patient advice - sleep hygiene

Last reviewed 01/2018

Sleep hygiene is the controlling of all behavioural and environmental factors that precede sleep and may interfere with sleep.

Sleep is an essential part of life and contri butes to us feeling well and happy. However, most people will experience problem sleeping at some point in their life.

Sleep disruption is a common issue, especially at times wen you may feel emotionally overwhelmed. There is no set rule as to how much sleep yo u need - it varies from person to person. Some people may need 8 hours sleep each night, others may need more or less than this. Sleep patterns can also vary with age, with older people often needing less sleep than younger adults.

Poor sleep habits (referred to as poor sleep hygiene) are among the most common problems encountered in our society. We stay up too late and get up too early. We interrupt our sleep with drugs, chemicals and work, and we over stimulate ourselves with late-night activities such as television.

Below are some essentials of good sleep habits. Many of these points will seem like common sense, but in daily routines they are very often ignored.

Your Personal Habits

Fix a bedtime and an awakening time.

Do not be one of those people who allows bedtime and awakening time to drift. The body "gets used" to falling asleep at a certain time, but only if this is relatively fixed. Even if you are retired or not working, this is an essential component of good sleeping habits.

Avoid napping during the day.

If you nap throughout the day, it is no wonder that you will not be able to sleep at night. The late afternoon for most people is a "sleepy time." Many people will take a nap at that time. This is generally not a bad thing to do, provided you limit the nap to 30- 45 minutes and can sleep well at night.

Avoid alcohol 4-6 hours before bedtime.

Many people believe that alcohol helps them sleep. While alcohol has an immediate sleep-inducing effect, a few hours later as the alcohol levels in your blood start to fall, there is a stimulant or wake-up effect.

Avoid caffeine 4-6 hours before bedtime.

includes caffeinated drinks such as coffee, tea and many sodas, as well as chocolate, so be careful.

Avoid heavy, spicy, or sugary foods 4-6 hours before bedtime.

can affect your ability to stay asleep.

Exercise regularly, but not right before bed.

Regular exercise, particularly in the afternoon, can help deepen sleep. Strenuous exercise within the 2 hours before bedtime, however, can decrease your ability to fall asleep.

Your Sleeping Environment

Use comfortable bedding

Uncomfortable bedding can prevent good sleep. Evaluate whether or not this is a source of your problem, and make appropriate changes

Find a comfortable temperature setting for sleeping and keep the room well ventilated.

If your bedroom is too cold or too hot, it can keep you awake. A cool (not cold) bedroom is often the most conducive to sleep.

Block out all distracting noise, and eliminate as much light as possible

Reserve the bed for sleeping and sex.

do not use the bed as an office, workroom or recreation room. Let your body "know" that the bed is associated with sleeping

Getting Ready For Bed

Try a light snack before bed.

Warm milk and foods high in the amino acid tryptophan, such as bananas, may help you to sleep

Practice relaxation techniques before bed.

Relaxation techniques such as yoga, deep breathing and others may help relieve anxiety and reduce muscle tension.

Don't take your worries to bed.

Leave your worries about job, school, daily life, etc., behind when you go to bed. Some people find it useful to assign a "worry period" during the evening or late afternoon to deal with these issues.

Establish a pre-sleep ritual.

pre-sleep rituals, such as a warm bath or a few minutes of reading, can help you sleep.

Get into your favourite sleeping position.

if you don't fall asleep within 15- 30 minutes, get up, go into another room, and read until sleepy.

Getting Up in the Middle of the Night

Most people wake up once or twice a night for various reasons. If you find that you get up in the middle of night and cannot get back to sleep within 15-20 minutes, then do not remain in the bed "trying hard" to sleep. Get out of bed. Leave the bedroom. Read, have a light snack, do some quiet activity, or take a bath. You will generally find that you can get back to sleep 20 minutes or so later.

Do not perform challenging or engaging activity such as office work, housework, etc. Do not watch television.

A Word About Television

Many people fall asleep with the television on in their room. Watching television before bedtime is often a bad idea. Television is a very engaging medium that tends to keep people up. We generally recommend that the television not be in the bedroom. At the appropriate bedtime, the TV should be turned off and the patient should go to bed. Some people find that the radio helps them go to sleep. Since radio is a less engaging medium than TV, this is probably a good idea

Other Factors

Several physical factors are known to upset sleep

includes arthritis, acid reflux with heartburn, menstruation, headaches and hot flushes.

Psychological and mental health problems like depression, anxiety and stress are often associated with sleeping difficulty. In many cases, difficulty staying asleep may be the only presenting sign of depression. A physician should be consulted about these issues to help determine the problem and the best treatment.

Many medications can cause sleeplessness as a side effect. Ask your doctor or pharmacist if medications you are taking can lead to sleeplessness.

To help overall improvement in sleep patterns, your doctor may prescribe sleep medications for short-term relief of a sleep problem. The decision to take sleeping aids is a medical one to be made in the context of your overall health picture.

Reference:

• 1) East and North Hertfordshire NHS Trust (Accessed June 29th 2013). Sleep Hygiene Advice
• 2) Wrightington, Leigh and Wigan NHS Foundation Trust (Accessed July 1st 2013). Patient Advice - Sleep Hygiene.