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Sleep – Part 2 – The tips

If you are not getting enough sleep every night, there are a few things you can try.

First, download and fill out the first part of the Sleep Worksheet found in the Sleep Tips & Worksheet. After you have answered those questions, read through the list and make some decisions on page 2 of the Sleep Worksheet!

Actually write down the answers!  Print the whole thing out if it helps you.

The Sleep Tip & Worksheet is important because it can help you take a look at WHY you want to make the changes. Our WHY is often our greatest motivator!!

The full list of 18 tips to improve your sleep quality and quantity

1 – What’s your sleep schedule?

Having a consistent sleep schedule is one of the most important things you can do. Our society promotes round-the-clock activity. This can affect anyone, not just shift workers and students. Time dedicated to sleep is often consciously reduced due to work demands and social activities.(1,3,10,11)

Try to go to bed and wake up at the same time every day, including weekends, as much as possible.(12)

If you see that other activities keep running past your designated sleep time, then try to reorganize your day to include those activities at other times. Or let things go if you are too busy. Sleep is that important!

2 – Create a calming bedtime routine and practice it regularly.

Whether that includes bedtime yoga, meditation, a relaxing bath, warm herbal tea, and/or a soothing book, do what works to help you wind down for the night.(3,10,12)

But don’t start this routine at your desired sleep time. Start it with enough time to complete before your goal sleep time!

I make the mistake of reading exciting fiction and then I can’t put it down. Same with watching shows on Netflix. As you will see in the next section this has the added impact of exposing you to blue light right before bed.

If you add a calming tea, drink early enough to avoid those midnight bathroom wake ups.

3 – Bright light in the day; block the blue at night.

Expose your eyes to bright light during the day, especially in the morning. This also means avoiding bright lights at night wherever possible because it can extend the time it takes you to fall asleep. This includes watching screens before bed. Why? Because your eyes respond to cues from light. When the light is dimmer and has more red wavelengths (think of a sunset), your brain makes the “sleep hormone” melatonin.(3,12,13)

If you must work or use screens in the evening, consider blue blocking glasses. Or install filters on your devices. “F.lux” is great for laptops. Twilight works for android devices. Apple has a new option built into the settings.

4 – Is your bedroom comfortable?

Your bedroom should be cool and dark so you aren’t woken by being too hot or cold or when the sun gets too bright.(3,12) Your mattress should be comfortable, too. If sounds bother you, consider blocking them out with a fan or white noise machine.(11)

5 – Regular exercise.

Exercising 20-30 minutes each day can help, particularly aerobic exercises like walking, jogging, or swimming.(11) Try to finish your exercise a few hours before you plan to go to bed so you have time to relax.(1,3)

6 – Can you handle caffeine at night? Are you sure?

Caffeine works to wake you up by blocking the sleep-promoting effects of the compound adenosine. This reduces your ability to fall asleep. Caffeine can also increase the need to go to the bathroom, which can wake you up once you are asleep. The effects of caffeine on your body and brain can last several hours.(14)

A study published in the Journal of Clinical Sleep Medicine shows that the more caffeine you have before bed, the more it disrupts your sleep. They recommend not having caffeine within 6 hours of going to sleep. So, if you go to sleep at 10 p.m., eliminate energy drinks, coffee, caffeinated pop/soda, tea, etc. by 4 p.m. at the latest. Ideally, you would cut those out even earlier in the day.(3,12,13,16)

FUN FACT: If you have caffeine within 3-6 hours of going to sleep you may not even know that your sleep is being disrupted—even though it might be.(15)

7 – Avoid tobacco.

Nicotine stimulates your brain and your heart, making it harder to fall asleep.(14) Avoid tobacco products, including regular cigarettes and nicotine-containing e-cigs.(3,12) If you have a very difficult time quitting, avoid it for at least two hours before you want to go to sleep.(14)

8 – Nix the nightcaps.

You should avoid alcohol before bed because it negatively impacts sleep quality by reducing REM sleep.(14) Having alcohol before bed may seem okay because it can make you feel tired, but you don’t get quality sleep.(3,12,14)

9 – Stomach issues?

Having a large meal before bed can disrupt sleep. This is especially true if you experience acid reflux.(12) Try eating regular meals throughout the day so you’re not too hungry when it’s time to sleep. Save half of your huge amazing restaurant meal as leftovers. Even a portion of it added to a salad will make a fine leftover lunch and save $ too!

10 – Nighttime bathroom breaks?

Drinking a lot of liquids before bed can wake you up to go to the bathroom.  Try to hydrate throughout the day so that you’re not thirsty before bed.(12)  If I haven’t had enough water that day, I try to catch up at least an hour before sleeping so that I have time to go to the bathroom again right before bed.

If you do get up to go to the bathroom, remember that your body woke you up to use the facilities, not to stress about the day and lose sleep. Accepting that and not getting stressed that you might be up for good will help you go back to sleep more quickly. I used to get so stressed that I would be up for good!

If you are having multiple wake-ups in the night, you may benefit from seeing a practitioner to help sort that out.

11 – Are you a clock watcher?

Watching your clock when you can’t sleep prevents you from falling asleep. This is because it increases your mental activity (worry), rather than decreases it. This can make falling back asleep more difficult. If you’re lying in bed awake for 20 minutes, try getting up and reading (with low or red/yellow-tinted light) or listening to soft music until you feel tired.(3,11,12)

12 – Naps: yes or no?

Naps are necessary for small children, but if you have trouble falling asleep, try avoiding them. There is one exception, though. A study in the British Medical Journal suggests that if you’re a college athlete, napping may improve your performance.(12)

If you think you can make it through the day and nearly to bedtime then it’s best to try to skip the nap.

Take a small nap if needed but set a timer for 15 or 20 minutes.

Lay down for 5 minutes to meditate (but set an alarm just in case!)

If you feel super tired, try to get that nap in before noon. And go back to number 3 and get some daylight on your eyes!

13 – Stop multi-purposing your bed.

Your bed should be used for two things only: sleep and sex. If you’re lying in bed awake, try getting out for a short time and trying again. There is strong evidence that this can help prevent insomnia and, over time, can improve the quality of your sleep.(12)

14 – Calm your mind.

Along with the growing public interest in mindfulness and meditation, there is a growing body of research as well. A recent review of several studies showed that mindfulness and meditation significantly improved sleep quality.(17) You can also try breathing exercises or progressive muscle relaxation.(18)

Anything you like to do that relaxes you can be a meditation. Gardening, playing a musical instrument, coloring, journaling, gratitude, etc.

Sometimes if you wake in the night, you can do a simple meditation and that will help you calm enough to go back to sleep. There are plenty of options on Youtube. Headspace and Insight Timer are 2 apps out there.

15 – Be social.

Feelings of loneliness can affect your sleep. If you feel isolated and have little social support, you are more likely to suffer from the effects of stress and have more difficulty falling asleep and maintaining sleep. If your partner feels lonely and has poor quality sleep, you’re more likely to be affected, too. Loneliness is associated with many sleep disorders, including insomnia, nightmares, and anxiety.(1)

Try things to help you feel more connected like thanking people who help you in day-to-day life, reaching out to someone by email or social media, or signing up to volunteer in your community.

16 – Try to sleep along with your natural chronotype.

If you’re an “early bird,” go to bed and wake up early. If you are a “night owl,” then try to create a schedule where you can wake up later in the mornings.

How do you need to shift your schedule to make this work for you?

17 – Sleep “supplements”?

Before turning to something like melatonin (see below) you might want to try adding a tea or other calming herbal remedy into your bedtime routine. Tea can have you up going to the bathroom so if that would be a problem for you make sure to have that early enough in the evening after dinner. My current tea is Nighty Nite by Traditional Medicinals. Other favorites are chamomile, lavender or lemon balm.

Nearly everyone has heard of CBD oil by now and you can practically find a store on every corner (in our town at least). If your trouble with sleeping is anxiety or pain this may be something for you to look into. But, before you try this, note that CBD oil quality is important, and you should check with your healthcare professional to be sure it’s right for you. I’m currently using this local brand: https://peakcitycbd.com/products/natural-cbd-oil/

Melatonin supplements might help you feel sleepy and there is some evidence that it helps with jet lag. But, before you try these, note that they’re not recommended for everyone and have many known interactions. Be sure to read the warnings and cautions on the label and check with your healthcare professional to be sure they’re ok for you.(19)

If you suspect your circadian rhythm is off and your melatonin and cortisol levels are not right, let me know and we can talk about this.

FUN FACT: Some melatonin supplements are not meant to be swallowed but instead dissolved under the tongue (sublingual). Be sure to check your product labels to use it as recommended.

18 – Taking medications?

Some medications can disturb sleep (e.g., beta-blockers, corticosteroids, analgesics, antidepressants).(2) If you’re taking medications, speak with your doctor or pharmacist to see if yours is one of them and if there may be alternatives to consider.

Phew, that is a LOT of INFO in part 1 and part 2. I know it may be overwhelming. Download your free Tip Sheet & Worksheet. This will help you figure out what you want to do for your next steps.

References

1. Magnavita, N., & Garbarino, S. (2017). Sleep, Health and Wellness at Work: A Scoping Review. International journal of environmental research and public health, 14(11), 1347. doi:10.3390/ijerph14111347
LINK: https://www.ncbi.nlm.nih.gov/pubmed/29113118
LINK: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707986/

2. Besedovsky, L., Lange, T., & Haack, M. (2019). The Sleep-Immune Crosstalk in Health and Disease. Physiological Reviews, 99(3), 1325-1380. doi: 10.1152/physrev.00010.2018
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3. National Institute of Neurological Disorders and Stroke. (2019, August 13). Brain Basics: Understanding Sleep. Retrieved from https://www.ninds.nih.gov/disorders/Patient-Caregiver-Education/Understanding-Sleep

4. Harvard Health. (2018, May 9). Repaying your sleep debt. Retrieved from https://www.health.harvard.edu/womens-health/repaying-your-sleep-debt

5. Centers for Disease Control and Prevention. (2017, March 2). Sleep and sleep disorders. How Much Sleep Do I Need? https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html

6. Henst, R. H. P., Pienaar, P. R, Roden, L. C., & Rae, D. E. (2019). The effects of sleep extension on cardiometabolic risk factors: A systematic review. Journal of sleep research.
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8. Pires, G. N., Bezerra, A. G., Tufik, S., & Andersen, M. L. (2016). Effects of acute sleep deprivation on state anxiety levels: a systematic review and meta-analysis. Sleep Med, 24, 109-118. doi: 10.1016/j.sleep.2016.07.019.
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9. NIH Research Matters. (2013, October 28). How Sleep Clears the Brain. Retrieved from https://www.nih.gov/news-events/nih-research-matters/how-sleep-clears-brain

10. Harvard Health. (2015, August). Restructure your day to get a better night’s sleep. Retrieved from https://www.health.harvard.edu/sleep/restructure-your-day-to-get-a-better-nights-sleep

11. Harvard Health. (2016, September). Awake at 3 a.m.? Strategies to help you to get back to sleep. Retrieved from https://www.health.harvard.edu/sleep/awake-at-3-am-strategies-to-help-you-to-get-back-to-sleep

12. Kroshus E, Wagner J, Wyrick D, et al. (2019). Wake up call for collegiate athlete sleep: narrative review and consensus recommendations from the NCAA Interassociation Task Force on Sleep and Wellness. British Journal of Sports Medicine, 53, 731-736.
LINK: https://bjsm.bmj.com/content/53/12/731

13. John’s Hopkins Medicine. (n.d.). The Science of Sleep: Understanding What Happens When You Sleep. Retrieved from
https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-science-of-sleep-understanding-what-happens-when-you-sleep

14. Harvard Health. (n.d.). 3 simple ways to get more restful sleep. Retrieved from https://www.health.harvard.edu/staying-healthy/3-ways-to-get-more-restful-sleep

15. Drake, C., Roehrs, T., Shambroom, J., & Roth, T. (2013). Caffeine effects on sleep taken 0, 3, or 6 hours before going to bed. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 9(11), 1195–1200. doi:10.5664/jcsm.3170
LINK: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3805807/

16. Pickering, C., & Grgic, J. (2019). Caffeine and Exercise: What Next? Sports Med, 49, 1007. LINK: https://doi.org/10.1007/s40279-019-01101-0
LINK: https://link.springer.com/article/10.1007%2Fs40279-019-01101-0

17. Rusch, H. L., Rosario, M., Levison, L. M., Olivera, A., Livingston, W. S., Wu, T., & Gill, J. M. (2019). The effect of mindfulness meditation on sleep quality: a systematic review and meta-analysis of randomized controlled trials. Annals of the New York Academy of Science, 1445(1), 5-16. doi: 10.1111/nyas.13996
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18. Harvard Health. (n.d.). 4 ways to get better sleep. Retrieved from https://www.health.harvard.edu/staying-healthy/4-ways-to-get-better-sleep

19. Health Canada. (2019, September 26). Melatonin Natural Health Product Monograph. Retrieved from http://webprod.hc-sc.gc.ca/nhpid-bdipsn/atReq.do?atid=melatonin.sublinguale&lang=eng

20. International Journal of Preventative Medicine. (2018 Oct 12). The Importance of Sleep Hygiene in Polycystic Ovary Syndrome from the View of Iranian Traditional Medicine and Modern Medicine
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6202781/

21. The Connection Between Sex and Sleep, Chris Branter, Sleepzoo.com. (Aug 22, 2018).
https://www.psychologytoday.com/us/blog/the-truth-about-exercise-addiction/201808/the-connection-between-sex-and-sleep

22. ARC Fertility Blog, arcfertility.com. (Sept 24, 2019).
https://www.arcfertility.com/problems-with-sleep-you-might-have-problems-with-fertility-too/

23. Carly Mendes, Oh Baby Nutrition. (April 12, 2018).
https://www.ohbabynutrition.com/blog/reducing-inflammation-to-increase-your-fertility

24. Endometriosis.org, Ellen T Johson. (nd)
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25. Your Guide to Healthy Sleep. US Department of Health and Human Services. (Revised Aug 2011).
https://www.nhlbi.nih.gov/files/docs/public/sleep/healthy_sleep.pdf

26. Sleep deprivation and pain perception. Sleep Med Reviews. (Oct 2016).
https://www.ncbi.nlm.nih.gov/pubmed/16386930

27. Sleep and Premenstrual Syndrome. Journal of Sleep Medicine Disorders. (Aug 3, 2016).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5323065/

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