Sleep Hygiene

Sleep Hygiene – Tips for getting a good nights sleep

In this modern age of late night TV and smart phones by the bed, getting a good nights sleep has become somewhat of a struggle. Throw in any kind of health problem and restful sleep becomes almost impossible. ‘Painsomnia’ (insomnia caused by pain) can cause particular problems.  This post will explain the basic principles of Sleep Hygiene, tips and tricks for maximizing the quality and quantity of your sleep.

Sleep Environment

In order to promote good quality sleep it’s important that you have the right environment. The place where you sleep should be used just for that. If at all possible avoid doing anything in bed besides sleep (and any intimate bed based activities that aren’t right for the family living room) (Hakim et al., 2017). If you need a rest day try to make it as far as the sofa. To promote sleep, your brain and body need to associate the bed environment with going to sleep, not Netflix, e-books or you favourite radio station (Hakim et al., 2017).

It’s also important that your bedroom is a positive and relaxing environment, you need to feel comfortable there both physically and mentally/emotionally(Hakim et al., 2017). Think about pillows, sheets and support but also consider colour schemes, smells and decorations. The temperature of the room is also important, especially for people who have difficulties regulating their temperature. Excessively warm rooms can disrupt sleep (Stepanski and Wyatt, 2003).

If you have issues with pain and getting comfortable try popping into shops and trying different pillows. Often having a pillow between or under your knees can ease back pain and keep your legs in good alignment.

Creating a Routine

The first step is to create a sleep pattern. To get your body into a routine try to go to sleep at roughly the same time every night. It’s also important to wake up at roughly the same time even if you’ve slept poorly (Stepanski and Wyatt, 2003). As part of getting to sleep it can help to create a pre-sleep routine(Hakim et al., 2017). This can include simple things like having a bath, applying the same scented moisturiser and brushing your hair. Try to stick to things in the same order every night.

Your night-time routine should be relaxing, try to think positive and avoid dwelling on negative experiences and thoughts. Relaxation activites like reading, listening to music, meditation and breathing exercises can help(Hakim et al., 2017).

Avoid Napping

This one can be really difficult especially for people living with chronic fatigue, if possible try not to nap after about 3pm. If you absolutely have to have naps it might mean you’re simply using too much energy, if this is the case pacing can help you conserve energy.  Having naps too late in the day can make falling asleep at night even harder and lead to reversal of you sleep-wake cycle as well as daytime sleepieness (Hakim et al., 2017).

Diet and consumables

Try to avoid stimulants like caffeine and nicotine late in the evenings as they can keep you awake (Hakim et al., 2017). Make sure you check the ingredients of you favourite snacks, caffeine isn’t just in tea and coffee it’s in all sorts of things like chocolate!

Big meals close to bed time should also be avoided (Hakim et al., 2017). Try to avoid any stimulating foods like spicy things. If you are struggling with sleep try to avoid making big dietary changes of any kind.

Try to avoid alcohol, a lot of people think a tipple will help them get to sleep and it’s true.. alcohol does help you get to sleep faster but in the long run (after the first falling sleep phase) alcohol actually disrupts sleep(Stepanski and Wyatt, 2003). You may fall asleep but there’s no guarantee you’ll stay asleep or get a good quality of sleep.

If you do feel the need for a late night snack or drink there are some foods that can actually promote sleep. There is anecdotal evidence that food and drinks high in Tryptophan can help you sleep. Milk, turkey and lettuce are all tryptophan rich.. the evidence is spotty.. it might be a case of ‘warm milk before bed’ actually just being part of a set bedtime routine(Stepanski and Wyatt, 2003).

Exercise

High intensity exercise, energetic things that get your blood pumping can really help promote wakefulness during the day (Hakim et al., 2017). Relaxing activities like yoga can help sooth and relax you.

Try something energetic in the morning and something relaxing late evening.

Light Exposure

Our bodies take cue’s from daylight to help regulate our sleep/wake cycle. During the day being exposed to daylight helps to promote wakefulness(Hakim et al., 2017). When it gets dark in the evenings our bodies take it as a sign to sleep.

In order to really emphasis this sleep/wake cycle try to get direct sunlight during the day and avoid too much light during the evenings. Many of the light waves from tablets and smart phones are similar to those from daylight, using your phone at night can trick your body into thinking it’s still daytime. Watching TV in bed or late in the evenings has a negatve impact on sleep(Mindell et al., 2009).

If you are a regular user of tech in the evenings try looking into screen tinting apps. Apps like f.lux (f.lux, n.d.) tint the screen of your devices a warm orange to stop them interfering with your sleep/wake cycle (Tenax Performance, 2016). Although these apps can help the best approach is simply to avoid smart phones and tablets for about 90 minutes before sleep (Tenax Performance, 2016).

For people with serious sleep problems there is some evidence that wearing orange tinted glasses at night can stop artificial lighting from interfering with your sleep (Tenax Performance, 2016) (Mercola.com, n.d.).

Avoid ‘clock watching’

Once you’ve got yourself into bed and you’re struggling to sleep, watching the clock is guaranteed to keep you awake. Seeing how little time is left before your alarm goes off will increase your anxiety and annoyance that you’re still awake. If you need to have a clock in your room face it away from you as you’re laying in bed (Stepanski and Wyatt, 2003).

Take a break

If you’re laying in bed for a LONG time worrying about being awake sometimes it’s better to get up and try again later (Stepanski and Wyatt, 2003). You can’t force sleep, worrying about not-sleeping will keep you awake. Get up, do something relaxing for a few minutes then go through your bedtime routine and try again (Stepanski and Wyatt, 2003).

Supplements and Medications

The market is flooded with suppliments aimed at promoting sleep. Lavender is often used to promote sleep and reduce pain so it’s perfect for painsomnia(OʼMalley, 2017). Supplimenting magnesium also seems to help improve sleep quality (Abbasi et al., 2012).

If you’re doing all the right things and you’re still not managing to sleep it’s time to speak to your Doctor. Supplements like Melatonin can be used to top up your natural hormone levels and promote sleep, this is especially effective for shift workers.

If painsomnia is your problem then antidepressant medications like Amitriptyline can be very effective in promoting good quality sleep(Choy, 2016). Other medications including benzodiazepines, beta blockers, muscle relaxants, and eszopiclone can help too (Hakim et al., 2017). Speak to your GP or primary healthcare provider about these.


Hopefully these tips will help you get a decent nights sleep, if you’ve got any other suggestions I’d love to hear them!

If you’re struggling to impliment these tips or want to learn more then check out my Sleep Hygiene e-Clinic!

As always questions, comments and shares are welcome.

JBOT

Reference List

Abbasi, B., Kimiagar, M., Sadeghniiat, K., Shirazi, M., Hedayati, M., Rashidkhani, B. (2012) The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences. 17(12), 1161–9. [PubMed]
Choy, E.H. (2016) Current treatments to counter sleep dysfunction as a pathogenic stimulus of fibromyalgia. Pain Management. 6(4), 339–346. [Source]
f.lux, . f.lux. justgetflux. [online]. Available from: https://justgetflux.com/ [Accessed March 27, 2017].
Hakim, A., De Wandele, I., O’Callaghan, C., Pocinki, A., Rowe, P. (2017) Chronic fatigue in Ehlers-Danlos syndrome-Hypermobile type. American Journal of Medical Genetics Part C: Seminars in Medical Genetics. 175(1), 175–180. [Source]
Mercola.com, . Benefits of Blue Light-Blocking Glasses. Mercola.com. [online]. Available from: http://articles.mercola.com/sites/articles/archive/2016/08/11/blue-light-blocking-glasses.aspx [Accessed March 27, 2017].
Mindell, J.A., Meltzer, L.J., Carskadon, M.A., Chervin, R.D. (2009) Developmental aspects of sleep hygiene: Findings from the 2004 National Sleep Foundation Sleep in America Poll. Sleep Medicine. 10(7), 771–779. [Source]
OʼMalley, P. (2017) Lavender for Sleep, Rest, and Pain: Evidence for Practice and Research. Clinical nurse specialist CNS. 31(2), 74–76. [PubMed]
Stepanski, E.J., Wyatt, J.K. (2003) Use of sleep hygiene in the treatment of insomnia. Sleep Medicine Reviews. 7(3), 215–225. [Source]
Tenax Performance, . (2016) Think of sleep as training too. TenaxPerformace. [online]. Available from: https://www.tenaxperformance.com/2016/06/08/think-of-sleep-as-training-too/ [Accessed March 27, 2017].
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