SLEEP HYGIENE...WHAT IS IT AND WHY IS IT IMPORTANT?

What is Sleep Hygiene?

It is the science and practice of maintaining and restoring sleep health. Sleep hygiene is preparing your body and environment to be conducive to a good night’s sleep. So, what exactly does that mean? In the course of our busy lives, we tend to forget that at least one-third of our day is spent sleeping. We live in a 24-hour society, that focuses on our jobs and commitments to the family so much, that we tend to forget that we need to make time for sleep and to create the best environment that is conducive to a good night’s sleep.

How to maintain good Sleep Hygiene?

Let’s first take a look at the environment we sleep in. Most bedrooms these days take on several roles. Not only is it a bedroom, but we work in there, pay bills in there, watch TV in there, eat in there and let the kids play in there. This is no longer a bedroom...it’s a kitchen, an office, a living room, and a playroom. This is the first big “no-no” of sleep hygiene. You need to make your bedroom your sanctuary. It needs to be a private getaway for you and your bed partner. It is for what we call “the three S’s.”...Sleep, Sickness, and Sex. Our subconscious mind is very powerful. When we treat our bedrooms just like other rooms in the house, we lose the peaceful feeling that we should have once we cross the threshold. There are very few places for grown-ups to escape to, so keep your bedroom as one of those places.

What can you do to improve your Sleep Environment?

• Try to change the way that you use the room you sleep in. Keep the kids out. No food or work allowed!
• Make sure that your bedroom is at a comfortable temperature (around 60-65 degrees F is recommended). As we all have experienced, if the bedroom is too hot or too cold, it is difficult to sleep. Try to find a temperature that keeps both you and your bed partner comfortable.
• Make sure to minimize light intrusion. Your bedroom should be dark when you sleep so that your body produces melatonin, which is a hormone that helps induce sleep.
• Another environmental factor is noise. Trying to keep the noise level down in the bedroom is the goal. If that is not possible, then you can utilize an environmental sound machine or relaxing music which can mask many of the outside distractions.

Next, we can take a look at the physical things we should and shouldn’t do that will either help us to sleep or keep us awake.

What not to do before you go to sleep?

First, what shouldn’t you do when trying to get a good night’s sleep:

• Minimal or no alcohol before bedtime: If you want to have alcohol, you should have it no more than 4-6 hours before bedtime. It’s true that a nice glass of wine helps you to relax and fall asleep more quickly, but the flip-side of that is that it is only temporary. You may fall asleep initially, but will usually wake up more often to urinate or as the sedating effects of the alcohol wear off. Frequent awakenings from alcohol can dramatically affect the quality of your sleep. Keep all your liquid intake down before bedtime. Too much liquid can cause multiple awakenings due to the frequent urge to urinate.
• Do not exercise close to bedtime: By all means, we want you to continue your exercise routine, but it should be done earlier in the day and not within 6 hours of bedtime.
• No heavy meals close to bedtime: Not only is it uncomfortable to try and sleep with a full belly but if you already have reflux, eating and lying down soon after will only worsen your symptoms. Reflux is where the gastric acids are propelled back up the esophagus from the stomach. This can cause damage to the esophagus over time and can interrupt your sleep. Many people who have reflux will use OTC or prescription medications to help neutralize the acids or turn off some of the acid pumps in the stomach.
• No caffeinated beverages within 4-6 hours of bedtime: Caffeine is a stimulant. Stimulants are designed to keep you awake, so keep your intake to a minimum if possible. Another type of stimulant that most people don’t think of as a sleep-disturber is nicotine. Try to keep your nicotine intake down close to bedtime or this may be another factor that keeps you from a good night’s sleep.
• No napping: As we reach adulthood, we do not require naps like we did when we were toddlers. Taking a short 20–40-minute nap probably won’t disturb your sleep too much, but frequent napping for long periods of time will mess with your inner clock called the “circadian rhythm”. By napping during the day, you will find it harder to fall asleep and stay asleep at night. If you must nap, try not to nap after 3 pm.

What physical things can you do to help you to sleep better at night?

• Exercise: Exercise allows the body to release endorphins which help relax the body and mind. Remember, no exercise within 6 hours of bedtime...any time before that is fine.
• Balanced Diet: Eat a balanced diet and try not to eat too close to bedtime. Fatty foods and alcohol can aggravate reflux, and as stated above, reflux can disturb your sleep. Foods like peanut butter and dairy products are high in the amino acid tryptophan, which has been known to help induce sleep. Many people report that apples took before bedtime increases sleepiness and the ability to doze off.
• Set Sleep Schedule: Try to keep a regular sleep schedule if possible. The adult human needs at least 8 hours of sleep per night. Erratic sleep schedules actually prevent us from training our internal “clocks” which help us to control alertness and the ability to sleep.
• Clear your Mind: Lastly, what mental things are keeping us from sleeping? Many people use bedtime to rehash all of their problems or issues. This is the most difficult aspect to overcome in achieving a good night’s sleep. It is very hard to change the way we think and not to ruminate about our problems or short-comings. All of this “stinkin’ thinkin’” creates anxiety and that can keep you from falling asleep or staying asleep. We all have done this at some point in our lives. Worrying about finances, worrying about health, the kids, mom, and dad, work.... the list is literally endless. So how can we get our minds to dump all of the interference so we can sleep? Some people will do yoga or meditation. This is a great option, but not for everyone. Try to set aside a time before bed to use as your “worry time” Think through your most pressing issues or problems and try to formulate some solutions. Write your solutions down in a journal and set aside a maximum time to ruminate about these things, then put the journal away and try not to focus on it until tomorrow. Remember, many problems do not have clear solutions, and staying awake trying to solve them is usually counter-productive. Most problems and issues make more sense and can be thought through more clearly during the day when we have had a good night’s sleep.
• Other sleep-promoting tips: Make sure your mattress supports your weight properly and is comfortable. Wear comfortable, light-weight, natural fiber clothing to bed (ie: 100% cotton breathes and absorbs moisture). Be cautious with over-the-counter medications. Some such as antihistamines can keep you awake, others such as cough syrups or cold remedies can be sedating.

When should you contact a doctor or health care professional about your sleep?

If your bed partner reports that you snore or stop breathing during sleep. If your sleep is ALWAYS unrefreshing. If you try all of the above tips, etc. and you still cannot fall asleep or stay asleep. If you suffer from morning headaches. If you have difficulty performing your job or your normal activities of daily living. If you have fallen asleep inappropriately (ie: at a party, while driving). If you suffer from difficulty with concentration and problems with short-term memory, not caused by other diseases or medications. You should contact your doctor should you have any issues with falling asleep and staying asleep.

In our busy world, it is necessary to carve out some time to sleep. Try to utilize some of the tips above to get your body, mind, and environment ready for a restful and refreshing night’s sleep!

Read more about Sleep Hygiene

• Sleep Hygiene Practices and Their Relation to Sleep Quality in Medical Students of Qazvin University of Medical Sciences
• The Role of Sleep Hygiene in Promoting Public Health: A Review of Empirical Evidence

Author Profile:

Laura Castricone (Certified Respiratory Therapist)
My name is Laura Castricone and I am a Certified Respiratory Therapist. I have been practicing in the state of Connecticut since 1992. I have worked in several aspects of respiratory care including sleep medicine, critical care, rehab, and home care. I earned my respiratory certification at Quinnipiac University in Hamden, CT. Prior to becoming an RT, I attended the University of Connecticut pursuing a degree in English but left Uconn in my junior year to work with my father in the restaurant business. I stayed with him for over a dozen years. An education, by the way, that can never be bought! Once I married and had children, the restaurant business no longer fit my lifestyle. When my children were one and two years old, I decided to go back to school and that is where my career in respiratory care began. This career has been very rewarding and I have been blessed to meet some extraordinary people along the way. I grew up in Waterbury, CT, and now live in Litchfield County, CT with my husband and our crazy Jack Russell terrier, Hendrix. My hobbies include antiquing, gardening, writing plays, and painting miniature paintings.

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