The 6 key steps to improving your sleep hygiene

Insomnia, or trouble sleeping, is one of the most common complaints patients present to their primary care doctor, and it can be a stressful and debilitating ordeal for anyone.  There are different kinds of sleep problems –for example, you may have difficulty falling asleep, or you might wake in the night, or you may feel your sleep is not restful — and these problems can be the result of any number of different causes.  Some cases of insomnia may be caused by certain medical diseases, and if you have great difficulty sleeping, or are having other symptoms like fever, pain, difficulty breathing, weight loss, intolerance to heat, or you present substance abuse, you should be evaluated by your doctor.  If you suffer from insomnia, your doctor may recommend certain medications that can help you achieve normal, restful sleep patterns.  However,sleep troubles are often greatly improved with simple changes in behaviors and attitudes related to things like dietary habits, physical activity, stress and anxiety management, bedroom ambiance, and bedtime preparations — these factors are often collectively referred to as ‘sleep hygiene’.  Clinical studies have shown that improving basic sleep hygiene can be as effective as the latest sleep medications in treating insomnia.  Here I’ve summarized the most important tips for dealing with insomnia in 6 key steps for improving your sleep hygiene.

1) ‘Movement is medicine’: get your regular exercise!  Regular physical activity helps you fall asleep faster, have less waking in the night, and feel more rested in the morning.  If you’re having trouble sleeping, try and get about 20 minutes per day of exercise, if possible at least 4-5 hours before your bedtime.

2) Watch your diet and habits. Avoid caffeine within 10 hours of bedtime: no coffee, no energy drinks, no chocolate, and no dark tea (green tea has less caffeine) after lunch if possible.  Avoid nicotine (at least in the evening), as it can alter sleep patterns. You may feel like your nightcap relaxes you, but alcohol adversely affects sleep continuity and restfulness, so you should also cut out alcohol if you’re having trouble sleeping.  If you find yourself waking up at night to go urinate, try to limit your fluid intake for a few hours before bedtime.

3) Maintain your ‘sleep sanctuary’.  Make your bedroom almost like your temple for sleep: make it as comfortable and relaxing as possible by keeping it cool (if you like) and by diminishing ambient light, noise (turn off the TV or close the windows), and other stimuli.  Try to use the bedroom only for sleep and sex, and resist the temptation to work or study or watch TV in your bed if possible.  If you are used to working or studying in bed, your brain may unconsciously associate that setting with busy or stressful thoughts — the idea is for the bedroom setting to be only associated with, or (in other words) be an unconscious mental cue for, rest and sleep.

4) Get your brain ready for bed. Establish an estimated ‘bedtime’ around when you usually feel sleepy (about 7-8 hours before your established ‘wake time’).  Try to resolve all your errands and nagging worries before that time, and then forget about them; those 8 hours are your time to be relaxed.  Plan a specific bedtime prep routine of things you always do before bed: for example a bath or shower, brushing your teeth, putting on pyjamas, or a bit of reading — these routine activities will become more ‘unconscious mental cues’ to prepare your brain for sleep.  Avoid your screens (TV, laptop, etc) before bedtime.  Use relaxation techniques — like prayer, mindful meditation, guided meditation, light massage or stretching — to start to lull your brain to sleep.

5) Tuck yourself in and drift off to sleep. Go to bed only when you feel sleepy (don’t ‘force yourself’ to go to bed).  If you’re still awake after 20 minutes, leave the bedroom, perform some restful activity (such as reading or bathing or meditation), and only return to your bed when sleepy, repeating this process if necessary.

6) Up and at ‘em! Try to get up at the same established ‘wake time’ every morning regardless of the amount of sleep during the night.  This may seem difficult — ‘what if I’ve barely slept??!‘– but staying in bed later or taking long daytime naps if you haven’t slept much at night may end up altering your brain’s sleep-wake cycle and worsening your sleep troubles.  Don’t stress about how much you’ve slept: fretting about the exact amount of time you sleep will only make you more anxious and stressed and rob you of more sleep.  Your body will cope, so just keep following the other steps to improve your sleep hygiene and you will eventually be able to feel tired and fall asleep at the appropriate time.

I hope this information is helpful to you all — try and follow these steps as best you can to maintain a healthy sleep pattern!  And remember that severe insomnia, especially associated with the other symptoms I mentioned above, may be due to conditions requiring evaluation and treatment by your doctor.

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