Improved Support for Insomnia Sufferers by patrick foster

Improved Support for Insomnia Sufferers

Anthony Bellavia MDES Program NSCAD 2013

Improved Support for Insomnia Sufferers A thesis project presented to The School of Graduate Studies Nova Scotia College of Art and Design by Anthony M. Bellavia in partial fulfillment of the requirements for the master of Design Program Nova Scotia College of Art and Design Halifax, Nova Scotia Canada April 2014

Copyright c Anthony M. Bellavia. All rights reserved. No part of this book may be used or reproduced in any manner whatsoever without written permission except in the case of brief quotations embodied in critical articles or reviews. Book Design and illustrations by Anthony M. Bellavia

Table of Contents 10

Abstract

Introduction

Background

Psychological Dimension

Accessibility

Other Practitioners Working in the Field

Treatment

Outline of Inquiry

Methodology

Methods

Design Concepts

Survey and Results

Design Targets

Design Concepts

Design Iterations

Design Overview & Conclusion

Overview

Final Design

108

Post-Script

112

References

116

Appendix

List of Figures 13

Figure 1: Mental Disorder to Insomnia

Figure 23: Surveys Everywhere

Figure 45: Playlight Sketches

Figure 2: Feedback Loop

Figure 24: Mind map on Mental Disorders

Figure 46: Playlight

Figure 3: Psychologist

Figure 25: Mind maps on Form

Figure 47: Puzzle Sphere Sketches

Figure 4: Internalization Hypothesis

Figure 26: Visualization of Research

Figure 48: Hyper-arousal Hypothesis

Figure 5: Hyper-arousal Hypothesis

Figure 27: What will Help?

Figure 49: How to Tame your Monster Sketches

Figure 6: Intake System

Figure 28: First Iteration

Figure 50: How to Tame your Monster

Figure 7: Insomnia Access

Figure 29: Second Iteration

Figure 51: Sleep Detective Sketches

Figure 8: Modpod Campaign

Figure 30: Third Iteration

Figure 52: Sleep Detective

Figure 9: Lilo Plush

Figure 31: Survey Results Infographic

Figure 53: Alt. Sleep Cycle Sketches

24 25 27

Figure 10: Real Monsters Figure 11: What Anxiety is like Figure 12: Awareness and Action

Figure 32: Insomnia Mindmap

Figure 54: Alt. Sleep Cycle

Figure 33: Survey Mindmap

Figure 55: UV Contacts Sketches

Figure 34: Design Targets

Figure 56: UV Contacts

Figure 13: Treatment Methods

Figure 35 Puzzle Therapy Sketches

Figure 57: Chosen Route

Figure 14: Adult Insomnia

Figure 36: Puzzle Therapy

Figure 58: Reasons for Choice

Figure 15: Symptoms of Insomnia

Figure 37: Communication Clock Sketches

Figure 59: Iteration 6.1

Figure 16: Solutions for Insomnia

Figure 38: Communication Clock

Figure 60: Iteration 6.2

Figure 17: Fear of the Unknown

Figure 39: Nightlight Sketches

Figure 61: Iteration 6.3

Figure 18: Quantity vs. Quality

Figure 40: Nightlight

Figure 62: Iteration 6.4

Figure 19: Supplementary Features

Figure 41: Sleep Journal Sketches

Figure 63: Iteration 6.5 Figure 64: Design Process Overview

Figure 20: Exercises

Figure 42: Sleep Journal

Figure 21: Design Research Process

Figure 43: RE:Sleep Sketches Figure 44: RE:Sleep

Figure 65: Final Design Overview

Figure 22: Combine Action with Process

66 67

117

Figure 66: Survey

Abstract

How might design improve access or assistance to those suffering from insomnia and racing thoughts? Insomnia and racing thoughts are two of the most common symptoms of depression and anxiety. Addressing these symptoms directly may have an overall effect on the disorder itself. The significance of this study is that it seeks to help sufferers cope with their ailments and generate an outlet they can go to when things worsen. The thesis examines practitioners in multiple disciplines to discern the issue. The issue is explored using design methodology and methods. It is also guided by three key features that the thesis aimed to address and a set of design targets. The final output of the culminating research resulted in the development of a device to help sufferers relax, cope, and deal with their ailments.

Introduction

Consider this a leap of faith....

Introduction

Mental illness is a major issue in society. One in five Canadians suffer with a mental illness (Escobar 2013 pp. 2). Factor in the family and friends of these individuals and it affects many people. According to the Mood Disorder Society of Canada (2011), the prevalence of a mental disorder is highest in the young adult age group which ranges from ages 18-25. Many organizations, artists, and designers are trying to help sufferers by improving awareness of mental disorders which may be helpful However, more should be pursued. A designer could do more than provide public awareness; rather, be part of the solution and develop something that will actually assist sufferers through treatment and accessibility. The significance of using design solutions to address mental disorders has three possible dimensions. Firstly, it may assist in reducing costs. According to the mental health commission of Canada (2013), mental health problems cost the economy an estimated 50 billion dollars a year. Second, it may help reduce time to be treated and diagnosed. The mood disorders society of Canada (2011) state that â&#x20AC;&#x153;on average a person with a mood disorder will see 3 to 4 doctors and spend over 8 years suffering bouts of illness before they receive a correct diagnosis and appropriate treatmentâ&#x20AC;?. Lastly, and most important, it may help save lives. Individuals have been known to commit suicide as a result of a mental disorders.

Figure 1 - From mental disorders to insomnia and racing thoughts.

Insomnia and Racing Thought Depression and Anxiety Mental Disorders

13 Anthony Bellavia

In addition, individuals may not pursue avenues because their disorders hold them back (Mood Disorder Society of Canada 2009 pp. 3-6). For example; 64% of students with a mental disorder dropout of university (Gruttadaro and Crudo 2012 pp. 8). Section two provides some evidence that designers do not address mental disorders because they may not know how or it is not their area of expertise. Additionally, in order to address this issue it requires time, money, and interdisciplinary research. From a design perspective it may be possible to identify a focus that hones in on a particular aspect of mental disorders. For example, the most prominent mental disorders in society today are depression and anxiety (Basta et al, 2007 pp. 280). Depression and anxiety affect almost the same number of people as those suffering from heart disease and diabetes (Mood Disorders Society of Canada 2011). In both anxiety and depression, insomnia and racing thoughts are the two predominant symptoms (Escobar 2013 pp. 6) (see figure 1). The two symptoms create a cyclical loop, one proliferating and augmenting the other (see figure 2).

Introduction

Insomnia is most frequent in people with underlying mental disorder. (Basta et al, 2007 pp. 280) Recent tests have shown that one-third of subjects with insomnia were also diagnosed with a mental disorder (Ohayon 2002 pp. 100). In addressing the issues associated with insomnia this thesis focuses on three key factors; 1. Connect sufferers with professionals: Focusing on the relationship between practitioner and patient may help breakdown barriers of communication. 2. Educate for understanding: Increasing understanding for those experiencing such symptoms so they may be able to cope and deal with their ailments easier. 3. Self-help: Allowing people the ability to help themselves may bring them strength and confidence.

Insomnia

Racing Thoughts Figure 2 - The symptoms feed each other.

15 Anthony Bellavia

Background

Context is everything; literary, contextual and media review

Pyschological Dimension: Research into and treatment of mental disorders is primarily dominated by the field of psychology. Most, if not all, psychologists follow the DSM. DSM stands for Diagnostic and Statistical Manual of Mental Disorders. The DSM is used for standard classification of mental disorders and listing of diagnostic criteria for every psychiatric disorder (American Psychiatry Association 2012b). Psychologists strive to understand the mind; when the mind is working efficiently and when it is not. The DSM is used to gain a generalized understanding and provide a definition for each of the mental disorders (American Psychiatry Association 2012b). Some may argue that the difficulty in addressing mental disorders stems from their ill-defined nature. For instance, definitions in the DSM are continuously fluctuating and changing. The nature of the DSM is charting symptoms and matching them with a disorder much like filling in a checklist. The way a disorder is defined is based on these symptoms being cobbled together. This may be why designers have difficulty addressing the issue of mental disorders directly. However, the nature of charting these symptoms falls within the scope of a design issue but not the scope of this research. Not only are they not professionals in the field, but additionally the definition and diagnosis of mental disorders are continuously being revised. These disorders are not readily visible nor can they be easily described.

For instance, mental disorders are like a faint whisper. In order to hear or understand it one could divide the whisper into separate words. Once one understands the individual words one can decipher the whisper. The DSM tries to give mental disorders a discernible form to grasp. The symptoms of mental disorders are more defined than the disorder themselves; there is less variability with insomnia and racing thoughts than depression and anxiety (see figure 3). There are several theories linking insomnia and racing thoughts; the internalization hypothesis and the hyper-arousal hypothesis (Basta et al, 2007). These theories identify how these symptoms are an important aspect of depression and anxiety.

Figure 3 - Mental disorder become defined by their symptoms

17 Anthony Bellavia

The Internalization Hypothesis:

Figure 4 - Illustration of a figure on the Internalization Hypothesis in Basta et al, 2007.

Background

Many individuals cope with stress and conflict by internalizing them which leads to an emotional arousal. These individuals remain in a state of continuous emotional arousal, most likely from racing thoughts about what was internalized, resulting in physiological arousal (Basta et al, 2007). The physiological arousal makes it difficult to fall asleep or return to sleep once awakened. The result may lead to the development of a fear of not being able to sleep. This fear amplifies

the emotional arousal which in turn perpetuates the insomnia (Basta et al, 2007) (see figure 4). As Basta and his colleagues (2007) explain; this model maps out the vicious cycle of insomnia.

Figure 5 - Illustration of a figure on the Hyper-arousal Hypothesis in Basta et al, 2007.

Hyper-arousal Hypothesis: The hyper-arousal hypothesis model also focuses on emotional and physiological arousal (see figure 5). Insomnia is a result of both emotional and physiological arousal working in conjunction (Basta et al, 2007). Emotional arousal derives from depression and anxiety, which is the internalization of emotions. Emotional arousal is also derived from stressful events and the fear of not being able to sleep (Basta et al, 2007). Physiological arousal stem from genetic predisposition, physiological changes (such as aging or

menopause), and stimulants (such as caffeine, nicotine, and/or stress hormones) (Basta et al, 2007). Both theories identify the emotional arousal drawn from the internalization of emotions, which defines depression and anxiety. The theories solidify the significance and validity of addressing insomnia and racing thoughts to deal with depression and anxiety.

19 Anthony Bellavia

Accessibility: Professional help from psychologists is probably one of the best ways to be treated for mental illness. Generally, individuals seek help for a disorder not the symptoms, but the symptoms such as insomnia and racing thoughts signify the disorder. Seeking help when they arise could be beneficial for the sufferer. However, there is an issue of accessing the professionals. Based on the survey conducted by the National Association for mental Illness, also known as NAMI, finding and accessing accommodations for people with mental disorders is a problem as well as those suffering from insomnia (Gruttadaro and Crudo 2012 pp.12-14). Insomnia sufferers in the system face the same issues of accessibility. However, while in the system it may propagate their conditions into something worse similar to those with mental disorders. Maybe instead of focusing on the disorder, focus should be placed on thos symptoms such as insomnia at an early stage as it may prevent the system from becoming overburdened (see figure 7). Fieldwork indicates that navigating the mental

Background

call intake

intake service

clinician

psychologist

Figure 6 - Illustration of the new intake system for mental healthcare at South Shore, Nova Scotia (Ware 2013).

health system is not as simple as one might expect. Gathering information is not easy and is time intensive - not an efficient way to access the service. In the healthcare system there is no direct line to treatment or assistance to begin the road to recovery or it is not readily apparent. There are several other key issues related to accessibility, in particular, wait times and navigation. As mentioned earlier in the introduction, wait times to receive treatment or assessment are lengthy. Recently, Bridgewater, Nova Scotia, reduced wait times by cutting out the middlemen in the process for scheduling appointments (Ware 2013). According to an article in

The Chronicle Herald newspaper (Ware 2013), the old system intake had one person answer a call who passed the client’s information to the intake service, then the information was delivered to a clinician who would then book an appointment and assign a psychologist to the client (see figure 6). The new system is “a single intake system with one phone number for... mental health services and for clients of all ages” (Ware 2013). How many other healthcare intake systems are operating under the “old” system? Who is to say there are not other areas that could also benefit from similar solutions to fix the wait times.

Navigating the mental health system is extremely convoluted. Participants in NAMIâ&#x20AC;&#x2122;s survey on mental illness, found accessibility to services to assist with their disorders difficult (Gruttadaro and Crudo 2012 pp.12-14). For instance, the Nova Scotia the Capital Health website is used to find information on treatments, facilities, and how to access them. This proved extremely difficult to use to find exactly how or where to receive that assistance.

Figure 7 - Illustration of how people with insomnia may access the system like those with mental disorders (Anthony Bellavia 2013).

In the Mood Disorders Society of Canada document (2011) it stated one has to do some research to get some help. The question must be asked, why? Why does an individual have to do research to find or access assistance for medical ailments? Individuals with broken bones donâ&#x20AC;&#x2122;t have to do research to get help, so why do people with mental disorders have to? Can a designer make finding assistance and getting assistance more accessible for all? Can a designer teach individuals to seek help when they are suffering from insomnia and racing thoughts? By improving accessibility how do you counter balance when the system gets overloaded? If accessibility is improved can one draw resources from another area to facilitate it?

21 Anthony Bellavia

Other Practitioners Working in the Field: Modpod Creative, a design studio in Australia developed a public awareness campaign for mental illness (2011) (see figure 8). The campaign attempted to educate Australians; it stated that 1 in 5 people suffer from a mental disorder. Martin Kittsteiner. a German toy designer also increased awareness through the creation of his Paraplusch plush toys (2010) (see figure 9). His plush toys altered the discourse on mental health by focusing on the younger population. He sought to have children talk about mental health with their parents so they gain a better understanding of mental illness. Starting at a young age may reduce stigma about mental illness and talking about it. Both of these awareness campaigns inspire discourse; however, as a designer, it is important to strive to be part of the discourse as well as inspire it. While many have strived to raise awareness there are other design related practitioners who work to let sufferers know they are not alone through connection by inspiring empathy. Empathy is used to connect with an audience on a more intimate or even a personal level. Empathy is employed in multiple ways, below are several artists that convey empathy through personal representations and through sharing personal experience. Figure 8 - One image from the Modpod Creative Mental Awareness Campaign (Modpod Creative 2011).

Background

Figure 9 - This is Lilo, a Martin Kittsteiner Paraplusch Plush Toy. He represents OCD(Kittsteiner 2010).

23 Anthony Bellavia

Toby Allen’s work also engaged empathy through representation. Toby personified mental disorders; he gave them a face and a tangible form (see figure 10). He depicted each disorder as a monster (Allen 2013). Sufferers may have identified with his personifications. They may have agreed or disagreed with the disorders representations whether they appear as the disorders feel. Nonetheless, Toby was trying to empathize with sufferers, he wanted to illustrate that he understood what sufferers were going through, to convey that they were not alone. A post on Buzzfeed also inspired empathy by compiling 24 comics by multiple artists about anxiety and what it is like to live with (see figure 11). Each comic showed each artist’s personal experience with anxiety (Chack and Hiott-Millis 2013). The depictions of their personal experience allowed others to connect with them, empathizing with the sufferers and letting them know they were not alone.

Figure 10 - Personification of Depression n monster form, this is but one work in Toby Allen’s series called “Real Monsters” (Allen 2013).

Background

Figure 11 - One of the comics in the buzzfeed article (Chack and Hiott-Millis 2013). The comic was retrieved from boggletheowl.tumblr.com.

25 Anthony Bellavia

Good

Bad

Don’t eat that!

Figure 12 - Awareness can help others recognize when someone is in need (Anthony Bellavia 2013).

Let’s get youa some In addition, NSCADhelp. student named

Sandy Escobar developed a guide for students with mental disorders called; Surviving Thriving at NSCAD With a Mental Illness: A Student-Created Comprehensive Guide (2013). The guide has great information particularly concerning stigmatization and academic accommodations. As well, it provides a means of connecting with social groups that deal with individuals with mental illness and contact information to get assistance. However, there is a lot of vagueness and the guide lacks

I don’t feel well.

Background

the depth to provide concrete help. It also may lack a level of empathy in the way the information is told. The author seems to be trying to relate with her fellow students but it may come off as insincere. It seems to read like an article in a medical journal or a text document. It may be the use of visuals and wording that make it seem less sincere or empathetic.

Letâ&#x20AC;&#x2122;s get you some help. I donâ&#x20AC;&#x2122;t feel well.

The designers and artists above address mental disorders in general and do not focus on the symptoms, however, communicating understanding through awareness and empathy may also be helpful in addressing insomnia and racing thoughts. While these examples are not forms of treatment they provide something different but still valuable. It is important to inform society of mental disorders as well as communicate to the sufferers some societal understanding of their plight. When one understands what they are going through they may be able

to take appropriate action in seeking treatment (see figure 12). This may also apply for connecting to those who are suffering, they may be able to see when someone is suffering and bring it to their attention or get them help. Empathy and knowing one is not alone in suffering may help one cope better in life. Personal experience and speaking directly to sufferers may make individuals more comfortable in approaching the issue and potentially more comfortable talking about their issues. Because they see the designer can relate and truly understands.

27 Anthony Bellavia

Figure 14 - 30% of adults suffer from insomnia (Robinson, et al 2013).

Treatment Methods

Figure 13 - Treatment methods for insomnia (Basta et al, 2007 pp. 288).

Background

1. Lifestyle 2. Education 3. Therapy 4. Medication

Figure 15 - Symptoms of insomnia (Robinson, et al 2013).

Treatment: According to Basta and his colleagues (2007), professionals may take a multidimensional approach to insomnia. Insomnia is suggested to have several influences; - genetic predisposition - psychological and physiological stress - decrease in sleep mechanisms with age (pp. 287-88) One treatment may not be enough, sometimes more is better; education can be one of the strongest weapons in treatment (see figure 13).

A site called Help.org provides a plethora of information on multiple symptoms and ailments. An article on Help.org written by Robinson and his colleagues clarifies the definition of insomnia (2013) (see figure 14). Insomnia is not about the number of hours or how quickly you fall asleep; rather, it is defined by the quality of sleep and how you feel after you sleep (Robinson, et al 2013). When one considers this definition it is likely that more people may have suffered from insomnia than is generally thought (see figure 15).

29 Anthony Bellavia

challenging thought s

associations with be d

relaxation tec hniques

good and bad habits

Insomnia is connected with other ailments such as racing thoughts making it co-dependent. Everyone with insomnia suffers from it differently in their own personal way. The healthcare professional or the individual must seek to discover what the insomnia is linked to (Robinson et al 2013). Robinson and his colleagues (2013) refer to this as acting as a sleep detective. Much like a detective, an individual has to find the clues as to why they cannot sleep. Causes for insomnia may be simple, like too much coffee, or complex, like an underlying condition such as anxiety and depression. Robinson and his colleagues (2013) associate sleeplessness and anxiety. Sleeplessness invites invasive thoughts that may lead to further trouble with sleep and potentially lead to dreading sleep (Robinson et al 2013). This link between anxiety, depression, insomnia, and troubled thoughts further underlines the significance of addressing the two symptoms in order to affect the whole disorder itself.

Figure 16 - Solutions to treat insomnia (Robinson, et al 2013).

Background

The article by Robinson and his colleagues (2013) provides a plethora of helpful information; nevertheless, the authors recognize the need for professional help (see figure 16). They cite several reasons to seek professional help: - if insomnia doesn’t respond to self-help strategies and techniques; - if it relates to significant issues at home, work, or school; - if it occurs every night; - and if there is associated chest pain or shortness of breath (Robinson et al 2013) Once an individual comprehends what insomnia is they can start to deal with it correctly similarly to a psychologist’s work. Consider monsters, much like Toby Allen’s monsters. Most of the time the reason people are afraid of monsters is because they do not understand them. Once people understand the monster they are less afraid and able to face it head on (see figure 17). Robinson and his colleague’s (2013) article is extremely informative and helpful; providing self-help techniques, understanding, and information on when to seek professional help. Unfortunately, the article does not identify how or where to receive professional assistance. Also, when individuals do seek professional help the professionals may not suggest or identify self-help information such as this article.

Figure 17 - Think of horror movies. At first individuals are scared and so is the audience, but when the audience and the individual learn about the monster they gain a sense of courage in facing it (Anthony Bellavia 2013).

31 Anthony Bellavia

100%

3:30

Thursday, December 25

sleep aid function using white noise sleep notes to track daily activities

graph of sleep quality and quantity reminders

Figure 19 - Supplementary features on the Sleep Cycle app (Maciek Drejak Labs 2010).

Background

There are alternative methods of addressing and treating insomnia and racing thoughts of anxiety and depression. Professional help is probably the best, but it may not be enough. Below are three examples of developments striving to assist individuals; Sleep Cycle Alarm Clock app, SAM app, and I can’t Sleep journal. All three developments engage the user on an individual level and allow the user to engage with the material. Maciek Drejak Labs has developed an app called Sleep Cycle Alarm Clock (2010). Sleep Cycle Alarm Clock assists those suffering from insomnia or sleep disruption. The developers focus on quality of sleep rather than quantity. Sleep quality denotes how well one has slept and how rested and refreshed one feels when they awake (Maciek Drejak Labs 2010) (see figure 18). The app monitors a person’s sleep by using a phone’s motion detection technology. According to Maciek Drejak Labs (2010), we move differently in each stage of sleep; the motion detection in the phone can determine which stage of sleep we are in. The app wakes a person at the point in which a person is at the lightest sleep stage to ensure one feels refreshed and rested. Traditional alarm clocks do not determine the best time to wake up and they can shock the system and do more harm than good (Maciek Drejak Labs 2010).

QUANTITY

QUALITY

Figure 18 - sleep quality vs. quantity (Maciek Drejak Labs 2010).

The supplementary features available on the app could be emphasized (see figure 19).The sleep notes function may help identify issues resulting in poor sleep, such as drinking too much caffeine, and in that way an individual may be able to rectify them on their own. The sleep aid functions indirectly deal with racing thoughts. The white noise from the sleep aid feature may assist in drowning out racing thoughts (Maciek Drejak Labs 2010). The app has the potential to be more than the sleep quality app it is advertised as. Improving and placing a stronger emphasis on the supplementary features may make it viable in assisting those with depression and anxiety by addressing insomnia and racing thoughts. Conversely, the app is limited to those with access to mobile devices and tablet devices. Also, the app does not particularly address the value of professional help nor does it provide information on how to receive professional assistance.

The University of the West of England has developed an app called SAM, Self-help Anxiety Management, in collaboration with Myoxygen (2013). SAM is an app to help people understand and manage their anxiety (University of West of England 2013). While the app does not directly deal with insomnia and racing thoughts it deals with an aspect of insomnia. Insomnia is strongly connected to anxiety and much like racing thoughts it is perpetuates anxiety (Robinson et al, 2013). The app is meant to help people understand the causes of their anxiety as well as monitor thoughts and behaviour. SAM provides many selfhelp exercises and opportunities for personal reflection (University of West of England 2013). The app also links professional and self-help as it mentions in the terms and conditions of use that if you are already in therapy for anxiety it would be beneficial to discuss using the app in therapy. Furthermore, it states if you have specific questions to consult a professional (University of West of England 2013). The app covers a lot of options from information to exercises to reduce stress (see figure 20). It also acknowledges the significance of professional help. It focuses on engaging the user and allowing the user to generate content to facilitate the functionality of the app. However, the multiple aspects of the app may be quite overwhelming and confusing to use. This may turn people off from engaging the app to begin with. Simplicity and ease of access are important to get people to

feel comfortable engaging with something. In addition, the links and external information on receiving assistance were specific to the UK which would not help people from different countries. To improve it, the app could recognize and determine the location of a user and provide information based on the locale, like many apps that exist today.

Figure 20 - Exercise available on the SAM app (University of West of England 2013).

33 Anthony Bellavia

Knock Knock generated a sleep journal called “I can’t sleep” (2009). The sleep journal engages the user directly while letting the user generate the content. The premise of the journal is that people need to be able to express themselves in order to relax. The description in the journal explains that the reason people cannot sleep is because their thoughts are swirling inside their heads. In order to clear their minds they should write them down; make them into something tangible and real (Knock Knock 2009). What Knock Knock is doing is employing catharsis to improve the effectiveness of the journal. Knock Knock addresses insomnia and racing thoughts; they recognized that the thoughts keep people awake. However, would people want to write? People may not engage with the journal due to the fact we live in a tech savvy society. Can the journal encompass more than simply the ability to write down thoughts? While the journal does promote independent treatment many may not want to write and it may not be enough on its own. The treatment methods such as the apps use allow individuals to monitor their own well being and take action when the need arises. This may empower the sufferer and make them feel like they can change. They also have secondary functions that help individuals cope with their ailment. People may not know how to address their ailments properly, but the apps provide that knowledge.

Background

Additionally, they allowed people to engage with their products. Engagement is beneficial in the understanding of new knowledge. It may be better for people to learn about insomnia and racing thoughts on their own terms, let them engage the material in a way that makes them feel comfort and it gets the user invested in a product and may get them to use it more. The designers and practitioners of psychology focused more on insomnia and racing thoughts. They tried to educate people on what insomnia is, what are the causes, what are the consequences, and how to help treat it. There seems to be a number of treatment methods which may suggest that there is a need for multiple types of treatment. Individuals may react to various treatment methods differently where one would work for one person but not for another. Having a variety of options may be available to sufferers may give them hope for a cure because if one does not work maybe another will.

The contextual review has revealed many practitioners working in the area of mental health. The review has shown that one cannot solely rely on the medical facilitates and professionals. All of the practitioners in this contextual review approach the issue of insomnia directly or indirectly. Some focus on the mental disorders that cause insomnia. They use awareness of these disorders to reduce stigma and inspire discussion about the issue. In some cases, practitioners tried to relate and empathize with sufferers so they know they are not alone. Awareness can be a driving force for initiating discussion and action, but it does not involve taking part in that action. In the same lines, others used a medical approach as a tool for educating and self-help. They used education to bring awareness of the causes and treatments of insomnia so individuals may possibly help themselves. This approach allows individuals to make a difference in their own lives. It gives them the power to change which, in respect to those with mental disorders, may restore their sense of dignity and pride. However, this approach requires self-motivation which is not always available.

People are different and as Robinson and his colleagues suggest (2013) insomnia changes from one individual to another. It may be that a combination of different aspects from each option may prove to show great results. The question is which aspects does one draw from or how does one ensure that a solution, which may not help everyone, helps a majority of insomnia sufferers? On the other hand, the amount options may suggest that the solution to addressing the issue is still relatively unknown and the practitioners are still trying to figure it out. The contextual review gives a context for the issue at hand to push forward into addressing the issue. The review is simply one step in the process of this inquiry. Each practitioner used their own method of inquiry or methodology for their research. It is the task of the researcher to identify an appropriate methodology for their research. The methodology assisted in discerning the appropriate approach to addressing the issue at hand. It is a matter of selecting an appropriate methodology for the development to continue. The next section determines a methodology for this inquiry as well as the methods for which the research is carried out.

There are medical treatments available but they are either expensive or difficult to assign to an individual as the right treatment. The shear amount of options available may suggest that there may not be one solution to address the issue.

35 Anthony Bellavia

Outline of Inquiry

Itâ&#x20AC;&#x2122;s not about the destination....

Methodology The principle for a methodology is provide a structure. The structure acts as guidelines to follow and drive research forward. There are multiple types of methodology but it is up to the researcher to identify an appropriate method of inquiry. The methodology this inquiry is the design process. The However, the design process itself was lacking and seemed incomplete. Therefore, this design process adopts principles of action research to fill the holes in the design process. According to Swann’s article (2002) action research is closely related to the design process (p. 56). Action research was selected as a good pairing for the design process for several reasons; • • • •

both target similar types of problems, The design process meets the three criteria, the design process’ structure is similar to action research, both use action as a method of inquiry.

“Action research arises from a problem, dilemma, or ambiguity in the situation” (Swann 2002 p.55). One may argue that the design process arises in a similar fashion. Designers and practitioners using action research as a methodology try to make sense of a situation, remove the ambiguity so it is clear, and address the problem directly.

Actions research also has three criteria for it to be applicable. The criteria are; 1. Subject matter is situated in a social practice that needs to be changed; 2. it involves a participatory activity, where the researcher works in collaboration; 3. and it incorporates a cycle of planning, acting, observing, and reflecting. The design process met all three criteria making it suitable for action research; 1. In the case of this subject, it is a social issue that needs to be addressed as mental illness is on the rise. 2. The research is participatory because it engages with professionals and sufferers alike to formulate the best possible solution or output. 3. Figure 23 illustrates how the design process integrates the action research cyclical process. The design process itself looks fairly similar to the stages and steps of action research (see figure 21). The process of action research consists of four stages or steps; planning, acting, observing, and reflecting. When overlaid onto the design process similarities can be seen

(see figure 22). Both processes function in a cyclical fashion while putting focus on the importance of reflection. Reflection allows for the critical evaluation of work and take a step back to gain perspective. It is difficult to distance oneself from their work but reflection allows for that distance. Reflection could propagate iterations of ideas and fix flaws that could only be seen through evaluation. One of the strengths of action research is that the research is driven by action (Swann 2002 p.56). In design and action research the actually research is conducted through action such as surveying, sketching, and designing. Designing itself is a form of research. Each design carries new knowledge not previous known. This knowledge is extracted through critical reflection. Once the knowledge has been extracted one is able to bring it into the next design or iteration. In this case knowledge cycles through the design process which may assist in making the overall design better. The final output or iteration does not necessarily mean it is completed, rather the final output may open up an entirely new discourse to work from starting at the beginning of the cycle but with new knowledge taken from the previous. This is important to the process as a whole (Swann 2002 p.55).

37 Anthony Bellavia

New Issue New Concept

Identity Issue Develop Concept

Plan

Out

u do yo How le peop ion help ss depre ? with nxiety and A

Step back

Can focusing on the symptoms effect the whole disorder?

Sketch How will it look? What form will it take? Object? App? What?

te Evalua Work , works What esn’t? what do

Research How do you trea t symptoms? What are the symptoms?

Step back Step back

loped a deve Have of your n versio mething so s; ea id ntial substa

Develop

Feedback

Go ba ck work w and ith the feedba ck give n. Don’t be to go ba afraid “Plan it ck to Out”

Was it helpful? How do others preceive it?

Step back

Reflection and Output

Reiterate

How can it be improved?

Step ba

Did the work do what it was meant to do? Was it successful or not? How can it go one step further? Does this open up new avenues? Anthony Bellavia MDES6115 Fall 2013

Figure 21 -Design Research Process.

Outline of Inquiry

New Issue New Concept

Identify Issue Develop Concept

Plan

Out

u do yo How le peop ion help ss depre ? h it w nxiety and A

Step back

Can focusing on the symptoms effect the whole disorder?

Sketch How will it look? What form will it take? Object? App? What?

Evalua Work

, works What esn’t? what do

Investigation How do you trea t symptoms? What are the symptoms?

Step back Step back

loped a deve Have of your n versio mething so s; idea ntial substa

Develop

Feedback

Go ba ck work w and ith the feedba ck give n. Don’t be to go ba afraid “Plan it ck to Out”

Was it helpful? How do others preceive it?

Step back

Reflection and Output

Reiterate

How can it be improved?

Step ba

Did the work do what it was meant to do? Was it successful or not? How can it go one step further? Does this open up new avenues? Anthony Bellavia MDES6115 Fall 2013

Figure 22 - Combining action research with the design process used in this research.

39 Anthony Bellavia

Plan Act Observe

Methods:

er: Gend or Male

r: de r en e o l Ma

l Ma r: de en le ma Fe

Male

e al

r: ende

e al

The methods of inquiry are just as important as the methodology. The tools help guide how the inquiry progresses in both depth and direction. The tools of research are selected by the researcher to determine which would be best for the inquiry. The methods chosen for this inquiry were surveys, sketches, artifacts, and design itself.

a :M

er: nd or le Ma

Surveys! Surveys everywhere!

er: Gend or Male

Gend

er: Ma le or Femal l Diso e rder? If yes :Y/N , name o f Diso How rder: do yo u co How pe wit do yo h ins u co omnia pe wit ? h rac ing t ho Menta

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er: Gend or Maolre e al M r:

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Figure 23 - Survey for sufferers and non-sufferers. Distributed to online game communities, Facebook, family and friends, community centres for sufferers.

Outline of Inquiry

Surveys can develop understanding from different points of view, such as the view from a professional and an individual involved in the issue. Surveys would address what sufferers need, what are the difficulties sufferers go through, and if there is difficulty in accessing assistance. As development continues, a survey would be used to test effectiveness of design output. The surveys were be given out to a random population to try and account for experimenterâ&#x20AC;&#x2122;s bias. The surveys were distributed to individuals in person by either the surveyer and volunteers (see figures 23). The surveys consisted of only a few questions as to not burden peopleâ&#x20AC;&#x2122;s time (see appendix for the survey data).

Sketching and making artifacts will serve to visualize the form and concepts of the final output. Sketches and artifacts will assist in several ways; • • • •

make the concepts visible allow the designer to visualize ideas bring up questions and issues relating to the topic through metaphoric comparison

Sketching involves the drawing of possible forms of the final design output, as well as, creating mind maps and drawings related to the topic (see figures 24 - 27). The artifacts involve modelling what the final output may look like as well as inspire new ideas about the topic.

Figure 24 - Mindmaps for what the final design output may look like.

41 Anthony Bellavia

Figure 25 - Mindmaps on the topic of mental disorder.

Outline of Inquiry

Figure 26 - Visualization of research.

43 Anthony Bellavia

Figure 27 - Trying to figure out what would help when one is depressed.

Outline of Inquiry

Artifacts or models serve as a method for visual thinking. Artifacts in the context of design can be models, sculptures, or mock ups made to further understand a subject. They allow for understanding and analysis of ideas or research in a practical and tangible form. Here are three iterations of artifacts developed to identify aspects of insomnia and racing thoughts. The main purpose of the first iteration of artifactsâ&#x20AC;&#x2122; was to identify treatment and causes for insomnia and racing thoughts (see figure 28). The artifacts were to address the difficulty and complexity in determining a proper treatment, but also the causes for the symptoms. In order to treat something, it must be clearly defined, or diagnosed. The first iteration of artifacts was too literal. The artifacts were more product-based rather than explorations of form.

Figure 28 - Model of a phone mounted alarm clock that can record and talk back.

45 Anthony Bellavia

The construction of the second iteration of artifactsâ&#x20AC;&#x2122; main purpose was to take a more abstract approach to design (see figure 29). These artifacts addressed the idea of thought as a texture; focusing on making something intangible tangible. Many people are influenced by what they can see and touch; people cannot see or touch mental disorders therefore, people have difficulty understanding them. The second iteration targeted the domain at its roots; it allowed for an alternative approach in identifying issues in relation to mental health.

Figure 29 - These models use texture or rather texture of thought varies from person to person. No one thinks the same, thus no texture is the same.

Outline of Inquiry

This iteration of artifacts hint at a narrative of progression that could use further exploration. The third iteration was to discover a narrative through the progression of the artifacts (see figure 30). The single artifact in this iteration seeks to address how thought progresses into identity. Thoughts formulate a mind-set that may lead to a mental disorder. If allowed to percolate, the mind-set and disorder may become part of a personâ&#x20AC;&#x2122;s life and part of their identity as a whole. With this in mind, stopping the progression of this narrative can prevent the disorder from arising in the first place. The third iteration opened up the notion of how mental disorders may progress in a linear fashion and how it relates to identity. The artifact warrants an exploration into identity and states of mind.

Figure 30 - The narrative in this artifact suggests that a thought can develop into a mind-set which, in turn, evolves into a mental disorder and part of a personâ&#x20AC;&#x2122;s identity.

47 Anthony Bellavia

The design process alone was not sufficient enough to drive this inquiry as the methodology. However, by incorporating the principles of action research the design process was able to facilitate the inquiry. Action research and the design process share many commonalities which made the assimilation easy. After the methodology was selected the methods were chosen believed to best suit this inquiry. Each of the method pushed this inquiry forward toward developing a final output. Each one adding new knowledge into the inquiry. These methods of research informed the next stage of the inquiry process which is research through design. Each design concept developed came with new knowledge that was gained by reflecting upon them. That knowledge informed and cycled through the other designs. Each of the strengths and weaknesses were careful noted. These strengths and weaknesses were considered in the continued development of the designs. This information informed how the next design concept and iteration would proceed.

Outline of Inquiry

49 Anthony Bellavia

Design Concepts

No longer shall we be paralyzed by analysis.......

This section focuses on making use of the information gathered through contextual search & review, visual thinking, and survey to generate a series of design concepts. These concepts serve as a vehicle to formulate the final design output.. This by-product does not necessarily have to be a physical product; it may take on the form of a program or idea. The following design iterations are the first to be articulated and not the final design output. These iterations are critically reflected upon to ensure the final design is the best selection. Before the design concepts were conceived a survey was conducted to further understand the general public, their habits, and coping strategies. (see appendix for survey).

the 20â&#x20AC;&#x2122;s and primarily of Caucasian descent. No personal information was collected and participants remained anonymous.

Each question was posed to uncover personal habits and trends across the general public. Each question was crafted to see what people already engage with in their lives. The information collected could possibly be used to identify what type of design might be helpful for the target population.

The responses were at times not applicable and therefore were not able to be considered in the generalized results; some of these surveys did not have questions three and four completed. Some of the participants did not provide hours for each individual thing but rather supplied hours for all combined. These responses were discarded. According to the results people mostly engage with websites and phones with an average rating of 8.7 out of 10 for the websites and 7.6 out of 10 for phones. The least engaged was community programs at 2.6 out of 10. On average people spent 13.2 hours a week on the web and 10.7 hours on phones while community programs were only at 2.3 hours a week. The results for the insomnia and racing thoughts question indicate that most people turn to television or reading when they cannot sleep or calm their thoughts.

The participants were not involved in the conception or critical reflection of the following concepts. The survey was short, only four questions, to promote completion. Most people treasure their time and the survey sought not to burden it. The survey was distributed to 54 individuals and collected anonymously. The participants were chosen from a group of people in Hamilton, Ontario, Canada in the month of December 2013. The age of the participants ranged from primarily in

It is difficult to avoid a bias as one may arise subconsciously; therefore the results cannot be generalizable to the general population. Also, the number of participants was too low to be generalizable as well. The survey was not terribly successful, but it did inform the initial iterations. The results gave an idea of what might work as a final design and what might not. It also inspired several mindmaps based on what participants selected to further understand why they chose what they did (see figure 31).

Figure 31 - Graphic on next page. Infographic based on the results of the survey. The graphic uses a generalization of answers provided for each of the questions on the survey.

51 Anthony Bellavia

Rating Usage

7.6 SMART PHONES

6.4 APPLICATIONS

6.7

Average rating out of 10 based on how often people engage a particular media. With 10 being the most used and 1 being the least.

SOCIAL MEDIA

2.6 COMMUNITY PROGRAM

etisbew

8.7 WEBSITES

5.2 BOOKS

13.2

3.5 OTHER

hours per week are spent on websites which holds the largest portion of our time spent.

3.6

69.1 hours per week are spent on these options

Introduction

MP3 PLAYER

5.7 GAMES

62.5% of the coping strategies are actually counterproductive for falling asleep

Coping Strategies 53 Anthony Bellavia

Discussion The results of the survey illustrate a general tendency to gravitate to technology during the day and when one is trying to cope with insomnia and racing thoughts. Both the web and smart phones provide easy access to information, contact with others, and seemingly limitless potential. The two may provide a sense of companionship similar to a human relationship or even a pet via a personal discourse developed between person and technology overtime. It could be that society perpetuates this discourse by validating the new societal norm of being connected or online Fewer people are involved with community programs. However they may be involved in alternative ways such as attending or supporting local shows and bands.

Design Concepts

Figure 32 - Mindmap of what is out there to help with insomnia, what is possible, and what will help.

In terms of the design concepts, it may seem that a concept involving the web or smart phones would promote engagement while a community program design may not. However, the use of the web or smart phones could be counter-productive in assisting those with insomnia. It is important to identify why the web and smart phones are so engaging; the aspects identified could perhaps be the key to developing a successful design.

Figure 33 - Mindmap based on the results of the survey to figure out why people chose what they did.

Based on the results of this survey, the majority of the sample selected poor coping techniques that are a detriment to sleep according to the research of this thesis (Robinson et al., 2013). For instance, watching television and reading may also be counter-productive for sleep as they both put strain on the eyes and involve light which disrupt the sleep cycle (Sisson 2010)This might be because participants do not know a better option or they are comfortable with their methods. However, like the web and smart phones, understanding what makes people gravitate to these options may be integral in developing a successful design. what makes people gravitate to these options may be integral in developing a successful design (see figure 32 and 33). The results reveal of incite that goes into the

final designâ&#x20AC;&#x2122;s consideration. The final design output should be conscientious of general tendencies to use particular products over another. The design should take into account that people may not know how to cope with insomnia and racing thoughts correctly. The design should also be aware that people may be apprehensive to try something outside their normal routine. The results of the survey also prompted the generation of the design targets.

55 Anthony Bellavia

Iterations of Design Targets • connect with healthcare professionals

FIRST ITERATION OF TARGETS

• Inform and educate • provide solutions and assistance

SECOND ITERATION OF TARGETS

• relevant in today’s society

THIRD ITERATION OF TARGETS

• accessible for all • conducive to creating a calm environment • physical and mental body

Design Concept Targets Each concept aimed at a particular set of targets. These design targets were developed in order to focus the concepts and ensure they remain true to the main issues of the thesis. All the concepts are described in detail as to how they work and what they are about; in addition, concepts were subjected to critical reflection to determine viability. (see figure 34).

Design Concepts

Figure 34 - Design targets developed to focus design concepts. The targets were not all conceived at once, rather more came about as the concepts were in development.

After the first five concepts were developed feedback was given from peers and instructors in conjunction with personal reflection. Consequentially this lend to the addition of several new design targets (see figure 34).

The next set of design concepts focus on the physical and mental body; focusing on improving the health of the individual. These designs do stray from the other targets, but it is important to explore other avenues even if they may necessarily be correct. Even if they do not work, they may help rule out options or support why other options may be better (see figure 34).

57 Anthony Bellavia

Design 1

Puzzle

The first design concept focused on design targets one, two, and three. The first concept is a Puzzle Therapy Program. The puzzle therapy is meant to distract people from their invasive thoughts and is a substitute for TV and reading as a calming mechanism. According to a workshop on sleep and relaxation at Dalhousie University (Peloquin 2013) puzzles can stimulate but not enough as to excite. Puzzles require little effort or light making them suitable for an activity when one cannot sleep (see figure 35 and 36). This concept has three components; the box, the puzzle pieces, and the puzzle.

The puzzles themselves use a plethora of imagery for diversity. Once one completes their puzzle they could bring it to the therapy program. The puzzle therapy program helps those with insomnia and racing thoughts as well as those suffering from mental illness. The therapeutic effect of puzzles could also benefit those with mental illness due to having similar consequences. The program unites sufferers together with professionals. It is used as an alternative style of group therapy. Here puzzles are distributed, traded, and used as a tool to assist in therapy.

Puzzle Box The puzzle box itself has information on insomnia as well as tips for better sleep on the back. On the inside of the lid there is information on how to seek professional assistance if issues persist or worsen. Puzzle Pieces The puzzle pieces could also hold tips. When pieces are clustered together the tips will reveal themselves on the back side on the pieces. Many people already cluster like pieces until they identify where they fit in the whole puzzle. In addition, the pieces are textured making them tactile. The texture helps users complete the puzzle in low light situations combining touch and sight rather than solely relying on sight.

Reflection Would people engage with a puzzle rather than the television or phone? The puzzle requires getting out of bed while a phone or television remote may be easier to access. Puzzles also require a particular amount of space which some may not have available. What if someone finishes the puzzle before they are able to trade it or get a new one, do they revert to an old habit or to not sleeping? In order for this program to work there needs to be quite a few participants to warrant the group format. It also requires medical professionals to take the time to participate in the therapy program which they may not have the time to do.

Figure 35 - Sketches for the puzzle therapy concept.

Design Concepts

DESIGN 1 Puzzle therapy can help distract people from invasive thoughts and is a good substitute for watching TV for falling asleep. It will also provide information and ways to connect with healthcare professionals.

Puzzle Box

The puzzle box itself will bare facts and information such as information on insomnia, tips to help with sleep, and how to seek professional help if needed.

What is insomnia?

Different routes one can take to get professional help.

Tips for better sleep.

back of puzzle box

inside of puzzle box

Puzzle Pieces Tips could also appear on little clusters of pieces.

avoid big decisions before bed.

Puzzle Puzzles are simple, relaxing, and occupy the mind making them great for rest and relaxation. Also, they can help those with mental afflictions by occupying their minds and calming them down when they need it.

Flat view Each puzzle piece will also have a texture making them tactile and easier to use in low light.

The puzzle itself can use a variety of imagery. No two puzzles could be the same. In addition, a program called Puzzle Therapy would be developed to distribute, trade, and work with medical professionals to help those with mental afflictions.

Figure 36 - Design one concept called Puzzle Therapy. Anthony Bellavia Winter 2014 MDES Program

59 Anthony Bellavia

Design 2

Customization

The second design concept focused on design targets two, three, and four. The second concept is a called the communication clock. Individuals are able to express themselves through cathartic conversation as well as obtain information on sleep methods (see figure 37 and 38). The clock is discussed according to three aspects; connect, talk and discuss, and customization.

Each clock could be unique to the owner giving a personal sense of ownership and connection with it. People are able to customize how the clock will look to suit one’s own personality and aesthetic.

Connect People are able to connect their smart phones to the clock to charge and activate the built-in application. A sensor connected to the clock is placed beside the pillow to detect tossing and turning; if one persistently tosses and turns the talk feature automatically activates. Talk & Discuss When one cannot sleep the clock begins to talk. The clock lists options for one to select; people select whether they would like to hear sleep tips or tell the time. Furthermore, people are able to have a conversation with the clock. The clock responds with a set of prerecorded responses based on keywords spoken. The responses vary and include questions for individuals to reflect upon to understand what is happening, such as, “did someone agitate you today?” If one wants to communicate with the clock they simply need to say, “Are you awake?” Any conversation are recorded and stored in both the clock’s hard drive and written in text form on the phone.

Reflection There are several issues with this design. Firstly, while the conversation feature helps with engagement it has its drawbacks. People could get annoyed by the clock spouting out tips resulting in agitation making sleep more difficult. Having a conversation with the clock could wake a partner or someone else in the household. A person may need to talk while not around the clock and when they finally see the clock the need to talk may be gone rendering it useless. If the clock responds based on keywords, responses could be heard over and over breaking the connection between the clock and person rendering them useless. The responses would need to be updated constantly or have a very large database of responses. The tone and voice the clock used to speak is important in connecting with people but many interpret tones and voices differently. So how do you determine how it will speak or are there options for one to select? In terms of comfort, would one be okay with the clock watching over them? Another issue is the user may not have a smart phone? Also does it have to be a clock? The light from the clock may keep people up. In addition, the focus on time can cause anxiety because people are able to see how long they haven’t been able to sleep.

Figure 37 - Sketches for the communication clock concept.

Design Concepts

DESIGN 2 The communication clock is able to help those with insomnia through cathartic conversation and provide information on sleep ease methods.

Connect Phone

Connecting a phone actives the built-in application and charges the phone.

Sensor Pad to record tossing and turning.

Persistent tossing and turning will activate the talk feature.

Talk and Discuss When you canâ&#x20AC;&#x2122;t sleep the clock will begin to talk. It will list options for you to select on how to help your sleep or respond to any questions.

Challenge thoughts with prerecorded phrases Offers tips such as sleep in a cooler room. instead of visual time, able to tell time.

Able to communicate with clock at anytime by asking... Are you Awake?

What do you need?

Able to record self. Recordings are stored verbally and visually with in text notes stored on the phone and hard drive of the conversation clock.

Customization People are able to get customized clocks with different and unique characters and colors to fit their own personal aesthetic.

NOT RECORDING/ACTIVE

RECORDING/ACTIVE

It will offer tips on what to talk about to figure out what is causing distress in your sleep. It will ask about your daily events and what is on your mind. Based on some trigger words it will respond accordingly.

Figure 38 - Design two concept called Communication Clock. Anthony Bellavia Winter 2014 MDES Program

61 Anthony Bellavia

Design 3

Remote System

The third design concept focused on design targets three and four. The third concept is a light called â&#x20AC;&#x153;Nightlightâ&#x20AC;?. The Nightlight controls the amount of light exposure while providing relaxing alternatives to help with sleep impairments (see figure 39 and 40). The Nightlight is explained in four features; the clock system, live nightlight, audio feature, and remote system.

The entire system is controlled from a remote that can set times and activate the nightlight, visualizer, and white noise features. The system also has the potential to be controlled from a smart phone instead of a remote.

Clock System The clock system controls the amount of light based on the personal bedtime and wake up time of the user. For instance, the light gradually increases as one needs to wake or dims as one wants to sleep. When the light is completely off at bedtime a secondary low light projects onto the ceiling. This is known as the live nightlight feature.

Reflection Not everyone is always in their room so the light would need to be installed in other rooms as well. Also, there are other sources of light such as laptops and televisions that are unaffected by the dimming feature making this light ineffective in terms of controlling the overall environmental light exposure. Would the audio feature disturb anyone else sleeping in the household? Would this alternative be engaging enough to stop people from reaching for their phones or television remotes?

Live Nightlight The base of the light rotates while projecting short repetitive animations of figures. These animations are meant to calm and relax the mind similar to how mobiles calm and quell babies to sleep. The animations are varied to provide choice. Audio Feature The base of the light projects relaxing sounds. People can select a white noise or visualizer to play. The duration of the sound and light are programmable to turn off after a particular amount of time.

Figure 39 - Sketches for the Nightlight concept.

Design Concepts

DESIGN 3 The Nightlight uses soothing and relaxing stimulants to help those with sleeping issues.

Clock System

Lights dim up and down based on bedtime and wake up time.

When the light is completely off a secondary light will project onto the ceiling, this feature is called Live Nightlight.

OFF

Live Nightlight This feature rotates the base of the light while projecting short repetitive animations to relax and soothe to sleep.

Jellyfish

Bird

Abstract

Fish

The projections come in variety that one may choose from.

Audio Feature The light will also be able to use audiable features to relax and assist with sleep. Visualizer The visualizer tells a story of a world for someone to imagine being part of White Noise

Remote System Bedtime

Wake

11:00pm 8:00am Live Nightlight Active

Visualizer Active

White Noise Active

Audio Level

The system is connected to a remote that can set times, live nightlight, visualizer, or white noise.

The white noise is a consist low frequency sound to lull people to sleep.

Next Setting Setting

Figure 40 - Design three concept called Nightlight. Anthony Bellavia Winter 2014 MDES Program

63 Anthony Bellavia

Design 4

Connection

The fourth design concept focused on design targets two, three, and four. The fourth design is a type of sleep journal where individuals can work out their thoughts through catharsis by writing them down. Through this catharsis act individuals could empty their minds and relax the body so one is able to sleep (see figure 41 and 42). The book has three sections; the introduction, the body, and the connection.

The final section is for those whose sleeplessness exceeds the assistance available through this journal. People are able to clearly identify how to access professional aid and the different routes to do so.

Introduction The introduction introduces insomnia and racing thoughts as well as how they relate to mental disorders. It educates people to gain a better understanding of their own ailment. To support the text there is a series of info graphics on the opposite page providing information about insomnia. The final portion of the introduction has a table of contents. Body The pages in the body are of two types, one allowing people to write and the other supplying information as tips. Individuals are able to write out anything that is troubling them. If one does not know what to write about, suggestions are supplied on each line, greyed out so as not to disturb anything written over top. They can be used as a way of identifying what is the cause of the individual’s sleeplessness in order to rectify it. The accompanying pages have tips on how to improve sleep with a corresponding graphic. The graphic is meant to engage users in the process they need to feel comfortable and safe working through this at night. The Lighthearted graphics employed could make people feel less intimated with the subject matter.

Design Concepts

Reflection Important facets of the journal are type and layout. The tone set from the typography and layout style determines whether someone feels comfortable using the journal or not. Should the book be telling people what to write about? What if they don’t like to write? What if they like to draw, does the journal appeal to an artist? While a sleep journal is engaging is it the same type of engagement as a phone or the internet? The journal requires a lot more effort which some may be unwilling to make. What happens when it’s filled up, does someone buy a new one? Figure 41 - Sketches for the Sleep Journal concept.

DESIGN 4 Sleep Journal to help those with insomnia through catharsis and connect with professional assistance.

Introduction

Insomnia and Racing Thoughts

Info on insomnia and racing thoughts and how they relate to mental disorders. In addition, it will explain how using a sleep journal to identify the causes and the cathartic nature of using the journal; how it will help relieve thoughts and relax a person at the same time.

Infographics

Table of Contents Introduction body Connections

1-3 3-30 31-33

SLEEP JOURNAL for insomnia and racing thoughts as it relates to those with

Body

TIP Lifestyle

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Fusce pellentesque magna et sodales lobortis. Maecenas semper sed purus quis bibendum. Curabitur ut nulla a ipsum consequat consectetur ut eget est. In sodales vestibulum suscipit. Sed fermentum blandit orci. Nam bibendum semper nulla nec ultricies. Lorem ipsum dolor sit amet, consectet run tern adipiscing elit. Fusce pellentesque deloratened sodales lobortis. Maecenas semper ges tosi et quis bibendum. Curabitur ut nulla.

Write Something

eaten?

Stressful Event? Exercise? Coffee?

Connection

If you find

Additional Support Lines

that things are getting worse or the tips are not helping maybe it’s time to find professional help. Most people start with physicians but if you don’t know where or how to get help here’s how you can start.

Figure 42 - Design four concept called Sleep Journal. Anthony Bellavia Winter 2014 MDES Program

65 Anthony Bellavia

Design 5

Information

Sleep Monitor

The fifth design is an application for smart phones called Re:sleep. Our society has grown accustomed to using apps. People turn to their phones often, even when they cannot sleep, Based on this information the design seeks to take advantage of societal trends. The app assists those with insomnia and also helps improve patient practitioner relations (see figure 43 and 44). People work through the app in 3 stages; the initial setup, the information, and the main menu.

Once the initial setup is concluded the user is presented with either a text document or flash video. Each provides information on sleep such as sleep effects, how sleep is related to mental disorders, layout and explains the apps features.

The sleep monitor feature monitors sleep quality by using the smart phones built-in motion detection. This feature is similar to the Sleep Cycle app (2010). If users toss and turn the phone texts them and provides a link to the Tips: Can’t Sleep feature. In essence this is trying to get people up because staying in bed when you can’t sleep does not help (Robinson et al., 2013).) Users are also able to set a wake time (see figure). Based on the user’s time to wake up the app calculates when would be the best time to go to sleep. The phone then sends a text message saying “you should go to bed soon.” In addition, users may activate the visualizer or white noise through this feature.

Initial Setup The initial setup requires people to enter their health card number to gather information on the person. The next phase asks if this app was prescribed by a medical professional. If yes, the doctor fills in the next section about the patient’s condition, medication, and links to their database so they can receive direct notifications about their patient. If no, the app asks if the user would like a mental/medical evaluation. This provides direct and easy access to an evaluation instead of going through other avenues to obtain an appointment. This is discussed further in the Connect with Pro feature. The other questions determine if the user would like to connect with a professional and share their information with a professional database in order to monitor their wellbeing.

Main Menu The main menu is where the user will be able to select a feature. The features are Connect with Pro, Tips, Sleep Monitor, and Sleep Information. Connect with Professional This feature uses the user’s current location to show the user the closest locations for mental/health evaluation. Once the user selects a location the user then provides an e-mail, phone number, and basic information. Once that is filled out, the user receives an e-mail and phone call with their appointment details and a reminder. Tips The first part of this feature provides tips to improve sleep before one goes to sleep. Each option available in this feature opens up into a more detailed explanation or exercise. The second part of this feature focuses on when one can’t sleep. It functions in the same way except it provides different information.

Figure 43- Sketches for the RE:Sleep concept.

Design Concepts

Reflection First of all would doctors actually prescribe the app? Would this burden the healthcare system more than it already is? Is this promoting a bad habit of turning to one’s phone? While the phone is a viable option to catch a large audience it may be perpetuating a pattern not useful for insomnia. Not everything needs an app. In addition, is this app too complex? The number of features and options could overwhelm a user thus reducing a desire to use it. Covering a broad spectrum in a design may be positive in other instances but it may be stretching the design too thin in this context. In addition, everyone does not use or have a smart phone. By making an app it limits the audience it reaches.

DESIGN 5 Application to help those with insomnia and connect with professional assistance.

Initial Startup Is this info correct?

First Name: Anthony Last Name: Bellavia Street Address: 53 Picton Street West City: Hamilton Province: Ontario

Was this Prescribed?

Do you wish for a mental evaluation?

Please pass to Physician or professional to fill out. Name: Dr. Michael Bellavia

Do you wish to connect with a professional if needed?

YES

Medications: Lerazpam

YES

Do you want your info shared with a professional database?

Disorder(s): PSTD and Depression

YES

Symptoms: Insomnia and low mood

If YES please see “Connect with Pro”

Network to Connect Data: Bellaviatk190074-RC

Welcome to

Re:Sleep Enter Healthcard Number

Information Information on sleep

Flash Video

Sleep Effects: mood productivity drowsiness irritability

Sleep Monitor

Drowiness

How sleep is related to mental disorders: symptoms connection sleep detective

Able to detect what stage of sleep one is in through body movement during sleep by using the phone`s motion detection. Set Wake Able to set what time have to get up and determine when to sleep or vise versa.

Features: Connect with Pro Tips Sleep Monitor

2 of 3 with disorders have issues with sleep

Main Menu Physician: Dr. Michael Bellavia Email: anthony@gmail.com

Connect with Pro Locations of Facilities

Connect with Pro Tips

Before Sleep

Can’t Sleep Sleep Monitor Sleep Info Please select a location for evaluation.

Sleep Journal

Visualize a Fantasy

Environment

Challenge Thought

Associate Bed with Sleep

Light exposure

Based on your wake time, it will indicate when to sleep.

White Noise

Environment quiet dark cool relaxing

Avoidance caffeine big decisions arguments smoking naps alcohol The app will text when tossing and turning.

Progressive Muscle Relaxation

Diet and Exercise

Monitor sleep quality and schedule. Active

Notice: An email and/or phone call will be made with appointment information and details.

Tips: Can’t Sleep

Tips: Before Sleep

Sleep Monitor

Phone Number: 905-525-9877 Symptoms: insomnia anxiety hopelessness racing thoughts

Set Wake Active 7:00am Set Visualizer Active

Can’t sleep?

You should go to bed soon

Figure 44 - Design five concept called RE:Sleep.

Set White Noise Active It will also provide a link to TIPS: CAN’T SLEEP OK

Anthony Bellavia Winter 2014 MDES Program

67 Anthony Bellavia

Design 6

Hardware

The sixth design is called the “Playlight”. This design incorporates the ideas of the Nightlight design but involves a sense of play to allow the user to engage with it. Users are able to stay in bed without disturbing anyone who is sleeping next to them. The amount of engagement required is minimal like a puzzle, this helps create a calming environment like other games such as Bejeweled. The calming nature of the design could relax and quiet the minds of users through slight stimulation (see figure 45 and 46). The Playlight has three components; the orbiter feature, the play feature, and the hardware

The hardware itself comes in two components; the projector and the motion sensor. The projector is mounted on a wall and projects a low light so as not to place a lot of strain on the eyes. The motion sensor is installed on the ceiling to easily detect movements of the glove.

Orbiter Feature The Playlight projects a galaxy-like environment onto the ceiling. Users are then able to move the stars, or “orbiters”, around so they orbit other larger orbiters. Users can move orbiters with a two fingered glove by squeezing the index finger and thumb together to grab them. To release an orbiter simply separate the fingers. The glove will only have two fingers because it requires little effort with fingers and detecting the entire hand may be difficult.

Reflection Can the projector and sensor be combined and does it have to be mounted on a wall? It may come down to the aesthetic of a room. A sensor on the ceiling and a projector on the wall may be visually unappealing. The sensor may also get in the way of the experience if it shares the same space as the projection. What makes this design special is its simplicity; the simple motion of moving objects with your fingers. While the game features are interesting they detract from the simplicity. The prime objective of the games are to use play to educate but the educational element could be something else like a supplementary book or app.

Play Feature The Playlight uses the orbiter feature for matching-style games where users group orbiters based on colour or subject.

Figure 45 - Sketches for the Playlight concept.

Design Concepts

Bejeweled: A gem-matching game. The game focuses on setting moods such as relaxing or reving up (Popcap 2014)

DESIGN 6 The playlight will help calm and help those with insomnia through interaction and play.

Orbiter Feature

People are able to move orbiters and create their own orbits, smaller orbiters will orbit larger orbiters.

To grab and move an orbiter simply squeeze the index and thumb toward each other. To release seperate the fingers.

Play

Using the built in features little games can be played that can be fun and relaxing as well as educational. insomnia depression

racing thoughts suicidal

eat late

insomnia

stress

anxiety

coffee

big decisions

low mood

agruments

hopelessness

naps

These games will involve matching small orbiters with larger ones based on color or topic.

Hardware

The solar system projection will be shoot out of a wall mounted projector.

A motion sensor will also be installed on the ceiling to detect the movements from the glove.

Figure 46 - Design six concept called Playlight. Anthony Bellavia Winter 2014 MDES Program

69 Anthony Bellavia

Design 7 The seventh design is a puzzle sphere that draws its conception from the first design concept. The puzzle sphere helps create a calm environment and distraction using a sense of play (see figure 47 and 48). The sphere has three components; the sphere, the function, and the texture. Sphere The spherical puzzle is broken up into several columns and rows. To complete the puzzle users rotate the rows and columns along the x- and y-axis to align an image or pattern. Function To rotate the columns or rows the user must pull the ends along the axis they wish to rotate. To lock an axis and stop it from rotating the user pushes that axis in. Texture The sphere will also use a relief texture to make it tactile and make it easier to use in low light environments like when lying in bed. Reflection What does one do when they complete the puzzle? Do they buy a new one? This almost seems like a temporary solution as it does not last. People may become agitated and frustrated by the puzzle because it might be too difficult to complete. After some research it was clear that spherical puzzles already exist. The puzzle is limited in what it is capable of accomplishing and therefore not one of the best designs to tackle this issue.

Design Concepts

Figure 47 - Sketches for the Puzzle Sphere concept.

DESIGN 7 The puzzle sphere will help create a calm environment to assist those with insomnia.

Sphere

To complete the spherical puzzle people must align the pattern by rotating the columns along the x-axis and y-axis.

Function To complete the spherical puzzle people must align the pattern by rotating the columns along the x-axis and y-axis.

Push to lock

Pull to unlock

Once unlocked able to rotate and when locked unable to rotate..

Texture To complete the spherical puzzle people must align the pattern by rotating the columns along the x-axis and y-axis.

flat view

Figure 48 - Design seven concept called Puzzle Sphere. Anthony Bellavia Winter 2014 MDES Program

71 Anthony Bellavia

Design 8

Back story

The eighth design is a digital game to use before sleep called “How to Tame Your Monster”. The game aims to get users to take on material related to insomnia and mental disorders ,as well as, provides an easy avenue for connection. Games are on the rise in our society. People play games on their computers, gaming consoles, tablets, Facebook, and phones. While many are not and do not classify themselves as “gamers” many still partake in some form of gaming (see figure 49 and 50). This game is divided into several features, creation and the menu.

A back story for each person’s avatar can be obtained here. The story is based on the physical features or the symptoms people use provide. People become educated about their ailments through their avatar’s story.

Creation Users begin their experience with the game by creating an avatar based on their own personal ailments. Physical features become unlocked based on symptoms and associated mental disorder. This concept draws from Toby Allen’s personification of mental disorders as monsters (2013). Based on this concept users personify and project their own ailments and learn how to deal with them. As one engages their avatar it becomes more docile. Menu Users engage their avatar by selecting options from the display menu. There are five categories to select; evaluate my monster, back story, subdue, training, and connect. Evaluate my monster This function connects people with medical professionals. The professionals use the avatar as a tool for evaluation because all of its physical features are linked with a symptom or with a corresponding mental disorder.

Design Concepts

Subdue and Training This option lists a number of different medications known to treat particular symptoms and disorders. Side effects for each medication are provided. This is where users deploy their avatar to play games. The avatar serves as a surrogate for the user as it learns how to cope with its specific symptoms. Connect The connect feature allows users to connect with each other via a forum style communication system. Many find solace in knowing they are not alone in their plight. This forum format allows them to speak, share, and even play together. Medical professionals may also monitor and connect with users in the forum. Reflection This concept relies on medical professionals being active in the game which may be too great a burden to the healthcare system. Also, is a monster the best way to represent ailments? This could be viewed as villainizing mental disorders. People may end up feeling worse about having a disorder which is not the goal of this design. Moreover people may not be able to articulate their symptoms or disorder. And what if they don’t want to play a game? This could potentially alienate a particular demographic.

Figure 49 - Sketches for the How to Tame your Monster concept.

DESIGN 8 How to Tame your Monster will help those with insomnia and other disorders by engaging the material provided and connect with professional assistance.

Creation

People create an avatar for their ailment. different physical features are available based on the disorder and symptoms.

Menu As one continues to engage with their avatar it grows and its attitude changes becoming more docile. People can engage with their avatar by selecting one of the menu items.

evaluate my monster

People will be able to connect with medical professionals in order to plan for a course of action in treatment and check severity.

Pro: Tell me about yourself? Analysis will be based on avatar â&#x20AC;&#x153;featuresâ&#x20AC;? as well as a built in live chat system for direct communication.

back story Based on the disorder and symptoms people use to create their avatar information will be provided about them.

insomnia feature = information on insomnia

subdue

Provide a list of medications known to treat particular disorders as well as their side effects. Lerazapan

Treatment: Depression Side effects: Dry mouth drowsiness

connect

training

Many find comfort in knowing they are not alone. A forum where people may speak, share, and even play together may bring solace.

The training section is full of a series of games and exercises performed with the avatar.

general treatment games

Toby

avatar rules

Tense muscles when the bar reaches the line.

Hi there, I am new to the forum. Iâ&#x20AC;&#x2122;m from Denver.

Hi Toby, welcome. I see we share some of the same features :) Walker

Figure 50 - Design eight concept called How to Tame your Monster.

Much like educating a child with a teddy bear, the avatar serves as a surrogate for educating.

Anthony Bellavia Winter 2014 MDES Program

73 Anthony Bellavia

Design 9

Professional

This design addresses the first five design targets. This design concept draws upon the idea of the sleep detective based on Robinson and his colleagueâ&#x20AC;&#x2122;s article (2013). This is a sleep detective program that doubles as an application for smart phones. The program tries to identify what is causing the individualâ&#x20AC;&#x2122;s sleeplessness. Once identified this allows one to more readily rectify issues causing the sleeplessness (Robinson et al, 2013) (see figure 51 and 52). The sleep detective program as described below is broken up into three sections; detective, mobile, and professional.

If individuals find their sleeplessness persists even with the proffered solutions the app can link the individual to professional assistance. The app can redirect all info about their daily events and sleep patterns to the medical professionals.

Detective

Reflection This design requires a high level of engagement and relies on interaction to work properly. As a result many potential users may be turned off from using this program. This design may actually be better paired with another design or something else such as the nightlight or conversation clock

The first part necessitates people recording their daily events and what their sleep was like each day. This can be done via a monthly calendar or the associated app. Mobile Once people input both their daily events and sleep schedule the app can calculate averages for the events that occur and when sleep was at its best and worst. This would allows people to visualize and understand their life and sleep better. The app will then offer solutions to rectify or deal with the events to improve sleep quality.

Figure 51 - Sketches for the sleep detective concept.

Design Concepts

DESIGN 9 The Sleep detective program and application will assist those in identifying why they cannot sleep and provide a link to medical professionals.

Monday

Sleep Detective Tuesday

Wednesday

Detection Write down what happened each day and sleep schedule in each square.

slept 12am - 6am

Thursday

Friday

Sunday

Professional

Mobile The sleep detective will also be available as a mobile app. Calendar Entry

Sleep Detective

Ate late Stressful day Late night argument Noise

Saturday

Calendar

MONDAY FEB 4 2014 Ate late Stressful work day

Results

Late night argument Caffiene

Professional

Results

Professional If issues continue and ways to correct sleeplessness do not help, please tell your medical professional.

SEND INFO Click send info if you wish to receive professional help. Your information will be sent to a medical professional.

Noisy

Results

FEB 2014

Ways to correct

Ate late Stressful work day

Averages for the month

do not eat 2 hours before bedtime Practice deep breathing and refocus HELP

Figure 52 - Design nine concept called Sleep Detective

Anthony Bellavia Winter 2014 MDES Program

75 Anthony Bellavia

Design 10

Setting and Reminder

Design 10 also focuses on both physical and mental aspects, particularly focusing in on the sleep cycle. Normally, people have a monophasic sleep cycle where they sleep once per day (Lejuwaan 2010). However, there are different sleep cycles called polyphasic sleep cycles. According to Lejuwaan (2010) polyphasic sleep cycles involve sleeping multiple times in a single day. There are subdivisions within polyphasic sleep cycles all of which involve a core or bulk sleep and a set number of naps throughout (Lejuwaan 2010).

Individuals are able to input their daily schedule, including work schedule, into the app. The app app then generates an Everyman sleep schedule that suits the individual’s needs. The app has two alarms; one to remind the user to go to sleep and one to wake up the user.

According to the Polyphasic Society (2010) these types of sleep cycles were generated by those with insomnia. On the other hand, Dhand and Sohal’s (2006) research indicated that more than one nap a day may be detrimental to one’s health. This conflicting finding may be due to research based on a monophasic rather than polyphasic sleep cycle with naps. Based on the combined research however, the Everyman sleep cycle is possibly the best for those with insomnia. Everyman sleep involves one small core sleep (3.5 - 4.5 hours) and two to three 20 minute naps during the day The result of the research is an alternate sleep cycle app (Lejuwaan 2010) (see figure 53 and 54). The alternate sleep cycle app is broken up into three components; explanation, settings, and reminder.

Reflection It is unclear at this time whether this concept is a viable solution. More research into these sleep cycles is required. There are pros and cons but also significant unknowns. One example is while these cycles may be good for some, those suffering from insomnia with a mental disorder may

find this more harmful because of such things as racing thoughts. Racing thoughts could actually prevent people from napping during the day or from falling asleep quickly. Would the nap time be lost, thus reducing sleep time? These sleep cycles also require a lot of adjustments. This design becomes a lifestyle of its own which may be asking for too much commitment from people. The short core sleep period also has individuals awaken early in the morning when others are asleep when little or nothing is open or on TV. Users may become bored and fall asleep or their thoughts may begin to race, therefore disrupting the cycle on which the app is based.

Explanation The app first starts off by explaining what polyphasic sleep and Everyman sleep are. It then goes into detail on how basing strategies on these cycles might help with insomnia. Figure 53 - Sketches for the Alternative Sleep Cycle App concept.

Design Concepts

DESIGN 10 The Alternate Sleep Cycle program and application will help improve sleep quality by altering the sleep cycle.

Explanation

Polyphasic Sleep Polyphasic sleep is an alternate sleep cycle that involves sleeping multiple times a day instead of sleep at one time which is also known as monophasic sleep.

The first part of the app will explain Polyphasic Sleep, primarily focusing on the Everyman Sleep Schedule and how it might help feel more rested.

Everyman Sleep This sleep schedule consists of one core sleep and 2 to 3 naps during the day.

Settings Setting Schedule Please provide us with some details about your daily life and routine.

Work Schedule

Individuals will be able to set their daily schedule into the app to configure the optimal Everyman sleep schedule.

Health

Time Zone

Reminder The app will set 2 alarms; one for when to sleep and one to wake up.

Sleep Detective

Nap time!

Wake Up!

Figure 54 - Design ten concept called Alternative Sleep Cycle app.

Anthony Bellavia Winter 2014 MDES Program

77 Anthony Bellavia

Design 11

Customization

This design focuses on the physical and mental body to improve sleep quality, primarily focusing on the eyes. According to Sisson (2012) our brain produces melatonin which makes people tired. However, artificial light reduces melatonin production thereby making sleep more difficult. Our society is obsessed with light and the type of light being used is especially problematic for melatonin production. Sisson states that blue/green light is the worst kind of light for the eyes as it more thoroughly suppresses melatonin levels (2012). One way to counter or at least reduce suppression is to wear orange UV blocking glasses (Polyphasic Society 2010). The following design concept plays off the idea of the glasses to create orange tinted UV blocking contact lenses (see figure 55 and 56). The design of the contacts is explained in three parts; the prescription, the melatonin suppression, and the customization.

The contacts will come in a variety of colors to change oneâ&#x20AC;&#x2122;s eye color to whatever they desire. Reflection There still needs to be more research done on contact lenses and their range of capabilities. Can contacts be made to transition from high to low UV blocking technology? Would the orange tint interfere with oneâ&#x20AC;&#x2122;s vision? Would this reduce melatonin suppression enough to make a difference in sleep? These questions are crucial to the viability of this design concept. This design may be a band-aid solution, ignoring the real problem of artificial light. Research into artificial light and how it affects people would be necessary to continue with the development of this concept.

Prescription The contacts are made to fit and suit any prescription lenses required. The lenses adjust to the lighting situation increasing the UV protection in highly lit areas while decreasing it in low light areas. Suppression As mentioned earlier, the contacts use UV blocking technology. The pupil area of the contact uses a slight orange tint to improve the UV blocking efficiency and reduce blue/green light.

Figure 55 - Sketches for the UV Contacts concept.

Design Concepts

DESIGN 11 UV contact lens to improve natural sleep mechanisms.

Perscription

The contects will be made to fit any perscription lens required.

Melatonion Suppression The contacts will have a slight orange tint and UV protection to block out blue light. This will help reduce melatonin suppression from the light.

Major Suppress Melatonin

Minor Suppress Melatonin

Customisable The lens could come in various colours while still blocking out blue light.

Figure 56 - Design eleven concept called UV contacts.

Anthony Bellavia Winter 2014 MDES Program

79 Anthony Bellavia

Design Iterations All of the design concepts presented in the previous section have potential, however, one must be selected to move forward. By no means are the other designs disregarded. The selected concept can draw from the strengths of the other concepts while being avoiding their faults. It should be noted that the selected design is one believed to best address the problem, however this does not preclude returning to or developing another concept (see figure 57).

choose a route

start going down this route go back and choose another or continue?

Figure 57 - Visualization of selecting a concept to iterate, like selecting a path to go down. One is able to back track at any time and try a new path or concept.

Design Concepts

Design 6, the Playlight, was chosen for further development. It was selected for several reasons (see figure 58); firstly, this design met many of the design targets created to narrow the scope of the design. Secondly, the overall simplicity of the design, mentioned in this designâ&#x20AC;&#x2122;s reflection, is part of its strength. The design requires little of the user in terms of interaction; this makes sense when trying to get people to fall asleep. In addition, there is potential for this design to move forward and to integrate other design concepts. The design concept gets users involved without being intrusive.

DESIGN 6

Playlight Design Reasons for Choice Simplicity of interaction Adherance to the design targets Further potential for development.

Figure 58 - Design selected for iterations. Also the reasons for selecting this design.

81 Anthony Bellavia

6.1

This design combines the projector and sensor as a single unit that rests on the head board.

FUNCTION

The sensor will detect movement from behind the user. When the projector is off it will close itself.

ISSUES

head boards are not universal sensor placement may affect detection Figure 59 - Design iteration 6.1

The first iteration, or design 6.1, focuses on changing the hardware. The sensor and projector have been combined to make it less cumbersome (see figure 59). All of the next iterations focus on combining the two components. Although, for this iteration the device is mounted to the headboard. This idea was trying to adapt the device to the environment of the bedroom, assimilating it as part of the bed. When the device is turned off the projector retracts back into the device. The problem with this iteration is that headboards are not of standardized design. Moreover not everyone has a headboard. One other problem comes from the placement of the sensor. After reviewing and testing other motion sensor technology such as the Xbox Kinect1 and Wii2 remote sensor it was observed

Design Concepts

that a sensor has difficulty orienting to an object that is not aimed directly at the sensor. Therefore, the sensor may have problems detecting the hand if it is placed on the headboard.

6.2

This design also combines the projector and sensor but instead is mounted on the ceiling.

FUNCTION

The projection reflects off a mirror on the inside on to the ceiling.

ISSUES

Projection limited by reflection. Aesthetic unappealing like a smoke detector. Figure 60 - Design iteration 6.2

Iteration 6.2 combines the senor and projector but is mounted on the ceiling (see figure 60). The device resembles a smoke detector. The sensor orients toward and the user below resolves the sensor issue of the last iteration. The projection bounces off of a reflective surface on the inner dome portion and is refracted onto the ceiling. The reflecting of the projection may limit how far the projection reaches. The overall aesthetic of the device is off-putting and may garner more attention than the projection itself.

1 The Xbox Kinect allows for controller-free gaming using ones full body. For a description see www.xbox.com/en-CA/Kinect 2 The Wii is also a gaming console that focuses on motioncontrolled active play. See www.nintendo.com/wii/what-is-wii/

83 Anthony Bellavia

6.3

This iteration uses a screen and sensor pad instead of a glove or projector.

FUNCTION

The screen with a built in sensor is mounted to the ceiling. Users move orbiters around using the pad.

ISSUES

Takes focus away from ceiling to the pad. Ceiling screen is too cumbersome. Figure 61 - Design iteration 6.3

Iteration 6.3 abandons the projector to test other possibilities (see figure 61). This iteration uses a screen and touchpad. The screen is mounted to the ceiling with a built in sensor. Users interact with the screen using a touchpad. The problem with this iteration is that it draws focus away from the screen to the touchpad. Much like people who record events only to see them through their device and completely miss the experience in front of them.

Design Concepts

6.4

This iteration combines the sensor and projector again which is mounted between the wall and the ceiling.

FUNCTION

In addition to the new projector, orbiters will have a tail of light similar to shooting stars and sparklers.

ISSUES Placement?

Figure 62 - Design iteration 6.4

Iteration 6.4 goes back to the use of a projector (see figure 62). Iteration 6.3, while a poor design, highlighted that a projector still maybe the best option for this design. This new projector is mounted on the ceiling with its back against a wall. The projector is slightly angled at the tip to project onto the ceiling. The sensor is located on the flat surface of the device facing down toward the user. This iteration also includes a minor adjustment to the way users interact with the orbiters. As orbiters are moved a tail of light follows similar to shooting stars and sparklers. The tail is not very long but it adds another dimension to the interaction. While a minor adjustment, this may add an extra element of interest to engage users in the experience.

85 Anthony Bellavia

The glove is replaced with two rings.

FUNCTION

6.5

The band is made a rubberish material so it make fit any size fingers. Atop the band are the motion sensors.

ISSUES

sizing and comfort

Iteration 6.5 focuses not on the hardware but rather the elements and functions of the design (see figure 63). The last iteration added a tail feature to get users invested in the experience. Getting users invested is of the utmost importance if the device is to have an impact. With this in mind, this iteration adds a feature that has additional small orbiters which gradually change color to match the orbiter in their sphere. In terms of elements this iteration focuses on the glove and the instruction manual. The glove is replaced with two rings. The rings are made of a flexible rubber material so they fit on any size fingers. The sensor itself is embedded inside the rubber of the rings. The issue with the rings is that they may not be comfortable and a rubber ring may not be the best material.

Design Concepts

Continuation of 6.5 intregrating the sleep detective concept with the instructions and alteration to orbiters.

FUNCTION

Able to identify what is causing sleep disruption. Able to identify chains to receive professional help if need be.

Orbiters gradually change their color to match those they orbit.

Figure 63 - Design iteration 6.5

The instruction manual serves multiple purposes. First, it instructs the user how to use the device. Second, it incorporates the sleep detective design of design 9. Users could record aspects of their day to potentially identify what is causing their sleeplessness. Lastly, the manual identifies a multitude of avenues for seeking and receiving professional medical assistance if sleeplessness persists or intensifies. However, adding the links to professional help may reflect a level of uncertainty in the effectiveness of the device. Is there another way to tell people to seek help if things get worse or donâ&#x20AC;&#x2122;t change? Could the instruction manual and the components exist as something else such as an app?

After careful evaluation of each of the iterations, a final design output was developed. The final drew upon aspects from the design concepts as well as the iterations.

87 Anthony Bellavia

Overview & Conclusion

The end isnâ&#x20AC;&#x2122;t really the end, it is what you make of it.

Design Concepts

Design Overview This section maps out the process of developing the final design, the final design itself, and closing statements about the final design and research. The final design draws from the research conducted, previous iterations, as well as, feedback from fellow design associates and professionals. The next few pages go into an overview of the design process in the development phase to illustrate the journey toward the final design (see figure 64 and 65).

89 Anthony Bellavia

Figure 64 - Design Overview seen over the next few pages.

This is an overview of the final design. It will follow the process and development from conception to final ouput.

Before the design could be conceived a survey was conducted to gather ideas and inform how the design should take shape. Mindmaps were created based on the survey results to further understand why participants chose what they did and how could aspects of the selections be incorporated into the final design.

Design Overview

Iterations of Design Targets • connect with healthcare professionals

FIRST ITERATION OF TARGETS

• Inform and educate • provide solutions and assistance

SECOND ITERATION OF TARGETS

• relevant in today’s society

THIRD ITERATION OF TARGETS

• accessible for all • conducive to creating a calm environment • physical and mental body

To ensure the design does not stray from the issue design targets were developed to keep the design focused and concise.

91 Anthony Bellavia

Design Overview

Numerous sketches were done while in the conception phase. Along with the sketches more in depth research was conducted to make each concept viable for production.

93 Anthony Bellavia

DESIGN 2

DESIGN 3

The communication clock is able to help those with insomnia through cathartic conversation and provide information on sleep ease methods.

Puzzle Box

The puzzle box itself will bare facts and information such as information on insomnia, insomnia, tips to help with sleep, and how to seek professional help if needed.

DESIGN 4 Sleep Journal to help those with insomnia through catharsis and connect with professional assistance.

The Nightlight uses soothing and relaxing stimulants to help those with sleeping issues.

Connect Phone

Insomnia and Racing Thoughts

Clock System

Connecting a phone actives the built-in application and charges the phone.

Lights dim up and down based on bedtime and wake up time.

When the light is completely off a secondary light will project onto the ceiling, this feature is called Live Nightlight. Nightlight.

DESIGN 5 Application to help those with insomnia and connect with professional assistance.

Introduction

Infographics

Initial Startup Is this info correct?

First Name: Anthony Last Name: Bellavia Street Address: 53 Picton Street West City: Hamilton Province: Ontario

Do you wish to connect with a professional if needed?

Introduction body Connections

OFF

Talk and Discuss Live Nightlight This feature rotates the base of the light while projecting short repetitive animations to relax and soothe to sleep. inside of puzzle box

YES

Challenge thoughts with prerecorded phrases Offers tips such as sleep in a cooler room. instead of visual time, able to tell time. time.

Re : Sleep

1-3 3-30 31-33

Enter Healthcard Number

SLEEP JOURNAL

Symptoms: Insomnia and low mood

Bird

TIP Lifestyle

Are you Awake?

Abstract

Information on sleep

Flash Video

Sleep Effects: mood productivity drowsiness irritability

Sleep Monitor

Able to detect what stage of sleep one is in through body movement during sleep by using the phone`s motion detection.

Drowiness

How sleep is related to mental disorders: symptoms connection sleep detective

Set Wake Able to set what time have to get up and determine when to sleep or vise versa. 2 of 3 with disorders have issues with sleep

Body

Able to communicate with clock at anytime by asking...

avoid big decisions before bed.

Fish

The projections come in variety that one may choose from.

Lorem ipsum dolor sit amet, consectet run tern adipiscing elit. Fusce pellentesque deloratened sodales lobortis. Maecenas semper ges tosi et quis bibendum. Curabitur ut nulla.

Write Something

eaten?

Main Menu

Stressful Event? Exercise?

Connect with Pro

Coffee?

Tips

Physician: Dr. Michael Bellavia Email: anthony@gmail.com

Locations of Facilities

Connect with Pro

Before Sleep

Phone Number: 905-525-9877 Symptoms: insomnia anxiety hopelessness racing thoughts

Can’t Sleep Sleep Monitor

What do you need?

Sleep Info Please select a location for evaluation.

Audio Feature

Puzzle

The light will also be able to use audiable features to relax and assist with sleep.

Able to record self. self. Recordings are stored verbally and visually with in text notes stored on the phone and hard drive of the conversation clock.

Flat view

Puzzles are simple, relaxing, and occupy the mind making them great for rest and relaxation. Also, they can help those with mental afflictions by occupying their minds and calming them down when they need it.

NOT RECORDING/ACTIVE

Customization

The puzzle itself can use a variety of imagery. No two puzzles could be the same.

People are able to get customized clocks with different and unique characters and colors to fit their own personal aesthetic.

In addition, a program called Puzzle Therapy would be developed to distribute, trade, and work with medical professionals to help those with mental afflictions.

RECORDING/ACTIVE

Bedtime

Visualizer Active

White Noise Active

Audio Level

Anthony Bellavia Winter 2014 MDES Program

The puzzle sphere will help create a calm environment to assist those with insomnia.

Anthony Bellavia Winter 2014 MDES Program

DESIGN 8 How to Tame your Monster will help those with insomnia and other disorders by engaging the material provided and connect with professional assistance.

Sphere

To complete the spherical puzzle people must align the pattern by rotating the columns along the x-axis and y-axis.

Setting

Set Wake Active 7:00am

Setting

Set Visualizer Active

Anthony Bellavia Winter 2014 MDES Program

Sleep Detective Tuesday

Progressive Muscle Relaxation

The app will text when tossing and turning.

Can’t sleep?

Based on your wake time, it will indicate when to sleep.

Challenge Thought Environment quiet dark cool relaxing

You should go to bed soon

Set White Noise Active

DESIGN 9 Monday

Diet and Exercise Avoidance caffeine big decisions arguments smoking naps alcohol

Monitor sleep quality and schedule. Active

White Noise

Light exposure

Sleep Monitor

Visualize a Fantasy

Associate Bed with Sleep Environment

Additional Support Lines

Wednesday

Thursday

Friday

Anthony Bellavia Winter 2014 MDES Program

DESIGN 10

The Sleep detective program and application will assist those in identifying why they cannot sleep and provide a link to medical professionals.

Creation

People create an avatar for their ailment. different physical features are available based on the disorder and symptoms.

Sleep Journal

The white noise is a consist low frequency sound to lull people to sleep.

The system is connected to a remote that can set times, live nightlight, visualizer, or white noise.

Wake

11:00pm 8:00am Live Nightlight

If you find

Notice: An email and/or phone call will be made with appointment information and details.

OK Tips: Can’t Sleep

Tips: Before Sleep

Connection

White Noise

Remote System

Active

DESIGN 7

Visualizer The visualizer tells a story of a world for someone to imagine being part of

Each puzzle piece will also have a texture making them tactile and easier to use in low light.

Information

Jellyfish

If YES please see “Connect with Pro” OK

Features: Connect with Pro Tips Sleep Monitor

for insomnia and racing thoughts as it relates to those with

Tips could also appear on little clusters of pieces.

Welcome to

Table of Contents

When you can’t sleep the clock will begin to talk. It will list options for you to select on how to help your sleep or respond to any questions.

Puzzle Pieces

YES

Network to Connect Data: Bellaviatk190074-RC

Persistent tossing and turning will activate the talk feature. feature.

Tips for better sleep.

YES

Do you want your info shared with a professional database?

Disorder(s): PSTD and Depression

Different routes one can take to get professional help.

back of puzzle box

Do you wish for a mental evaluation?

YES

Medications: Lerazpam

Sensor Pad to record tossing and turning.

What is insomnia?

Was this Prescribed?

Please pass to Physician or professional to fill out. Name: Dr. Michael Bellavia

The Alternate Sleep Cycle program and application will help improve sleep quality by altering the sleep cycle.

Explanation

Polyphasic Sleep

Saturday

Sunday

Polyphasic sleep is an alternate sleep cycle that involves sleeping multiple times a day instead of sleep at one time which is also known as monophasic sleep.

It will also provide a link to TIPS: CAN’T SLEEP

Anthony Bellavia Winter 2014 MDES Program

DESIGN 11 UV contact lens to improve natural sleep mechanisms.

The first part of the app will explain Polyphasic Sleep, Sleep, primarily focusing on the Everyman Sleep Schedule and how it might help feel more rested.

Perscription

The contects will be made to fit any perscription lens required.

Everyman Sleep This sleep schedule consists of one core sleep and 2 to 3 naps during the day.

Menu As one continues to engage with their avatar it grows and its attitude changes becoming more docile. People can engage with their avatar by selecting one of the menu items.

Function

evaluate my monster

To complete the spherical puzzle people must align the pattern by rotating the columns along the x-axis and y-axis.

Settings

People will be able to connect with medical professionals in order to plan for a course of action in treatment and check severity.

Setting Schedule Please provide us with some details about your daily life and routine.

Work Schedule

Push to lock

Pull to unlock

Individuals will be able to set their daily schedule into the app to configure the optimal Everyman sleep schedule.

Melatonion Suppression The contacts will have a slight orange tint and UV protection to block out blue light. This will help reduce melatonin suppression from the light.

Major

Health

Pro: Tell me about yourself?

back story Based on the disorder and symptoms people use to create their avatar information will be provided about them.

insomnia feature = information on insomnia

subdue

Texture

Provide a list of medications known to treat particular disorders as well as their side effects.

To complete the spherical puzzle people must align the pattern by rotating the columns along the x-axis and y-axis.

Lerazapan

Treatment: Depression

Detection Write down what happened each day and sleep schedule in each square.

slept 12am - 6am

Calendar Entry

Sleep Detective

Ate late Stressful day Late night argument Noise

Calendar

general treatment

Stressful work day

Results

Late night argument Caffiene

games

Anthony Bellavia Winter 2014 MDES Program

Tense muscles when the bar reaches the line.

SEND INFO Click send info if you wish to receive professional help. Your information will be sent to a medical professional.

Reminder The app will set 2 alarms; alarms; one for when to sleep and one to wake up. up.

Sleep Detective

Nap time!

Wake Up!

Noisy

Ways to correct

Stressful work day

Averages for the month

do not eat 2 hours before bedtime Practice deep breathing and refocus

Much like educating a child with a teddy bear, the avatar serves as a surrogate for educating.

Anthony Bellavia Winter 2014 MDES Program

HELP

Anthony Bellavia Winter 2014 MDES Program

Each concept was thorough and tried to cover as many design targets as possible. The concepts were reflected upon and critiqued to identify which design may be best to continue with into the iteration phase.

Design Overview

Customisable The lens could come in various colours while still blocking out blue light.

Ate late

Hi Toby, welcome. I see we share some of the same features :) Walker

Suppress Melatonin

Professional If issues continue and ways to correct sleeplessness do not help, please tell your medical professional.

Results

FEB 2014

The training section is full of a series of games and exercises performed with the avatar.

Hi there, I am new to the forum. I’m from Denver.

avatar rules

Results

Toby

MONDAY FEB 4 2014 Ate late

Professional

training

connect Many find comfort in knowing they are not alone. A forum where people may speak, share, and even play together may bring solace.

Minor

Professional

Mobile The sleep detective will also be available as a mobile app.

Side effects: Dry mouth drowsiness

flat view

Suppress Melatonin

Time Zone

Analysis will be based on avatar “features “features features”” as well as a built in live chat system for direct communication. communication. Once unlocked able to rotate and when locked unable to rotate..

Anthony Bellavia Winter 2014 MDES Program

DESIGN 6 The playlight will help calm and help those with insomnia through interaction and play.

Orbiter Feature

People are able to move orbiters and create their own orbits orbits, orbit s, smaller orbiters will orbit larger orbiters.

To grab and move an orbiter simply squeeze the index and thumb toward each other. To release seperate the fingers.

Design 6 was selected for iterations. It was selected for several reasons; it met many of the design targets created to focus the design, the overall simplicity of the design, the design poses great potential for further development and a sense of excitement it created in its conception. Play

Using the built in features little games can be played that can be fun and relaxing as well as educational. insomnia depression

racing thoughts suicidal

eat late

insomnia

stress

anxiety

coffee

big decisions

low mood

agruments

hopelessness

naps

These games will involve matching small orbiters with larger ones based on color or topic.

Hardware

The solar system projection will be shoot out of a wall mounted projector. projector.

A motion sensor will also be installed on the ceiling to detect the movements from the glove.

Anthony Bellavia Winter 2014 MDES Program

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More sketching and research was done to identify problems and fill holes in the design.

Design Overview

Multiple iterations of each component of the design were developed as well as adding additional components.

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Figure 65 - Final design overview seen over the next few pages.

Function

Design Overview

Hardware

Orbiters

Rings

Package

App

Function When people cannot sleep, they can use the Playlight to relax and create a calming environment in which to fall asleep. The Playlight uses a projection of a galaxy-like environment where users interact with the stars or â&#x20AC;&#x153;orbitersâ&#x20AC;? by plucking them out in space and moving them to orbit larger orbiters.

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Hardware The hardware remains the same as the 6.4 iteration. The device combines the sensor and projector as one. It is mounted in between the ceiling and wall. The sensor is located on the surface of the device facing the user to ensure each movement is detectable. The elongated projector is slightly angled at the end to cover the greatest surface area of the ceiling.

bottom

side

back

Design Overview

Orbiter Interaction Users interact with orbiters by wearing two flexible rings. The users simply squeeze their two fingers together to grab and move orbiters. To release them the user separates their fingers. As the orbiters move a trail of faint light follows. Also, as an orbiter circles another larger one it gradually changes its color to match, indicating

that they are linked. When users put the rings on, the Playlight powers on. After 30 minutes of inactivity the Playlight powers off.

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Rings The rings are to be worn on the index finger and thumb. The rings are made of a flexible thin steel. The ring is not connected all the way around. It is similar to a crescent moon so it fits different finger sizes. The sensor is located in a thin band which runs across the entire span of the ring. The rings are black with a thin green band. According to an article by Fire Mountain Gems and Beads (2014) black stands for sleep

Design Overview

disorder awareness and green represents mental health awareness. The rings also have an alternative purpose. The rings may also serve as a vehicle for public awareness. Users may wear the rings at all times. This allows identification of fellow sufferers and demonstrates they are not alone. The rings may also provoke questions, providing an opportunity for disseminating information

about the issue. The ringsâ&#x20AC;&#x2122; public awareness function makes this a dual purpose design that promotes awareness and provides a practical tool to manage insomnia.

Presentation While the product itself is important the way it is presented is equally or just as important. The packaging must make the product stand out and approachable. The packaging was inspired by the idea of children reading at night under their blanket with a flashlight. The sleeve for the box represents the blanket while the box represents the bed itself. The box is opened by pulling out

the tabs like pulling out a tucked in bed sheet, inside is the device. On the lid of the box are the instructions for how to use the device and the registration code for the supplementary app.

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App The above device is accompanied by an app. This app records how long users use the light and how often. It graphs the data it receives into simple graphs. The app texts users if they are relying extensively on the light. For example, if a user is using the light 4 or more times a week, and for more than 2-3 hours a night the app texts them the following morning. The text will indicate their usage and inform them to consult

Design Overview

their doctor for further assistance. The second feature of the app is a sleep detective function as mentioned in Design 9. Users indicate what they did that day by selecting from a list of options. Users can also add their own options if they cannot find one to adequately suits the situation. The app will graph the results of their selections. The user may be able to identify connections between events and actions and

their sleeplessness. The sleep detective feature may also help medical professionals. For example; if the app sends a text indicating the need to see a medical professional for assistance the professional may look at the sleep detective what may be wrong or how they can help.

PLAYLIGHT You have used the pla ylight 7 days this week. You should t alk to y our doctor about get ting professional help.

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Conclusion In the conceptualization phase of this research the guiding targets were as follows: • • • • • •

connect with healthcare professionals inform and educate provide solutions and assistance be relevant in today’s society be accessible for all create a calm environment

Originally this thesis focused on three key features. However, a review of the research brought several issues to light. First, research into insomnia and racing thoughts is extremely broad. The actual causes of insomnia and racing thoughts vary immensely as do the treatment methods. Connecting people with medical professionals is an entirely new area of research which is out of the scope of this thesis. The final design does not directly educate users but it enhances understanding about insomnia and racing thoughts. The sleep detective feature present in the app allows users to identify what may be causing their sleeplessness. Users could use the information from the sleep detective feature to curb particular activities and habits that influence their sleeplessness. This functions as a self-help feature.

Design Overview

Most self-help programs require a lot of work on the user’s part. However, pushing users to help themselves maybe counterproductive. Work can require a particular level of effort which may deter people and set them up for failure. Instead, the final design incorporates a sense of play to promote interaction and continued use of the product. Play can require little effort or at least make it seem like little effort because one is having fun. This appears to be best when trying to relax users before sleep. The final design focuses on a preventive approach. By employing a sense of play while keeping the interaction required to a minimum, this design calms and relaxes users when their sleeplessness strikes. Its use aims to quell stirring thoughts and allows the user to more easily relax and fall asleep. While the light function assists at night the app helps during the day. The app also takes a preventive approach by allowing users to identify possible causes for their sleeplessness. In addition, the app also recognizes when the issue exceeds the scope of the Playlight and recommends professional assistance.

There are obvious limitations to the Playlightâ&#x20AC;&#x2122;s effectiveness especially since it has not yet been tested. It is not the solution as the issue does not have a single solution nor can the issue of insomnia necessarily be solved. A letter written by Stephen Fry to a distressed fan exemplifies the scope of the issue (Usher 2009). Stephen Fry is an actor who sufferers from Bipolar disorder. A fan reached out to him because she believed Fry could understand her situation. Stephen describes the circumstance like the weather (Usher 2009). He says when things are down it is like a storm. The storm may last for some time and it feels like it may never end. However, the storm does not last forever. One day it will be sunny again. He uses sunny as a metaphor for when things begin to look up again (Usher 2009).

metaphor, the weather may be random and cannot necessarily be controlled but you can prepare for it and teach people how to endure. The final design addresses the issue from the particular perspective of preparing people for and helping them endure the storm. Like all treatment methods this design may not help everyone. It does offer a unique tool for coping with sleeplessness, a preventative function to understand personal habits and events that influence sleep and a public awareness capability. It provides a means of connecting with other sufferers as well as encouraging connection with the medical community as necessary.

Other articles such as Hyperbole and a Half describe coping in a similar way (Brosh 2011). Essentially, they are suggesting that there may not be a solution and that time may be the only true antidote. They are discussing specific mental disorders rather than insomnia. But maybe insomnia is similar since it is so closely related to the specific disorders discussed. Maybe insomnia also does not have a cure. However, continuing with Stephen Fryâ&#x20AC;&#x2122;s

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Post-Script

Once upon a time.....

Post-script

Playlight Scenario Tick tock tick tock tick tock. The sound of the clock hands echo into my ears. A drop of sweat runs down my brow and rolls down my face. It falls onto my pillow with a light thud. The pillow soaks up the drop as the next drop runs down my forehead. Tick tock tick tock tick tock My thoughts stir like a storm. Casting the sea of my mind into a fit of rage. As the sea becomes more violent the storm grows in magnitude. Tick tock tick tock tick.... I can’t sleep. I can’t stop thinking about not sleeping. It’s turned into an endless cycle that feels like some kind of cruel joke. “Will this ever end?” I squeeze my eyelids tight as if trying to suffocate my eyes. Tick tock tick tock tick tock All feels lost. I relax my eyelids and gently open my eyes. I stare at the blank ceiling as my distress continues to mount. I reach over to my night stand and grab two rings. I place one on my index finger and one on my thumb. As I set the second ring, out of the corner of my eye, I see a small beacon of light. It appears to be a star of some kind resting on my ceiling. A few moments after, another appears along with several more. It is not long until my ceiling is home to a plethora of little stars of light. I reach out to my ceiling and begin to pluck at the stars. To my amazement one of the stars begins to move with my fingers. As the star moves a stream of light trails behind. I let go as the star

approaches another. To my bewilderment the star begins to circle the other. I continue to move stars and create new orbits. Not long after I feel myself slowly becoming drowsy. The sea of my mind has been quelled. The infernal ticking of my clock is nothing more than a muffled mummer. I close my eyes and drift to sleep. I open my eyes. The sun’s rays bathe my room with a golden tint. I seat myself at the edge of the bed and wipe tired eyes. I pause for a moment and notice two rings on my hand and then suddenly my alarm goes off. “I have to go to work!” I jump out of bed and get myself ready for work. I run out the door and barely catch the bus. I breathe a sigh of relief as I rest my head on a pole. I lift my head and notice a man staring at me. I look to my left and right but can’t figure out why he is looking at me. I stare back at him examining his demeanor. Peripherally, I see my hand grasping the pole. That’s when I notice it. The two rings are still on my hand. I stare at the rings for a moment, perplexed, and then I look back at the man. He reveals his rings. He smiles and nods as if he recognized me. I smile back and nod. I check my phone and open one of my apps called Playlight. I click on the usage option and notice it says I have an average usage of 1.5 hours and used 3 days this week. As I look at the usage of my Playlight I think to myself, “Hm, if this continues it will just text me saying to see my doctor....maybe I should.” I arrive at work to find my desk covered in paper work. Sheila walks over and places a coffee on my desk.

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She smiles at me and says, “you look like you could use this.” “Thanks.” I reply. I start working while drinking my coffee. I go through five cups in an hour. Around noon I stop working and check my phone. I look at my phone and open my Playlight app again. This time I click on the sleep detective. I open the feature and a block of text appears. The text says, “what you do during the day affects how you sleep at night.” I scroll down and see a list of options to check off. I notice drinking a lot of coffee and having a rough day at work are listed as two of the options. I click them and a graph appears with past options I selected. I notice that I have selected drinking a lot of coffee many times. “Maybe I should cut down.” I say to myself. After work I go to the bar with my friends. They are all drinking and discussing last night’s game. I go to take a swig of my beer, but I stop. I remember that one of the options in that list was that drinking too much affects sleep. I set the beer down and join in the conversation. I return home and set the rings on my night stand. I stare at my ceiling. Tick Tock tick tock tick tock

Post-script

The clock begins to echo again and the storm in my mind begins to swell. I crash my arm on my nightstand. “Not again.” I move my arm and hit one of the rings. I pick it up and hold it above me. As I gaze upon the ring I notice one of the stars appear on my ceiling. I put the ring on and more stars appear. I quickly grab the other ring and set it on my thumb. After I put the ring on

my ceiling is engulfed with stars again. I begin to play around with the stars once again. I feel a calmness flow over me. I pause for a moment. I remove the rings and set them on my night stand once more. I pull the sheets up to hug my body. I turn to my side and close my eyes. The calmness still flows over me. I smile for an instance and drift to sleep.

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References

No idea is derived from nothing or no one

Design Concepts

Allen, T. (2013). Real Monsters Reboot. Retrieved from http://cargocollective.com/zestydoesthings/Real-Monsters-Reboot. Retrieved on November 3, 2013. American Psychiatry Association (2012a) Highlights of Changes from DSM-IV-TR to DSM-5. Retrieved from http://www.dsm5.org/ Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf. Retrieved on November 10, 2013. American Psychiatry Association (2012b) About DSM-5. Retrieved from http://www.dsm5.org/about/Pages/Default.aspx. Retrieved on November 10, 2013. Basta, M., Chrousos, G., Vela-Bueno, A., and Vgontzas, A. N. (2007). Chronic Insomnia and Stress System. Sleep Medicine Clinic, 2(2): 279291. Brooks, S. (2004). The Kutcher Adolescent Depression Scale (KADS). Child and Adolescent Psychopharmacology, 9(5): 3-6. Brooks, S. and Kutcher, S. (2004). The Kutcher Generalized Social Anxiety Disorder Scale for Adolescents: Assessment of its Evaluative Properties Over the Course of a 16-Week Pediative Psychopharmacotherapy Trail. Journal of Child and Adolescent Psychopharmacology, 14(2): 273 - 286. Brosh, A. (2011, October 27). Adventures in Depression. Hyperbole and a Half. Retrieved from http://hyperboleandahalf.blogspot. ca/2011/10/adventures-in-depression.html Camp, C., Feldman, R., Papalia, D., and Sterns, H. (2011). Adult Development and Aging, Third Edition. New York: McGraw Hill Create. Chack, E. and Hiott-Millis, L. (2013). 24 Comics That Capture The Frustration Of Anxiety Disorders For those who have dealt, are dealing, or simply want to learn more. Retrieved from http://www.buzzfeed.com/erinchack/comics-that-capture-the-frustration-of-anxiety-disorders. Retrieved on October 8, 2013. Dhand, R. and Sohal, H. (2006). Good Sleep, Bad Sleep! The Role of Daytime Naps in Healthy Adults. Current Opinion in Pulmonary Medicine. 12(6): 379-382. Escobar, S. (2013) Surviving Thriving at NSCAD with a Mental Illness: A Student-Created Comprehensive Guide. Retrieved from http://nscad. ca/en/home/studentresources/healthsafetysecurity/nscad-wellness/resourcesforstudents.aspx. Retrieved on September 17, 2013. Fire Mountain Gems and Beads (2014). Awareness Ribbons: Color & Cause Guide. Retrieved from http://www.firemountaingems.com/ encyclobeadia/beading_resources.asp?docid=AWARENESSRIBBONS Friedman, K. (2008). Presenting your Research. Design Research Quarterly. 3(1): 8-15. Gruttadaro, D. and Crudo, D. (2012). College Students Speak: A Survey Report on Mental Health. NAMI: National Alliance on Mental Illness. pp. 1-24. Retrieved from http://www.newportacademy.com/blog/64-of-college-students-with-mental-health-issues-including-addictionwill-drop-out/ . Retrieved on July 5, 2013.

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Kittsteiner, M. (2010) Paraplusch: Psychiatry for Abused Cuddlytoys. Retrieved from www.parapluesch.de. Retrieved on October 12, 2013. Knock Knock (2009). I Can’t Sleep: A journal for passing the time when insomnia strikes and my brain is circling in on itself, cannibalizing the trivialities of the day and exaggerating the ticking of the clock, reminding me that every minute spent awake is another minute closer to when I’ll have to get up, though many of the great artists and sages were insomniacs and that’s part of how they got so much done, so if I can’t sleep I might as well write and channel my misery into something productive. Venice, CA: Knock Knock. Kutcher, S. (2008). Psychotherapeutic Support for Teens (PST) Practical Pointers for Primary Care Health Providers Treating Adolescent Depression – Supportive Rapport. Retrieved from teenmentalhealth.org/for-health-professionals/clinical-tools/ Lejuwaan, J. (2010). Alternative Sleep Cycles: You don’t really need 6-8 Hours. High Existence. Retrieved from http://www.highexistence. com/alternate-sleep-cycles/ Maciek Drejak Labs (2010) Sleep Cycle App. (version 4.3) [mobile application software]. Retrieved from http://itunes.apple.com Mäkelä, M. (2007). Knowing Through Making: The Role of the Artefact in Practice-led Research. Knowledge, Technology & Policy. 20(3): 157-163. Mattelmäki, T., & Matthews, B. (2009). Peeling apples: prototyping design experiments as research. Paper presented at Nordes 2009: Engaging artefacts, Oslo, Norway. Microsoft (2014) Why Kinect? www.xbox.com/en-CA/Kinect Modpod Creative (Oct. 2011) Seeing Mental Illness. Retrieved from www.modpodcreative.com/seeing-mental-illness/. Retrieved on July 19, 2013. Mental Health Commission of Canada (2013). Why investing in mental health will contribute to Canada’s economic prosperity and to the sustainability of our health care system. Retrieved from http://strategy.mentalhealthcommission.ca/pdf/case-for-investment-en.pdf. Retrieved on November 7, 2013. Mood disorders Society of Canada (2011). Finding Hope. Retrieved from http://www.mooddisorderscanada.ca/documents/Finding%20help/ Finding%20help.pdf. Retrieved on November 10, 2013. Nimkulrat, N. (2009). Creation of Artifacts as a Vehicle for Design Research. Paper presented at Nordes 2009: Engaging artefacts, Oslo, Norway. Nintendo (2014) What is Wii? www.nintendo.com/wii/what-is-wii/ Nova Scotia School of Art and Design (2012). Green Folder: Identifying and Responding to Students in Distress. Retrieved from http://nscad. ca/en/home/studentresources/healthsafetysecurity/nscad-wellness/resourcesforfaculty.aspx. Retrieved on September 25, 2013.

References

Ohayon, M. M. (2002) Epidemiology of insomnia: What we know and what we still need to learn. Sleep Medicine Reviews, 6(2): 97-111. Polyphasic society 2012. http://www.polyphasicsociety.com/polyphasic-sleep/overviews/ PopCap (2014). Bejeweled Games. www.popcap.com/bejeweled-games Robinson, L., Saisan, J., Segal, R., and Smith, M. (2013). Can’t Sleep? Causes, Cures, and Treatments for Insomnia. Retrieved from www. helpguide.org/life/insomnia_treatment.htm. Retrieved on August 4, 2013. Rubinstein, D. (2013). The Walking Cure: On a seventeen-day winter trek with Quebec’s first Aboriginal surgeon, the author discovers that you can change your life, one step at a time. The Walrus. 9(14): 32-38. Retrieved from http://thewalrus.ca/the-walking-cure/ Sisson, M. (2010). How Light Affects our Sleep. Mark’s Daily Apple. Retrieved from http://www.marksdailyapple.com/how-light-affectsour-sleep/#axzz28HY2NGdi Swann, C. (2002). Action Research and the Practice of Design. Design Issues, 18(2): 49-61. University of West of England (2013). Self-help Anxiety Management. (version 1.1.1) [mobile application software]. Retrieved from http:// itunes.apple.com Usher, S. (2009, October 9). It Will be a Sunny Day. Letters of Note. Retrieved from http://www.lettersofnote.com/2009/10/it-will-besunny-one-day.html Ware, B. (2013). South Shore wait times slashed: Mental health, addiction services take 4 weeks instead of 8 months. The Chronicle Herald News. Retrieved from http://thechronicleherald.ca/novascotia/1161997-south-shore-wait-times-slashed

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Appendix

Wait! Thereâ&#x20AC;&#x2122;s more.

Appendix

Figure 66 - Survey Questions.

Participants 54 people were surveyed in the city of Hamilton, Ontario in the month of December 2013. Question 3 Results: Number of times an options was listed

Question 1 Results: Average rating of use for each option listed

Question 2 Results: Average number of hours spent per week on options listed

5.2 6.4 3.6 6.7 2.6 5.7 7.6 8.7 3.5

4.4 hrs 6.9 hrs 4.3 hrs 8.1 hrs 2.3 hrs 10.1 hrs 10.7 hrs 13.2 hrs 9.1 hrs

Books Apps MP3 Social Media Community Programs Games Phone Website Other

Watch Television Reading Toss and Turn Take Medication Play Games Surf the Internet Listen to Music Work Clean sex Find a Distraction Positive Thinking Deep Breathing Draw or Write Visualize a Story Talk it Out Physical Activity ASMR (white noise videos) Cuddle with Pet Yoga Eat Drink Alcohol Meditate Nothing Drink Tea Cry Smoke Weed Avoid Coffee knit Play Guitar Sit at Window Mindfulness

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￼Improved Support for Insomnia Sufferers

Improved Support for Insomnia Sufferers