Sleep, that elusive specter. You're supposed to get eight hours of it every day, but a lot of us don't. So we take drugs like caffeine to keep us perked up throughout the day. But then coffee and energy drinks can give us insomnia, so we take melatonin or Ambien to knock us out. We're always somewhere between active and exhausted. What gives?
If this more or less describes you, sleep experts say that it could be that you're sleeping "dirty." It may be weird to think of something as cerebral as sleep in terms of cleanliness, but sleep hygiene is a real thing recommended by neurologists and slumber experts. It can include everything from darkening the room to avoiding caffeine. And just like brushing your teeth or exfoliating your skin, maintaining good sleep hygiene can extend to other areas of health and well-being.
"Sleep is one of the foundations for overall health," Dr. Jade Wu, a sleep psychologist, researcher and author of the upcoming book "Hello Sleep," told Salon in an email. "You may not notice problems right away when you sacrifice sleep, but if that happens often, it makes you more prone to health problems and to not being able to fully enjoy life."
For pretty much any disease or illness that humans can get, poor sleep will make everything worse. In fact, sleeping badly seems to be a significant predictor of death from any cause.
"Sleep hygiene is usually the first approach to improve one's sleep because it's practical, it's easy, and it's free," Dr. Rui Pereira, a postdoctoral research fellow at the University of Birmingham, told Salon. "Adopting some very mild and very simple behavioral measures before going into the more extreme, like pharmacological options in terms of dealing with your sleep, is probably preferable. Explore the simpler options first, it may be easier and quicker as well. And probably cheaper."
Despite being a sleep psychologist, even Pereira admits that he struggles to get enough rest. He is currently studying the links between sleep deprivation and social functioning, having previously researched sleep in professional athletes. All that travel, competition and training makes sports stars prone to sleep issues. He says that good sleep hygiene is undervalued by most people, but it's relatively simple to start a few good sleep hygiene habits now.
The great thing about improving your sleep hygiene is that most people can do it without the assistance of a doctor and you don't have to buy anything. Forget white noise machines and melatonin supplements (unless they're working for you), here are a few practical tips that can clean up the quality of your sleep.
Going to bed at the same time every night helps your body and mind settle into a rhythm. At a certain time, usually as the sun starts to set, your body starts to release a chemical called melatonin. This hormone regulates our sleep-wake cycle and is the same stuff sold in supplements at pharmacies. When it enters the brain, it signals to the body to start shutting down. As morning approaches, melatonin levels drop, signaling that it's time to wake.
Of course, life happens and sometimes a good night's sleep can be elusive. "It may be a struggle when you've had a rough night," Pereira said. "But that's exactly where you should stick to it. Regardless of your sleep quality overnight, stick to your sleep-wake schedule, make it the same without too much fluctuation over weekends. And this routine will pay off in the end."
Balance is critical, Wu emphasized. "It's good to have healthy habits, but we don't need to become a monk to have good sleep," Wu said. "There needs to be some flexibility (yes, you can go out late and have some cocktails sometimes!) for your generally good sleep habits to be sustainable."
"Listen to your body," Wu said. "Not everybody needs the same amount of sleep or to sleep at the same time. Working with, instead of against your body, is best for your long-term sleep health."
You may have heard that you should limit electronics after a certain hour. Staring at bright screens can mess up sleep patterns, which is why so many people are into blue-light blockers and "dark mode" on their favorite apps.
But this is a misconception Wu explained. "Actually, it's fine to look at screens in the evening, as long as you get plenty of light exposure during the day," Wu said.
While you are actually sleeping, however, it's best to keep the room as dark as possible. Even a small amount of light from a clock or a TV can elevate heart rate or knock blood sugar out of a normal spectrum. But making a room pitch black is easier said than done if you live in a big city flooded with sodium-tinted luminosity. Street lights can cause all kinds of problems with sleep, so investing in blackout curtains or an eyemask might help, just make sure you're letting in enough daylight, like in tip 2.
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Your bed should really only be used for sleeping (and perhaps love-making), nothing more, Pereira said. Pre-sleep activities like reading a book before bed are fine, but doubling your bed as an office or dinner table can make it hard for your brain and body to associate your bed with sleep.
"Don't use your bed as a workspace or as a meal space," Pereira said. "Otherwise, you will start associating, even subconsciously, your bed with a wide array of activities that it should not be associated with. Keep your bed strictly for sleeping, or other activities that should only be done in bed. So anything else that can be done outside of bed i.e. working, eating, even watching a movie, try to avoid doing it in bed."
Instead, think of your bed as a temple for dreaming. Of course, like much of the advice on this list, it depends on your circumstances. Some people are lucky enough to have a bed, let alone the space to devote entirely to it. Your mileage may vary here.
When traveling, it may help to bring something from home that reminds you of your bed, such as a pillow or blanket. "Make this new room as familiar as possible," Periera said. "This may sound a bit ridiculous considering we're talking about adults, but bringing the pillow, duvet, blanket or something that will help make that room feel more familiar will help you relax. It will help you be less anxious about sleeping in this odd room that you've never seen before and that will help you getting sleep."
The great irony of forcing yourself to relax is the harder you try, the more difficult it can be. It can take practice getting into sleep mode. Simple relaxation techniques like meditation, progressive muscle relaxation techniques, yoga or reading a book can all help the body and mind calm down and enter drowsy mode.
"Never try to go to sleep. Falling asleep is a natural, automatic process," Periera said. "If you focus really hard on the need to fall asleep, you will most likely impair the automatic nature of sleep and you will not be able to. That's kind of the irony of sleep. If you try really hard to fall asleep and all those strategies like counting sheep and things like that, most likely you will struggle a lot. So don't try."
But if these tactics don't work — nothing is more annoying than being told to meditate when your brain is wired or anxious — it can be supremely frustrating. It takes practice and like any skill, you may fail at it. And the lack of rest can create irritability, a sort of self-fulfilling cycle. Think of it as a skill to cultivate over time, not something you have to be good at instantly. And if improving sleep hygiene isn't helping, there may be something else at play.
Sleep hygiene is important but it can only go so far. If any of these techniques fail to work, it could be a sign or a serious sleep disorder like narcolepsy or restless leg syndrome.
"A common misconception is that people with sleep problems will benefit from working harder on sleep hygiene. This is not always the case," Wu said. "Often, sleep hygiene practices are not nearly enough. For example, for those with sleep disorders like obstructive sleep apnea."
This is when a person's breathing is repeatedly interrupted during sleep. The most common cause of obstructive sleep apnea is a partial or complete blockage of the airway, usually caused by the collapse of the soft tissue in the back of the throat. This blockage can occur multiple times during the night, triggering frequent awakenings and a lack of restful sleep. This condition can be serious and requires proper diagnosis from a physician. Sorry, but blackout curtains and a meditation video on YouTube won't help here!
"Sometimes working harder on sleep hygiene can even backfire, for example, for many people with insomnia," Wu said. "So if you have significant sleep problems that affect your functioning during the day or make you concerned, consult with a sleep specialist to see what treatment is most effective for you. "
Almost everyone loves getting high from caffeine. An estimated 80 percent of American adults consume this drug every day. While it kicks in fast, it can take 10 hours or more to excrete, meaning most people reading this right now are under the influence of this lovely stimulant. Of course, dose and individual metabolism differences also play a role in how caffeine affects us, but this substance is so ubiquitous we hardly notice its day-to-day influence on our consciousness. That makes it easy to overlook in the equation of sleep hygiene.
Caffeine works by getting in the way of a chemical the body makes called adenosine. Adenosine accumulates in the brain throughout the day and is responsible for making us feel tired. As adenosine levels increase, so does the feeling of fatigue. But the more caffeine you consume, the more adenosine the body produces. This can make it hard to quit, because once you do, a flood of adenosine will give many people headaches or make them extra tired.
"Sleep literature is quite consensual in recommending you stay away from [caffeine] after 4pm, yet this is hard for many people when struggling with their sleep," Pereira said, admitting he doesn't consume caffeine at all. But caffeine can create dependency almost like addiction, so it can be hard to quit. "I would recommend you take it slow and do not engage in too extreme changes in your routine suddenly. Start by reducing your caffeine intake after 9pm. Then move it to 6pm after one week. Then after 4pm in a month. Much like any change (e.g., New Year Resolutions) the trick is to make it realistic and therefore achievable."
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