Sleep Hygiene Instructions
Many aspects of modern life can be quite disruptive for a good night’s sleep and there are many things that you can do to improve the quality of your sleep. Listed below are some helpful tips — things to avoid and things to do to help ensure you get a good night’s sleep.
Carefully read each of the 14 Sleep Hygiene tips. Try to prioritize which, if any, of these tips apply to you. To start out, pick 2 or 3 sleep hygiene goals that you believe you can commit to working toward accomplishing. Once you have achieved a sleep hygiene goal continue to add additional goals as needed. Trying to change too many things at once can often lead to failure — so try to be realistic.
Dietary Factors
- Cut down on caffeine products.
Caffeine is a commonly used stimulant that interferes with sleep. Depending on the amount you consume and your metabolism, caffeine can be active in your system for many hours. While many people are aware that caffeine is found in coffee and tea, caffeine is also found in many other foods. Chocolate, many soft drinks (colas, Dr. Pepper, Mountain Dew, even some brands of orange soda) and some medications (e.g., Excedrin) contain caffeine. While it is not necessary to completely stop eating or drinking foods containing caffeine, it is recommended that you stop taking caffeine for a full 8 hours before you intend to go to sleep.
WARNING! If you regularly consume large amounts of caffeine, drastically stopping your usage all at once can result in withdrawal symptoms such as headaches and nausea. It is recommended that you consult with your doctor and cut back slowly.
2. Eat regular meals and don’t go to bed hungry.
Keeping consistent mealtimes is an important way to keep your body on a smoothly running schedule. Hunger may disturb sleep. A light snack at bedtime (especially carbohydrates) may help sleep. Avoid greasy, spicy foods, sugars or complex proteins prior to sleep. If you wake-up frequently with heartburn, this might be a sign of acid reflux disease, which can cause middle of the night awakenings. For some people acid reflux is worse at nighttime, because acid can flow backward through the esophagus easier when you are lying down. You should consult with your primary care physician if you have frequent heartburn.
3. Avoid moderate to heavy alcohol use in the late evening.
Many people with insomnia have a “night cap” to help them fall asleep. While alcohol sometimes helps people fall asleep, overall, it negatively impacts the quality of your sleep. Alcohol is associated with middle of the night awakenings and intense dreams in the second half of the night. Alcohol suppresses your REM sleep.
4. Avoid excessive liquids in the evening.
When you sleep the function of your kidneys slows down. Your kidneys process and produce urine. Even though your kidney function is reduced while you sleep, if you drink too much fluid prior to bedtime, you may need to make many nighttime trips to the bathroom.
5. Smoking may disturb your sleep.
Although many people smoke as a way to relieve stress, physiologically nicotine is a stimulant. Smoking before bed or during the night when you are unable to sleep will only aggravate your insomnia.
6. If you are taking medications, consult with your doctor about their impact on your sleep.
Many medications, both prescription and over-the-counter, can disturb sleep. You should be aware of how these medications might disrupt your sleep. You may not have a choice of stopping the medication if the benefit of the medication outweighs the side effects of sleep disturbance. Sometimes, however, your physician may be able to prescribe an alternative medication or change the timing of the medication so it minimizes the impact on your sleep.
Environmental Factors
7) Make sure your bedroom is comfortable and free from light and noise.
NOISE. A comfortable noise-free sleep environment will reduce the likelihood that you will wake up during the night. Noise that does not awaken you may still affect the quality of your sleep. Many people living next to highways or near airports become accustomed to noise — so much so that they do not notice it at all when they are awake. Even though you may become used to it, such noise can significantly disrupt the depth of your sleep. Carpeting, insulated curtains, and closing the door may help. You should also consider purchasing a “white noise” machine (for example, Marpac/Dohm sound machines). There are many sound machine devices that can be purchased at retail stores and online. Sometimes, even the noise of a humidifier or fan can be effective. If you purchase a machine, make sure the device has a “white noise” setting. White noise is an even, monotonous sound — like listening to static. White noise screens out environmental noises and prevents you from having a startle or orienting response whenever a sound occurs. This can reduce awakenings due to noises. [One of the effects that pain has on sleep is that it appears to make it shallower. Since sleep is shallower, people experiencing pain are more susceptible to waking up due to even slight noises.]
LIGHT. Understanding how light regulates your sleep-wake cycle is a very important factor in gaining control over when your body wakes up and falls to sleep. There is a tiny group of cells in the hypothalamus of your brain called the SCN. This region of your brain acts like a pace maker to regulate your sleep-wake cycle. The SCN uses light traveling from your optic nerves to keep the timing of your internal clock in sync with the environment. If you do not get enough light in the early morning when you want to be awake, the timing of your sleep cycle can become delayed, making it harder to fall asleep and wake up when you desire. A problem can also occur with too much bright light prior to bed. The rule of thumb is to use light to keep your body in phase with your schedule. Even room lighting can influence the body’s clock. When you wake up in the morning, make sure to expose yourself to adequate lighting. At night prior to bed, try to keep the lighting dim. Use a small reading lamp that illuminates reading material rather than lighting a whole room. Outdoor light is more intense than indoor lighting. Taking a 30-minute walk first thing in the morning is an excellent way to keep your body’s internal clock on track. During the winter when there is less light, consult with your physician about whether a light box might be helpful for you.
8. Make sure your bedroom is a comfortable temperature during the night.
Like light, temperature is another important factor that can significantly influence your sleep quality. Excessive heat or cold can disrupt sleep. Being overheated is a particularly common problem. When you sleep, it is normal for your core body temperature to drop. This drop in core body temperature is regulated by the same center in the brain (SCN) that controls the timing of your sleep-wake cycle. Studies have shown that being too warm significantly interferes with your sleep. Avoid taking a hot bath immediately before bedtime.
Research Shows that Taking a warm bath 2 to 3 hours before bedtime, however, actually improves your sleep quality (more deep sleep). This is because raising your body temperature at this time leads to an increased cooling effect when you are ready for bed. This strong drop in your core body temperature just before bed can promote sleep.
Lifestyle Factors
9. Get up at the same time each day, 7 days a week.
A regular wake time leads to regular times of sleep onset, and helps set your biological clock.
10. Avoid long naps.
Staying awake during the day helps you fall asleep and stay asleep at night. For some people, however a short nap during the day can be refreshing and does not impact on your sleep. Everyone is different, but naps longer than 30 minutes increase your chances of difficulty sleeping at night.
11) Sleep only as much as you need to feel rested during the next day.
Spending too much time in bed during any one sleep period can have negative consequences for the next night. People sometimes sleep too long on weekends — more than they needed to make up for their lack of sleep during the week. Restricting your time in bed helps to consolidate and deepen your sleep. Excessively long time in bed leads to fragmented and shallow sleep.
12) Do not take your problems to bed.
Because our days are often so busy, it is easy to fall into the habit of problem-solving or worrying at night. Worrying and planning the next day’s activities interferes with initiating sleep and produces shallow sleep. Plan some time earlier in the evening for problem-solving. Specifically: consider spending about 15 minutes, far from your sleep period, to write down your top sleep-interfering worries or problems, create a to-do list by breaking down those worries or problems into small, concrete tasks with details about where/when the task will be done, and try to complete those tasks. Try to review the list, even if very briefly, each day and update it. If your mind drifts to these worries or problems during your sleep period, remind yourself that you have already thought about the issues and have a plan in place. This will hopefully calm the thoughts at night and allow you to sleep better.
13) Avoid clock watching.
Everyone falls into this trap from time to time. We have trouble sleeping and we begin to worry that if we don’t get enough sleep we will feel exhausted the next day. Try setting the alarm and turning it so you can’t see it. Frequently checking the time often leads to frustration, anger, and worry, which may increase your frustration thereby making it quite difficult to fall asleep.
14) Exercise regularly.
Regular exercise is important for your overall health. For some people, moderate aerobic exercise for 30 minutes or more may help promote and deepen sleep. Try not to schedule exercise immediately before bed because the elevation in your body temperature so close to bedtime may interfere with sleep initiation.
These recommendations were created by the Johns Hopkins Behavioral Sleep Medicine Program. For more information, please visit: http://www.hopkinsmedicine.org/psychiatry/specialty_areas/geriatric_neuro/sleep/