Sleep-Hygiene
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Sleep Hygiene: Habits for Better Zzzs

September 22, 2021

According to the National Sleep Foundation about 30% of adults experience sleep disruptions, which is difficulty falling asleep or staying asleep. While this might be temporary and may be related to an acute stressor, for others poor sleep quality could be the norm. There are simple things you can do to improve your sleep quality at night. These healthy sleeping habits sometimes called “sleep hygiene”, can help you have a restorative nights’ sleep.

Maintain a sleep schedule

It is important to have a consistent sleeping schedule. This means that you should go to bed and get up at the same time each day, even at weekends. You also need to get the right amount of sleep each night.

The National Sleep Foundation recommends the following:

* Adults 18-64 years old: 7-9 hours per evening * Adults 65+: 7-8hrs per night * Children in grade school: 9-12h per night * Children with special needs: 11-14h per night

Creating an environment for good sleep

You should create a bedroom that is dark, quiet, and comfortable for quality sleep. Not only sleep hygiene but the sleep atmosphere also matters. Because sunlight can disrupt our circadian rhythms or inner body clocks, exposure to sunlight can have an impact on sleep quality. Specialized cells in the eyes detect sunlight and transmit light signals to our brains. The body then experiences a series chemical reactions that alter our biology and behavior. As the sun sets in the evening, the body’s temperature drops and the sleep hormone melatonin starts to rise. This makes us more open to sleeping. Bright sunlight shining through the windows in the morning can have the opposite effect. It causes a variety of chemical reactions that help us feel awake. The duration of light exposure, as well as its intensity and spectral content, have a significant impact on the quality of sleep and how it affects subsequent sleep onset and duration.

Exposure to light at night can disrupt the body’s biological clock. This includes blue light from cell phones, tablets, laptops, televisions, and some LED lights. Blue light can delay the release of melatonin, which can cause it to take longer to fall asleep. This can lead to a loss of deep sleep. Experts recommend that you avoid bright screens at least one hour before bed.

Even though my day is hectic, I try to keep a consistent sleep schedule. Before I go to bed, I spend 30 minutes in bed working on puzzles from The New York Times. I also read paperbound books as opposed to eBooks. This helps me to relax. Before I retire, I enjoy a cup if herbal tea that is caffeine-free.

How food affects sleep

Avoiding alcohol, caffeine, heavy meals and smoking in the evening is something I highly recommend. Although alcohol consumption before bed can make you more relaxed and help you fall asleep faster, it can also cause disruptions to your sleep and lower quality sleep later in the night. Heartburn can be caused by eating a heavy meal prior to bed, and can disrupt a good night of sleep.

Tryptophan, an amino acid found in proteins, is believed to increase sleep quality by increasing serotonin. These foods high in tryptophan can boost serotonin levels:

* Low-fat dairy products

However, high levels of sugar and saturated fats in foods such as chips, cakes, cookies and candy can decrease serotonin.

Naps: helpful or hurtful?

The National Sleep Foundation says that napping doesn’t affect a good night of sleep so long as it’s limited to 20-30 minutes per night and isn’t done between 1 and 3 p.m. in the afternoon. This is when the natural circadian rhythm of most people drops a little, which results in an energy drop.

Remember that if you sleep for more than 30 minutes, your body will transition from the light to the deep stages of sleep. You may feel tired when you wake up.

Sleep better with regular exercise

It has been proven that regular exercise can improve the quality of your sleep along with sleep hygiene. According to the 2018 Physical Activity Guidelines Advisory Committee Scientific Report (PAGAC), strong evidence has shown that moderate to vigorous exercise improves sleep quality by reducing the time it takes to fall asleep, and increasing the ease of waking up in the morning. It can also increase deep sleep time and decrease daytime sleepiness.

The National Sleep Foundation recommends that you exercise in the morning rather than the afternoon to get a deeper and longer night of sleep. In a review published in Sports Medicine in 2019, researchers reviewed 23 studies that examined sleep quality and sleep onset after exercise in the evening. Evening exercise of low intensity did not affect sleep quality or the ability to fall asleep. High-intensity exercise that is less than an hour before bedtime can increase the time taken to fall asleep. This results in poorer quality sleep.

Supplementing your Zzzs

The use of herbal medicine and supplements to improve sleep is gaining a lot of attention. Valerian, chamomile and lavender are the most popular plant extracts used for insomnia. However, there are few clinical studies that support their effectiveness.

Studies in humans have shown that low levels of vitaminD are associated with short sleep duration and poor quality. The brain is home to many areas that regulate sleep, including vitamin D receptors as well as the enzymes controlling its activation/degradation. Vitamin D also plays a role in the production of melatonin. This is necessary for the regulation of the human circadian rhythms, sleep hygiene, and sleep. Clinical studies showing the efficacy of vitamin D supplementation in improving sleep quality are lacking, as is the case for plant extracts.

The pineal gland of the brain makes melatonin from tryptophan. Nighttime melatonin production is ten times greater than that of daytime. The brain and other parts of the body send signals to melatonin that help them initiate and sustain sleep. Prolonged screentime suppresses the increase of melatonin at night. This makes it difficult to fall asleep. As we age, our nighttime melatonin levels also decline.

Melatonin supplements can be used to mimic the natural effects of the melatonin hormone by increasing sleep quality and promoting phase shifting. Although the evidence from clinical trials proving the effectiveness of melatonin in the treatment of insomnia may be of poor quality, it is clear that melatonin does have a modest and positive effect on sleep.

Sleep Hygiene Wake-up call

Chronic sleep deprivation can lead to fatigue, forgetfulness and inability to focus. It can also cause difficulty learning new concepts, as well as inability or failure to remember things. Inadequate sleep can lead to weight gain, chronic conditions like diabetes, high blood pressure, heart disease, and other health issues such as obesity. Although it can be difficult to practice good sleep hygiene, it is worth the effort.

Nina B. Radford MD, Cooper Clinic Cardiologist, and Director of Clinical Research, contributed this article.