By Bill Bowerfind, M.D., The Oregon Clinic-Pulmonary Critical Care and Sleep Medicine Division, Gateway Medical Office
Can you remember how good it feels to get a good night's sleep? Your mind is clear, your thoughts are positive and your body is raring to go. Deep, restorative sleep benefits every part of your body, from your immune system to your metabolism to your energy level and cognitive function. You can feel it immediately upon awakening. It's heavenly.
If your sleep has been less than heavenly lately, you're probably feeling the effects: grogginess, grumpiness, sluggishness. It's tempting to run to the drugstore for help, but hold off. Sleep aids may be way overrated, doing little to increase sleep while causing significant daytime side effects. For better sleep without the side effects, examine your own sleep habits. There may be a few habits you've picked up – or let slide – that are responsible for your restless nights.
The 12 tenets of peaceful sleep
- Ensure that you are getting enough sleep. Voluntary sleep deprivation is the most common cause of daytime sleepiness. We all tend to shortchange our hours of sleep to get more work done, watch more TV, etc. Make sleep a bigger priority and give it the respect it needs. Although some can get away with less, most people need seven or eight hours of sleep per night to get all the benefits of good sleep.
- Reserve the bedroom for sleep and intimacy only. Other activities, such as watching TV, reading, planning, having conversations and eating should be reserved for other rooms. Your brain needs to know that this is the room where you sleep.
- Along with No. 2 above, ban all television sets, computers and smart phones from the bedroom. Their lights and sounds are disruptive on so many obvious levels, but here's one side effect you might not know about: The bright light emitted from their screens can suppress melatonin, a hormone that's normally released during periods of darkness to help us stay asleep.
- The American Academy of Sleep Medicine suggests that you think of your bedroom as a cave: a place that should be cool, quiet and dark. Most people need a drop in body temperature to prepare for sleep, and a cool room helps with that. But your room shouldn't be so cold – or warm – that you are too uncomfortable to sleep. Fiddle with the thermostat until you find the sleep temperature that works best for you.
- Set a regular bedtime and wake time, and stick with that schedule consistently – even on weekends.
- If you find that you are lying awake for what seems like more than 15 or 20 minutes, get out of bed and engage in some form of relaxing activity, such as reading, outside of the bedroom – nothing too stimulating – and then return to bed when you feel drowsy.
- Expose yourself to bright light first thing upon awakening. That stimulates the time sensors in your brain to establish that wake time. If it's still dark or gray out when you get up, consider investing in a full-spectrum therapeutic light box (10,000 lux is recommended). Follow the instructions on the package – you don't have to look right into the light. Sitting in front of the light for 30 minutes while you eat your breakfast or read the news can help you feel more awake. Light therapy also helps reduce the symptoms of a form of winter depression known as seasonal affective disorder.
- Avoid napping, particularly in the late afternoon and evening. Any napping during the day will detract from deep, consolidated, prolonged sleep at night. If you slept poorly the night before – and we all do, every once in a while – don't make up the hours with a nap the next day. It'll only detract from your sleep the next night, and could start a cycle of daytime napping and nighttime sleeplessness. Instead, try to power on through the day, knowing that the next night's sleep will be that much better.
- Avoid caffeine after noon – or earlier for some, depending on your bedtime. Caffeine has a half-life of 4 to 6 hours, which means that it takes that long to eliminate half of it from your body. A little in the morning, when you get up, shouldn't bother you by bedtime. But drinking caffeine after noon could cause sleep problems.
- Avoid tobacco. Like caffeine, nicotine is a stimulant that can interrupt sleep. Many smokers light up before bed and have trouble getting to sleep, or wake up in the middle of the night to smoke and then have trouble falling back to sleep. For deep, restful sleep, avoiding tobacco altogether is your best bet. Struggling to quit? We can help.
- Limit alcohol to no more than one to two drinks, and avoid it completely within three hours of bedtime. Some people think that alcohol helps them sleep, but the opposite is true. It may help you nod off more quickly, but it impairs sleep during the second half of the night, resulting in less restorative sleep and reduced sleep time overall.
- Avoid large meals and excessive fluids within three hours of bedtime. Overeating too close to bedtime can cause digestive issues that disturb sleep, and the more you drink before bedtime, the more often you'll wake up needing to use the bathroom.
Follow these tenets faithfully for a few weeks and see if your sleep gets better. If it doesn't – if you are still restless at night, suffering from insomnia or awakening with excessive daytime sleepiness – talk with your doctor before you reach for sleep aids. You could have a treatable sleep disorder or another medical problem that is causing your sleep issues. It's also possible that medication interactions are contributing to your daytime drowsiness or nighttime stimulation. Sometimes changing medications, or the timing of when you take them, can make all the difference.
Whatever you do, don't let it slide. Restorative sleep is important to every aspect of your mental and physical functioning. Work with your doctor to get back to the peaceful, heavenly sleep that you need and deserve.