INSOMNIA: Sleep Hygiene
Sleep habits and environmental factors greatly influence the quality of our sleep. Collectively, they are referred to as “sleep hygiene.” Once under control, they can help improve our sleep, so that we wake refreshed and stay alert throughout the day. Most are under our control.
The areas critical to sleep hygiene are:
- Circadian rhythms
- Psychological stress
- Drugs such as nicotine, caffeine, and alcohol
“Circadian rhythms” refers to our day/night cycle of about 24 hours. These rhythms significantly influence the quality and quantity of our sleep. Consistency and stability of our circadian rhythms are critical. Factors that may disturb this cycle are bedtime, exercise, noise, daytime naps, and most important, exposure to light.
Such stress factors as marital or relationship problems, job crises, exams and deadlines can markedly disrupt our sleep. Every time we go to bed, we must clear our mind of the clamor and bustle of the day, and this may take some time. If we go to bed worrying about today’s or tomorrow’s events, sleep will not come easily.
It may be helpful to establish a “pre-sleep” ritual to break the bond between the day and the night. Make a list of your stress factors, fold up the paper, and put it somewhere other than the bedroom to end the day. Reading pre-sleep, or meditating, or taking a relaxing warm bath –even counting sheep! – can all help push away the psychological stressors.
As we age, our sleep patterns change. We may wake more often during the night, or wake earlier than we did when younger. All this can interfere with the quality and quantity of our sleep. Night time awakenings can also interact with other conditions that cause our sleep to be broken, like depression or the withdrawal that happens with drinking alcohol before bedtime. These nocturnal awakenings greatly affect how we will feel the next day.
Nicotine, caffeine, and alcohol significantly impact sleep. Caffeine can stay in the body for as long as 14 hours, decreasing the amount of sleep we get, and increasing the number of nocturnal awakenings, thus affecting our daytime mood and performance. Nicotine has similar effects as caffeine, except that nicotine in low doses can act like a sedative. Initially, alcohol can be sedating, allowing you to fall asleep quickly, but during sleep, as it clears from your system, it can cause awakenings that may last two or three hours. Headache, sweating and intense dreaming may also result. The effects can be felt most keenly in the morning, when the drinker awakes groggy and/or hungover.
Poor quality sleep can have important short and long-term consequences. Studies have shown that performance and alertness are adversely affected by sleep deprivation. Sleep quality and quantity reduced by only one and one-half hours a night reduces alertness during the day by about one-third. The risk of occupational injury or death rises when daytime alertness is compromised, due to impaired ability to think clearly and process information. Sleep disorders (like apnea) that cause sleep deprivation have been associated with hypertension, stroke, and heart attack.
If you want to increase the quality and quantity of your sleep, here are some things you can do on your own:
- Use ear plugs, an electric blanket or air conditioner to minimize noise, light, and heat or cold during sleep: the faintest noise or light can affect your sleep quality. Control the temperature of the room so that it is comfortable for you.
- Avoid naps. If you do nap, make it short, and stay awake as long as you can before napping. Do not nap if falling asleep is a problem.
- Avoid drinking fluids after 7:00 or 8:00, to prevent waking at night to urinate.
- If you have to get up during the night, avoid bright lights. Use a night light.
- Avoid stimulants near bedtime or when awake at night. This includes nicotine, caffeine, tea, soda, and over-the-counter medications that contain stimulants. Caffeine in large amounts can cause headaches during the night that may awaken you. Alcohol increases awakenings and is associated with sweats and nightmares.
- A heavy meal too close to bedtime interferes with sleep. Avoid protein. Consume carbohydrates or dairy products instead, particularly milk. Milk has been shown to help people go to sleep due to the amino acid L-tryptophan it contains.
- Once in bed, don’t watch TV, eat, or have intense conversations. These bring daytime issues right back into your sleep preparation and can interfere with sleep.
- Avoid exercising vigorously before bed. If you are stimulated by exercise, perform it in the morning or afternoon.
- Pets moving about in the bed can interfere with your sleep. Relegate dogs or cats to the floor, or another room.
Practicing good sleep hygiene will help you to wake up refreshed and alert, and keep you from drowsiness during the day. If otherwise, consider that another, unrecognized sleep disorder may be at fault. Sleep disorders can go undiagnosed for years, resulting in unnecessary suffering, accidents, additional expense, and poor quality of life. In this case, visit your doctor or a sleep specialist.