All cultures have sleep problems and they are becoming more common. The impact of sleep disorders and other sleep problems is significant in both personal and economic cost. Insomnia alone costs billion in lost productivity in the United States every year. The need for simple, easy-to-implement treatments is growing, leading to the popularity of whats called good sleep hygiene.
Note: The content on Sleepopolis is meant to be informative in nature, but it shouldnt take the place of medical advice and supervision from a trained professional. You should immediately consult your healthcare provider if you suspect you might have a sleep disorder or other medical condition.
What Is Sleep Hygiene?
A set of practices and habits that are associated with sleep hygiene, such as the environment and bedtime routine, is called sleep hygiene.These sleep hygiene tips are meant to improve your quality and length of sleep. They were originally developed to relieve mild to moderate insomnia symptoms, though the term has since become a catch-all phrase for a variety of behaviors that promote healthy sleep.
Hygiene
Conditions or practices conducive to maintaining health and preventing disease.
The term sleep hygiene was first used in 1939, but became part of the lexicon of modern sleep medicine in 1977 when psychologist Peter Hauri described a list of simple actions intended to improve sleep.These are the recommendations for a typical checklist of sleep hygiene::
- Wake up every morning at the same time, even weekends.
- Create a quiet, dark, and cool sleeping environment
- Avoid eating meals or drinking caffeine or alcohol in the hours before bedtime
- Reduce or eliminate naps
- Before you go to bed, turn off all sources of blue light (including smartphones, tablets and televisions) at least an hour in advance
Other common suggestions include reserving the bed for sleep and sex only, and exercising regularly but not too close to bedtime. Though these tips are intended to improve sleep and even eliminate insomnia, many sleep hygiene lists dont prioritize recommendations, describe how to practice good sleep hygiene, or explain how the suggestions prevent or treat persistent insomnia.
These suggestions are science-based. If they are put into practice, can they improve sleep patterns or sleep disorders like insomnia?
The Research Behind Sleep Hygiene
These sleep hygiene tips may seem to make sense and could prove to be beneficial for those who are struggling to get to sleep well. It is not clear if they are effective in treating insomnia or other sleep disorders.
Insomnia
Difficulty falling asleep, staying asleep, or falling back to sleep. Insomnia symptoms lasting three months or longer are considered chronic insomnia, or insomnia disorder.
Few studies support sleep hygiene as a treatment for chronic sleep problems.. Although some studies have suggested that good sleep hygiene can be used in conjunction with cognitive behavioral therapy for sleep disorders, the latest science doesn’t support it as a treatment for other sleep disorders or insomnia.
Despite the dearth of research studies, sleep hygiene recommendations have become ubiquitous.
There are many resources for sleep hygiene available online and in books. Inadequate sleep hygiene was included as a cause of insomnia in The International Classification of Sleep Disorders manual in 1990, but has since been removed due to a lack of reproducible studies.
Although the American Academy of Sleep Medicine has updated their guidelines to include references to sleep hygiene, they don’t recommend it as a treatment for chronic sleeplessness due to a lack of scientific evidence.Examined as individual recommendations, some sleep hygiene suggestions have more evidence as treatment for difficulty falling or staying asleep than others.
Consistent Sleep And Wake Times
One of the best sleep hygiene tips that can be scientifically supported is consistency in sleeping habits. Inconsistent sleep habits and wake times can include long or frequent naps, shift work, frequent travel across time zones, and frequent waking up at night.
The circadian rhythm is highly sensitive to environmental cues, including light and darkness, meal times, and the sleeping environment.Inconsistently waking up and going to bed at different times can disturb the circadian rhythm. This can lead to daytime sleepiness, insomnia symptoms, such as difficulty falling asleep or staying asleep, and even irritability.
Even a single night of inconsistent sleep can cause decreased cognitive functioning on laboratory tests. Sleep specialists recommend that you go to bed at the same time every night, and that you wake up on weekends and weekdays at the same times. Consistency in waking routines, including meal and work times and going outside, appears to help sleep, as well.
Consistency helps to align the circadian rhythm of sleep with that of other circadian-influenced functions, such as digestion, hormone release, and body temperature. Insufficient sleep can have a negative effect on your metabolism, cognitive function, and cardiovascular health.Consistency in sleep is also associated with lower body fat in women, as well as better mental health. Consistent sleep patterns may reduce the time taken to fall asleep. This process is known as sleep latency.
Avoid Using Electronic Devices Before You Go To Bed
One of the most common sleep hygiene suggestions is to turn off electronic devices such as smartphones, tablets, and televisions before bed.The blue light emitted by these devices may impact the circadian rhythm in a similar way to sunlight, delaying or preventing sleep.
The visible light spectrum includes blue light, which is easily detected by the human eye. The wavelengths of light are related to the amount of energy they emit. Blue light has a short wavelength and emits more energy than light with a longer wavelength.
Blue light helps us stay alert and happy during the day.. Blue light has a positive impact on cognitive function and improves reaction times. Blue light is mainly generated by sunlight, which scatters easily into the air and water molecules of the atmosphere.
FAQ
Q:Why is the sky blue?
A:Blue light is scattered in the atmosphere, making it appear blue rather than other colors.
Nearly all of the blue light we see from sunlight and electronic devices reaches the retina of the eye, which sends light and darkness signals to the brain. These signals are crucial for the regulation of sleep and wake time, hormone release, hunger, and metabolism.
Many sleep scientists believe that while blue light in the day can be beneficial for health, blue light after sunset is not good for the brain and body. Although glasses that filter out blue light from electronic devices have gained popularity, there is not much scientific evidence to support their effectiveness.
These artificial sources may produce blue light:
- Devices for reading
- Smartphones
- Computers
- Tablets
- Televisions
- LED lights
- Video games
Although there is no evidence of eye damage from artificial blue light, the American Academy of Ophthalmology believes blue light can disrupt the circadian rhythms and disrupt sleep.As a sleep hygiene recommendation, avoidance of blue light within a few hours of bed appears to have sound scientific support.
The Perfect Environment For A Peaceful, Dark, And Quiet Night’s Sleep
Some aspects of the sleep environment can have a profound effect on your ability to sleep.Core body temperature decreases just before and during sleep, while darkness helps promote release of melatonin. A quiet bedroom can help maintain sensory gating. This is the brain’s way of protecting sleep and filtering out potentially dangerous stimuli.
The body prepares for sleep by lowering core temperature. The core temperature is measured in the deeper parts of your body, such as the blood or vital organs. Core temperature begins to drop in the late afternoon and gradually decreases over the course of the evening. Core temperature falls further after sleep begins, while skin temperature remains steady.
A cool bedroom may help keep core body temperatures constant and promote healthy sleep. The bodys ability to regulate its internal temperature – called thermoregulation – is reduced during sleep. Because sweating and shivering decrease significantly, the body may respond to an excessively warm environment by waking up to cool itself.
The need to maintain a stable temperature may lead to delayed or disrupted sleep.
Melatonin
A sleep-promoting hormone produced by the pineal gland in the brain. Supplemental melatonin can be taken to help regulate sleep and wake cycles.
The circadian rhythm is strongly influenced by light and darkness signals.Even small amounts of artificial or natural light can send wake signals to the brain and reduce or stop the release of melatonin. Reduced use of lights at night, especially those emitting blue light, can help promote sleep and decrease the time taken to fall asleep.
Any noise can disrupt sleep, especially if it is inconsistent or reverberating.Research shows that deep sleep is more effective in quiet environments, and awakenings are more common in noisy ones.. Although certain brain waves can help protect the brain from waking during the deeper stages through sensory gating (sensory gating), noise or other stimuli can still wake a person in the N1 and REM phases of sleep.
Avoid eating, drinking, or using caffeine before going to bed
Proponents of good sleeping hygiene discourage eating before bed, or even eating at all. Some studies have mixed results, with some suggesting that prebedtime meals can wake up the digestive system, disrupt the circadian rhythm, increase body fat, and even cause a disturbance in the circadian rhythm.
Other research shows that small, nutrient-dense meals may help promote healthy sleep and prevent sleep difficulties due to hunger. Eating foods high in protein could even help boost metabolism and burn more calories.Small amounts of protein-rich foods may offer nutrition to muscles and other tissues that undergo repair processes during sleep.
Most studies about metabolism and sleep support not eating in the few hours before bed, or eating only lightly. Although healthy sleep does not require fasting, large meals can disrupt sleep patterns, cause heartburn and stimulate organs that would otherwise remain less active.
Other common tips for sleep hygiene include avoiding alcohol and caffeine.Caffeine is a stimulant which blocks the receptors for Adenosine. This neurotransmitter causes sleepiness when levels rise throughout the day.. Caffeine can disrupt sleep, even if it is taken in the morning.
FAQ
??????? How much caffeine does the average person consume?
A:Caffeine is the most well-known drug in the US.More than half of Americans consume at least 300 milligrams a day, or the equivalent of three cups of coffee.
Research supports the recommendation to avoid caffeine close to bedtime. Although caffeine may be helpful in combating fatigue, it can also cause sleep disruptions and increase the need for stimulants to keep alert.Caffeine can lower sleep quality, and create a state of physical withdrawal during sleep that results in lowered mood and morning sleepiness.
Proponents of sleep hygiene have supported the claim that alcohol can cause sleep problems with solid research. Although alcohol is a nervous system depressant and not a stimulant, its effects on sleep can be as disruptive as those experienced by some caffeine users.
While alcohol can be helpful in helping non-alcoholics fall asleep faster, it can also make awakenings more likely. This could be because alcohol wears off during sleep and causes rebound wakefulness.The circadian rhythms ability of the master clock to sync with smaller local clocks in tissues and organs is also affected by alcohol.. This can lead to compromised liver and gastrointestinal function as well as sleep disruption.
Alcohol suppresses REM sleep, which may impact overall sleep quality as well as the cognitive and physical processes that take place during REM, such as dreaming and memory consolidation. In addition,alcohol reduces the production of melatonin and changes the pattern of sleep stages, also known as sleep architecture.
Memory consolidation
Stabilizing memories after they have been acquired by the brain is a cognitive process.
The risk of developing sleep-related breathing disorders like sleep apnea increases when alcohol causes a greater than normal relaxation in the neck and head. It may also cause or worsen insomnia, snoring, and parasomnia disorders such as sleepwalking.
Avoiding Naps
On many sleep hygiene lists, a common recommendation is to reduce the number of naps. Sleep specialists often advise patients with insomnia or other sleep disorders to reduce the frequency of naps. This will increase sleep efficiency and drive to sleep.
Though brief naps may help to restore alertness and diminish the feeling of sleepiness in people who are considered good sleepers, numerous studies demonstrate thatdaytime sleeping can reduce or disrupt the homeostatic drive to sleep at night. For that reason, specialists in insomnia treatment often recommend foregoing naps to help regulate the circadian rhythm and sleep-wake cycles. Not napping is part of the protocol of sleep restriction, a type of therapy used for chronic insomnia.
What Works For Chronic Insomnia?
While most sleep hygiene suggestions are supported by science, they dont appear to be sufficient in themselves to treat persistent sleep disorders such as chronic insomnia. This may be in part because most people suffering from insomnia disorder try to alleviate their symptoms early on with relatively simple sleep hygiene suggestions, which are often ineffective. To understand the role sleep hygiene plays in treating sleep disorders and difficulties, more research is required.
Poor sleep hygiene is not the cause of chronic insomnia. It can be a sign of psychological trauma. The circadian rhythm is finely attuned to cues both from the environment and the brain. Patients may associate sleep problems with difficulties falling asleep, such as bedtime, bedtime and evening routine.Hyperarousal of the nervous system can result, making sleep more difficult and perpetuating symptoms of insomnia.
Sleep hygiene may be effective for mitigating temporary sleep difficulties associated with poor sleep habits or life circumstances. It may also be used in conjunction with CBT-I, which is Cognitive Behavioral Therapy for Insomnia. CBT-I is well-supported scientifically and has a proven track record of effectiveness for chronic insomnia.
CBT-I Protocol includes:
- Stimulus control therapy is a treatment that strengthens the relationship between sleep and the environment. SCT involves using the bed solely for sleep and sex, getting out of bed only if you are unable to sleep within ten minutes, returning back to bed only when you feel sleepy, not going to bed and getting up every day.
- Therapy to reduce sleep.Sleep restriction limits time in bed to the average number of hours spent sleeping. The purpose of sleep restriction is to diminish the association between the sleeping environment and wakefulness. This therapy can regulate the circadian rhythm, and help improve sleep patterns. Sleep restriction is backed by extensive scientific studies, and can have a significant effect on insomnia symptoms.Sleep restriction reduces sleep latency and increases time in deep, slow-wave sleep..
- Cognitive therapy is used to address sleep anxieties and beliefs. Education about sleep and the impact of erroneous beliefs has been proven to be an effective complement to other CBT-I therapies.Cognitive therapy can help establish new thought patterns, reduce anxiety, and dispel negative associations with sleep.
Last Word From Sleepopolis
The research in support of sleep hygiene as a treatment for more than temporary sleeplessness is limited and inconclusive.
Insomnia symptoms are common and typically transitory.Chronic insomnia lasting six months or longer is nearly always a result of negative psychological associations with the bed and the attempt to sleep, and is rarely the result of sleep hygiene or easy-to-correct lifestyle choices.
Sleep hygiene may be particularly helpful for those with poor sleep habits. People who can sleep well in normal circumstances and practice common-sense sleep hygiene behaviors like caffeine avoidance, will find that many sleep hygiene tips are effective in improving their sleep. Most of us will experience temporary sleep difficulty at some point in life, and may benefit from improved sleep hygiene.
