Sleep Hygeine
Why is sleep so essential?
Sleep is an essential part of our lives. It’s an opportunity for your body to repair itself, both physically (e.g., repairing muscles) and psychologically (working through anxiety). But for millions of people sleep is a struggle every night. They may lay in bed for hours trying to fall asleep,or they may wake up frequently and feel unrested in the morning.
When factors such as anxiety (physiological hyper-arousal), depression (emotional distress and worry), or poor sleep habits interfere with sleep patterns the natural ability of the body to repair itself becomes disrupted. If sleep is disrupted for an extended period of time it can lead to the following effects:
- Increased emotional distress and irritability
- Increased clumsiness and poor coordination
- Decreased work performance and memory lapses
- Increased risk of automobile accidents
- Difficulty concentrating
Sleep can be divided into 5 distinct stages on the basis of brain-wave patterns called EEG (electroencephalography). Each sleep cycle (which last about 100 minutes) is divided up into physically repairing sleep and psychologically repairing sleep. When we first fall asleep, more time is spent in physically repairing sleep, later on during the night more time is spent in psychologically repairing sleep. Age influences the balance between these two types of sleep. Babies spend more time in psychologically repairing sleep (dream state) because their bodies don’t need much physical repair. Older adults spend more time in physically repairing sleep because their bodies are more vulnerable to damage.
The first four stages are called non-REM (rapid eye movement) sleep while the 5th stage is called REM sleep.
Stage 1 |
A transitional stage between waking and sleep where alpha waves disappear slowly, and theta waves move in; body muscles relax, heart beats slower. |
Stage 2 |
Theta waves prominent, with intermittent sleep spindles and K-complexes (bursts of faster activity and higher amplitude activity, respectively) |
Stage 3 |
Appearance of large slow delta waves, which are dominant in stage 4 (This is deep sleep) |
Stage 4 |
Delta waves dominate. The sleeper breathes deeply and has slowed heart rate and lowered blood pressure (This is deep sleep) |
Stage 5 |
Characterized by REM (rapid eye movements), absence of muscle tone, mixed frequency EEG. Called paradoxical sleep because EEG activity is typical of an aroused nervous system, while the responsivity of the sleeper to the environment is very low. |
Dreams occur during non-REM and REM sleep, but you remember the ones in REM more because they are more vivid, bizarre, and emotionally laden and are therefore more likely to be remembered when you wake.
Although medications are often prescribed to help people fall asleep, sleep medications were never designed to be a long term solution to sleep problems. Medications often have side effects such as drowsiness, and they can cause a person to become dependent on the medication in order to sleep. Fortunately, there are several things that you can do on your own to improve your sleep.
Ways to Improve SleepTiming:
- Establish a pattern to your sleep by going to bed at the same time each evening and getting out of bed at the same time every day, even on weekends regardless of how much you slept.
- Avoid taking naps but if you do nap, make it no more than about 25 minutes. If you have problems falling asleep at night then you should not take naps.
Sleep Behavior:
- Establish a pre-sleep ritual to give your body cues that it is time to slow down (e.g., taking a bath or reading a few minutes before bed).
- Use the bed only for sleep or for sex (don’t use your bed as a desk, do not read, eat or watch TV in bed).
- If you are unable to sleep for more than 15 minutes then get out of bed. Engage in a quiet un-stimulating (boreing) activity and return to bed when sleepy.
- Restrict the amount of time you spend in bed to your usual amount of sleep (e.g., 7 hours) even if you did not sleep as well as you would have liked. Do not lay in bed extra hours in the morning feeling frustrated - it will not help.
Bedroom Environment Tips:
- Sleeping is associated with a decline in core body temperature from a state of relative warmth. You can raise your body temperature by taking a warm bath 20 minutes before bed and as your temperature cools it will signal your body that it is time to sleep.
- Fluctuations in room temperature disrupt the dream state so maintain a steady temperature in the room throughout the night. A cool room is more conducive to sleep than a warm room.
- Eliminate illuminated wall clocks or other sources of light (Note: A night light is often needed so that people can get up in the night to go to the restroom with out falling).
Ingestion:
- Caffeine (a stimulant) should be discontinued 4-6 hours before bedtime
- Nicotine (a stimulant) should be avoided near bedtime or if you wake at night . Dont smoke a cigarette if you can not sleep.
- Alcohol (a depressant) may initially promote sleep onset but it causes awakenings later in the night
- A light snack may be sleep inducing but a heavy meal too close to bedtime might interfere with sleep
Mental Control:
- Avoid mentally stimulating activity just before going to bed (e.g., action movie, stimulating conversation, loud music)
- Relaxation techniques such as deep breathing and visual imagery can help sleep onset
- Mentally quiet tasks such as listening to relaxing music, calming thoughts, etc can help sleep onset
