By Sarah “Steve” Mosko, PhD
Humans spend roughly a third of their lifetimes in slumber. Studies abound showing that a good night’s sleep (usually 7-9 hours) promotes a sense of well-being and that sleep loss leaves us feeling exhausted, irritable and easily overwhelmed by the day’s challenges. Not surprisingly, sleep consistently ranks in surveys as one of life’s most pleasurable activities. However, the percentage of both U.S. men and women in all age groups who are chronically sleep-deprived, averaging six hours sleep or less, has risen significantly in recent decades, according to the Centers for Disease Control.
Among the likely causes are societal shifts, like longer work hours, shift work, greater emphasis on getting ahead, and technologies that lure people into staying up late. This trend toward shorter sleep is particularly worrisome given the conclusions from sleep experts in a report titled “Sleep: A Health Imperative” that insufficient or mistimed sleep can contribute to serious health problems like cardiovascular disease, obesity, diabetes, depression and cancer, as well as auto accidents.
Because sleep is right up there with eating as a fundamental biological drive, you’d think that sleeping would be as easy as falling off a log, especially where people are increasingly short on sleep. Yet, the incidence of insomnia – loosely defined as difficulty falling or staying asleep – is about 30 percent of the adult population, and in a recent national survey, one in three adults reported difficulties related to sleep loss, such as trouble concentrating or remembering.
Sleep disturbance can be a symptom of other medical conditions, like chronic pain, breathing disorders or psychiatric problems, and in those instances professional help is needed. But when such medical conditions are not the cause, sleep problems are commonly rooted in poor sleep habits reflecting lack of knowledge about sleep and how to nurture it. Here’re some important tips, starting with the lower hanging fruit.
First, it’s critical to appreciate that sleep is a 24-hour (circadian) rhythm generated by the brain’s biological clock. This means you can’t expect to sleep well at inconsistent times from day to day. Getting up every day at about the same hour keeps your internal clock set to local time and promotes getting sleepy at roughly the same time each night. Develop a relaxing pre-bedtime routine (like bathing and reading), and keep the bedroom quiet, dark, cool and reserved just for sleep (and sex). Performing work, playing videogames and other waking activities in bed are cues to stay alert, not go to sleep.
Be aware that not everyone needs eight hours of sleep, just enough to feel rested and to function well. Avoiding napping is also helpful, but if you must, nap early in the day and keep it short, under 20 min. And, because the brain’s clock is set by environmental lighting, exposure to bright outdoor light early in the day helps the clock maintain a healthy alignment and eases troubles falling asleep at bedtime.
Avoiding substances known to disturb sleep is another basic tenet of good sleep hygiene. Caffeine has a longer action in the body than most people realize (the half-life, or time for the body to eliminate half the amount imbibed, is typically 5-10 hours), so it can contribute to trouble staying asleep as well as bedtime insomnia. Limit caffeine to first thing in the morning and don’t overdo it. Other stimulants, like tobacco and chocolate, are also no-nos in the evening. And, while many people look to alcohol, a central nervous system depressant, for help in falling asleep, once metabolized it promotes rebound sleeplessness later in the night.
Maintaining a healthy diet and body weight is also a foundation of healthy sleep, as weight gain promotes esophageal acid reflux, snoring and stoppages of breathing called apneas, all of which cause awakenings. Avoiding meals near bedtime minimizes reflux too, but if you need a late night snack, stick with a combo of complex carbohydrates and protein because that makes the sleep-promoting amino acid tryptophan more available to the brain. Regular aerobic exercise not only keeps body weight in check (and reduces anxiety and depression), but also promotes sounder, deeper sleep. Though sleep experts previously thought that exercise close to bedtime is too stimulating, the latest findings from the National Sleep Foundation support that some people benefit from exercise timed just before retiring.
Sleep disturbance is a natural consequence of added stressors, and a healthy dose of wisdom and patience can go a long way to prevent a temporary bout of insomnia from becoming chronic. The biggest mistake people make is to become over-focused and worried about getting to sleep. This leads to spending wasted hours in bed trying too hard to sleep, which only fosters anxiety and arousal. Over time, this pattern can become engrained so that the insomnia persists long after the original stressor has passed. The take home message here is twofold: If you can’t sleep, relocate to another room to do something relaxing, like reading, until you feel sleepy, and take to heart that you’ll get back to sleeping better soon enough.
Not including over-the-counter sleeping pills, Americans received over 60 million prescriptions for hypnotic medications in 2011, according to IMS Health which tracks healthcare statistics. However, sleeping pills are not without side effects, like next day drowsiness, dependence and loss of efficacy over time. Unnecessary pharmaceuticals also harm the environment because, after being excreted from the body, they go to water treatment plants not designed to remove them.
When the time-tested guidelines described here for nurturing sleep naturally are made a routine practice, most people can successfully reduce sleep struggles without drugs, even during times of heightened stress. However, if this self-help approach does not do the trick, a sleep expert can guide you through a non-pharmacological program called “cognitive behavioral therapy” that studies show is as effective as prescription hypnotics in treating chronic insomnia.