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Though commonplace in “therapy lingo,” the concept of sleep hygiene is one that few have heard of. Despite the prevalence of individuals with a wide range of sleep concerns ranging from tossing and turning all night long, to difficulty falling asleep, to waking up in the middle of the night, few pay attention to the conditions necessary for quality sleep.
While many are quick to take over-the-counter medications such as Tylenol PM or NyQuil to do the job, if not even a glass of wine, such strategies may not lead to restful sleep, and worse can lead to dependence. Although Lunesta and Ambien commercials make the promise of a peaceful night’s rest with a pretty glowing butterfly coming to deliver a deep slumber, medication may not always be necessary. In fact, when I discuss how to improve sleep hygiene with clients, they are often surprised to learn of the laundry list of strategies that can enhance their chances for quality sleep.
1) Exercise
The attainment of restful sleep is related to the activities of your entire day, not just the hour or so before you go to bed. Studies have shown exercise to lead to improved sleep quality, faster time to fall asleep, as well as longer sleep duration. However, it is also important to be mindful of when to time exercise. Though some may believe an intense workout right before bed can lead to exhaustion, this may actually do the opposite. It may lead to greater alertness, increased body temperature, and make it more difficult to fall asleep. Regular exercise timed in the morning or afternoon could be more optimal.
2) Set aside 9-10 hours for sleep
This often seems like a tall order, but a common challenge for many sleepers is leaving enough time for quality sleep. Many times for example, college students will try to sleep “efficiently,” meaning that they study until the last minute and leave a total of 6 hours to sleep. As their minds are often still going, they often complain of racing thoughts or difficulty winding down. They lay wide-awake, calculating the hours ticking away, panicking about the sleep they aren’t getting. Allowing for ample time in bed makes it so that even if an hour or two is lost, one still has the comfort of knowing that they will have the requisite hours for the day ahead. And despite what people say about getting by on 5-6 hours, 8-9 is essential for everyone, no exceptions!
3) Adjust your sleep environment
When I ask my clients about the environment in which they sleep, I’m often amazed by their answers. Some fall asleep with the tv on, cell phone in hand, or somewhere with bright lights and loud noises entering their sleep space. Creating a quiet, dark, and cool comfortable setting is highly important for obtaining quality sleep. For some, earplugs and eye masks help them along this aim. For those who are made anxious by the bright glow of their alarm clocks, covering the face of the clock with fabric or even tissue can ease their minds. If one checks their phone or answers text messages while in bed, removing these items from arms length can also be helpful.
4) Set the mood for sleep
Related to adjusting one’s environment is setting the mood for sleep. Though it sounds a bit comical, what is meant is the idea of preparing for sleep an hour or so prior to actually getting into bed. In our busy days, it can be easy to run around doing a million different things, and then hopping into bed and expecting sleep to magically come. For many, if not most individuals, it is not this simple. Setting aside the last hour of your day before bed to wind down can make a huge difference.
Some may choose to take a warm bath or shower to metaphorically and literally cleanse themselves of their day. They may even clean up their houses or rooms to de-clutter their environment and minds. List-making and organizing for the day ahead can even be comforting and keep from the to-do list from popping up while in bed. Others may choose to do a relaxing activity such as knitting, reading, or meditating.
Whatever it is, lowering the lights, turning off the tv, computer, cell phone, and tuning into your body and self-care needs is very important. Studies have also shown that the bright lights emitted from devices such as phones or computer screens can further activate the brain, thereby making it harder to wind down for bed. Making a rule of turning off all devices may be very helpful.
5) Attend to physiological needs
Often it isn’t until we’ve taken the time to slow down that we come to realize the many physical needs we have neglected throughout the day. Our bodies may be tense and stiff, or we may find ourselves hungry or thirsty. Hydrating and staying nourished throughout the day is essential, but realistically does not always happen for everyone. Though large meals are typically discouraged before bedtime, some light snacks can quiet a growling stomach and aid sleep. Warm milk and yogurt are often recommended as snacks because many dairy products contain calcium and tryptophan, which aid sleep. As calcium and magnesium work together, a family physician can be consulted to determine if adding these supplements to one’s diet could be beneficial. However, do stay away from the rocky road ice cream, as sugars and the caffeine in chocolate can keep you awake.
As such, monitoring caffeine intake throughout the day can be very important. According to the American Academy of Sleep Medicine, the half-life of caffeine is 3-5 hours, which means this is the amount of time it takes to eliminate half of the substance from the body. Caffeine’s lasting effects can range for 8-14 hours. For a list of caffeine levels in common products, go here.
6) Take a deep breath
When all physiological needs have been met, the mood has been set, the environment altered, many may still experience sleep disturbance. When not medically-related, it can be related to anxiety and thoughts around sleep. Sometimes one sleepless night can create a negative feedback loop, whereby one expects sleep not to come again, and the problem perpetuates. It is a self-fulfilling prophecy of poor sleep.
Often times taking the pressure off of the need to sleep can be helpful. Taking a few deep breaths, doing meditation, or prayer can calm the mind down to promote sleep. Even so, consider the worst case scenario. What happens if you don’t sleep well one night? You may be groggy the next day, and perform at an average level of performance. It is rarely the end of the world. There is a high likelihood that you can still accomplish what you need to for the day. I recall the words I read once by a meditation guru who said that often a solid meditation of 20 minutes can provide many of the same elements that a full night’s sleep can achieve. This is not to say that we should ever forgo sleep, but that rather we can allow our bodies to rest in a variety of ways.
Whether it is writing in a diary, listing 3 positive things that happened throughout the day, or drinking chamomile or mint tea at night, we can usually find something that consistently helps put us to sleep. Should none of the strategies listed above be of help, consulting with a physician or sleep expert can be helpful. Circadian rhythm disturbance can be associated with concerns such as ADHD or bipolar disorders when present with a host of other symptoms. Consulting with a mental health professional can also assist in determining if such factors may be contributing to sleep issues.
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