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Sleep hygiene

Dr Henriette Smith October 2017

· Mind,Life Skills

The term "hygiene" is often misunderstood as strictly being synonymous with "cleanliness." The true meaning of hygiene has to do with sets of practices, habits, and environmental influences that impact one's health. Hygiene of all kinds are important to your health and well-being as most are aimed at reducing your chances of coming into contact with diseases, getting infections, spreading germs and viruses, or preventing oral cavities and gingivitis.

If all of these other types of hygienic practices are aimed at preserving your health, exactly what is sleep hygiene and how can it help you in your everyday life?

The Importance of Quality Sleep

Getting a full night's sleep every night is important to people's overall health and happiness. Most of us are aware that when we lose a few hours of sleep, we are often tired and cranky the next day and have difficulty concentrating, staying alert, and being in a positive mood. And all of these things can occur after just one day of lost sleep.

If you're regularly losing sleep, you're putting yourself at risk to a whole slew of health issues and medical conditions including

  • heart disease
  • heart attacks
  • stroke
  • diabetes
  • obesity
  • cognitive impairment
  • memory loss
  • chronic stress
  • heart arrhythmia
  • increased likelihood of accidents
  • depression
  • mood disorders

It's mind blowing to think that all of these problems can occur simply from losing a few hours of sleep a night. In today's 24/7 world where our time is in high demand, many people feel that their sleep comes second to societal needs. With our professional, social, academic, and family lives requiring so much of our time, it's no wonder that so many people experience sleep deprivation.

How To Practice Sleep Hygiene

Many people may realize the impact that poor sleep quality is having on their daily lives, but may be unsure of what types of activities are contributing to their sleep loss, or simple practices they could be doing to ensure they get not only more sleep, but better sleep.

Many people believe that because they slept between the 7-9 hours of recommended nightly sleep, that they're doing things right. However, while getting enough hours of sleep is very important, getting quality sleep is more important. If you're doing things that are disruptive to your sleep, your body and mind are not truly resting enough to repair and prepare themselves for the next day.

Getting (or not getting) great sleep every night is often due to two important factors: your personal habits and your sleeping environment. The things you do during the day and leading up to sleeping at night can impact your sleep just as much as the environment you choose to sleep in. Optimizing both your personal habits and your sleep environment is paramount to successful sleep.

Personal Habits

  • Establish a regular bedtime routine. Going to bed and waking up at the same time each day sets the body’s "internal clock" to expect sleep at a certain time night after night. Part of keeping a healthy bedtime routine is to keep it up even on the weekends by avoiding staying up late and sleeping in. Depriving yourself of sleep during the midweek and binge-sleeping on the weekends does more harm to your sleep cycles than good.
  • Exercise regularly. Exercise breeds energy and also helps reduce stress, anxiety, and depression. Exercise in the late afternoon is best for sleep because the physical activity helps wear us out, and the post-workout body temperature drop helps cool the body, making sleep come more readily. However, exercise too close to bedtime can make sleep difficult to come, as your body doesn't have enough time to cool itself off.
  • Eating healthy. It's no secret that some foods are great for sleep, and others can help keep us awake at night. Fatty foods, processed carbs, and spicy foods are the worst for sleep. Foods high in fat and processed carbs don't have the nutrients and vitamins your body needs to produce energy, leaving you feeling sluggish during the day. Spicy foods, eaten too close to bedtime, can disrupt your sleep by causing acid reflux, which can disturb your sleep. Foods that help promote sleep are those that are high in amino acids, proteins, antioxidants, and vitamins.
  • Don't eat too close to bedtime. Eating too close to bedtime can disrupt your sleep, mostly because it gets your stomach acids going, and lying down can cause those acids to creep up into your throat. If you're really craving a late night snack, try a bowl of cereal with milk or cheese and crackers. These types of foods are rich in minerals, such as tryptophan and calcium, which help promote sleep.
  • Balance Fluid Intake Drink enough fluid at night to keep from waking up thirsty—but not so much and so close to bedtime that you will be awakened by the need for a trip to the bathroom.
  • Avoid caffeine and nicotine close to bedtime. Caffeine and nicotine are stimulants that, when taken within 4-6 hours of bedtime, can make it difficult to go to sleep or stay asleep until the chemicals wear off. Many people may recognize that drinks such as soda, tea, and coffee contain caffeine, but may not realize that foods such as chocolate and some pain releivers also contain caffeine. Similarly, smokers should refrain from using tobacco products too close to bedtime.
  • Avoid alcohol before bedtime. Many people falsely believe that alcohol help promotes sleep as it makes them drowsy and more likely to fall asleep quicker. However, after a few hours it acts as a stimulant, increasing the number of awakenings and generally decreasing the quality of sleep later in the night. It is therefore best to limit alcohol consumption to one to two drinks per day, or less, and to avoid drinking within three hours of bedtime.
  • Get light when possible. Your circadian rhythm, the internal clock that regulates periods of sleep and wakefulness, is triggered by light and darkness. Getting ample amounts of natural light during the day and less light at night helps keep your circadian rhythm in harmony with the external world.
  • Practice relaxation techniques before bedtime. To help get your body and mind prepared for sleep, try some relaxing activities to prepare yourself for sleep. Take a bath (the rise, then fall in body temperature promotes drowsiness), read a book, watch television, or practice relaxation exercises. Avoid stressful, stimulating activities—doing work, discussing emotional issues. Dwelling on problems or bringing arguments to bed can keep you awake and worrying. Activities such as meditating, praying, and stretching can help ease the stresses in the body and mind before bedtime. Writing your frustrations out in a journal can also be therapeutic and stress relieving.

Your Sleep Environment

  • Associate your bedroom with sleep and sex only. These are really the only activities that your bedroom should be designed for. Doing any other activities in your bedroom can cause your mind to associate it with other stimulating endeavors. Don't watch TV, listen to the radio, or talk with your partner about important life occurrences or problems in bed. Bringing stimulating content or conversation to bed can keep you awake engaging in it or worrying about it.
  • Keep electronics out of the room. All electronic devices including TV's, tablets, laptops, cellphones, portable gaming systems, and e-readers should be ditched before bedtime. For starters, the content may be stimulating and keeping you awake as you play "just one more game" or read "just one more post." Furthermore, the light emitting from these devices is similar in wave-length to daylight and can trick your circadian rhythm into believing it's daylight and delay the release of melatonin, a hormone that promotes sleep.
  • Keep your room dark. Light is bad for sleep as it can disrupt your circadian rhythm. Keep your room dark by using heavy window shades, wearing a sleep mask, and avoiding staring at glowing electronics.
  • Keep your room quiet. Noise can keep you awake so make sure your room is as free of unnecessary sounds as possible. If you're still having trouble sleeping because of noisy neighbors or others in the house consider using earplugs to block out sound or try "white noise." Fans and sound machines that make continuous rhythmic sounds can be both relaxing and aid in drowning out distracting or sudden noises.
  • Keep your room cool. As you go to sleep your body temperature begins to drop as it prepares itself for slumber. Keeping your room a cool temperature (between 60-67 degrees) can help aid the process of cooling your body.
  • Make your bed as comfy as possible. Most mattresses are good for about 9 years. If your mattress is out of date or uncomfortable, getting a new mattress can go a long way towards great sleep. Having an uncomfortable pillow or bedding can keep you from sleep as well. If you're constantly readjusting your pillow before bedtime, it may be time to get a new one.
  • Set your alarm and keep it away from your bed. Too often people get used to using their phone as their wake-up device. Having your phone close to your bed makes it too easy to continuously check it for new texts, emails, or just looking at the time. Constantly reminding yourself of the time can create anxiety, making sleep more difficult. Also, keeping your alarm away from your bed reduces the chances of hitting the snooze button over and over, and it makes you get up out of bed to shut it off.
  • Nap Early—Or Not at All. Many people make naps a regular part of their day. However, for those who find falling asleep or staying asleep through the night problematic, afternoon napping may be one of the culprits. This is because late-day naps decrease sleep drive. If you must nap, it’s better to keep it short and before 5 p.m.
  • Don’t stay in bed awake for more than 5-10 minutes. If you find your mind racing, or worrying about not being able to sleep during the middle of the night, get out of bed, and sit in a chair in the dark. Do your mind racing in the chair until you are sleepy, then return to bed. No TV or internet during these periods! That will just stimulate you more than desired. If this happens several times during the night, that is OK. Just maintain your regular wake time, and try to avoid naps.
  • Use a sleep diary. (Link for sleep diary) This worksheet can be a useful way of making sure you have the right facts about your sleep, rather than making assumptions. Because a diary involves watching the clock, it is a good idea to only use it for two weeks to get an idea of what is going on and then perhaps two months down the track to see how you are progressing.

By following these best sleep hygiene practices on a nightly basis, you're almost guaranteed to get more fulfilling sleep at night and be more awake and alert during the day. That said, not all sleep problems are so easily treated and could signify the presence of a sleep disorder such as apnea, restless legs syndrome, narcolepsy, or another clinical sleep problem. If your sleep difficulties don’t improve through good sleep hygiene, you may want to consult your physician or a sleep specialist.

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This blog is only for informational and educational purposes and should not be considered therapy or any form of treatment. We are not able to respond to specific questions or comments about personal situations, appropriate diagnosis or treatment, or otherwise provide any clinical opinions. If you think you need immediate assistance, call your local doctor/psychologist or psychiatrist or the SADAG Mental health Line on 011 234 4837. If necessary, please phone the Suicide Crisis Line on 0800 567 567 or sms 31393.