Why Am I So Tired? The Science of Sleep for BCBAs

Why a BCBA's Own Sleep Is a Clinical Issue

BCBAs (board certified behavior analysts) get praised for doing more. We add the case. We answer the late text. Lindsay Anderson opened this talk by flipping that habit around. Your sleep is not a side issue. It shapes the care you give.

The numbers back her up. A CDC survey in 2022 found that 36.8% of adults do not get enough sleep. That bar sits at seven hours, which is only a floor. A 2023 Gallup poll found 57% of Americans would feel better with more sleep. In 2020, the National Center for Health Statistics looked at trouble falling asleep. They found 14.5% of adults struggled most days or every day. The group with the most trouble was 18 to 44 years old, and women more than men. As Anderson pointed out, that is a fair picture of our field.

Poor sleep hits the body, the brain, and the mood. Physical risk goes up for heart disease, diabetes, obesity, and colds. Thinking suffers too: more risk taking, weaker reasoning, and poor planning. Mood shifts toward irritability and lower frustration tolerance. At work that looks like more injuries, more critical mistakes, burnout, and worse clinical calls.

Anderson tied this to ethics code 1.10, awareness of personal biases and challenges. The code asks analysts to notice when a health issue may interfere with their work. She was clear that bad sleep is not an ethics violation. It is a barrier worth naming. She also named the culture behind it, and the thoughts it plants, like having to earn rest first. Acceptance and commitment training (a way to unhook from thoughts) helps here. Notice the thought, name the value, pick one committed action.

we're actually doing a disservice to our clients if we aren't prioritizing our own sleep

From the talk — Lindsay Anderson

The Four Pillars of Sleep, Starting With Quantity

The framework comes from Dr. Matthew Walker. He is a sleep scientist and professor at UC Berkeley who wrote Why We Sleep. He names four pillars: quantity, quality, regularity, and timing. Anderson pointed attendees to his self-assessment quiz at sleepdiplomat.com. Each pillar can be measured. Each one can be fixed.

Quantity is the total sleep you get in 24 hours. For adults the range is seven to nine hours. The right number inside that range is personal. Some people brag about running on four or five hours. Genetic short sleepers (people who truly need less sleep) do exist. They get the same benefits in four to six hours that most people need eight hours to get. Most of us are not them.

Then comes the weekend question. You cannot win back every health benefit you lost. Heart health recovers more than the rest. A 2025 study by Luo looked at sleeping in on weekends. As long as it was under four hours, it lowered the risk of high blood pressure. You can also bank sleep ahead of a stretch you know will be short. This softens the hit to your thinking. Both tricks limit harm. Neither beats steady sleep.

just because seven hours is the minimum to avoid negative health outcomes, that doesn't necessarily mean you'll be thriving at seven hours

From the talk — Lindsay Anderson

Quality and Regularity: What a Good Night Looks Like

Quality means how easily you fall asleep and stay asleep. It is scored as time asleep over time in bed. Anderson set the target at 85% or higher. Below that you start to see low energy, irritability, and low mood. The most exact measure is a polysomnogram (an overnight lab sleep study). A wearable gives a rough read. A paper sleep log works too. The pattern to look for is simple. Fall asleep within about 20 minutes. Have few long wake ups. Stay asleep for most of your time in bed.

Wake ups themselves are normal. The research calls them brief arousals (short wake ups during sleep). Anderson cited a study by Bonnet from 2007. It found about 83 wake ups a night for ages 21 to 30. Ages 31 to 40 average about 116. Ages 41 to 50 average about 109. Almost all of them go unnoticed. When a big one does wake you, telling yourself it is normal keeps the anxiety down.

Regularity is going to bed and waking at about the same time daily. Steady timing has been linked to better alertness, heart health, inflammation, mental health, and thinking. Walker suggests staying within 15 minutes each day. If that feels rigid, an hour still helps a lot. The common break is social jet lag (weekday and weekend clocks clash), which brings fatigue, poor focus, and irritability. A 2023 National Sleep Foundation position paper looked at this tradeoff. Sleep should stay on a steady schedule when possible. But if work day sleep runs short, one to two hours of catch up sleep on days off may help.

keeping a regular schedule is just as important, if not maybe more important, than the total amount of sleep you're getting

From the talk — Lindsay Anderson

Timing: Work With Your Chronotype, Not Against It

Timing is where sleep sits in the 24 hour day. The goal is awake in daylight and asleep at night. Shift work makes that hard, and Anderson said so. Beyond that, try to match your chronotype (when your body wants sleep). It is genetic, so you are not choosing it. The one caution is for extreme night owls, since very late bedtimes have been linked to higher heart disease risk.

Dr. Michael Brios, a clinical psychologist and sleep specialist, splits chronotypes into four animals. He has a free quiz at chronoquiz.com. Bear is the most common at about 55%: up around 7 a.m., bed near 11 p.m., peak focus from 10 a.m. to 2 p.m. Lion is about 15%: up before 6 a.m., bed by 10, peak from 9 a.m. to 2 p.m. Wolf is another 15%: up after 7:30, midnight bedtime is common, peak from 1 p.m. to 5 p.m. Dolphin is about 10%: schedules are harder to hold, light and noise wake them, and sleep is more broken.

our chronotypes dictate which time of day we feel most alert and which time of day we feel most sleepy

From the talk — Lindsay Anderson

Four Daily Supports That Move Sleep in the Right Direction

The first is morning light. Light sets your circadian rhythm (your body's internal daily clock). Studies show that more light before 10 a.m. means better sleep quality that night. Every extra 30 minutes of morning light adds to that benefit. Take a short walk. Drink your coffee outside. Open a window and stick your head out. The point is light reaching your eyes.

The second is movement. Regular activity is linked to shorter sleep latency (how long falling asleep takes) and better overall quality. It has shown promise with insomnia. Moderate effort works best, while hard workouts close to bedtime can backfire. A study by Al Noir found that 10 minutes of light morning exercise added 2.56 minutes of sleep. Small, but it moves the right direction.

The third is mindfulness, which just means paying attention on purpose, in the present moment, without judging it. That can be breath, body sensations, a repeated phrase, progressive muscle relaxation, or yoga. A 2021 study by Rush looked at mindfulness meditation for sleep. It worked as well as other proven treatments and beat the control group by a wide margin. Those gains held at 5 and 12 months later. A 2025 study by Algosy found that long term yoga helped sleep latency, duration, and efficiency.

The fourth is a bedtime routine. Adults need cues too. Do the same things in the same order so your brain learns what comes next. One study had a group read 15 to 30 minutes in bed each night. That group reported better sleep quality than the control group. Leave about 20 minutes to actually fall asleep. Sprinting upstairs at 9:59 will not hit a 10 p.m. goal. Use a timer an hour before bed, or a sticky note on the mirror as a prompt.

we all have those days where you really can only manage a few minutes of light exercise

From the talk — Lindsay Anderson

Sleep Barriers, Part One: Medical Issues and Screens

Start with the body. Obstructive sleep apnea (throat blocks air during sleep) is the big one. Recent estimates put it at up to 33% of adults. If you are wiped out all day and snore loudly or gasp at night, get checked. Restless leg syndrome (an urge to move your legs) affects about 7%. The cause is often unknown. Low iron, pregnancy, and some medical conditions can play a role. Alcohol, caffeine, and stress make it worse. GERD (stomach acid rises at night) may affect up to 20% of adults, and it gets worse lying down. Eating about three hours before bed, raising the head of the bed, and sometimes medication all help. Anderson also flagged vitamin D deficiency. Every one of these belongs with a doctor, not a sleep hack.

Then there is the phone. A large 2025 study by Zong looked at more than 165,000 adults. People who used handheld devices within an hour of bed every day slept less. They were more likely to fall short of the recommended seven to nine hours. On average, they also went to sleep over 19 minutes later. Nineteen minutes sounds like nothing. Stack it across a month on top of poor quality and it adds up.

What you do on the screen matters more than the screen itself. Research in adolescents found that active use like scrolling and gaming hurt sleep far more than watching television. So the action step is specific. Put handheld devices away an hour before bed. If you want something, watch TV instead, and set a timer so the next episode does not start on its own.

your brain has to keep waking you up all night long in order to breathe again

From the talk — Lindsay Anderson

Sleep Barriers, Part Two: Food, Drink, Room, and Stress

Food shows up in the data. Diets high in processed food and added sugar are linked to worse sleep quality. That shows up as less deep sleep, blood sugar swings, and more inflammation. Irregular meal times were tied to more sleep problems in teens, college students, and adults. Skipping breakfast keeps showing up next to later bedtimes, though no one has pinned down why. The action step is a regular meal schedule that includes breakfast, if that works for you. Add more fruit and vegetables too.

Drinks are sharper. Anderson cited two meta-analyses (studies that combine results from many other studies) by Gardner. Two alcoholic drinks within three hours of bed can delay the start of REM sleep (the dreaming stage of sleep). It also shortens that stage, and more alcohol means more disruption. Caffeine cut total sleep time by 45 minutes, and the closer to bed, the bigger the loss. That work gave clean cut-offs. Stop pre-workout at least 13.2 hours before bed. Stop coffee at least 8.8 hours before bed.

Your room counts too. A study of 47,000 women across the country looked at bedroom light. Sleeping with a TV or a light on came with more poor sleep. That included a sleep debt over two hours, trouble staying asleep, and frequent napping. A small nightlight or a little light from outside was not tied to a real change. In a lab study, people slept in a near silent room. They got more deep sleep and fewer wake ups than at home. Heat hurts as well. So use a nightlight instead of overhead lights. Add steady low noise, like a fan, if quiet is not possible. Keep the thermostat between 65 and 68 degrees.

Stress is the one most attendees named. A 2024 American Academy of Sleep Medicine survey found 74% of Americans report stress disrupting their sleep and 68% lose sleep to anxiety. The action step is a five minute to-do list right before bed. In a study of 57 adults ages 18 to 30, one group wrote out upcoming tasks. That group fell asleep faster than the others. More specific lists worked even better. Revenge bedtime procrastination (staying up late for yourself) is the other trap. Talker Research surveyed 2,000 Americans last December. They found 96% do it, about 3.5 times a week. Each time, they stay up an hour and 50 minutes later than usual. Treat it as a function question (the reason a behavior happens). Schedule 10 minute blocks of your own time during the day.

nighttime is the only time that they have for themselves

From the talk — Lindsay Anderson

When You Cannot Sleep, Trackers, and a Sample Plan

Some nights fall apart anyway. Anderson's first rule is to stay calm, because a rising heart rate makes falling back asleep harder. She uses acceptance language for the spiral. It sounds like telling yourself that sleep is not coming right now, and that you can accept that. Do not check the clock, since that starts the math on how little sleep is left. Skip the optional bathroom trip, because walking across the room raises your heart rate. Try box breathing (timed breathing in a set pattern). Her version is in for four, hold for five, out for eight, hold for five. Long exhales calm the heart and switch on the parasympathetic nervous system (the calm down body system). If about 20 minutes pass and you are still awake, or anxiety is climbing, get up. Keep the lights dim, read something boring or listen to a podcast, and go back when you feel sleepy. If this happens often, consider CBTI (cognitive behavioral therapy for insomnia, a short structured therapy). It is highly effective, and many insurance plans cover it.

Trackers came up in questions, and the answer was balanced. On the plus side, a 2025 study found that people who wore a device more often moved more. More activity feeds better sleep. Trackers also surface patterns you would miss. For example, they can show how a late bedtime or a couple glasses of wine changes your night. Just measuring a thing tends to change behavior, the same way a step counter makes you walk more. On the minus side, the American Academy of Sleep Medicine says consumer sleep tracking falls under health and wellness. It does not fall under FDA oversight, so accuracy varies by device and maker. No tracker replaces a medical evaluation. There is also orthosomnia, the obsessive chase of perfect sleep scores, which makes sleep worse.

The talk closed with a worked example you can copy. Goal bedtime 10 p.m., with eight and a half hours needed, so wake up at 6:30 a.m. Walk from 7:00 to 7:15 for movement and morning light. Meals at 8 a.m., 1 p.m., and 6 p.m. Last coffee by 1 p.m. A few 10 minute breaks for yourself during the day. Thermostat down by 8 p.m. so the room is cool by bedtime. Timer at 9 p.m.: phones away, lights dim. Then hygiene, five minutes writing the to-do list, and about 15 minutes of reading, yoga, or meditation. Lights out at 9:40 with box breathing, which leaves the 20 minutes it takes to actually fall asleep.

using a sleep tracker is going to be an individual choice

From the talk — Lindsay Anderson