Following on from last month’s post on the importance of sleep for health, this post is about optimising the quality and quantity of your sleep.
If you are unable to fall asleep or stay asleep when you want to, you are suffering from insomnia. Insomnia can be acute (over just a few days) or chronic (lasting for weeks or months) and it can be primary (of an unknown cause) or secondary (e.g. as a result of medication or lifestyle factors). Perhaps more commonly though, a lack of sleep can be the result of simply not allowing enough hours in the day for sleep. To find out more about how much sleep you need, see my previous blog post on that subject.
If you feel tired, it is important to be aware that there is a difference between sleepiness and fatigue. Excessive daytime sleepiness is caused by a lack of sleep and results in you falling asleep easily in the day during unstimulating tasks like reading, meetings and, most worryingly, driving. Fatigue is physical tiredness due to a lack of rest, not sleep. So if you are feeling tired, but not sleepy, you may just need to rest more. If that doesn’t help, then you may be lacking deep sleep and you will need to work on that.
If you are not sleeping well or getting enough sleep, the first thing to do is to look at your sleep hygiene.
What to Do
Consistency is key to good sleep hygiene, because it keeps your internal rhythm (known as the circadian clock) on track, so try to establish a daily routine that sets you up for a good night’s sleep:
Have a regular wake up time every day
Exercise outside in the morning if you can to tell the brain and body it is the start of the day
Try to eat your meals at the same time every day and try to finish your evening meal three hours before bedtime
If you find that thoughts keep you awake, set aside time before bed to review the day and plan ahead, because writing it down can really help get it out of your head, and once the allocated time is up, stop
Dim the lighting in the evening to a warm glow similar to candle light and use the night shift option for screens on IT equipment
Have a warm bath about an hour before bed, as the drop in body temperature afterwards induces sleep
After your bath, do something calming like meditation, a breathing practice (see below) or gentle exercise like yoga, tai chi or qigong
Reading before bed may also help you to switch off.
If you wake in the night, it is better to stay in bed resting (if you can bear it) than to get up and do things, as you will at least benefit from the rest. Breathing exercises can be helpful in getting back to sleep. Let go of the fear of not sleeping: control the factors that you can and let go of the rest. Enjoy the peaceful time and remember that rest can be as beneficial as sleep.
What to Avoid
Light, sound and a buildup of carbon dioxide at night can disrupt sleep, so eliminate as much light and sound from the bedroom as possible and ensure adequate ventilation through an open door or window.
If you smoke, be aware that nicotine is a stimulant and so can delay the onset of sleep as well as disrupting the quality of your sleep.
Caffeine is also a stimulant and it makes you pee, which is not a winning combination for a good night’s sleep. It has a half life of about six hours, so it is best to avoid caffeine after midday or at least six hours before bedtime if you want a to sleep well, and remember that there is caffeine in some soft drinks and in chocolate, especially the dark variety.
Although alcohol is a depressant rather than a stimulant, it can still have a detrimental effect on sleep quality. It may help you get to sleep, but it will disturb your slumber later on as the liver gets to work on it overnight.
You may not need to avoid smoking, caffeine or alcohol completely, just be aware of the impact that they can have on sleep and modify your behaviour accordingly, so cut down and/or change the timing of your consumption if you have a sleep problem.
Catching Up on Lost Sleep
If you haven’t slept well and feel that you need to catch up on lost sleep, try to nap before midday. Avoid napping in the afternoon or evening because that can negatively impact sleep.
If you feel that you need a pick me up in the afternoon, meditating for 10 minutes can be as reviving as sleep without having a negative impact on the quality of your sleep at night, in fact by teaching the body and mind to settle, routine meditation can improve sleep quality.
A really good way to meditate is to focus on the breath. The box breath exercise is supposed to be particularly good for wakefulness: breathe in for a count of four, hold your breath for a count of four, breathe out for a count of four and hold again for a count of four, repeating for 10 minutes and all the time breathing through your nose. For variety you could try the 3,4,5 breathing exercise breathing in for a count of three, holding for a count of four and breathing out for a count of five. If you feel comfortable with that, you can try extending it to 3,5,7. Making the out breath longer than the inbreath is particularly calming.
Medical Help for Insomnia
If you don’t see an improvement in your sleep after implementing the lifestyle factors suggested above for a month or so, it is advisable to see a doctor about it. Your GP should be able to diagnose if you have a particular sleep disorder such as sleep apnea, narcolepsy, restless leg syndrome or circadian rhythm disorder which requires treatment. Your GP may also be able to refer you for cognitive behavioural therapy for sleep if he or she feels that is appropriate. Sleeping pills should be avoided for daily, long-term use as they are addictive and have been linked to dementia, but they can serve a purpose for insomnia caused by acute stress, among other things.
If you are blessed with being able to sleep well, don’t short change yourself, give yourself at least eight hours of sleep opportunity every night. And if you don’t sleep well, please seek help. Your life really does depend on it.
If you would like to read more about sleep, I can highly recommend these three books:
- Matthew Walker's Why We Sleep (the new science of sleep and dreams)
- Chris Winter's The Sleep Solution (why your sleep is broken and how to fix it)
- Satchin Panda's The Circadian Code (lose weight, supercharge your energy and sleep well every night)