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dc.contributor.authorPerucho, Isabel
dc.contributor.authorVijayakumar, Kamalakannan M.
dc.contributor.authorTalamas, Sean
dc.contributor.authorChee, Michael Wei-Lang
dc.contributor.authorPerrett, David I.
dc.contributor.authorLiu, Jean
dc.identifier.citationPerucho , I , Vijayakumar , K M , Talamas , S , Chee , M W-L , Perrett , D I & Liu , J 2019 , ' A web-based photo-alteration intervention to promote sleep : randomized controlled trial ' , JMIR , vol. 21 , no. 9 , e12500 .
dc.identifier.otherPURE: 260281606
dc.identifier.otherPURE UUID: 3b998b87-e635-43e9-a31e-620dc0747ffc
dc.identifier.otherORCID: /0000-0002-6025-0939/work/64360978
dc.identifier.otherWOS: 000487968700001
dc.identifier.otherScopus: 85072847353
dc.descriptionThis work was supported by grants awarded to JCJL by the Singapore Ministry of Education (start-up grant number: R-607-264-057-121 and AcRF Tier 1: IG15-B052).en
dc.description.abstractBackground: Receiving insufficient sleep has wide-ranging consequences for health and well-being. Although educational programs have been developed to promote sleep, these have had limited success in extending sleep duration. To address this gap, we developed a web-based program emphasizing how physical appearances change with varying amounts of sleep. Objective: The aims of this study were to evaluate: (1) whether participants can detect changes in appearances as a function of sleep, and (2) whether this intervention can alter habitual sleep patterns. Methods: We conducted a 5-week, parallel-group, randomized controlled trial amongst 70 habitual short sleepers (healthy adults who reported having <7 hours of sleep routinely). Upon study enrolment, participants were randomly assigned (1:1) to receive either standard information or an appearance-based intervention. Both groups received educational materials about sleep, but those in the appearance group also viewed a website containing digitally-edited photographs that showed how they would look with varying amounts of sleep. As outcome variables, sleep duration was monitored objectively via actigraphy (at baseline, and at post-intervention weeks 1 and 4), and participants completed a measure of sleep hygiene (at baseline, and at post-intervention weeks 2, 4, and 5). For each outcome, we ran intention-to-treat analyses using linear mixed-effects models. Results: In total, 35 participants were assigned to each group. Validating the intervention, participants in the appearance group: (i) were able to identify what they looked like at baseline, and (ii) judged that they would look more attractive with a longer sleep duration (t(26) = 10.35, P < .001). In turn, this translated to changes in sleep hygiene: whereas participants in the appearance group showed improvements following the intervention (F(1,107.99) = 9.05, P = .003), those in the information group did not (F(1,84.7) = 0.19, P = .66). Finally, there was no significant effect of group nor interaction of group and time on actigraphy-measured sleep duration (smallest P = .26). Conclusions: Our findings suggest that an appearance-based intervention – while not sufficient as a standalone – could have an adjunctive role in sleep promotion.
dc.rightsCopyright © Isabel Perucho, Kamalakannan M Vijayakumar, Sean N Talamas, Michael Wei-Liang Chee, David I Perrett, Jean C J Liu. Originally published in the Journal of Medical Internet Research (, 27.09.2019 This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited.en
dc.subjectPublic healthen
dc.subjectPhysical appearanceen
dc.subjectOutward appearanceen
dc.subjectBF Psychologyen
dc.titleA web-based photo-alteration intervention to promote sleep : randomized controlled trialen
dc.typeJournal articleen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews. Institute of Behavioural and Neural Sciencesen
dc.contributor.institutionUniversity of St Andrews. Centre for Social Learning & Cognitive Evolutionen
dc.contributor.institutionUniversity of St Andrews. School of Psychology and Neuroscienceen
dc.description.statusPeer revieweden

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