The Sleep Blog!
Many of us struggle with getting a good night's sleep on a regular basis. This can be a common concern that I hear from my clients, especially since sleep deprivation can have a negative impact on our overall physical and emotional well-being.
The good news is that there are things we can do to help improve our ability to get a good night's sleep. These habits are known as "sleep hygiene." What follows is a list of the techniques and habits recommended by sleep experts, and that I have also found to be helpful for my clients (… and for myself!)
There are a lot of ideas here - I wanted this blog post to be a somewhat comprehensive deep dive, rather than a brief "best of" list. This is because what works for some people may not work for others. It can, however, be somewhat overwhelming, so I recommend choosing a few to get started with, and add on from there if sleep remains elusive.
Try to find out how much sleep you need
There is variation in how much sleep each person may need - the amount of sleep that is optimal for your my body may not be the amount of sleep that is optimal for mine. Most adults need around 7-10 hours of sleep / night (with teens needing about 8-10). Your first step might be to notice how much sleep you are getting on days when you feel your best. Also, keep in mind that it takes most people about 30 min to fall asleep from the time your head hits the pillow, so subtract this amount when determining how long you've slept for the night.
Go to bed and wake up at the same time each day
Our brains establish a pattern known as a circadian rhythm. This is your body’s natural sleep-wake cycle that functions a bit like a clock to signal when to release the hormones that make us tired or alert. If your schedule constantly changes, then your brain cannot figure out the pattern, and the clock will not function properly. Going to bed and waking up at roughly the same time each day can help your natural circadian rhythms to become well established. You may then find that you naturally start getting tired when bedtime rolls around each day. And you also get to have fun picturing a tiny clock in your brain! (I'm going for one of those Salvador Dalí surrealist melting clocks!)
Get some sunlight in the morning
Exposing our bodies to sunlight in the morning hours can also help set our circadian rhythms. When sunlight strikes our eyes, it travels along our optic nerves to stimulate parts of the brain to understand that it's daytime. No need to stare directly at the sun for this (which is not advised!) - something as simple as going for a brief morning walk or having your breakfast by a window can do the trick.
Exercise
Exercise can be an important part of physical and mental well-being, and also has benefits for sleep. Often anxiety and tension are part of what make it difficult to fall asleep, and exercise is a natural way to expel some of those experiences from our bodies. If you have trouble sleeping, consider adding a healthy exercise routine that works for your specific body.
However, make sure to complete your exercise during the day - exercising too late at night can rev our bodies up and make it more difficult to sleep. Sleep experts recommend avoiding intense exercise 3 hours before bedtime.
Establish a calming nighttime routine
Establishing a routine can also help signal to our bodies that it's time to wind down, and transition into bedtime. Reading a comforting book, taking a warm shower, doing meditation, or coloring may work well. Make sure to choose a wind-down routine that feels relaxing and does not involve looking at a screen, as described below.
Give yourself a “screen curfew”
This is likely the most unpopular tip on this list, and can be difficult in today’s world. I also struggle with putting my phone down (…aw come on...just one more hilarious dog video!). However, researchers have foound that it's important to avoid screens at night. The light emitted by phones, tablets, TVs, and computers is similar enough to the wavelength of sunlight that it can trick your body into thinking it’s daytime. This can cause your body to release the biochemicals associated with daytime wakefulness, and can disrupt your body's attempt to initiate sleep. Sleep experts recommend avoiding screens for at least 30 minutes before bedtime.
If avoiding the screen is not possible, there are some apps, screen filters, and external glasses that can block the blue light, which is the wavelength most responsible for mimicking daylight.
Avoid Stimulants, like Caffeine and Nicotine
Caffeine
Caffeine can create a vicious cycle - a cup of coffee may sometimes feel like our only option to stay alert after a sleepless night, but it might end up making it harder to fall asleep the following night, perpetuating the problem. Caffeine is a stimulant which works by blocking the biochemicals that would make us sleepy. Normally, during the course of the day, these biochemicals build up gradually, and when they reach a certain point, we get sleepy. Caffeine works by blocking our body's ability to sense those sleepiness-inducing chemicals. Most sources suggest that the effects of caffeine can last for 4-6 hours, so if you do use caffeine, you might want to avoid drinking it late in the day, to give those biochemicals time to build up again before your bedtime. If you choose not to avoid caffeine entirely, consider white or green tea, which have lower caffeine contents than coffee or espresso.
Over the course of my clinical work, I've noticed that some people can be more sensitive to caffeine than others. This can be especially true for those with more sensitive systems and those with anxiety. For people in these groups, just a little caffeine can feel like a lot, and caffeine can multiply with anxiety to create a additional stress and tension at bedtime.
If you find that you are sensitive to caffeine, keep in mind that caffeine can also be found in sources that may not be as obvious, such as chocolate, some sodas, and some medications such as Excedrin and Midol. Other prescription medications can also have a stimulant effect, such as medications for ADHD. If you struggle with sleep, consider reviewing your medications with your physician to see if any of them might be contributing to the problem. If one of your medications has a stimulant effect, talk with your doctor about whether there is a different time of the day you could take it. (DO NOT stop taking your medications or modify your dosage or timing on your own- work with your physician on this!)
Nicotine
Nicotine can be similar to caffeine in that it is a stimulant and may keep us awake. For optimal sleep, it is recommended to avoid nicotine entirely, or at least to avoid it in the evening.
Avoid Alcohol Before Sleep
What - avoid caffeine, nicotine, AND alcohol before bed? What kind of @&#*!! blog IS THIS!?!??!! Yeah, sorry party animals! The science is in, and it turns out alcohol before bed is not as helpful as it may seem. Yes, alcohol does often make us sleepy and can help with falling asleep, but it turns out those effects do not last, and those who drink close to bedtime often have difficulty staying asleep.
Once our body breaks down the alcohol, it releases chemicals that can actually wake us back up. It also has an effect that can block REM sleep, which is the stage of sleep when we dream and when important processes take place in our brain related to learning and memory. This means you might wake up feeling groggy, and could potentially impact your learning and memory processes. Lastly, alcohol is a diuretic, which basically means it makes you have to pee more - this can also contribute to your body waking up in the middle of the night. So... yeah....sorry!
More on Nighttime Peeing!
You know you were secretly wondering about this - it's important to stay hydrated, but drinking too much water before bed can cause our body to wake up in the middle of the night when we gotta pee. Wellness experts recommend emphasizing hydration earlier in the day, so you don't find yourself additionally thirsty before bed.
Avoid long naps during the daytime
This one might seem odd, but sleep experts recommend avoiding naps during the day. Taking a nap when we are tired might feel awesome, but it can throw off our sleep-wake cycle, and make it more difficult for us to fall asleep at our natural daytime. If we do need to nap during the daytime, experts recommend napping for 30 min or less, and doing so earlier in the day (before 5:00 PM). Napping too late in the day can disrupt our sleep drive for the nighttime. Finding a quiet relaxing activity, such as listening to calming music or meditating, could be a rejuvenating replacement for a daytime nap, as discussed more below.
Avoid prolonged tossing and turning
Our brains are really good at forming associations, or learning which things go together. If we spend too much time frustratedly tossing and turning in our bed at night, then our mind can start to associate our beds with restlessness. To avoid this, notice if it seems like you have been unable to sleep for a while. If that's' the case, consider getting up and going to another room, preferably one that can feel relaxing and dimly lit, and try some relaxing activity there to help your brain re-set. Make sure this is something that does not involve a screen, otherwise you may end up feeling more alert. Things like reading a book, coloring, or listening to music or a relaxing podcast can work well.
Use your bedroom just for sleeping
In terms of our brains making associations, it can also be helpful to avoid doing non-sleep activities in your bed or bedroom. For example, if your brain associates working or online shopping with your bed, then it might get confused when suddenly it's supposed to fall asleep in the same place. Try to keep non-sleep activities out of your bedroom if possible, or at least not in your bed.... although sleep experts do point out that sex is an exception. (So yeah, you can totally have awesome and consensual sex in your bed - sleep experts say so! Just try to avoid the other non-sleep stuff.)
Don't watch the clock:
If you wake up and can't fall back asleep, avoid the temptation to look at the clock. In fact, it's advised not to have a visible clock facing your bed. Seeing what time it is can trigger all those "what if" fears to cascade into our minds and increase our stress level - Oh no, it's already 2:00 AM and I haven’t' fallen asleep yet! What if I don't get enough sleep tonight, and then I mess up that huge presentation, and then I don't get that promotion, and then everyone will hate me, and then my dog will give me the side eye and judge me, and then....
Let's just not go there - don't find out what time it is. Instead, just try to breathe deeply, let your body get as relaxed as possible, and focus on a calm peaceful phrase, image, or place. Even if you don't fall back asleep, the additional relaxation will benefit your mind and body.
Also keep in mind that, if you are short on sleep before an important event, chances are good that your body will do OK, as long as you've slept well the previous few nights. If you find that you're someone that has trouble sleeping the night before a high-pressure event, you can set yourself up for success by emphasizing sleep during the nights leading up to this event.
Prep your Sleep Environment:
Preparing an optimal sleep environment can do a lot to set our bodies up for success with sleep. Ideally, the room where you sleep should be quiet, dark, and cool. If it's hard to achieve a quiet environment, consider ear plugs or a white noise machine or app. Minimize light from electronics, and consider an eye mask or blackout curtains if you live near ambient light. The temperature of the room can also make a difference - our bodies tend to wake up in the night if it is too warm or too cold, with the optimal sleeping temperature being 60-75 degrees F.
Notice patterns with food:
Sleep experts advise avoiding heavy meals within a few hours of bed, and avoiding foods that are likely to cause stomach upset. However, some of us may find ourselves waking in the night feeling hungry or having low blood sugar. If this happens to you (especially likely if you have hypoglycemia) then make sure your evening meal contains a good amount of protein that can keep your blood sugar up through the night. Talk with your physician or a nutritionist for your specific needs.
Learn relaxation techniques
Techniques such as paired muscle relaxation or deep breathing can help with those late-night insomnia battles, or just help you relax during the day. I often teach these techniques to my clients in session, but there are also great ways to learn them on your own. Some free apps include “Breathe” and “Calm,” and Kaiser Permanente offers free sleep/relaxation podcasts on their website. If you can, try to have these resources downloaded or readily accessible on your device, so you minimize the time you spend looking at the screen at night.
Listen to yourself
See if you notice any patterns or themes in your sleep difficulties. Do your sleepless nights come before or after certain events? Are there distressing emotions or memories coming up? In the calm space at the end of the day, our minds offer important information about what we may need. Listen to this wisdom, and reach out for support from a friend or therapist if needed.
Talk to a Health Professional
If you continue to struggle with sleep, additional strategies may be helpful. Talk with your healthcare provider – she or he can determine if you would benefit from medication or being screened for a Sleep Disorder. A therapists can support you in designing a healthy sleep routine and sticking with it!
So there you have it! Go ahead and pick a few of these sleep hygiene ideas to focus on implementing for a few weeks, and continue to add more from the list as you feel they may be useful. Don’t hesitate to reach out for professional guidance at any step along the way. Sweet dreams!
Additional Resources
American Academy of Sleep Medicine
Rose Kormanyos is an Independent Licensed Marriage and Family Therapist. She is the owner of Redwood Counseling, a private therapy practice in Sharonville, Ohio where she works with individuals and couples. www.redwoodcounselingcincinnati.com
Note: This Blog is for informational purposes only, and is not intended to diagnose or treat any medical or mental health condition. Reading this blog and implementing the suggestions here is not a replacement for medical attention. Speak with a healthcare professional if you are in need of assistance, and call 911 if you are having an emergency.