If you’re an avid reader of this blog you know by now that our mission is to discuss actionable lifestyle changes that can be readily implemented to optimize health and help us feel a whole lot better, both physically & mentally–without taking unnecessary medications or breaking the bank in the process.
Good sleep hygiene is another one of those areas that can drastically effect the way you feel and your overall well-being. As an added bonus, these changes can be implemented immediately without costing you a dime.
What is Sleep Hygiene?
“Sleep hygiene” refers to your habits, both good and bad, before turning in for the night. Depending on your approach, you’ll awake feeling refreshed and ready to start the day or groggy, irritable, and a bit unfocused. Admittedly, as of lately, my sleep hygiene hasn’t been stellar so I’m writing this article for myself as well as all of you.
Why is Sleep so Important?
There is little doubt that sleep plays a pivotal role in our health and well-being. When I think about sleep and the effect it has on our brain, I like to do so by picturing the brain as a filing cabinet. Throughout the day we are retrieving files, making corrections, creating new documents, and haphazardly storing them in an unorganized stack. When we sleep, we sort through these files and restore that organization preparing us for all the new files we’ll be acquiring the following day.
It also give our body the opportunity to conserve/replenish energy and gives it the opportunity to repair and rejuvenate itself. A number of studies have shown that a great deal of tissue repair, muscle growth, and protein synthesis occur while we are sleeping. This is why many professional athletes such as LeBron James, Roger Federer, and Usain Bolt attempt to sleep 10-12 hours per night to ensure they’ll be able to recover from the daily stress that comes along with training and competing at the highest of levels.
Tips for Optimizing Sleep Hygiene
1) Have a routine:
Hey it works for kids right? Getting into a routine is probably one of the best habits for ensuring a good night’s sleep. Set a time for going to bed each night and stick to it. If you know you like to wind down and do some reading for 30 minutes each night, make sure you are allocating enough time for it.
The interesting part about habituating a specific bedtime is, your body begins to feel accustomed to your wake time, and you will eventually start waking up without an alarm clock.
2) Avoid Stimulants Like Caffeine & Nicotine:
It’s recommended that we avoid caffeine and nicotine for 4-6 hours before going to sleep at night. Ideally, you’d avoid nicotine altogether as this is one of the best changes anyone can implement in their life from a health perspective.
3) Avoid Alcohol:
A common misconception is that alcohol can have a relaxing effect on the body which one would mistakenly think is helpful for falling asleep. However, the research shows that alcohol disrupts normal sleep architecture causing us to get less “good” sleep.
In a prospective study published in the Korean Journal of Family Medicine, a questionnaire was given to 234 men who had visited a general hospital. After correcting for confounding variables like age, nicotine use, anxiety, depression, and chronic disease it was found that those males who used alcohol more readily suffer from “poorer sleep quality, experience difficulty in maintaining sleep rather than falling asleep, suffer from shorter overall sleep duration and have worse subjective sleep quality.” 
4) Avoid Naps:
The jury is still out on this, but in my personal opinion, if you find yourself to be tired throughout the day, you are likely not getting a good night’s rest. Taking occasional naps throughout the week will likely interfere with your ability to establish a regular nightly routine as you are no longer sleepy around the time of your pre-established bedtime.
5) Regular Exercise:
Exercising regularly causes our bodies to feel tired by the end of the day and in need of some much needed rejuvenation. Keep in mind that exercising a few hours before bed might be disadvantageous as your sympathetic nervous system is activated as opposed to your parasympathetic nervous system which is needed for sleep. Therefore, it’s important that we exercise, just not right before going to bed. For more on exercises to maintain a healthy core, check out this prior post.
6) Optimize your Sleep Environment:
Consider purchasing black-out curtains to prevent any sunshine from coming in when you are still getting some much needed z’s. A sleep mask is another more affordable, easily implementable strategy.
Sunlight affects your circadian rhythm for the day and is a signal to your body that it is time to wake-up. When light hits your body, the amount of melatonin being produced decreases. Melatonin is a hormone produced by your pineal gland that stimulates the suprachiasmatic nucleus, one of the regions of the brain responsible for sleep, that it is time to go to bed. When there is a decrease in melatonin, this region of the brain is no longer activated which contributes to us waking up.
If you find yourself having to go to sleep in a noisy environment or if your significant other snores, consider sleeping with earplugs.
7) Reduce Screen Time:
Screen time plays a major role in sleep hygiene, especially in adolescents. In a 2015 study, it was found that teenagers were 17% more likely to get less than 7 hours per sleep each night compared to teenagers back in 2009. In part, this reduction in time spent sleeping was attributed to increased screen time.  For more on how to track your screen time to get more hours back in your day, check out this prior post.
What are the Consequences of Poor Sleep?
A lack of sleep impairs our cognition. Studies have shown that chronic restriction of sleep to six hours or less per night produces decreased cognitive performance and alertness.  According to an article published in Healthline, it has also been linked to worsening feelings of anxiousness and depression.
As a Pain Management physician, I thought it would be interesting to include some information about how a good night’s rest can affect chronic pain. A number of retrospective studies have shown the relationship between sleep deprivation and chronic neck and back pain.
A meta-analysis of experimental human and animal studies revealed that “sleep deprivation can produce hyperalgesic changes.” When an individual has hyperalgesia, they experience a heightened sense of pain when exposed to a painful stimulus. This means that individuals who are sleep deprived have a heightened response, aka feel more pain, when exposed to a painful stimulus. 
Unfortunately, the list of detrimental effects of sleep deprivation goes on and on, but a comprehensive review of this topic will have to be saved for another day.
As you can see, being intentional about your approach to sleep hygiene can mean the difference between a you who is firing on all cylinders vs a you who is just puttering along. If you find yourself to be a bit tired or irritable throughout the day, consider implementing some of the actionable steps above as you may have a sleep debt that hasn’t been met. Doing so can have tremendous health benefits and allow you to operate as the best version of yourself!
How about you? What is your bedtime routine? Do you have useful tips for getting a better night’s rest that weren’t covered in this article? We’d love to hear from you!
Valerio, T. D., Kim, M. J., & Sexton-Radek, K. (2016). Association of stress, general health, and alcohol use with poor sleep quality among US college students. American Journal of Health Education, 47(1), 17-23.
Twenge, J. M., Krizan, Z., & Hisler, G. (2017). Decreases in self-reported sleep duration among US adolescents 2009–2015 and association with new media screen time. Sleep medicine, 39, 47-53.
Van Dongen, H., Maislin, G., Mullington, J. M., & Dinges, D. F. (2003). The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation. Sleep, 26(2), 117-126.
Lautenbacher, S., Kundermann, B., & Krieg, J. C. (2006). Sleep deprivation and pain perception. Sleep medicine reviews, 10(5), 357-369.
Artner, J., Cakir, B., Spiekermann, J. A., Kurz, S., Leucht, F., Reichel, H., & Lattig, F. (2013). Prevalence of sleep deprivation in patients with chronic neck and back pain: a retrospective evaluation of 1016 patients. Journal of pain research, 6, 1.