News and Articles

Improving Sleep through Proper Sleep Habits

How is my Sleep Hygiene?

Sleep habits, or sleep hygiene, are behaviors that we learn throughout our lives, from childhood to adulthood.

Most teenagers and young adults tend to be late sleepers and sleep into the late morning (“delayed phase”). However, our society is structured so that schools and most work places start early in the day. When these teens and young adults go to bed late and get up early to meet their school or work demands, sleep deprivation sets in. This condition is obvious, because on weekends or holidays they tend to “sleep in” trying to make up for their sleep loss. During the week however, they are required to wake up early, thus feeling tired and sleepy. This creates a significant problem for the circadian rhythm (a pattern repeated approximately every 24 hours). Our brain cannot adapt to such rapidly changing sleep patterns. Therefore although a person may be physically awake in the morning, the brain is still trying to sleep, resulting in poor performance at school or in the work place. 


Why do people go to bed late? There may be some genetic predisposition. However the biggest issue could surprisingly be artificial lighting. For thousands of years people have depended on the sunrise and sunset to help us set our biological clocks. Now, however, we have artificial lights including television and computers. When the sun goes down, instead of slowing down and sleeping, we remain active with the “help” of artificial lights. 

Another cause of poor sleep is alcohol. Many people rely on alcohol to help them fall asleep. The problem is that although alcohol may be a sedative/depressant, when the effects of the alcohol wear off there is rebound awakening. Typically, as the effects of alcohol wear off in the middle of the night, people awaken and experience difficulty falling back to sleep.

Coffee is another important issue in sleep health. The effect of caffeine takes about eight to ten hours to wear off. It is helpful to avoid caffeinated beverages anytime after lunch. Also, gourmet coffees contain a very high dose of caffeine. A regular cup of coffee contains approximately 80 to 150 milligrams of caffeine, but some of the gourmet coffees contain 300 to 500 milligrams of caffeine.

Good Sleep Hygiene Hints

Behavior

Maintain a consistent wake-up time. This will promote strong circadian rhythm. Wake up time is the only thing you can voluntarily control in your sleep cycle. This routine will force you to become sleepy earlier and eventually you will have a regular sleep-time. When you get tired and sleepy after sunset, don’t fight it. It’s time to go to bed!

Create a relaxing evening and bedtime routine. Activities like reading, listening to music, and taking a warm bath can help ease your body and mind, prompting you toward sleep. Keep lights low. Avoid stimulating activity during the evening. Any activity that promotes anxiety or emotions such as work, doing bills, or problem solving will make it difficult to fall asleep.

Minimize time in bed of you are not sleeping. If you are not tired, then you’re not ready for bed. If you find that you are “forcing” yourself to go to sleep, it will not work. This scenario creates additional anxiety and frustration. Get out of bed and do something you find relaxing, such as reading.

Only use your bed for sleeping. Don’t read or watch television in bed as this will promote a poor sleep habit. You need to create a conditioned response where the feeling of a pillow and cuddling up with a blanket will lead you to restful sleep.

Designate a time and place for worrying. Stress and associated worrying are common obstacles to a restful night. Sometimes behaviors used to manage stress – drinking alcohol and caffeine, napping repeatedly, or working at night – can lead to sleep problems. That’s why it’s a good idea to set aside a regular time of day when you’re not trying to sleep, to work out stressful issues and problems. This will help relax your mind later when you lie down to sleep.

Environment

A simple rule for a good sleeping environment is, “Keep it dark, cool, and quiet.”

Dark Our brain is designed so that we sleep at night. Consider using blackout curtains or eye shades to block out any lights you cannot avoid.

Cool We tend to sleep better in a cool environment. A warm room can make us uncomfortable and disturb our sleep.

Quiet Any noise can potentially wake you up. If noise is unavoidable, consider earplugs or “white noise” machines.

Decorate your bedroom so that it is a relaxing place which invites sleep. Be sure it is safe to move around in the dark. Also, try to minimize allergens and dust, as sinus allergies can disturb your breathing and lead to frequent awakenings. This means keeping pets, such as cats and dogs, out of your bedroom.

Expose yourself to bright natural light in the morning. This will signal your brain that it is daytime and promotes a strong circadian rhythm which will improve sleep at night.

Diet

Caffeine Caffeine can interfere with sleep. It is found in coffee, tea, cola, cocoa, chocolate, and most “energy drinks”. Limit the number of caffeinated beverages you drink in a day, and avoid drinking them past noon. Many individuals claim that they sleep fine after drinking coffee. This is usually a misperception. Their sleep tends to be more disturbed and less refreshing. They usually wake up in the morning needing to drink more caffeine.

Alcohol Although alcohol may initially help you fall asleep, it can disrupt sleep later in the night. This is known as rebound arousal and is a common pattern among people who consume more than two drinks in the evening. Alcohol is also a potent muscle relaxant. It can make sleep related breathing disorder (such as sleep apnea) much worse. There are some individuals whose sleep apnea can be managed simply by the avoidance of alcohol.

Nicotine Nicotine is a stimulant found in cigarettes, cigars, and certain medications. Smoking before bed can make it harder to fall asleep, and nicotine withdrawal during sleep can disrupt sleep patterns.

Eating or drinking too much shortly before bed can interfere with falling asleep and staying asleep. However, a light snack can be soothing, and may help you fall asleep more easily.

Exercise

Expose yourself to bright natural light in the morning or early part of day. This will signal your brain that it is daytime. When evening comes, with the setting of the sun, keep your house dim and avoid using bright lights. This pattern will promote a strong circadian rhythm and improve sleep at night. Vigorous exercise during the daytime also helps one to sleep better at night. Exercise in the evening, however, will likely make sleep worse because of elevated body temperature which may take several hours to cool down. Our body temperature has a circadian pattern and cools down when we sleep.

In general, daytime exercise can aid falling asleep more easily and will help you sleep better throughout the night. Try to exercise in the morning or during the day. This will promote an early sleep-time and help you transition into deeper sleep within the same night.

In conclusion, healthy living and common sense are key components to good, satisfying sleep.

Inchel C. Yeam, MD, FCCP Diplomate, American Board of Sleep Medicine,
Pulmonary & Critical Care Medicine,
American Board of Internal Medicine