Sleep Hygiene

Sleep is as important for health and performance as food or exercise. Yet while people don’t hesitate to blame their diet for energy lapses or lack of exercise for injury or performance issues sleep rarely gets the attention it deserves. Yet without proper sleep we become stressed, fatigued, moody, and more prone to injury or persistent pain. We lose focus, suffer cognitive lapses, and perform at our worst.

We spend 1/3 to 1/4 of our lives sleeping. It is one of the essential components of recovery yet there is an epidemic today of people not getting enough sleep, having difficulty falling asleep or even having insomnia.

Big Pharm has many ‘quick fix’ approaches for sleep disorders, but they all have major side effects. Natural products abound, but how can a consumer know what the actual science has demonstrated actually works, from the hype advertisements and wellness claims.

As an alternative to medications and the latest unproven remedies let’s look at the Sleep Science and what has been demonstrated to promote good ‘Sleep Hygiene.’ For our purposes Sleep Hygiene means approaches and methods designed to improve both the quality and quantity of sleep you get.

How big a problem is lack of sleep? We are in an age where there is a poverty of time. In a paper written in 2019 by Laura Giruge and Ashley Whillans from the Harvard Business School titled ‘Beyond Material Poverty: Why Time Poverty Matters for Individuals, Organisations, and Nations’ it writes -

Over the last two decades, global wealth has risen. Yet, material affluence has not translated into time affluence. Instead, most people today report feeling persistently “time poor”—like they have too many things to do and not enough time to do them. This is critical because time poverty is linked to lower well-being, physical health, and productivity.

Did you know that 35% of people sleep less than 6 hours a day. 1/3 of people have insomnia or have had it in their lifetime. Nearly 60% of athletes have mild-moderate sleep problems.

· Lower alertness and concentration/decreased focus.

· Pain (increased pain sensitivity/experience) (Chloe, 2023)
   42% of chronic neck and back pain patients experience sleep problems.

· Increases infection risk (increased inflammation) (Lasselin 2016) Those sleeping less than 6 h were at greater risk of developing a cold compared to those sleeping greater than 7 h per night (Prather 2015)

· Performance (increased neuromuscular fatigue)

· Increased sports injuries are associated with lack of sleep.
  Sleeping less than 8 hours/night is associated with 1.7x higher risk of injury (Milewski 2014)

· Increases the risk of heart disease (by 20%) even in non-smokers who exercise and have no genetic risk factors (Daghlas 2019).

· Metabolism (impaired glucose/carbohydrate metabolism) & Endocrine dysregulation (cortisol, anabolic – testosterone)
  It’s been estimated that adults who sleep less than 7 hours/night are 30% more likely to be obese (Ding 2018, Lasselin 2016)
  “A chronic pattern of sleep duration of ≤6 h a night has been associated with a higher body mass index (BMI)” (Papatriantafyllou 2022).

· In 1989, Ford and Kamerow’s study demonstrated that insomnia increased the likelihood of psychiatric disorders.

For most adults 8-10 hours is enough for maintaining good health. People in their teens (13-18 years old) need somewhat more and children between 6-12 years old need around 9-12 hours. These numbers vary from person to person and our genetics can affect how long we need to sleep each night (Fu & Ptacek 2022).

Sleep Trackers can measure both how long you sleep and the quality of your sleep (e.g. reaching REM sleep). However, in spite of their growing popularity none of the sleep measurement devices are very accurate yet. Questoinairres are often used in Sleep Clinics. But, there is no consensus yet. One widely used scale is the ‘Pittsburgh Sleep Quality Index (PSQI)’.

2 SIMPLE MEASUREMENTS I RECOMMED ARE:

1.What time do you get into bed and what time you get out of bed
2.How rested or fatigued do you feel when you awaken

SLEEP HYGIENE - THE BASICS

Here are my Top 4 Tips for Getting a Good Night Sleep

• Know when you get into bed at night and get up from bed in the morning
  •Sleep Trackers are inaccurate

• Avoid food or alcohol within 3 hours of bedtime

• Keep your room temperature a little cool

• Ensure that there is minimal ambient light or sound in your bedroom

• Maintain a regular sleep schedule (bedtime), pre-bed routine, and regular sleep duration of 7-8 hours.

• Seek bright light during the day, especially in the early morning to reset your circadian rhythm.
  •It’s been recommended that early morning light exposure close to the horizon helps to re-set the circadian rhythm so it’s easier to fall asleep at night (Rivera 2020).
 •Let your eyes physically relax by looking at the morning horizon or a panoramic view. We call this ‘soft’ eyes. It is when you are not straining to focus on a single object but allowing the eyes to take in the expanse of your field of vision. 
  •Take in at least 30-60 minutes of direct sunlight/day.

•Keep your bedroom quiet. If necessary, consider a pair of ear plugs.

• Avoid caffeine after 2 P.M. or 12 hours before bedtime (realize if you can sleep on caffeine, you’re not actually achieving deep REM sleep)

• “To avoid reductions in total sleep time, coffee (107 mg per 250 mL) should be consumed at least 8.8 h prior to bedtime…Caffeine consumption reduced total sleep time by 45 min” (Gardiner 2023)

• Wake up at same time; even on weekends to maintain a regular sleep and wake pattern.

• Exercise during the day is the single best way to improve the quality of your sleep.

•Deep sleep is often compromised by certain sleep aids such as alcohol or sleeping pills.

• A warm shower prior to bed can help you prepare for sleep by triggering the cooling process that naturally occurs during sleep.

Although technology has solved many issues in our daily lives, it undoubtedly created other issues. Did you know “exposure to blue-wavelength light in particular from these devices may affect sleep by suppressing melatonin and causing neurophysiologic arousal…Wearing amber vs. clear lenses for 2-h preceding bedtime for 1-week improved sleep in individuals with insomnia symptoms.” (Shechter 2018).

If you’re going to be viewing electronics close to bedtime investing in anti-blue light glasses can help your sleep. You need to make sure that you have optimal levels of melatonin to sleep quickly and stay asleep throughout the night. If not, you can consider avoiding the use of electronic displays all together for at least one hour before sleep.

There are many ways to improve sleep hygiene besides taking pills. These options include behavioral, lifestyle, diet, environmental or psychological strategies. Experiement until you find what works for you!

If you are still having issues trying to figure out where to start just make some easy changes first such as start exercising during the day and ensure that you have a comfortable mattress or sleep environment at night. If even after exploring the options suggested in this article you are still having significant sleep problems, then find a sleep professional for additional assessments and strategies.