Sleep Hygiene
The more physical & mental fatigue we build up over the day, the better chance of falling asleep and the better probability of good quality deep sleep.
Here are some tips for getting your sleep habits back on track:
No daytime naps. Get up at the same time in the morning, and go to the bed relatively the same time at night.
The sleep between midnight and 4:00 a.m. provides much of our most restful and deep sleep. Missing this hours may result in not waking up up refreshed, despite getting your usually number of hours of sleep. REM or time when we dream occurs from 4am onward. So if you get to bed later you may ahve more vivid dreams.
Moderate movement or exercise during the day helps to promote physical fatigue. It is important for our sleep driver to detect enough physical and mental fatigue to help put us into deep sleep.
Turn off all screens at least an hour before bed, disengage from our active life.
Create a nighttime routine that sends a signal that it’s time for sleep.
Dark room for sleep, cover up any light sources, black out blinds if possible, cool temperature, white noise if necessary all help to maintain sleep.
Behavioural treatment to encourage relaxation may include breathing and relaxation techniques. (see section on apps under stress management)
If you are too tense at night, you may have a disrupted sleep/wake cycle. Cortisol is a hormone which is released when we are stressed. In addition it also rises naturally in the early morning hours of the morning to help with us wake up. Normally the levels of cortisol decrease throughout the day. However cortisol which may be released from our adrenal glands at times of stress, and with chronic stress, the release may remain elevated, leading to insomnia and eventually a dysfunctional immune system and weight gain. Sleep and stress management are also important considerations for weight management, as are movement and food habits.
Melatonin is released around 9 pm and helps to induce sleep. and levels drop off by 9 am. Blue light may inhibit the release of melatonin. the impact of blue lights is equivalent to 2 cups of coffee! If on electronics, go to system preferences on Macs or control centre on PCs and switch to night shift /night light and choose the warmest light. For iPhones it is night shift and androids it is night mode.
Aromatherapy like lavender or frankincense can be used in a diffuser or sprayed on sheets, or a few drops added to a carries oil for massage. (see supplements section for more detail).
Magnesium bisglycinate starting at 100 and increasing by 100 mg up to 400 mg as tolerated, or epsom salts bath can be calming. Magnesium increases GABA which is a calming neurotransmitter. Magnesium citrate is also effective, though more likely to soften bowel movements and lead to diarrhea, so magnesium bisglycinate is therefore suggested.
Short term use of melatonin 2 hrs. pre-sleep, ideally around 9 pm.
For those who need some stimulation, music, light reading, audio books, podcasts, not watching any screens.
If you can’t sleep after 20 min. get up to avoid associating bed with an active mind, go to a different room, do a non-screen activity briefly, then return to bed
If unsure of your required sleep, figure out your average sleep over a week and divide by 7 for your daily requirement.
Good sleep = better focus, better stress management, smaller waistlines, longer life.
Silence your cell phone and if possible put in another room, as early am texts, notifications, or calls disrupt sleep quantity and quality
Open blinds in the morning, so you can let in daylight, you could also use a light alarm clock which gradually increases light in the room which may be helpful during short winter days to maintain your circadian rhythm.
Alcohol can induce sleep but disrupt deep sleep and cause more fragmented sleep.
Initial use of marijuana may increase deep sleep and decrease REM sleep, but with repeated use, this effect decreases. with discontinuation , there may be initial insomnia and decreased total sleep time with more dreams ( more REM sleep). Prolonged use can lead to tolerance despite increasing the dose.
Benzodiazepines may induce sleep but block stage III sleep, so there may be less alertness experienced in the morning.
As the days get shorter into the fall, wake up light alarm clocks, may be helpful to maintain your sleep schedule by getting up at a decent time.
Philips and other companies have wakeup light alarm clocks which simulate the rise of the sun.
“Good night Mind” by Dr. Colleen Carney is a nice readable book on CBT for insomnia
Addressing sleep is a very important component to recovery in many disorders. Treatment involves attention from the very beginning of our day.
Disclaimer: Although I am a registered MD, information on this web site is provided for informational purposes only and is not intended as a substitute for the advice provided by your physician or other healthcare professionals or any information contained on or in any product label or packaging. Please view this website’s “Disclaimer” for further details.