Five tips for a better night's sleep.
Sleep is a tricky topic. How many hours should we get? Seven, eight or nine? What has been the impact of television/screens/ipads? Should we sleep more like our ancestors in two big chunks (Bi-modal sleep)?
The overwhelming response from most people would be that they'd really just like a bit more of it.
Here's my top five tips to get a better night's sleep:
1. Stop unhealthy habits before bed
Finish eating or drinking at least two hours before you try to lie down.
Get off that computer or off the couch at least one hour before bed - seriously.
Check any nighttime medications* don't have caffeine in them.
2. Clear your bedroom of unhelpful items (make a checklist)
Get a blackout curtain if a street light shines in (it's not just for toddlers).
Is your room too warm or too cold?
Get rid of your shining alarm clock. No one needs to see the time in neon.
Turn off your mobile phone. I mean it.
Children and pets are warm, nurturing creatures but they don't always need to share the bed with you. We often get shoved into a cold corner of the bed to accommodate them. Restore your boundaries.
Is your mattress more than 8-10 years old? It might be time for an upgrade.
Do you love your pillow? (see my post on pillows)
Covers too heavy or restrictive?
Spouse or partner that is restless, noisy, or generates too much heat - um, acceptance?
Some medical conditions❡ interfere with sleep.
3. Do you love a daytime nap?
Do not daytime nap for more than 45 minutes
No napping after 3 pm
4. Exercise
A few surprises. A 2010 (1) study found people with no previous sleep difficulties slept better the night following exercise. But for people who had been diagnosed with insomnia, a fairly comprehensive study from 2013 (2) found people had to exercise daily and consistently for up to four months before there was a measurable benefit.
Put simply:
Consistently do a bit more physical activity during the day.
Expose yourself to bright light on waking – tell your body it's daytime.
Expose yourself to bright light in the afternoon to keep your body awake longer.
5. Consistency of sleep habits
Wake up at the same time every day - almost the hardest one to implement for anyone, especially an insomniac.
Develop a flexible before bed routine. It might include a warm shower or bath, meditation or a calming book.
In-bed routines - breathing techniques, progressive muscle relaxations (that's a whole other BLOG)
Reduce fluid consumption in the evening to avoid the need to wee all night.
(1) Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia. Sleep Med. Oct 2010; 11 (9): 934-940. Kathryn J. Reid, PhD, Kelly Glazer Baron, PhD, Brandon Lu, MD, Erik Naylor, PhD, Lisa Wolfe, MD, and Phyllis C. Zee, MD, PhD
(2) J Clin Sleep Med. 2013 Aug 15;9(8):819-24. Exercise to improve sleep in insomnia: exploration of the bidirectional effects. Baron KG1, Reid KJ, Zee PC.
* Some medications that can interfere with sleep:
- Antihistamines: Benadryl (daytime drowsiness)
- Sympathomimetic Amines: bronchodilators and decongestants
- Antihypertensives and Beta blockers: Clonidine, Aldomet, Reserpine (daytime drowsiness)
- Steroids: Prednisone, dexamethasone
- Thyroid medications:
- Anti-epileptics and antipsychotics (daytime drowsiness)
- Parkinson medications: (daytime drowsiness)
- Stimulants for ADHD
- Anticholinesterase drugs for Alzheimer's
- Antidepressants: Prozac, Fluoxetine
- Analgesics: opiates, Tramadol, Ultram
- Chemotherapeutics: (nausea and vomiting)
- Diuretics: (frequency at night)
❡ Some medical conditions that can interfere with sleep:
- Respiratory disorders
- Cardiovascular disorders
- Gastrointestinal disorders
- Musculoskeletal pain and dysfunction (Book Online)
- Diabetes
- Renal disorders
- Prostate problems and small bladder causing urinary frequency
- Cancer
- Dementia
- Dental disorders
- Restless leg syndrome or Periodic Limb Movement Disorder (PLMD)
- Fibromyalgia (alpha wave intrusion)
NOTE: People who do shift work have special challenges as they consistently interrupt their diurnal rhythms. It is outside the scope of this post.