By: Caris Talburt Fitzgerald, MD, assistant professor of Psychiatry and Sleep Medicine at UAMS
If you have found yourself having sleep problems, the following is a very specific list of rules that you can follow to help bring your arousal down and push your internal sleep drives much higher for better sleep. The only thing is that when you decide to try to improve your sleep with these rules, you must not cherry pick the list (meaning you must follow every rule at the same time) and you must continue following all the rules together for 14 consecutive days. You can expect to see benefit the 15th day.
START WITH A FIXED WAKE TIME. If you are not sleeping well at night, the last thing you should do is sleep in. Instead, you must channel that leftover sleepiness into deeper sleep the next night. This remains true even if you stayed up late on purpose the night before. Our drive into sleep grows stronger the more predictable our wake time has been. Brains thrive on a consistent wake time! It is an essential part of good sleeping habits.
PUT 16-17 HOURS BETWEEN SLEEP PERIODS (AVOID NAPPING). Napping or resting the eyes at any point during the day subtracts from the push the body will get into deep sleep that night. Focus your body’s drive for sleep to the most appropriate time, which is at night, in line with your circadian rhythm in one long period.
AVOID ALCOHOL. Many people believe that alcohol helps them with sleep and initially it often does. Unfortunately, the rest of the night is much lighter and less refreshing than it would have been otherwise if you have alcohol in your system.
AVOID NICOTINE. Nicotine withdrawal starts after two hours and is very stimulating to your brain. You cannot get as good of rest if your brain is repeatedly going into nicotine withdrawal.
AVOID CAFFEINE. This includes coffee, tea, and most sodas as well as chocolate. Caffeine is a blocker into deep sleep. For some this means insomnia and for others it may just mean that the sleep is not as restful.
AVOID EXCESS ACID PRODUCTION BEFORE BED (ALCOHOL, HEAVY MEALS, LATE MEALS, SPICY, OR SUGARY FOODS 4-6 HOURS BEFORE BED). If you have reflux, it may serve to repeatedly lighten your sleep throughout the night, leading to less restful sleep and is known to cause problems with nasal flow in the night.
NO BRIGHT LIGHT THE HOUR BEFORE BED, INCLUDING TV, COMPUTER, CELL PHONE SCREENS, AND FLUORESCENT LIGHTING. Your body needs to be without bright light to create the right neurochemical/hormonal environment for sleep. This cannot be done if you are staring at a bright light source.
WHITE NOISE IS OKAY, BUT NO MUSIC OR TV. Changes in tone and volume serve to lighten sleep and make your night less restful.
EXERCISE REGULARLY, BUT NOT RIGHT BEFORE BED. Regular exercise, particularly in the afternoon can help deepen sleep. Strenuous exercise within two-three hours of bedtime, however, may decrease your ability to fall asleep on time.
RESERVE THE BED FOR SLEEP AND SEX. Do not use the bedroom as an office, workroom, or recreation room. Your brain must be trained to associate your bed with sleep.
DO NOT STAY IN YOUR BED IF YOU CANNOT SLEEP. If you do not think you will be able to quickly return to sleep, you should get up and go to another room to do something quiet in dim light (NO SCREEN TIME) until you feel sleepy enough to try again.
ESTABLISH A BEDTIME ROUTINE. Pre-sleep rituals, such as a warm bath or a few minutes of reading, especially when done consistently without bright light, will send clues to your brain that the time to sleep is coming.
DON’T TAKE YOUR WORRIES TO BED. From bedtime to wake, your only job is to rest. Any and all worries should be reserved for non-sleep hours. If a worry comes to you, acknowledge it and let it go. Try refocusing on a happy memory, or more specifically, try to remember as many small details as you can about a favorite day in your past.
DO NOT STARE AT YOUR ALARM CLOCK. This only increases your anxiety about the time you have left to sleep before your wake time. Set your alarm, turn it away from you, and do not peak until it alerts you to wake. Always assume when you wake up that you have plenty more time to sleep. Remember that if you happen to get poor sleep one night, but you stick to these rules, that sleep debt will only help force a deeper sleep the next night to get you back on track.
If these interventions are not successful for your sleep problem when done altogether for a full 14-day duration, you likely need to visit with a sleep physician.