Earlier in this thread, I witnessed Fable and CE agreeing with each other. I found this terrifying and thus I now have insomnia.
Therefore, I thought I would post a handout I often give my patients on how to get a good night's sleep.
Sleep Hygiene
According to the National Institutes of Health, approximately 40 million Americans suffer from chronic, long-term sleep disorders each year, and an additional 20 million experience occasional sleeping problems. Insomnia tends to increase with age and affects about 40 percent of women and 30 percent of men. Since sleep is as critical a component of health as diet, it is important to learn healthy sleep habits or what is called good “Sleep Hygiene.”
Listen to your body
· Your body pays attention to certain signals that help it establish when to sleep and when to wake up. For example, your body keys into a drop in your body temperature as a signal that it is time to sleep. For this reason, hot showers, hot tubbing, or vigorous exercise is not recommended within 3 hours of bedtime. For people that have body temperature issues, you can try taking a hot bath 90 minutes before bed to raise your body temperature, which will lead to an eventual drop in body temperature that may leave you feeling sleepy. Alternately, if you have a zone-type heating/cooling system in your house, set it to maintain a cool temperature in your bedroom. Since your body temperature needs to fall in order for you to sleep, it is important that your room not be too hot or that the number of bed coverings do not make you feel overheated.
· Your brain produces a chemical called melatonin that helps to regulate sleep. Melatonin is sensitive to light levels, so keeping room lights low before bed can be helpful. Some sources recommend not having a bright clock or clock radio close to your face when sleeping. Others suggest turning off the TV or computer 1 hour before bed, both because of the light and because these devices tend to energize the mind, making your body more alert at a time you want to be drowsy. On the other hand, it is useful to expose yourself to at least 15 minutes of daylight or full-spectrum light at the start of the day, which will make you feel more alert.
Work with your natural rhythms
· Given that your body has certain cues that help it know when to sleep and when to wake up, it is important to develop sleep rituals that work with these. Choose a bedtime and rising time that fit with your lifestyle and schedule. It is particularly important to get up close to the same time each day, since this is a basic way your body sets its “inner clock.” If you are having sleep problems, try to rise at the same time each day no matter how poorly you have slept or whether it is your day off.
Create a superior sleep environment
· It is important to make your bedroom as dark, comfortable, and quiet as possible. Your bed, sheets, and pillows should all have the feel, firmness, and weight that is right for you. The look and color of your bedroom (e.g. inviting vs chaotic) can also be an important component. Make sure your blinds or drapes are sufficient to block out early morning sun, since light can disrupt melatonin levels and wake you prematurely.
· If noise is a problem, consider purchasing a “sound machine” that generates natural sounds from sources such as rain, ocean, streams, etc. A monotonous “white” noise generator like a fan can also work in this regard. This can help block out unpleasant external noise as well as internal noise, as is the case with people who have tinnitus or “ringing in the ears.” In extreme situations, like a partner who snores loudly or who coughs through the night, you may need to consider other sleeping arrangements, at least temporarily.
Sleep Behaviors
· If possible, sleep only when you are sleepy, since this reduces the time you lie awake (and often irritated) in bed. If you can't fall asleep within 20 minutes, get up and do a quiet activity such as reading until you are sleepy. Try not to expose yourself to bright light while you are up.
· Try to avoid napping. If you must nap, the ideal time for a nap is for a period of 15 to 30 minutes before 3pm. This will help ensure you do not disrupt your night-time sleep.
· Only use your bed for sleeping and sex. This helps to condition your body to sleep once you lay down in bed. Refrain from using your bed to watch TV, pay bills, do work, or even read.
· Consider establishing a before-bed routine, which can include meditation, prayer, relaxation, gentle yoga stretches, or some other relaxing activity. It is not necessarily the case that simply going unconscious will assure you of restful, quality sleep.
· Your body needs the bulk of its fluid intake in the morning and early afternoon. Trying to make up your fluid intake in the evening is counterproductive and having to get up at night to use the bathroom interferes with your sleep. Even if you go right back to sleep, your sleep cycle has already been disrupted. Experiment with reducing your fluid intake to a minimum after dinner to see if this improves the quality of your sleep.
Medical Issues
· Sleeping medications are the course of last resort. In many cases, the side effects and poor quality sleep that can result from some medications create more problems than they solve. If you need to take sleeping medications, intend to take them for as short a period as possible.
· Regular exercise is recommended to help you sleep well, but the timing of the workout is important. Exercising in the morning or early afternoon will not interfere with sleep. Refrain from exercise at least 3 hours before bedtime.
· Stay away from caffeine, nicotine and alcohol at least 4-6 hours before bed. Caffeine and nicotine are stimulants that interfere with your ability to fall asleep. Coffee, tea, cola, cocoa, chocolate and some prescription and non-prescription drugs contain caffeine. Cigarettes and some drugs contain nicotine. Alcohol may seem to help you sleep in the beginning as it slows brain activity, but you may end up having fragmented sleep.
· People with blood sugar issues may benefit from having a light snack before bed. If your blood sugar bottoms out during the night, it can interfere with sleep. A combination of protein and complex carbohydrates, such as peanut butter or turkey on whole wheat crackers or apple slices, is the best snack. Turkey contains tryptophan, which acts as a natural sleep inducer. Tryptophan is probably why a warm glass of milk is sometimes recommended by conventional practitioners, but given the number of people with dairy intolerances this is not something we typically recommend.
· If there are medical issues that are keeping you from sleeping, talk to your health care practitioner about it. Issues like pain or menopausal symptoms can often be managed if a comprehensive program is put into place that focuses on maximizing your quality and quantity of sleep.