Sleep and Learning

screen-shot-2017-01-29-at-2-26-16-pmPhoto credit: A.McKenzie

Science of Learning Featured Article

One common challenge that exists for many of us that live in this 24/7 world is getting enough sleep. As a perinatal educator this poses a very real problem. I have students that arrive to start an all day workshop bleary eyed and floppy tailed after working through the night on the maternity unit. Determined to find a technique that I could use to help people learn despite being sleep deprived, I began looking around at some of the research. While I confirmed that the loss of focus, the decreased ability to take in, process or retrieve information and the inability to make sound decisions (Sleep, Learning and Memory, 2007) are not just imagined symptoms, I was not able to find any real solutions to manage these challenges except providing coffee (which I sometimes do), chocolate (which I do) (Stoller, Papp, Aikens, Erokwu & Strohl, 2009) and naps (which happen all on their own).

So, I decided to look at the sleep and learning situation from another lens – is there a better way for people to learn when sleep and time are at such a premium? This research article by Mazza, Gerbier, Gustin, Kasikci, Koenig, Toppino and Magnin (2016) demonstrates that it is possible to “relearn faster and retain longer”. It involves learning and relearning and sleep but what is important is the timing of when these happen. Let me explain, but first, let’s take a look at the validity of the experiment.

Evidence for the reliability of the article

The authors’ wealth of research experience and clinical experience is evident in the way that they conducted the experiment:

  • Quality research relevant to the study was analyzed and presented – this included the effects of relearning on retention, the effects of spacing on relearning and the effects of sleep on memory retention;
  • Organization of the content is logical, content appears free of bias;
  • Clear purpose and methodology outlined – the purpose was to investigate what impact relearning after a period of sleep or wakefulness would have on long term memory retention;
  • Research design issues with another experiment investigating sleep and spaced learning were noted and improved upon – for example instead of using recall or recognition as a measure of memory retention, a relearning paradigm was used;
  • Participants were carefully selected and variables were controlled for – sleep quality, circadian topology, level of sleepiness, and basic long-term and short-term memory capacity;
  • Study was done in accordance to international law and local ethics committee – Declaration of Helsinki, French ethics committee;
  • Results were thoroughly discussed and alternative interpretations were reviewed;
  • Applicability of the study results – “These results suggest that an uninterrupted sequence of learning, sleep-dependent consolidation, and relearning (that is, repeatedly alternating study and sleep) is particularly efficient for long-term retention” (Discussion). The authors focused on adult learners and specifically procedural memory but they did speculate that this may be transferable for skill acquisition and retention as well.


Summarize the principle or principles described in the article.

In order to fully understand the principles behind their research design, the authors of the study touched upon several key learning strategies that have been shown improve memory and, according to the science of learning, changes the neural pathways in our brain (Michelon, 2008):

  • Repetitive practice – every time you practice something you relearn it. Thus the more you practice something the less time and less effort it takes to get to the level you want to achieve (Mazza et al, 2016);
  • Spacing effect – a concept or learning objective is presented to learners then a period of time to pass (days, weeks, or months) is allowed to pass and then the same concept is presented again (Casebourne, 2015). The cool thing here is that the advantageous interval for the spacing is determined by the length of time between the first learning session and the final test; the longer the interval the longer the spacing between the learning and the review (relearning session) before the final test (University of California, 2008).
  • Interleaving effect – is where several concepts or skills are presented during the same learning session. These are then alternated for repeated sessions (Stenger, 2016) i.e., ABC ABC ABC.
  • Sleep – Mazza et al (2016), discuss how sleep aids in stabilizing the learning via the “ . . . reactivation and integration of newly encoded memories into preexisting and permanent knowledge networks . . .” (para 2). Memory consolidation during sleep in strongly correlated to the degree to which the individual feels that this information or skill will be needed in the future (Born, & Wilhelm, 2012).

Understanding that all of these learning strategies enhance learning, Mazza et al (2016) proposed analyzing what effect interleaving repeated practice and sleep together would have on learning.

Let’s take a quick look at the study.

40 adults were randomly assigned to either a ‘wake’ group or a ‘sleep’ group and later another 20 adults were assigned to a control group. For the first session all participants were presented with 16 Swahili-French word pairings and given 7 seconds to study per pairing. After this, participants were asked to type in the matching French word for the Swahili word that was displayed, followed by a 4 s display of the correct match. This constituted the first retrieval attempt. Participants were given the opportunity to continue matching pairs until they matched them all correctly.

Participants in the ‘wake’ group had the first session at 09:00 and then came back for a relearning session at 21:00 that day which involved a first retrieval attempt and then repeated attempts at matching until they got them all correct.

Participants in the ‘sleep’ group had their first session at 21:00, had a period of sleep and then had their relearning session at 09:00 hr the next day which also involved a first retrieval attempt and then repeated attempts at matching until they got them all correct.

Participants in the control group had a first session at 21:00, had a period of sleep and then another first recall session at 09:00 the next day but no further opportunities for relearning.

1 week and 6 months after the relearning session all groups performed a midday recall task without corrective feedback.


During the initial learning session, results for all groups did not differ significantly. Results during the relearning session, however, were significantly different between the ‘wake’ and the ‘sleep’ groups with the ‘wake’ group requiring twice as many list trials to reach relearning criteria as the ‘sleep’ group. The performance of the control group was not significantly different than the ‘sleep’ group but was significantly better than the ‘wake’ group thus supporting that sleep aids learning.

1 week later and 6 months later, however, the ‘sleep’ group out performed both the control and the ‘wake’ group which supports the premise that sleep together with relearning is crucial for long term memory.


Mazza et al (2016) state that their results “ . . . indicate that when the interval between successive study sessions is filled with sleep rather than with wakeful activity, the process is much more efficient because it both facilitates relearning and enhances long-term retention” (Discussion).

With time and sleep in such short supply, I need to help promote efficiency in learning. Understanding that interleaving learning and relearning with sleep can help students learn faster and for longer sounds like it is just the ticket. Given that I often do not have students for two days it sounds like this could be tricky to implement. Time to get the creative juices flowing!

Applicability of the principle to practice

One of the workshops I facilitate is the face-to-face component of an online perinatal course. Due to the amount of material that needs to be covered it has just been extended from one 8-hour workshop to a one and one-half day workshop. Originally, I was planning on spreading out the content over the two days but since reading this study I have decided to have the students interleave basic skills and concepts learned and practiced on day one – problem solving (case study that involves triage and assessment and management of labour) and skills stations (birth in the absence of the primary care provider and post partum haemorrhage) – with a night’s sleep and then repeat (relearn) the same concepts again day two with another case study and student demonstration of the same skills.

The challenge is applying the findings of this study to one day workshops. Presently the expectation for the fetal health surveillance workshop is that students complete the required reading (a textbook) prior to attending. Due to sleep and time constraints, this often does not happen so I am required to introduce new material to students all in one day. What I am proposing to do is to develop a short quiz that will review the key terms and concepts and have the students complete it the night before the workshop. This way students that do complete the textbook reading will have an opportunity to relearn an additional time before attending the workshop and those that do not complete all of the textbook reading will review enough of the material to complete the exam (hopefully).

I realize that compliance is always an issue so I will endeavour to create an exam that is succinct and fun. (Learning is fun right?) I will review the answers to the quiz first thing in the morning. I realize that this does not replicate the learning sessions outlined in the study and that the quiz is not guaranteed to be completed but I am hoping that at least some of the students will take this on as I feel that even a small chance of improving the quality of the learning for the workshop and retention for application to the workplace will be worth the effort.

Analyzing this study has brought to light yet another aspect to consider when employing effective learning strategies. Incorporating sleep with learning and relearning appears to be an effective way to help students “relearn faster and retain longer”.

Mmm, anyone ready for a nap?


Image source : Pixabay


Born, J., & Wilhelm, I. (2012). System consolidation of memory during sleep. Psychological Research76(2), 192–203. Retrieved from:

Casebourne, I., (2015) Spaced Learning: An Approach to Minimize the Forgetting Curve ATD Association for Talent Development Retrieved from:

Mazza, S., Gerbier, E., Gustin, M., Kasikci, Z., Koenig, O., Toppino, T., Magnin, M., (2016) The Science of Learning Featured Article Relearn Faster and Retain Longer Psychological Science Vol 27, Issue 10, pp. 1321 – 1330. Retrieved from:

Michelon, P., (2008) Brain Plasticity: How learning changes your brain Sharp Brains. Retrieved from:

Sleep, Learning and Memory (2007) Healthy Sleep Retrieved from:

Stenger, M., (2016) Interleaved Practice: 4 Ways to Learn Better By Mixing It Up informED. Retrieved from:

Stoller EP, Papp KK, Aikens JE, Erokwu B, Strohl KP. (2009) Strategies Resident Physicians Use to Manage Sleep Loss and Fatigue. Retrieved from:

University of California (2008). Improving Long-term Learning Through Spacing Of Lessons. ScienceDaily. Retrieved from

Writing a Critique or Review of a Research Article (2014) University of Calgary Writing Support Services, Student Success Centre Retrieved from:



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