Sleep Medicine

Sleep Hygiene

Sleep hygiene is a term that we use to describe all of the different habits, behaviors, and schedules that promote a good night of sleep.

How Much Sleep Do I Need? Each individual has different sleep requirements. As a rule adolescents do best with 9 hours and 15 minutes of sleep. Adults do best with 6 or more hours of sleep. Most seem to benefit from 7 or more hours of sleep. Getting less than 6 hours of sleep can lead to problems with alertness, concentration, and mood.

It is best to sleep no longer than what is required to feel refreshed and alert. Spending extra time in bed tends to make sleep lighter, more broken up, and may lead to insomnia.

Bedroom Environment: Keep your bedroom quiet and dark for sleep. A steady background noise like a fan, a humidifier, a dehumidifier, or a recording of moving water may be helpful. If your home is in an area where there is outside noise that you cannot control, earplugs, white noise, or even noise canceling headphones might be needed.

It is not a good idea to play the radio and especially not a good idea to have the television on in the bedroom. Use of a night-light is fine.

In general, eating and drinking before sleep should be avoided. If you tend to wake in the middle of the night hungry, then a light snack before bedtime is appropriate. Once your sleep time begins it is not appropriate to drink anything other than water when you wake. Anything other than water sends a signal to your body that it is breakfast time and many complex digestive processes are initiated that could disrupt your sleep. Eating before bedtime may promote gastroesophageal reflux or heartburn.

Caffeine, Tobacco, & Alcohol: Caffeine is a stimulant and can be found in coffee, tea, colas, chocolate cocoa, and even some prescription and nonprescription medications. Heavy use of caffeine throughout the day or caffeine consumed in the hours before bedtime can make it difficult to fall asleep and stay asleep at night. It also has the potential to worsen restless legs. If you have difficulty sleeping at night, caffeine should be limited to no more than two beverages during the daytime and none after 1:00 p.m.

Nicotine is also a stimulant that interferes with our ability to sleep. Smoking in the late evening hours or during nighttime awakenings can make it more difficult to fall asleep or return to sleep and the sleep that is obtained may be lighter and more fragmented.

Alcohol causes slowing or depression of brain activity. When consumed in moderation before bedtime this may make it easier to fall asleep. Negative aspects of alcohol consumption include worsening of snoring and sleep apnea. In individuals with obstructive sleep apnea alcohol consumption before bedtime may even be dangerous because it can make apnea episodes longer and drops in blood oxygen levels deeper.

Although alcohol may help us fall asleep initially, it often makes sleep in the latter half of the night more broken up and may also promote vivid or troubling dreams. Sometimes it can cause morning headaches.

Exercise: Exercise can be particularly helpful in helping us fall asleep and enjoy a deeper sleep. Morning exercise tends to have little effect on sleep. Exercise within a few hours of bedtime can even make it more difficult to fall asleep or stay asleep. The best time to exercise to enhance our sleep tends to be in the mid to late afternoon hours.

Sleep Schedule: It is best to maintain a regular sleep schedule from day to day and between weekdays and weekends. We all have a pacemaker in our brain that controls our circadian rhythm. The circadian rhythm is the pattern that recurs about every 24 hours that controls almost all of our bodily functions. These are carefully timed during the day and night at appropriate intervals for our usual schedule. The circadian rhythm can only shift 60 to 90 minutes from one day to the next. As a result if we change our bedtime or wake up time by more than 2 hours from one day to the next we suffer from the equivalent of jet lag without ever having left home.

One of the best habits for good sleep is a regular wake up time. You may be tempted to make up for missed sleep by sleeping in longer – but this can throw off your body clock, setting you up for insomnia. If you get behind on sleep and have a day off from work or school, it acceptable to sleep in up to 1 hour later in the morning. Just make sure that you become active as soon as you awaken. If you are still sleepy, then a short nap of 30 minutes or less after lunch is helpful. If you are still tired, then go to bed slightly earlier than usual.

Stress, worry, and anxiety can have a negative effect on your sleep. If you feel anxious or tense, it is important to take some time to relax before going to bed and trying to sleep. Pursuing a quiet activity like reading, a craft, or watching television may be helpful. Biofeedback and other relaxation techniques can often be useful as well. It is good to plan for some quiet time before sleeping at night. If you have lots on your mind it is also a good idea to write down the things that are bothering you or make a list of the things that must be done the next day, so that you will be less likely to run through these things during the night trying to recall them.

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