Ways to Improve Sleep
Sleep hygiene recommendations
When we think of health-promoting habits, diet, exercise, and stress reduction activities usually come to mind. Equally as important as these are lifestyle approaches that can inspire us to have a good night sleep. These habits and practices—generally referred to as sleep hygiene—are thought to be elemental to good sleep and optimal health. Below are some of them and the explanation of what happens in our brain and body.
Let your body relax.
I would like to describe in simplistic terms what happens in order to go to sleep.
Our autonomic nervous system controls vital involuntary functions (circulation, respiration, thermoregulation, neuroendocrine secretion, gastrointestinal and genitourinary functions) through two interconnected sub-systems—the sympathetic nervous system and the parasympathetic nervous system.
The sympathetic nervous system stimulates the body’s fight or flight response or working mode.
The parasympathetic nervous system is responsible for a resting state, digestion, and procreative functions.
The two systems are complimentary to each other and aim to create a homeostatic (balance) state for bodily functions. In order for sleep to occur, the sympathetic system needs to quiet down and the parasympathetic system to be predominant. This is why it is very important to adopt techniques that will facilitate that.
In good sleepers, the rituals before bedtime, and the bedroom as well, are associated with relaxation and falling asleep. Insomniacs, on the other hand, have associated the bed with worrying or staying awake. This causes a state of hyperarousal, preventing the parasympathetic system from taking over and inducing sleep, resulting in a condition that we call psychophysiological insomnia.
Individuals who spend hours in bed engaged in reading, watching TV, or doing anything else other than sleep and sex weaken the relationship between bed and sleep.
The same happens when an individual stays awake in bed for more than 10 to 15 minutes. Staying in bed and struggling to fall asleep establishes the association between sleeplessness and the bed. With time the person starts dreading bedtime leading to insomnia.
- Use the bed ONLY for sleep and sexual activity. Nothing else. Do not watch TV or read in bed.
- Do not stay awake in bed for more than 10 to 15 minutes.
- If you have to get up several times during the night, that is OK. If you don’t sleep enough it will not be catastrophic for your health or work performance. The next day you will hopefully feel sleepier and sleep better. Just maintain your regular wake time, and try to avoid naps.
- Maintain a regular sleep routine. Go to bed at the same time each night and wake up at the same time. Ideally, your schedule should remain the same (+/- 20 minutes) every night of the week and weekend, otherwise your biological clock, and your sleep, will be disturbed.
- Have a comforting pre-bedtime routine, including a warm bath or shower, and meditation or quiet time.
- Have a quiet, comfortable bedroom and mattress.
- Set your bedroom thermostat at a comfortable temperature. Generally, a little cooler is better than a little warmer.
- Turn off any extraneous noise that may disrupt sleep. Background “white noise,” such as a fan, works for many people.
- If you are a “clock watcher,” hide the clock.
- If your pets awaken you, keep them outside the bedroom.
Do not nap
Napping improves alertness and decreases fatigue but it changes the need for sleep at night. That can create a decreased need for sleep at night due to the nap, which can produce daytime sleepiness and need for further napping. Many times to avoid falling asleep, I suggest that meditation is done close to bedtime as a preparation method for sleep. When meditating, it is important to be in an erect position to avoid sleeping.
Avoid substances that interfere with sleep
Caffeine is a chemical that acts as a stimulant, leading to increased autonomic response—increased heart rate, jitteriness, alertness—which can interfere with falling asleep. In addition, caffeine produces sleep fragmentation during the night. Caffeine has a half-life of three to seven hours in young individuals. With increasing age there is reduced capacity to metabolize and eliminate caffeine; its half-life can reach up to 10 hours in older adults. Even low doses early in the day can affect sleep efficiency and continuity. Studies have shown that a dose of caffeine equivalent to two cups has an objective impact as measured by an EEG (electroencephalogram) 24 hours after ingestion. Therefore, if you have trouble sleeping or staying asleep, abstain from caffeine, if possible.
- The effects of caffeine may last for several hours after ingestion.
- Caffeine can fragment sleep and cause difficulty initiating sleep.
- If you drink caffeine, do so only before noon.
- Remember that in addition to coffee, some sodas and tea contain caffeine as well.
Even though alcohol does allow individuals to fall asleep faster it reduces Rapid Eye Movement (REM), a phase during which dreaming occurs. REM is believed to aid memory and learning processes. In addition, it can also lead to a REM rebound effect, which is associated with nightmares or vivid dreams, sweating, and general sympathetic nervous system activation. Reliance on alcohol to fall asleep can also lead to dependence.
Nicotine is also a stimulant and can exacerbate insomnia in addition to triggering wakefulness due to withdrawal effects.
Over-the-counter medications may cause fragmented sleep.
Exercise early in the day. Exercise promotes continuous sleep when it is done earlier in the day. Your body requires several hours to return to baseline since exercise stimulates the sympathetic nervous system. In addition, rigorous exercise stimulates endorphins, which may cause difficulty initiating sleep.
Always remember to avoid trying to solve problems during bedtime. You can do this by having a daily routine that allows you to put the day to rest.
To do this, set aside 20 minutes in the early evening (about two or three hours before bedtime) to sit down with a pen and notebook.
- Think of what has happened during the day, how the day has gone, and how you feel about it—evaluate things.
- Write down anything you need to do on a “to do” list, including any steps that you can take to complete any loose ends. When it comes to bedtime, remind yourself that you have already dealt with things when they come to your mind. If new thoughts come up, note them on a piece of paper at your bedside, to be dealt with the next day.