"Sleep is the greatest legal performance enhancing drug that most people are probably neglecting”
–Dr. Matthew Walker
Sleep is essential. Not getting enough sleep can be disruptive to our daily routine and damaging to our overall health and wellbeing. Inadequate sleep may increase our risk of cardiovascular disease, obesity, type ll diabetes and contribute to psychiatric conditions such as depression, anxiety and suicidality. (Why We Sleep. M. Walker 2017).
Are you getting enough sleep? How much is enough and is it quality sleep?
The National Sleep Foundation recommends an average of 7 to 9 hours of sleep a night for adults 18-64 years of age.
Do you have trouble falling asleep? Trouble staying asleep?
Here are some tips from the experts on ways to start getting better sleep.
Top 12 Sleep Hygiene Suggestions
#1 Maintain a Regular Sleep Routine
- At home: Go to bed at the same time and wake up at the same time – EVEN if sleep the night before was inadequate.
- Science: Brain naturally releases melatonin about 30 minutes before bed time in people with a regular sleep routine. Establishing a regular wake-up time reinforces internal clock and will help you sleep the following night.
- Hint: If you are trying to change your sleep time, help your body adjust by making the change in small (15 minute) daily increments.
#2 Reduce the Amount of Time you Spend Awake in Bed
- Try not to go to bed before you are sleepy and get out of bed when you wake up in the morning.
- Science: Train the body to recognize the bedroom as a place for sleep.
- Hint: If you are in bed for more than 15 minutes before falling asleep, get up and leave the bedroom and engage in a boring activity (no TV or computers) until you are sleepy. Read under a low watt light bulb, sit in a comfortable chair in the dark, etc.
#3 Reserve the Bedroom for Sleep and Intimate Relations
- Do not: watch TV, pay bills, surf the internet, have arguments with the person you share a bed with, think about all of the things you didn’t do today and/or need to do tomorrow.
- Science: The mind associates locations with activities and brain function; engaging in mind stimulating activities in bed makes it harder for the brain to prepare itself for the sleep cycle (more classical conditioning).
- Hints: Take care of all of the busywork before beginning a nighttime routine.
#4 Establish a Bedtime Routine
- Establish a regular bedtime routine and make it a habit. It helps the body and mind wind down and prepare for sleep.
- Science: In many people it takes about 30 minutes to transition from wakefulness to sleep. By engaging in a regular pre-bed routine you can signal the mind to begin this transition so that you are able to fall asleep faster once you are in bed.
- Hints: Elements of the routine should be soothing, not exciting! Reading a book (not on the computer), listening to soothing music, brushing teeth/washing face, etc.
#5 Create a Comfortable Sleep Environment
- Temperature: Most people sleep better when the temperature in the room is on the cooler side.
- Light: avoid direct and fluctuating lights (TV)
- Noise: avoid any source of noise that fluctuates in intensity (radio or TV, musical transitions)
- Science: Sleep requires a reduction or suppression in environmental stimulus such as fluctuations in temperature, light and noise.
- Hints: Fans provide consistent temperature (better than air conditioning), have blankets readily available, have a “shield” for night lights, turn alarm clocks away or use dimmer, fix blinking lights, WHITE OR PINK NOISE IS OPTIMAL!
#6 Do not take long naps!
- Naps have a paradoxical effect on nighttime sleep
- Science: Naps reduce the “sleep deficit” essential for fast sleep onset and leads to sleep fragmentation & insomnia. It is better to sleep for one 7-hour period of time than one 6-hour period of time with a 2-hour nap.
- Hints: If you must nap, keep naps to less than 45 minutes and avoid napping after 3pm.
#7 Avoid Substances that Impair the Sleep Cycle
- Caffeine: coffee, tea, soda, energy drinks, large chocolate doses
- Recommendation: no use 6-8 hours before bedtime
- Tobacco: cigarettes, cigars, chewing tobacco, vapes.
- Alcohol: passing out is NOT “sleeping”
- Sleep Aids: prescription or over the counter
- Science: Alcohol suppresses REM sleep, which is the most restorative type of sleep.
- Hint: Use sleep aids on an infrequent and inconsistent basis for greater effectiveness and seek professional medical help if you are using sleep medications and/or are unable to sleep without them.
#8 Exercise, but not too late…
- Regular, physical exercise promotes sleep both physically (feeling tired) and chemically (chemicals in body associated with recovery promote sleep)
- Rigorous exercise stimulates the release of endorphins, so better to not exercise during 6 hours before bedtime.
- Science: Evidence suggests that as little as 20-30 minutes of exercise/day (even broken down into 5- minute increments) is enough to stimulate improved sleep.
- Hint: Work out in the morning to help wake up and promote sleep at night.
#9 Eat, but not too much…
- If hungry at bedtime, try a light snack. Suggestions: (one of the following) half a turkey sandwich, small bowl of whole grain cereal with milk (avoid cereals high in sugar), granola with low-fat yogurt or a banana.
- Avoid foods that cause indigestion
- Science: Pairing tryptophan-containing foods (e.g., turkey, milk) with carbohydrates may help lead to more rapid sleep onset.
- Hint: Stay away from big meals at night, eat healthy and reduce consumption of foods heavy in fats and sugars.
#10 Control light exposure
- Expose yourself to bright lights throughout the day
- Avoid bright lights after the sun goes down (or before bed)
- Science: Exposure to bright light increases serotonin and vitamin D levels (good for daytime wakefulness) and inhibits the production of melatonin (which is bad for bedtime sleepiness)
- Hint: Turn on bright lights (sunlight is the best) as soon as you wake up in the morning; spend time outdoors during the day; avoid bright lights, TV, computer monitors, etc. before going to bed.
#11 Control temperature fluctuations
- Capitalize on natural cooling of the body that occurs during sleep initiation.
- Maintain a consistent temperature throughout the night.
- Science: By taking a warm bath or a hot shower before going to bed you can artificially induce the feeling of sleepiness that is associated with the naturally occurring reduction in body temperature during the early stages of sleep.
- Hint: Take a warm bath or hot shower as part of your nightly sleep routine approximately 90 minutes before going to bed.
#12 Reduce Your Stress
- Take care of stressful situations in your life
- Science: Self-reported stress and anxiety are strongly associated with quantity and quality of sleep and rumination is one of the most frequently endorsed symptoms in people suffering from sleep disorders.
- Hints: Meditate before going to bed – if that doesn’t work, write out a list of the issues you are worried about and leave that list outside of the bedroom before going to bed.
Coping with Shift Work Sleep Disorder
- Limit number of night shifts you work in a row to prevent sleep deprivation from mounting.
- Avoid rotating shifts frequently so can maintain sleep cycle.
- Drink caffeinated beverages EARLY in your shift and AVOID them towards the end of your shift.
- Take frequent breaks and use them to move around as much as possible: walk around the station or truck.
- Expose yourself to bright lights during night shifts and wear dark sunglasses during drive home to block out sunlight.
- Create a dark, cool, sleeping environment at home that is free from disruption.
- Make sleep a PRIORITY when you are not working!
When to Seek Professional Help
- Persistent daytime sleepiness or fatigue
- Loud snoring accompanied by pauses in breath
- Difficulty falling asleep or staying asleep
- Prolonged periods of sleep without feeling rested
- Frequent morning headaches
- Frequent waking up more than 1 hour before alarm
- Inability to sleep without sleep aids
For additional information about sleep hygiene, please check out the following resources:
- American Sleep Association: http://www.sleepassociation.org/index.php?p=sleephygienetips
- Center for Sleep Medicine: http://www.metrohealth.org/body.cfm?id=1855
- The Center for Sleep and Wake Disorders: http://www.sleepdoc.com/index.php?id=44
- Psychology Today: http://www.psychologytoday.com/blog/prefrontal-nudity/201112/fix-your-sleep-hygiene
- Help Guide.org: http://www.helpguide.org/life/sleep_tips.htm
- National Sleep Foundation: https://www.sleepfoundation.org/
- Mayo Clinic https://www.mayoclinic.org/
A word about sleep medications:
Most experts do not recommend regular, long term use of sleep medication to treat sleep disorders. According to Dr. Matthew Walker, “sleeping pills do not provide natural sleep, can damage health and increase risk of life-threatening diseases.” Sleeping pills also have the potential to create what is known as rebound insomnia, a condition characterized by a return of or increase in insomnia severity which occurs after discontinuing sleeping pills.
Talk to your physician first if you are considering the use of a sleeping aide.
Cognitive Behavioral Therapy for Insomnia (CBT-I) is usually considered the standard, first line of treatment for insomnia. You can read more about CBT-I and other non-pharmacological options here.