Sleep is critical to good health and our sense of well-being—yet, its importance is often overlooked. Why is it overlooked? Is it because in the course of a stressful life, we are always trying to look for a bit more time? Do we consider being able to “get by” on limited sleep is a sign of strength? Do we think we can “get by” with a limited amount of sleep without accumulating a cost? Do we sense that we have little control over how much and how well we sleep?
Unfortunately, these perceptions are wrong! Sleep deprivation has a clear and definite impact on our health and well-being. Sleep deprivation has a negative impact on concentration, mood, personality and judgment. It can also increase our risk for medical conditions such diabetes, high blood pressure and vascular disease. Furthermore, the effects will accumulate over time. As the days and weeks and months go by, the impact will continue to increase. Many times sleep deprived individuals themselves are not aware of the full impact.
Fortunately, we do have the ability to take control of many of these factors. There are four steps to good sleep health:
- Acknowledgement of the importance of sleep to good health and sense of well-being. Planning to set aside the amount of time is critical.
- Awareness of the importance of timing. We all have an internal clock that allows us to sleep more easily at certain times of the day and may dictate likely times of increased sleepiness if we are sleep deprived. A regular routine will strengthen this pattern and other techniques can be used to shift this timing when necessary.
- Establishing the appropriate sleep environment is important. Usually, this means that is important to have quiet, comfortable sleep area that is free of distractions and removed from the stressors of the day.
- Finally, the transition from wake to sleep requires you to relax. For many, this may be challenging. Fortunately, many techniques are available, and can match an individual’s preference. Routine exercise and avoidance of caffeine, especially, late in the day may also prove to be helpful.
Of course, certain medical conditions, medications and, even specific sleep disorders (Sleep Disordered Breathing, Restless Legs Syndrome, etc.) may also contribute to problems with sleep. Sleep may be shortened or fragmented, but it may simply become inefficient. At times, medications may be appropriate. In these situations consultation with your primary care physician and, possibly, a sleep specialist may be appropriate.
- Do you feel refreshed upon awakening in the morning?
- Do you have difficulty falling asleep?
- Do you have difficulties waking up in the middle of the night and finding that you are unable to fall back to sleep?
- Do you feel that you sleep an adequate amount of time, but find that you are still tired/sleepy through the day?
- Do you find that you tend to doze at inappropriate times (driving, work, etc.)?
- Do you find that you need to sleep longer hours than your friends and peers?
- Have you ever dozed while driving a car?
- Do you frequently fall asleep/doze in social situations such as the movies, concerts, family gatherings, etc.?
- Do you find that you wake up earlier than necessary, but then feel tired during the day?
- Is there something about your sleep pattern that is disruptive to others? Do you snore excessively, kick or thrash excessively or yell/scream during the night?
If you answered yes to two or more of these questions, you should consider talking to your primary care doctor about whether you may have a medical sleep disorder.
The most important sleep hygiene measure is to maintain a regular sleep and wake pattern seven days a week. It is also important to spend an appropriate amount of time in bed, not too little, or too excessive. This may vary by individual; for example, if someone has a problem with daytime sleepiness, they should spend a minimum of eight hours in bed, if they have difficulty sleeping at night, they should limit themselves to seven hours in bed in order to keep the sleep pattern consolidated. In addition, good sleep hygiene practices include:
- Avoid napping during the day; it can disturb the normal pattern of sleep and wakefulness.
- Avoid stimulants such as caffeine, nicotine, and alcohol too close to bedtime. While alcohol is well known to speed the onset of sleep, it disrupts sleep in the second half as the body begins to metabolize the alcohol, causing arousal.
- Exercise can promote good sleep. Vigorous exercise should be taken in the morning or late afternoon. A relaxing exercise, like yoga, can be done before bed to help initiate a restful night’s sleep.
- Food can be disruptive right before sleep; stay away from large meals close to bedtime. Also dietary changes can cause sleep problems, if someone is struggling with a sleep problem, it’s not a good time to start experimenting with spicy dishes. And, remember, chocolate has caffeine.
- Ensure adequate exposure to natural light. This is particularly important for older people who may not venture outside as frequently as children and adults. Light exposure helps maintain a healthy sleep-wake cycle.
- Establish a regular relaxing bedtime routine. Try to avoid emotionally upsetting conversations and activities before trying to go to sleep. Don’t dwell on, or bring your problems to bed.
- Associate your bed with sleep. It’s not a good idea to use your bed to watch TV, listen to the radio, or read.
- Make sure that the sleep environment is pleasant and relaxing. The bed should be comfortable, the room should not be too hot or cold, or too bright.