Key findings
A simple morning sleep log is the standard way sleep experts track sleep at home.
The Consensus Sleep Diary (CSD) was built by insomnia experts and focus groups. Its 9 core items are time into bed, time trying to sleep, time to fall asleep, number of awakenings, total minutes awake, final waking time, time out of bed, a quality rating and comments. The expanded morning version adds how rested or refreshed the person feels, naps, alcohol, caffeine and medication.1
Limits The authors call the CSD a living document that still needs further validation. Dusk uses a shortened, bucketed version.
It takes about two weeks of logs to see your real pattern; single nights vary a lot.
The AASM's adult insomnia guideline makes a two-week sleep log the minimum for identifying sleep–wake patterns and night-to-night variability. It recommends logs before and during treatment.2
Limits This is a consensus recommendation, not an empirically derived minimum. Dusk's weekly profile uses fewer nights and should be framed as provisional.
How rested you feel is only loosely linked to what a sleep lab would measure, so your own rating is worth tracking in its own right.
In 1,483 older adults with home polysomnography, 38 sleep, demographic and clinical variables together explained only 11–17% of the variance in next-morning sleep-quality ratings. Sleep efficiency was the strongest objective predictor, followed by total sleep time.34
Limits Older adults only, and a single night of recording.
People judge a night mostly by how long they slept, how refreshed they feel, and how broken the night was.
In a choice experiment (n = 100: 50 good and 50 poor sleepers), total sleep time, feeling refreshed on waking and next-day mood were the top 3 of 17 factors, and good and poor sleepers weighed them the same way. People with and without insomnia both define sleep quality by tiredness on waking and through the day, feeling rested, and the number of awakenings.56
Limits Small samples. These are judgements about written scenarios, and they do not give numeric weights.
When sleep is troubled, it is common to feel you took longer to fall asleep and slept less than you did — the experience is real even when the estimate is off.
A review of 13 explanations found that people with insomnia commonly overestimate how long they take to fall asleep and underestimate total sleep compared with polysomnography. The best-supported explanations are light sleep being felt as wake, worry, and brief awakenings.78
Limits Not universal. The AI must never use this to dismiss what a user reports.
A one-question morning rating of your sleep is a valid way to track it over time.
A single-item 0–10 Sleep Quality Scale correlated −0.76 to −0.92 with morning-questionnaire and PSQI sleep-quality items. Test–retest reliability was 0.62–0.74, and it was responsive to change (standardised response mean 0.67–1.32).9
Limits Validated in clinical samples (insomnia, depression), not in app users. Dusk's 4-point feel scale differs from the 0–10 item.
Validated sleep questionnaires look at weeks, not single nights, and only a clinician should use their cut-offs to judge a problem.
PSQI (past month): a global score above 5 separated poor from good sleepers with 89.6% sensitivity and 86.5% specificity. ISI bands: 0–7 none, 8–14 subthreshold, 15–21 moderate, 22–28 severe; a cut-off of 10 detected community insomnia (86.1% sensitivity, 87.7% specificity), and a drop of about 8 points matched moderate improvement. ESS: normal sleepers score 0–10, and above 10 indicates excessive sleepiness (10.9% of workers).1014
Limits Dusk should not show these cut-offs to users as diagnostic thresholds. Under the FDA wellness guidance, showing diagnostic thresholds moves a product toward medical-device status.
Taking up to about 30 minutes to fall asleep is within the normal range.
NSF expert-consensus markers of good sleep quality include falling asleep in 30 minutes or less. Insomnia research criteria start at sleep-onset latency of 31 minutes or more on at least 3 nights a week (for at least 6 months in that analysis).1516
Limits Consensus built on observational data. Falling asleep in under 5 minutes every night can reflect sleep loss rather than good sleep.
Waking briefly once in the night is normal; long stretches awake are what matter more.
NSF good-quality markers for adults: no more than one awakening and 20 minutes or less awake after first falling asleep. Insomnia research criteria use 31 minutes or more awake after sleep onset, on at least 3 nights a week.1516
Limits Older adults wake more often; thresholds vary by age.
Most adults do best with at least 7 hours of sleep on a regular basis, though individual needs differ.
The AASM/SRS consensus: adults should sleep 7 or more hours regularly, and under 7 h is linked to adverse health outcomes. More than 9 h may suit young adults, people recovering from sleep debt and people who are ill. NSF ranges: 7–9 h for adults 18–64, 7–8 h for 65+, 8–10 h for teenagers.1719
Limits Based mostly on observational links. Applies to adults without sleep disorders. An 8 h cap on 'need' in scoring is a design choice, not a finding.
Sleep needs differ from person to person; few people sit far outside the usual range.
In 1.1 million people from three countries, 1 in 4 slept less than the recommended amount for their age, but only 5.8% were outside the 'acceptable' range. In adults, insomnia symptoms (9.6–19.4%) were more common than sleeping under 6 h (6.5%).1720
Limits Questionnaire-reported sleep. Western populations only.
Chasing a perfect sleep score can itself make sleep worse, so look at weekly trends rather than any single night's number.
Clinicians describe patients who diagnosed insomnia in themselves from tracker data and chased ideal numbers ('orthosomnia'). In one general-population sample (n = 523), 3.0–14.0% met algorithm-defined criteria, depending on the threshold.2122
Limits Case series and one cross-sectional study with an ad-hoc definition.
Being told you slept badly can make the next day feel worse, whatever your sleep actually was.
In an RCT of 63 adults with insomnia, those given fake negative sleep feedback reported less alertness (d = 0.79) and more sleepiness and fatigue (d = 0.55) by evening than those given positive feedback. Objective vigilance did not differ (d = 0.12).23
Limits Single RCT in people with insomnia; one day of feedback.
Sleep trackers are fairly good at telling when you're asleep but often miss time awake, and their sleep-stage numbers are rough estimates.
Seven consumer devices compared against PSG detected sleep with sensitivity of 0.93 or more, but wake with specificity of only 0.18–0.54. Stage estimates were inconsistent, and devices performed worse on disrupted nights. The AASM states that consumer sleep technology cannot be used to diagnose or treat sleep disorders.2427
Limits Device models and algorithms change quickly. Studies mostly use healthy young adults.
Doctors use the word insomnia for trouble sleeping on 3 or more nights a week for 3 months or more, with daytime effects — Dusk can't diagnose it, but a doctor can.
DSM-5 insomnia disorder and ICSD-3 chronic insomnia disorder both require difficulty falling asleep, staying asleep or waking too early, despite adequate opportunity to sleep. Symptoms must occur on at least 3 nights a week for at least 3 months and cause distress or daytime impairment.2829
Limits Diagnosis needs a clinical assessment that rules out other sleep, medical and mental-health causes.
For long-lasting insomnia, the recommended first step is a structured talking therapy called CBT-I, which is available in person or online.
ACP: CBT-I as initial treatment (strong recommendation, moderate-quality evidence). ESRS 2023: first-line for adults of any age, in person or digital (grade A). AASM 2021: multicomponent CBT-I strongly recommended. Across 87 RCTs, CBT-I improved ISI scores by g = 0.98; internet CBT-I gave g = 0.21–1.09 across outcomes.3034
Limits Dusk does not deliver CBT-I and must not claim to.
Healthy sleep habits help many people, but on their own they are not a treatment for long-term insomnia.
The AASM 2021 guideline suggests clinicians not use sleep hygiene as a single-component therapy for chronic insomnia disorder (conditional recommendation). Dusk's protocol (light, temperature, caffeine and alcohol timing, wind-down) is mostly sleep hygiene and environment change.31
Limits Applies to chronic insomnia disorder. For people with occasional poor sleep, habit changes are reasonable to try.
Loud snoring with pauses in breathing, gasping or heavy daytime sleepiness is worth raising with a doctor; a questionnaire or app can flag it but can't rule it in or out.
An estimated 936 million adults aged 30–69 have obstructive sleep apnoea (425 million moderate to severe). A STOP-Bang score of 3 or more has 93% sensitivity for moderate-to-severe OSA, but specificity is only about 29–47%. The AASM strongly recommends against diagnosing OSA from questionnaires without PSG or a home sleep apnoea test.133538
Limits STOP-Bang was validated mainly in surgical and clinic samples. Snoring without sleepiness or witnessed pauses is often benign.
Ongoing poor sleep and low mood often travel together; if both are with you, a doctor or therapist can help with both.
People with insomnia but no depression had about twice the odds of developing depression later (OR 2.60, 95% CI 1.98–3.42; 21 studies). Sleep disturbance was linked to suicidal ideation, attempts and suicide (unadjusted RR 1.95–2.95; 39 studies, n = 147,753).3940
Limits Observational associations. Effects are smaller in adjusted studies.
If you feel drowsy, don't drive — short sleep raises crash risk even when you don't feel sleepy.
In 3,201 adults aged 40–89, sleeping 6 h was linked to a 33% higher crash risk than 7–8 h, and severe sleep apnoea to a 123% higher risk. Both held without self-reported sleepiness. The AASM treats drowsy driving as a public-health priority.4142
Limits Self-reported crashes in middle-aged and older adults.
An urge to move your legs at rest, sudden muscle weakness when laughing, acting out dreams, or sleep problems tied to shift work are worth checking with a doctor rather than fixing with sleep habits.
RLS has five essential criteria, including an urge to move the legs that is worse at rest and in the evening and is relieved by movement. Narcolepsy type 1 includes cataplexy. Idiopathic REM sleep behaviour disorder (dream enactment) is linked to later neurodegenerative disease in up to 90.9% over long follow-up. Shift work disorder is a circadian disorder of insomnia and/or sleepiness.4346
Limits In-app copy should describe symptoms, not name disorders, and should not mention neurodegeneration to users.
Sleep often changes in pregnancy; check any supplement or new snoring with your midwife or doctor.
Pooled across 24 studies (n = 11,002), 45.7% of pregnant women had poor sleep quality (PSQI), and it worsened from the second to the third trimester. Sleep-disordered breathing in mid-pregnancy was linked to preeclampsia (adjusted OR 1.95) and gestational diabetes (adjusted OR 2.79).4748
Limits Dusk's protocol was not designed for pregnancy.
Dusk is a sleep-habit and tracking tool for general wellness; it does not diagnose or treat any condition.
The FDA's January 2026 guidance lists 'sleep management, such as to track sleep trends' as a general wellness claim. Products lose that status if their labelling or interface names specific diseases or diagnostic thresholds, issues clinical alerts or treatment guidance, or claims clinical accuracy. A notice that seeing a healthcare professional may be helpful is allowed if it names no disease and calls nothing abnormal. In the EU, the manufacturer's intended purpose decides medical-device status, and MDCG 2019-11 rev.1 says wellness and fitness apps do not qualify as medical device software.4951
Limits Regulatory text, not legal advice. CBT-I apps that treat insomnia (Somryst, SleepioRx) went through FDA clearance.
Dusk's nightly score is a personal trend marker built from your answers, not a medical measure — compare it with your own past nights, not with other people.
No nightly composite score has been validated against health outcomes. Sleep-health frameworks recommend tracking separate dimensions (satisfaction, alertness, timing, efficiency, duration). Dusk's weighting (feel 30, duration 30, wakings 25, onset 15) matches what drives people's own quality judgements.3552
Limits The weights are judgement calls informed by evidence.
What experts and guidelines say
- Sleep diaries: Carney, Buysse, Edinger, Krystal, Lichstein and Morin designed the CSD as a living standard for self-monitoring at home1. The AASM's 2008 insomnia guideline makes a two-week sleep log the minimum assessment2. The 2023 European guideline grades questionnaires and diaries "A" for diagnosis, and does not recommend actigraphy for routine evaluation (grade C)32.
- Recommended sleep duration: the AASM/SRS recommend 7 or more hours for adults, and say people worried they sleep too much or too little should talk to a healthcare provider17. The NSF recommends 7–9 h for adults19.
- Sleep health as a set of dimensions: Buysse proposes measuring satisfaction, alertness, timing, efficiency and duration (RU-SATED) separately rather than as one number52. Dusk's composite score is a pragmatic single number. Showing its components (as the app already does) fits this view.
- Consumer technology: the AASM says consumer sleep technology can support the conversation between patient and clinician but not diagnosis27. De Zambotti and colleagues call for standardised validation26. Baron coined "orthosomnia" and suggests building tracker use into CBT-I21.
- Insomnia care: ACP, AASM and the European Sleep Research Society (ESRS) all name CBT-I as first-line3032.
- OSA: questionnaires such as STOP-Bang are for triage only, and diagnosis needs PSG or a home sleep apnoea test3638.
- Named researchers: Colleen Carney (diary), Allison Harvey and Nicole Tang (subjective sleep, misperception), Charles Morin (ISI, CBT-I), Daniel Buysse (PSQI, sleep health), Kelly Baron (orthosomnia), Massimiliano de Zambotti (wearables), Dieter Riemann (European guideline), Jack Edinger (AASM behavioural guideline), Frances Chung (STOP-Bang).
Myths and overstatements
- Overstated
“Everyone needs exactly 8 hours of sleep.”
Consensus sets a floor of 7 or more hours for adults (7–9 h per the NSF), and need varies between individuals.1719
- False
“Taking more than 15 minutes to fall asleep is a sign of insomnia.”
Up to 30 minutes is within good-quality norms. Research criteria for insomnia start at 31 minutes or more on at least 3 nights a week over months.1516
- Overstated
“Waking up during the night means you slept badly.”
One awakening and up to 20 minutes awake are within good-quality norms for adults.15
- Overstated
“Your tracker knows how well you slept better than you do.”
Devices detect sleep well but miss much of the time awake and are inconsistent on stages. Self-report is the clinical standard for sleep quality.12427
- False
“Self-reported sleep is unreliable, so it doesn't count.”
Sleep diaries are the recommended clinical and research tool. Misperception is a recognised feature of insomnia, not a reason to dismiss the complaint.1732
- Overstated
“Good sleep hygiene cures insomnia.”
The AASM suggests not using sleep hygiene as a stand-alone therapy for chronic insomnia. CBT-I is first-line.3031
- Partly true
“Snoring is just harmless noise.”
Simple snorers often have normal sleepiness scores, but loud snoring with witnessed pauses, gasping or daytime sleepiness can signal obstructive sleep apnoea, which needs a sleep test.1338
- Unproven
“A higher sleep score means you are healthier.”
No nightly composite sleep score has been validated against health outcomes, and negative score feedback can itself worsen how the day feels.212352
- False
“Adding 'not a medical device' keeps an app out of medical-device regulation.”
Regulators look at the claims, labelling and functions (intended purpose), not the disclaimer.4951
When to see a doctor
Signs like these are a reason to talk to a clinician. They aren’t something a bedtime routine should try to fix, so Dusk doesn’t coach around them.
Loud, frequent snoring with witnessed pauses in breathing, choking or gasping at night, especially with heavy daytime sleepiness, morning headaches or high blood pressure (STOP-Bang features).
Loud snoring with pauses or gasping, especially with daytime sleepiness or morning headaches, is worth checking with a doctor. It's common, easy to test for, and not something a bedtime routine can fix. Dusk will keep tracking your habits in the meantime.3538
Dozing off or nearly dozing while driving, near-misses, or struggling to stay awake in passive situations (ESS-type sleepiness).
Please don't drive when you feel drowsy — pull over somewhere safe, or get a lift. Nodding off at the wheel is a reason to talk to a doctor soon, not something to work around.144142
Sudden muscle weakness triggered by laughter or strong emotion (knees buckling, jaw dropping), irresistible sleep attacks in the day, or frequent sleep paralysis or vivid hallucinations when falling asleep or waking.
Sudden weakness with strong emotions, or falling asleep without warning during the day, is something to raise with a doctor. Dusk's routine isn't designed for this, so please get it checked before relying on habit changes.1344
An uncomfortable urge to move the legs that starts or worsens when resting in the evening or at night and eases with movement.
An urge to move your legs at night that eases when you move is worth mentioning to a doctor — there are simple checks and treatments for it. Keep logging; it helps to bring your notes.243
Acting out dreams (shouting, punching, kicking, falling out of bed), injuring self or bed partner, or sleepwalking with risky behaviour (leaving the house, cooking, driving).
Moving or acting out dreams in your sleep, or sleepwalking, is worth checking with a doctor — especially if anyone has been hurt or nearly hurt. Until then, make the bedroom safe: move sharp or hard objects away from the bed.2945
Thoughts of self-harm or suicide, or feeling hopeless, mentioned anywhere.
I'm really sorry you're feeling this way. You deserve support right now. If you might act on these thoughts, contact your local emergency number. You can also talk to someone now: in the US call or text 988, in the UK and Ireland call Samaritans on 116 123, or find a local helpline at findahelpline.com.40
Low mood, loss of interest, or anxiety most days for 2 weeks or more alongside poor sleep (no self-harm content).
Poor sleep and low mood often feed each other. If your mood has been low for a couple of weeks or more, a GP or therapist can help with both. Dusk can keep supporting your routine alongside that.3239
Trouble falling or staying asleep (over 30 min to fall asleep, or a long waking) on 3 or more nights a week, with daytime impact, lasting 3 months or more; or no improvement after about 4–6 weeks of the protocol.
Sleep trouble that's been around for months usually needs more than habit changes. The most recommended approach is CBT-I, a short structured program you can do with a clinician or a clinically backed online course. Your Dusk logs are a good thing to bring along.162832
User is pregnant, trying to conceive, or breastfeeding.
Congratulations — sleep often shifts during pregnancy. Dusk will leave supplements out of your plan; please check any supplement, and any new loud snoring or restless legs, with your midwife or doctor.4748
Night shifts or rotating shifts, especially with insomnia or heavy sleepiness linked to the schedule.
Dusk's plan assumes a regular daytime schedule, so parts of it may not fit shift work. If shifts are leaving you exhausted or unable to sleep, an occupational health service or doctor can help plan around your rota.46
User asks about starting, stopping or changing prescription sleep medication, or mixing it with alcohol or supplements.
Changes to sleep medication are best made with the person who prescribed it — stopping some medicines suddenly can cause problems. Dusk can help with routines alongside whatever plan you agree with them.3032
Regularly sleeping under 5 h despite the chance to sleep, or 10 h or more and still sleepy.
Your logs show much shorter (or longer) nights than most adults need, for a couple of weeks now. If that isn't by choice, or you're still tired, it's worth talking it over with a doctor.1719
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