Sleep is critical in the well being of all animals, such that animals deprived entirely of sleep lose immune function and die in just a matter of weeks. Further, many of the major restorative functions in the body like muscle growth, tissue repair, protein synthesis, and growth hormone release occur mostly, or in some cases only, during sleep. The National Highway Traffic Safety Administration conservatively estimates 100,000 police-reported crashes are the direct result of driver fatigue each year. The Institute of Medicine estimates that drowsy driving is responsible for fully 20 percent of all motor vehicle crashes. That would mean that drowsy driving causes approximately 1 million crashes, 500,000 injuries, and 8,000 deaths each year in the U.S. Lack of sleep exacts a toll on perception and judgment. In the workplace, its effects can be seen in reduced efficiency and productivity, errors, and accidents. Just one week of sleeping fewer than six hours a night resulted in changes to more than 700 genes, and even one night of sleep deprivation is linked with brain tissue loss.
Sleep hygiene’ is the term used to describe good sleep habits. Sleep hygiene guidelines are designed to enhance good sleeping, and provide long-term solutions to sleep difficulties, without the use of medications. Medications used to treat insomnia tend to be effective in the short-term. Ongoing use of sleeping pills may lead to dependence and interfere with developing good sleep habits, prolonging sleep difficulties. Most sleep medications simply make the patient amnestic to their poor sleep, and do not result in restful or restorative sleep. Restorative sleep is essential in hormone production, stress control, cardiometabolic health and treatment of obesity.
Sleep Hygiene Tips
- Have a bedtime. One of the best ways to train your body to sleep well is to go to bed and get up at more or less the same time every day, even on weekends and days off! This regular rhythm will make you feel better and will give your body something to work from.
- Sleep when sleepy. Only try to sleep when you actually feel tired or sleepy, rather than spending too much time awake in bed. Do not nap outside the sleep time.
- Get up & try again. If you haven’t been able to get to sleep after about 20 minutes or more, get up and do something calming or boring until you feel sleepy, then return to bed and try again. Sit quietly on the couch with the lights off (bright light will tell your brain that it is time to wake up), or read something boring like the phone book. Avoid doing anything that is too stimulating or interesting, as this will wake you up even more. Don’t turn on the television, get on the phone or computer, or listen to the radio.
- Avoid caffeine & nicotine. It is best to avoid consuming any caffeine (in coffee, tea, cola drinks, chocolate, and some medications) or nicotine (cigarettes) for at least 4-6 hours before going to bed. These substances act as stimulants and interfere with the ability to fall asleep. Do not exercise 3 hours before bedtime.
- Avoid alcohol. It is also best to avoid alcohol for at least 4-6 hours before going to bed. Many people believe that alcohol is relaxing and helps them to get to sleep at first, but it actually interrupts the quality of sleep.
- The bed is for sleeping. Try not to use your bed for anything other than sleeping and sex, so that your body comes to associate bed with sleep. If you use bed as a place to watch TV, eat, read, work on your laptop, pay bills, and other things, your body will not learn this connection.
- No naps. It is best to avoid taking naps during the day, to make sure that you are tired at bedtime. If you can’t make it through the day without a nap, make sure it is for less than an hour and before 3pm.
- Sleep rituals. You can develop your own rituals of things to remind your body that it is time to sleep – some people find it useful to do relaxing stretches or breathing exercises for 15 minutes before bed each night, or sit calmly with a cup of caffeine-free tea.
- Having a hot bath 1-2 hours before bedtime can be useful, as it will raise your body temperature, causing you to feel sleepy as your body temperature drops again. Research shows that sleepiness is associated with a drop in body temperature.
- No clock-watching. Many people who struggle with sleep tend to watch the clock too much. Frequently checking the clock during the night can wake you up (especially if you turn on the light to read the time) and reinforces negative thoughts such as “Oh no, look how late it is, I’ll never get to sleep” or “it’s so early, I have only slept for 5 hours, this is terrible. ”
- Use a sleep diary. This worksheet can be a useful way of making sure you have the right facts about your sleep, rather than making assumptions. Because a diary involves watching the clock (see point 10) it is a good idea to only use it for two weeks to get an idea of what is going and then perhaps two months down the track to see how you are progressing. The point of the sleep diary is NOT to create a log of complaints to share.
- Regular exercise is a good idea to help with good sleep, but try not to do strenuous exercise in the 3 hours before bedtime. Morning walks are a great way to start the day feeling refreshed!
- Eat right. A healthy, balanced diet will help you to sleep well, but timing is important. Some people find that a very empty stomach at bedtime is distracting, so it can be useful to have a light snack, but a heavy meal soon before bed can also interrupt sleep. Some people recommend a warm glass of milk, which contains tryptophan, which acts as a natural sleep inducer.
- The right space. It is very important that your bed and bedroom are quiet and comfortable for sleeping. A cooler room with enough blankets to stay warm is best, and make sure you have curtains or an eyemask to block out early morning light and earplugs if there is noise outside your room. Background noise or white noise improves the ambiance and will reduce wake cycles.
- Keep daytime routine the same. Even if you have a bad night sleep and are tired, it is important that you try to keep your daytime activities the same as you had planned. That is, don’t avoid activities because you feel tired. This can reinforce the insomnia.
- Get regular exposure to outdoor or bright lights, especially in the late afternoon. Use blackout curtains in the bedroom to eliminate light in the bedroom during bedtime. Turn off or cover all sources of light in the bedroom.
- Don’t take another person’s sleeping pills or over-the-counter pills. Taking over-the-counter sleeping pills causes rapid development of tolerance. Diphenhydramine (an ingredient commonly found in over-the-counter sleep meds) can have serious side effects for elderly patients.
- Designate another time to write down problems & possible solutions in the late afternoon or early evening, not close to bedtime. Do not dwell on any one thought or idea—merely jot something down and put the idea aside.