MAXIMIZING THE QUALITY OF YOUR SLEEP:
Advice for Overachievers in the New Millennium
Donald B. Weaver, Ph.D.
Former Director, Insomnia Program
Sleep Medicine Associates of Texas, P.A.
At Sleep Medicine Associates of Texas, we prescribe facts about sleeping such as ten behavioral strategies and three mental strategies to improve our patients’ sleep efficiency. Your progress in sleeping can be enhanced by practicing these good sleep habits for at least four weeks in a row:
Ten Behavioral Strategies
- Maintain a Regular Sleep Schedule. It will be helpful for you to maintain a regular bedtime and arise time on both weekdays and weekends. Failure to do so, for example, by frequently staying up late can reset your internal biological clock to a later bedtime, leading to a circadian rhythm disorder called “delayed sleep phase syndrome.” Also, it’s especially important to avoid “sleeping in” in the morning after a night of poor sleep. Instead, you should arise at the same time every morning, on both weekdays and weekends, regardless of how poor the prior night’s sleep has been. Although this can be difficult to initiate at first, it can, after a few weeks, help normalize your sleep-wake rhythm, and increase your sleep efficiency.
- Get Enough Daylight. Lack of sufficient daily exposure to sunlight is often partially responsible for people’s difficulty in sleeping at night (daylight is a powerful regulator of the circadian cycle). It’s beneficial for you to spend at least 30 minutes per day outside, in natural sunlight, preferably during the first hour or two in the morning. If you’re unable to do so, try for a minimum of 30 minutes per day in strong artificial light.
- Avoid Post-Lunch Caffeine. Most people know that that the intake of caffeine and similar stimulants in the afternoon and evening can interfere with falling asleep and remaining asleep at night. Most clinicians therefore advise avoiding caffeinated coffee, tea, and carbonated beverages for the rest of the day after lunch, as well as caffeine-like substances found in chocolate, cocoa, and in some weight-control aids, pain relievers, diuretics, and cold and allergy remedies. Some individuals are highly sensitive to caffeine and should stop use entirely.
- Avoid Daytime Napping. With some exceptions (for example, in some cases of insomnia in the elderly), daytime napping solves only a short-term problem of fatigue, and it can contribute to the long-term development of insomnia at night, by disrupting normal sleep-wake rhythms, as noted earlier. In most cases, you should eliminate napping.
- Make Your Bedroom Quiet and Comfortable. Insomniacs often overlook the fact that their bed and bedroom may not be as quiet or comfortable as they could be to promote restful sleep. It’s wise to assess for any disruptive lights, sounds, temperatures, or touch sensations and adopt whatever measures are necessary to reduce or eliminate these discomforts (for example, using eyeshades, earplugs, a low-volume background sound, or a new mattress or pillow). A bedroom temperature of 65° F is recommended for good sleep.
- Avoid Alcohol Within Two Hours of Bedtime. Aside from the risk of developing alcoholism, it’s not productive to use alcohol as a sleeping aid, despite the popular notion that an evening “nightcap” promotes sleep. Research has shown that although one to two drinks within two hours of bedtime may assist with falling asleep, it tends to disrupt subsequent sleep by increasing later wakefulness. Also, alcohol intake prior to bedtime tends to relax the muscles of the throat and to suppress awakening mechanisms, thereby making snoring and sleep apnea episodes more likely, sometimes to the point of being life-threatening.
- Avoid Smoking Nicotine Products Within Two Hours of Bedtime. Aside from the health risks associated with smoking, it’s not productive to smoke up until bedtime. Like caffeine, nicotine is a central nervous system stimulant, and evening smoking tends to increase heart rate and blood pressure as well as stimulate brain activity in ways that are incompatible with sleep. Also, nicotine withdrawal symptoms during the night can contribute to wakefulness. People who stop smoking are likely to sleep better after 10 days of abstinence.
- Avoid Large Meals Within Two Hours of Bedtime. Although a light snack before bed can be beneficial, consuming large meals in the late evening is not recommended. It can be sleep-incompatible to assign your gastro-intestinal tract the task of digesting a large meal at night, and it can increase the risk of heartburn during the night.
- Avoid Exercise Within Two Hours of Bedtime. As part of the circadian cycle, core body temperature begins to decrease in the late evening, and this assists with falling asleep and remaining asleep later. Engaging in vigorous exercise within two hours of bedtime can be counter-productive because it tends to raise core body temperature and activate the nervous system. In the interest of improving sleep, the best time to exercise is in the late afternoon.
- Wind Down Before Bedtime. Insomniacs commonly complain of physical tension and mental alertness when they should be sleeping. In the interest of physical relaxation and mental calm, it’s wise for you to wind down for one to two hours before bed by engaging in an enjoyable, relaxing activity. During this wind-down period, you should avoid working, studying, talking on the telephone, arguing, watching exciting television shows, reading exciting books, and so forth.
Four Mental Strategies
- Avoid Worrying, Clockwatching, and Trying to Fall Asleep. Clinicians routinely prescribe only two activities for the bedroom: sleep and romance. Virtually all other activities belong outside the bedroom, both by night and by day. Bringing stressful matters into the bedroom will affect your sleep patterns. This holds particularly true for insomniacs who engage in the bedroom in sleep-preventing activities like worrying, watching the clock, and trying to force the onset of sleep — all of which generally serve only to increase body tension and mental alertness.
- Leave the Bedroom When Unable to Sleep. One way to stop mentally associating the bedroom with non-sleep-inducing activities is to leave the bedroom, after roughly 10 minutes (20 minutes for people age 60 and over) of sleeplessness, in order to worry or, say, watch television or read in another room for as long as it takes to feel sleepy, and then return to the bedroom with positive expectations of sleeping.
- Repeat. This sequence should be repeated in a given night as many times as are necessary to achieve sleep. Although this so-called “stimulus control” technique can be difficult to initiate at first, it can be very helpful after at least four weeks of practice.
- Associate the Bedroom with Relaxing. Good sleepers cultivate strong mental associations of physical relaxation, mental calm and good sleep with their bedtime and their bedtime rituals such as setting the alarm clock. Relaxing activities include muscle relaxing exercises, deep breathing, relaxing mental imagery and listening to relaxing, recorded guided imagery programs.
If our sleep disorder center can be of further help to you in combating snoring or other sleeping problems, feel free to set up a consultation at your earliest convenience.