A Better Night’s Sleep
Last time we talked about the effects of artificial light on restorative sleep and ways to mitigate them short of going completely off grid. Today we’ll address all of the other things you can do to improve sleep quality.
First off - why is this so important?
Aside from the obvious fact that a bad night’s sleep can make you less than pleasant to be around, chronically poor sleep also increases your risk of a variety of serious health issues. Bad sleep leads to increased cortisol and chronic stress signals to your body, which increases your risk for high blood pressure, heart disease, diabetes and insulin resistance, and lead to overeating and weight gain.
Bottom line is that it is a big stress on your body, and while sleep medication can help a little, the best thing for sleep issues is behavior change. There is even a special therapy for sleep called CBT-i (Cognitive Behavioral Therapy for insomnia) and it has better long term results than any sleep medication out there (even the one with the side effect that can lead to sleep-driving!). If you have wonderful sleep hygiene and you still are struggling with sleep then CBT-i may be the next step. There are also CBT-i apps that can help, especially since it can be difficult or cost prohibitive to find a real live therapist that offers CBT-i.
So what goes into wonderful sleep hygiene?
Screen avoidance (and artificial light in general) after sundown or at least for 1-2 hours before bed. For more on this topic see THIS POST
Avoid caffeine after 2 PM. If you are particularly sensitive to caffeine you may need to cut yourself off after your morning cup of coffee.
Along the same lines, avoid alcohol 3-4 hours before bed. I know this runs into dinner time for most people, which tends to be the most socially accepted time for drinking, but alcohol at night disrupts your restorative sleep. You might sleep all night after a couple of drinks, but you will have a higher proportion of light sleep and less deep sleep. You can wake up after 9+ hours in bed and still feel tired.
Maintain regular sleep/wake hours - even on the weekends. This means aim for bedtime and wake up time to be roughly the same time EVERY DAY. The average adult needs around 7 hours of sleep a night. So decide when you are going to wake up each day and then work backwards from there to determine at what time you need to be asleep each night. Give yourself 15-30 minutes of buffer time to fall asleep and then stick to that routine. Every day. No matter what.
Keep naps short. If you are tired a 20-30 minute power nap is ok, but a 3 hour nap in the afternoon will ruin bedtime. For more on why that is bad, see above.
Make sure to spend some time outside in the sunshine every day. Morning sun within 30-60 minutes of waking is even better as it helps set your body’s internal clock.
Move your body every day. Many people feel wired if they exercise right before bed, so make sure you time this appropriately for yourself. My husband has discovered he can do some strength based exercises before bed but for some reason stretching and yoga make him wired. Find what works for you but get some movement in every day.
Give yourself a bedtime routine. We do it instinctively with little children. Even when they are wound up and exhausted and running circles around the house while standing on their heads we know that trying for bedtime without the bedtime story first is futile. As with so many other things in life, we think we outgrow this need as adults, but that’s not really the case. Now, your bedtime routine doesn’t have to involve 3 books, a snack, prayers, 2 songs, and watching mom sit outside your room for 20 minutes (I see you fellow mamas), but you do need something. Even a simple nighttime routine will give your body the hint that it’s time to start winding down. I have a cup of Red Zinger tea every night before bed. I bring my tea with me when I am on call overnight at the hospital and when I go on vacation, because if I forget to, I don’t sleep as well.
Your bed is not for hanging out. Reading in bed as part of your nightly routine is ok. But no doom scrolling in bed. Your bed is for sleep and sex - that’s it. If you can’t fall asleep within 20 minutes of lying down at night or if you wake up in the middle of the night and aren’t falling back to sleep within 20 minutes then get out of bed and do something calm in low light/darkness. Once you are feeling tired again, then you can get back into bed and go to sleep.
Make your bedroom conducive to healthy sleep. This means a dark, quiet room at the proper temperature (generally 60-70 degrees Fahrenheit). Invest in room darkening shades if you don’t already have them, especially if you live at higher latitudes where the sun rises at 4 am in the summer. We are lucky enough to have a weekly milk delivery where we live but our milk person’s boots on our porch and the clanking of milk bottles in the cooler were waking me up like clockwork every Friday at 2am. We moved the cooler off the porch and now I can sleep through our weekly delivery.
But what if I had a really bad night and only slept 2 hours and I’m exhausted?
In this case, aim for an afternoon power nap and then go to bed early. When we miss out on sleep you start accruing sleep debt. You can’t cheat your body out of the sleep it needs. Once you miss out on sleep you have to make it up somewhere in order to reach neutral again. After a night of really bad sleep you still need to wake up at the same time in the morning. Maybe sneak in an extra cup of coffee (avoid the energy drinks with that chemical afterburn please!) and aim for a short nap if you’re dragging after lunch. When you start to feel tired in the evening go ahead and go to sleep. The next morning, make sure you wake up at the same time you do every day. It might take a few nights to completely pay back all your sleep debt and you might actually start to feel more tired as all the adrenaline and cortisol start to regulate themselves, but stick to the plan and it will eventually get better.
So there is your homework. Good sleep hygiene can be a lot of work but your family and friends will thank you for not being a sleep deprived grouch.
Next post we will talk about when to seek medical care for sleep related conditions.
