibliotherapy in brief behavior therapy for poor sleepers by correspondence. Sleep Biol Rythms. 2004;2:73–5.

    Article  Google Scholar 

  23. Loft MH, Cameron LD. Using mental imagery to deliver self-regulation techniques to improve sleep behaviors. Ann Behav Med. 2013;46:260–72.

    Article  PubMed  Google Scholar 

  24. Higgins A, Conner M. Understanding adolescent smoking: the role of the theory of planned behaviour and implementation intentions. Psychol Health Med. 2003;8:173–86.

    Article  Google Scholar 

  25. Gratton L, Povey R, Clark‐Carter D. Promoting children’s fruit and vegetable consumption: interventions using the theory of planned behaviour as a framework. Br J Health Psychol. 2007;12:639–50.

    Article  PubMed  Google Scholar 

  26. Orbell S, Hodgkins S, Sheeran P. Implementation intentions and the theory of planned behavior. Pers Soc Psychol Bull. 1997;23:945–54.

    Article  Google Scholar 

  27. Sheeran P, Orbell S. Implementation intentions and repeated behaviour: augmenting the predictive validity of the theory of planned behaviour. Eur J Soc Psychol. 1999;29:349–69.

    Article  Google Scholar 

  28. Sniehotta FF, Scholz U, Schwarzer R. Bridging the intention-behaviour gap: planning, self-efficacy, and action control in the adoption and maintenance of physical exercise. Psychol Health. 2005;20:143–60.

    Article  Google Scholar 

  29. Gollwitzer PM. Implementation intentions: strong effects of simple plans. Am Psychol. 1999;54:493–503.

    Article  Google Scholar 

  30. Gollwitzer PM. Goal achievement: the role of intentions. Eur Rev Soc Psychol. 1993;4:141–85.

    Article  Google Scholar 

  31. Armitage CJ. A volitional help sheet to encourage smoking cessation: a randomized exploratory trial. Health Psychol. 2008;27:557–66.

    Article  PubMed  Google Scholar 

  32. Luszczynska A. An implementation intentions intervention, the use of a planning strategy, and physical activity after myocardial infarction. Soc Sci Med. 2006;62:900–8.

    Article  PubMed  Google Scholar 

  33. Prestwich A, Lawton R, Conner M. The use of implementation intentions and the decision balance sheet in promoting exercise behaviour. Psychol Health. 2003;18:707–21.

    Article  Google Scholar 

  34. Verplanken B, Faes S. Good intentions, bad habits, and effects of forming implementation intentions on healthy eating. Eur J Soc Psychol. 1999;29:591–604.

    Article  Google Scholar 

  35. Gollwitzer PM, Sheeran P. Implementation intentions and goal achievement: a meta-analysis of effects and processes. In: Zanna MP, editor. Advances in experimental social psychology. San Diego: Elsevier; 2006. p. 69–119.

    Google Scholar 

  36. LeBourgeois MK, Giannotti F, Cortesi F, Wolfson AR, Harsh J. The relationship between reported sleep quality and sleep hygiene in Italian and American adolescents. Pediatrics. 2005;115(Supplement 1):257–65.

    Article  PubMed Central  PubMed  Google Scholar 

  37. Morin CM, Hauri PJ, Espie CA, Spielman AJ, Buysse DJ, Bootzin RR. Nonpharmacologic treatment of chronic insomnia. An American academy of sleep medicine review. Sleep. 1999;22:1134–56.

    CAS  PubMed  Google Scholar 

  38. Ebben MR, Spielman AJ. Non-pharmacological treatments for insomnia. J Behav Med. 2009;32:244–54.

    Article  PubMed  Google Scholar 

  39. Vyas UK. Non-pharmacological management of insomnia. Br J Med Pract. 2013;6:a623.

    Google Scholar 

  40. Bonnet MH, Arand D. Caffeine use as a model of acute and chronic insomnia. Sleep. 1992;15:526–36.

    CAS  PubMed  Google Scholar 

  41. Thimgan MS, Suzuki Y, Seugnet L, Gottschalk L, Shaw PJ. The perilipin homologue, lipid storage droplet 2, regulates sleep homeostasis and prevents learning impairments following sleep loss. PLoS Biol. 2010;8:1–13.

    Article  Google Scholar 

  42. Karacan I, Thornby J, Anch M, Booth G, Williams R, Salis P. Dose-related sleep disturbances induced by coffee and caffeine. Clin Pharmacol Ther. 1976;20:682–9.

    CAS  PubMed  Google Scholar 

  43. Monk TH, Reynols CF, Kupfer DJ, Buysse DJ, Coble PA, Hayes AJ, et al. The Pittsburgh sleep diary. J Sleep Res. 1994;3:111–20.

    Article  CAS  Google Scholar 

  44. Buysse DJ, Reynolds C, Monk T, Berman S, Kupfer D. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193–213.

    Article  CAS  PubMed  Google Scholar 

  45. Bastien CH, Vallieres A, Morin CM. Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Med. 2001;2:197–307.

    Article  Google Scholar 

  46. Cohen J. Statistical power analysis for the behavioral sciences 2nd ed. New Jersey: Lawrence Erlbaum Associates; 1988.

    Google Scholar 

  47. Bakeman R. Recommended effect size statistics for repeated measures designs. Behav Res Methods. 2005;37:379–84.

    Article  PubMed  Google Scholar 

  48. Retey J, Adam M, Khatami R, Luhmann U, Jung H, Berger W, et al. A genetic variation in the adenosine A2A receptor gene (ADORA2A) contributes to individual sensitivity to caffeine effects on sleep. Clin Pharmacol Ther. 2007;81:692–8.

    Article  CAS  PubMed  Google Scholar 

  49. Burke LE, Swigart V, Turk MW, Derro N, Ewing LJ. Experiences of self-monitoring: successes and struggles during treatment for weight loss. Qual Health Res. 2009;19:815–28.

    Article  PubMed Central  PubMed  Google Scholar 

  50. Bartholomew LK, Parcel GS, Kok G, Gottlieb NH, Fernandez ME. Planning health promotion programs: an intervention mapping approach. 3rd ed. San Francisco: Jossey-Bass; 2011.

    Google Scholar 

  51. Chambless DL, Hollon SD. Defining empirically supported therapies. J Consult Clin Psychol. 1998;66:7.

    Article  CAS  PubMed  Google Scholar 

  52. Lacks P, Rotert M. Knowledge and practice of sleep hygiene techniques in insomniacs and good sleepers. Behav Res Ther. 1986;24:365–8.

    Article  CAS  PubMed  Google Scholar 

  53. Holbrook MI, White MH, Hutt MJ. Increasing awareness of sleep hygiene in rotating shift workers: arming law-enforcement officers against impaired performance. Percept Mot Skills. 1994;79:520–2.

    Article  CAS  PubMed  Google Scholar 

  54. Murdock B. The serial position effect of free recall. J Exp Psychol. 1962;64:482–8.

    Article  Google Scholar 

  55. Alfano CA, Ginsburg GS, Kingery JN. Sleep-related problems among children and adolescents with anxiety disorders. J Am Acad Child Adolesc Psychiatry. 2007;46:224–32.

    Article  PubMed  Google Scholar 

  56. Ramsawh HJ, Stein MB, Belik S-L, Jacobi F, Sareen J. Relationship of anxiety disorders, sleep quality, and functional impairment in a community sample. J Psychiatr Res. 2009;43:926–33.

    Article  PubMed  Google Scholar 

  57. Adriaanse MA, van Oosten JM, de Ridder DT, de Wit JB, Evers C. Planning what not to eat: ironic effects of implementation intentions negating unhealthy habits. Pers Soc Psychol Bull. 2011;37:69–81.

    Article  PubMed  Google Scholar 

  58. Simmons VN, Webb MS, Brandon TH. College-student smoking: an initial test of an experiential dissonance-enhancing intervention. Addict Behav. 2004;29:1129–36.

    Article  PubMed  Google Scholar 

  59. Sniehotta FF. Towards a theory of intentional behaviour change: plans, planning, and self-regulation. J Health Psychol. 2009;14:261–73.

    Article  Google Scholar 

  60. Scholz U, Nagy G, Göhner W, Luszczynska A, Kliegel M. Changes in self-regulatory cognitions as predictors of changes in smoking and nutrition behaviour. Psychol Health. 2009;24:545–61.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors wish to thank the members of the former University of Sydney Health Psychology Research Lab and the current members of the Curtin University Health Psychology and Behavioural Medicine Group for their ideas and feedback throughout the study development, implementation and reporting. Additional thanks to Kirby Sainsbury for her support and advice.

Ethics Declaration

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

Conflict of Interest

Lucinda Mairs and Barbara Mullan declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. School of Psychology, University of Sydney, Griffith Taylor Building (A19), Sydney, 2006, NSW, Australia

    Lucinda Mairs

  2. School of Psychology and Speech Pathology, Curtin University, Room 211, Building 401, Bentley Campus, Perth, 2601, WA, Australia

    Barbara Mullan

Authors
  1. Lucinda Mairs
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Barbara Mullan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Barbara Mullan.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mairs, L., Mullan, B. Self-Monitoring vs. Implementation Intentions: a Comparison of Behaviour Change Techniques to Improve Sleep Hygiene and Sleep Outcomes in Students. Int.J. Behav. Med. 22, 635–644 (2015). https://doi.org/10.1007/s12529-015-9467-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12529-015-9467-1

Keywords

Search

Navigation