Practicing Good Sleep Hygiene

Good sleep hygiene is an important component of good health, according to Jennifer Rose Molano, MD, a neurologist and sleep medicine specialist with the UC Memory Disorders Center and UC Health. It involves a conscious effort to get regular, high-quality sleep. It requires the daily discipline and will to build in a de-activating period during the hour before bedtime.

While important for anyone who wants to maximize cognitive function during the day, sleep hygiene is the first step in treatment for people with serious sleep disorders, which include obstructive sleep apnea and sleep disruptions caused by medication side effects, medical conditions (such as asthma, thyroid disease or heart failure), neurological conditions (such as epilepsy, stroke or Parkinson’s disease), and psychiatric disorders (such as anxiety and depression).

“Establishing good sleep hygiene might not resolve all sleep issues, but it’s the first step,” Dr. Molano says. “If your sleep hygiene is poor, then it’s a challenge to get optimal treatment for your sleep issues, regardless of whether they’re due to a sleep disorder like obstructive sleep apnea or a medical condition.”

The sleep cycle, Dr. Molano says, is regulated by two main processes: 1) our circadian rhythm, or internal clock; and 2) the buildup of the sleep drive throughout the day. “It’s a combination of those two things that help us stay awake during the day and fall asleep at night,” she says. A faulty sleep cycle, for example, can be associated with insomnia. An individual is said to have insomnia if he or she cannot fall asleep, cannot stay asleep, wakes up too early, or wakes up unrefreshed.

“Our sleep drive is highly influenced by what we do during the day,” Dr. Molano says. “The two things that can influence our sleep drive at night are caffeine or taking prolonged naps in the afternoon. If people drink a lot of caffeine in the afternoon or if they take a one- or two-hour nap during the day, their body is a little bit confused when they try to go to sleep at 10 or 11 at night. Their body is getting a mixed signal; it doesn’t understand why it’s supposed to go to sleep.”

The basics of good sleep hygiene include:

  • establishing a routine of going to bed at the same time every night and rising at the same time every morning, even on the weekends
  • eliminating caffeinated beverages in the afternoon
  • eliminating afternoon naps; if you must have a nap, limit it to less than 30 minutes a day
  • switching to relaxing activities one hour before bedtime; these can include taking a warm bath or listening to music
  • creating a calm, quiet space for sleep

The last item, turning the bed and bedroom into a place for sleep, rather than for brooding or problem solving, is critical in our harried world. Dr. Molano describes insomnia as an “activating process,” in which the mind becomes active and alert at a time when it should be resting and letting go. As such, sleep hygiene is also about stimulus control.

“If you’re unable to fall asleep, it’s important to condition and train your brain that your bed is only for sleep and other nighttime activities. So that means if you’re unable to fall asleep, it’s ideal to go out to a different room and engage in a quiet activity like reading or writing in a thought journal. You should not watch TV, play video games or read e-mails from work in the bedroom, especially if you are prone to insomnia.”

Good sleep hygiene alone will not resolve every case of disrupted sleep, of course, and Dr. Molano spends a good part of her day helping patients find solutions to more complex sleep-related problems. But for the typical person who doesn’t get enough sleep, the rewards of good sleep hygiene can be significant.

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