Feeling Sleepy?

We all know how it feels to have had a poor sleep. You are groggy, it is hard to focus, and the whole day is spent yawning. That is why many experts recommend getting seven to nine hours of sleep each night, but on average a North American adult is only getting 6.9 hours – just shy of the recommendation. This is troubling as sleep disorders can lead to increased morbidity, which adds strain to the health care system and increases the monetary cost passed on to patients.

Over the years, several studies have demonstrated that chronic sleep deprivation leads to an increased risk of:

• Infections, such as pneumonia

• Diabetes

• Cardiovascular disease

• Cancer

• All cause mortality
  A few studies even found that sleep deprived individuals were not able to pick up social cues and are less able to process emotions.

  Needless to say, sleep deprivation is a growing public health concern, which affects the general population. To address this mounting concern health care professionals have introduced the concept of sleep hygiene education.

  What is Sleep Hygiene?

  The textbook definition of sleep hygiene is ‘a set of behavioural and environmental recommendations intended to promote healthy sleep’. Sleep hygiene was originally developed for the treatment of mild to moderate insomnia, but sleep issues are so prevalent that sleep hygiene education is being given to anyone with mild to moderate sleep issues of any kind.

  During sleep hygiene education, patients are taught healthy sleep habits and are encouraged to follow a set of recommendations to improve their sleep. Basically, sleep hygiene recommendations are:

• Avoid caffeine

• Avoid nicotine

• Avoid alcohol

• Exercise regularly

• Manage stress and anxiety

• Reduce bedroom noise

• Regular sleep times

• Avoid daytime naps

What does this look like in real life?

Most often, sleep hygiene put into practice begins 1-2 hours before your scheduled bedtime. For example if you plan on going to sleep at 10:30 pm, turn off all screens by 9:00 pm and prepare your living space for bedtime. For some that may mean cleaning up the kitchen, tidying the children’s toys, prepping meals for the next day, etc. Enjoy a cup of decaffeinated chamomile tea around 9:45 pm as you read and relax on the couch (or some other quiet and relaxing area within your living space).

Tip: save the time you spend in your bed for sexual activity and sleep only

After the tea is done, make a soft transition to the washroom and continue your nighttime routine (teeth brushing, face washing, using the toilet, etc). If possible, use only low light in the washroom and bedroom at this time. If you find your mind is still racing take this time to use one of the many meditation apps available (Buddhify or Calm.com). When you are feeling relaxed, make your way into the bed and enjoy your restful and restorative sleep.

The idea is to maintain a bedtime ritual (whatever one that works best for you) for at least 21 days in order to give your body the best chance to adjust and get into the routine. Soon, your body will be able sense that it is bedtime as soon as you are boiling the water!

Ultimately, modifying your pre-sleep behaviours is a reasonable approach to sleep improvement efforts. Remember, the quality of your sleep influences subsequent waking behaviours. A wonderful sleep leaves you feeling refreshed, mentally on point, and ready to tackle the day.

References:

Irish LA, et al. The role of sleep hygiene in promoting public health: A review of empirical evidence. Sleep Medicine Reviews. 22:23-36. 2015.
Ramar K, Olsen EJ. Management of Common Sleep Disorders. American Family Physician. 88(4):231-238. 2013.

Killgore WDS, et al. Sleep deprivation impairs recognition of specific emotions. Neurobiology of Sleep and Circadian Rhythms. 3:10-16. 2017.