Some help, most don’t. Here we round up the tools that psychologists and neuroscientists fully endorse – and the ones they say are simply not worth losing sleep over.

For decades the nation has been gripped by a pandemic of poor sleep. And the problem is only getting worse. Almost half of Brits are sleeping less and sleeping more poorly than they were 12 months ago.

According to Nuffield Health’s 2023 report, the UK average is now just 5.9 hours per night, down from a little over six two years ago. Nearly 13% get less than four hours of kip each night, miles below the NHS’ recommended 7-9 hours.

It’s making us grumpier, less productive, less active, less sociable and more prone to illness.

These issues are mirrored around the world, which has prompted the global sleep economy to surge from $432 billion USD in 2019 to a projected $585 billion this year. You can now invest in smart mattresses, smart eye masks and smart earplugs… but should you?

We pored over the latest research and consulted experts in the field of Cognitive Behavioral Therapy for Insomnia (CBT-I) to identify the sleep aids that show genuine promise, and the ones that, if anything, could be making matters worse.

Apps

Ask a number of clinical psychologists which gadgets they’d recommend to improve sleep and you’ll likely get the same answer. “We do not endorse any ‘gadgets’ for sleep as none of them work, none of them have ever worked, and it’s very, very unlikely that any will work in the future” – for example.

There is, however, one app that Dr David Lee, Clinical Director at Sleep Unlimited Ltd and author of Teaching the World to Sleep (2nd Edition, Routledge, London) says has a decent weight of evidence behind it. Sleepio is a six-week, app-based program designed to address the root cause of insomnia.

Drawing on artificial intelligence (AI) to provide poor sleepers with tailored CBT-I treatment, sessions focus on identifying thoughts, feelings and behaviors that lead to poor sleep. And it has the heavyweight backing of the National Institute for Health and Care Excellence (NICE).

In 2022, controlled trials found Sleepio to be more effective at reducing insomnia than improved sleep hygiene or even “dependency forming” sleeping pills. At the time, NICE declared that up to 800,000 people in England could benefit from using Sleepio.

“It certainly shows promise, yet the uptake of app-delivered CBT-I is not as good as face-to-face in person treatment,” notes Dr Lee. “People tend to prefer to be treated by people rather than computer algorithms.”

Wearables

The Sleepio app is compatible with devices like Apple Watch or Fitbit, which can automatically track and log sleep data. But Dr Lee says only one wearable is worthy of consideration in this list.

An actigraph device is a clinical-grade, wrist- or ankle-worn activity tracker, which healthcare providers, both public and private, might use to assess your sleep patterns.

In isolation these won’t help you sleep better. That’d be like saying simply donning cycling shorts will make you fitter. Yet research suggests actigraphy can be a useful tool to get a better read on how you’re sleeping, to identify circadian rhythm sleep disorders you might not be aware of, and to evaluate treatment outcomes.

It has also shown promise in understanding the role sleep can play in depression and dementia. This is, in part, due to its accuracy in recording sleep data when compared with electroencephalography (EEG) measurement, which Dr Lee says is “the gold standard”.

Of course, smart watches are capable of recording your sleep patterns, right? Not so, according to Dr Lee. “Most are inaccurate, freak people out about their sleep and end up causing an exacerbation of the problem,” he says. “No other apps or wearables have any validity or reliability at the present time, although things may develop.”

Smart mattresses

If not smart watches, there is some anecdotal evidence that smart mattresses could improve sleep quality, such as The Pod by Eight Sleep.

A health tech product with a roll call of celebrity ambassadors, from the world’s richest man Elon Musk to the world’s fittest man Justin Medeiros, it automatically adjusts the temperature under your covers from 12-43˚C to keep you in restful slumber.

One survey, in which its members completed the Pittsburgh Sleep Quality Index (PSQI) before and after one month of use, found that sleep quality scores improved by 32%. Users reported a 34% boost in daytime energy, 23% fewer sleep interruptions and fell asleep 44% faster – a 12 minute reduction in sleep onset.

“One of the primary reasons people wake up during the night is temperature-related discomfort, especially during REM sleep,” commented Dr Nicole Moyen, Director of Science & Clinical Research at Eight Sleep. “And these levels of sleep quality improvement are comparable [with those] from cognitive behavioral therapy.”

More generally speaking, Dr Lee urges caution when considering technological remedies. “Sleep is an ancient biological process,” he says. “Humans have been sleeping without apps [and gadgets] for tens of thousands of years. As a natural process, it requires a natural solution. Our very clumsy technology is no match for mother nature in this regard.”

White noise machines

In unnatural settings, however, such as noisy hospital wards, technology can play a role in eliminating or drowning out distractions that are keeping you awake at night.

White noise machines, for example, produce a static-like din containing all the frequencies of sound at the same volume, which can help mask background noises like beeping machinery.

“There is some evidence to show that white noise machines can be very helpful when sleeping in a noisy environment, such as in a hospital, or living in an inner-city with sirens going off throughout the night,” says neuroscientist Dr Lindsay Browning, a sleep expert at Trouble Sleeping and author of Navigating Sleeplessness.

But if anxiety or stress is keeping you up, rather than background distractions, then a white noise machine might not be the answer. “We tend to sleep better in the dark and in silence, so adding in additional noise, where unnecessary, may not be helpful in all cases.”

Earplugs and eye masks

It’s a similar story with earplugs and eye masks. One 2014 study, carried out on patients in an intensive care unit, found wearing earplugs and an eye mask to be a cost-effective and safe method to improve sleep quality.

And if you’re a shift worker, needing to sleep during the day, then earplugs may help mask background noises that are disturbing the peace. But just like with white noise machines, Dr Browning says, if your inability to sleep is caused by a whirring mind, rather than whirring machinery or flashing lights, then earplugs and eye masks are unlikely to do the trick.

“Our brains are quite good at telling the difference between warning signals that we should wake up to and normal environmental sounds, such as the central heating clicking in or rainfall outside,” she says.

An over reliance on earplugs can also cause some unpleasant side-effects. “Regular use can cause earwax buildup that makes you less likely to hear important sounds, such as the fire alarm or your crying children during the night,” Dr Browning says.

Weighted blankets

Low-tech solutions like weighted blankets can improve sleep quality – but this is generally down to personal preference rather than empirical proof. “There’s no evidence either way on weighted blankets,” says Dr Lee.

“But as there are no real side-effects to their use then they are neither endorsed nor contraindicated,” he continues. “If you like them – use them.”

Dr Browning notes that, despite this dearth of data, anecdotally children with special educational needs or sensory issues may find a weighted blanket helpful, such as those on the autistic spectrum. “If you do use one, it should not be so heavy as to restrict breathing during the night, especially with young children,” she says.

Heavy blankets may also cause overheating during the night, which can disturb sleep. “A low-cost alternative could be using fitted sheets and blankets tucked into the mattress, which can give a sense of security and feeling hugged during the night,” adds Dr Browning.

Firm pillows and a supportive mattress

Before you lighten the load on your wallet by investing in a heavy blanket, a shrewder decision would be to refresh your current bedding. “Ideally you should replace your pillows every two years,” says Dr Browning, because they absorb sweat and dead skin cells that we shed during the night.

And while your mattress might hold sentimental value, you should upgrade it every 7-8 years to ensure it remains supportive enough to keep your spine in a neutral alignment. “As a general rule, heavier sleepers [meaning heavier set sleepers] need firmer mattresses, compared with lighter weight people,” who can afford a bit of give.

Words: Sam Rider