How’s your sleep hygiene?
In the following excerpt from medical doctor Woodson Merrell’s The Source (Random House, 2008), you’ll find plenty of great solutions to help you get that restful, rejuvenating sleep you need to feel your best every day. Here’s how to get started now:
Make an effort to follow a consistent pre-bedtime routine. This can include turning off stimulating activities (including your favourite electronic gadgets) at least an hour before sleep; practising relaxation rituals, such as breath work and progressive relaxation techniques.
Keep a regular, reasonable schedule — get to bed as close as possible to the same time every night (ideally by 10 p.m.) and wake up at roughly the same reasonable time each morning.
Sleep doctors call this consistency “good sleep hygiene.” Of course, everyone knows that mothers are the best sleep hygienists in the world, but what follows are my best tips that even your mother may not know.
A good pillow
This is an easy change that can make a huge difference. The first thing I tell everyone to do is evaluate the pillow situation.
A pillow is supposed to support your head so that your neck, airways, and spine remain in a natural position with good alignment throughout the night. A very convincing 2001 German Sleep Medicine Lab study found that changing to a medium-firm pillow (the firmest was of no advantage) significantly improved both non-REM and REM sleep for people who have trouble sleeping without other underlying conditions or causes.
Bottom line: A pillow should support your head, not bury it.
Pillows also frequently contribute to allergies, which is a big no-no when it comes to getting a good night’s sleep. A crucial first step in improving sleep is to scrutinize your pillow for allergens, the source of which can be the filling (down and feather allergies are very common) or it can be dust mites inside the filling.
I highly recommend that you examine the range of nonallergenic foam pillows on the market and get one. When you find one that suits you, place it inside a dust-mite blocking pillow protector that goes under the pillow case ( Greenguide.com is a great source for information on pillow allergies). But you also want to toss your pillow in the dryer every few months to kill dust mites.
Change your pillow every couple of years as its unwavering service of eight hours each day gives it a relatively short life span
A better mattress
When it comes to mattresses, observe the Goldilocks imperative (not too hard and not too soft); medium-firm is your best bet.
If a mattress is too hard it bites back and can cause pain and even numbness (limbs falling asleep) at pressure points; likewise, if a mattress is too soft it becomes more work to move around and can cause muscle and joint strains.
The best mattresses support all of your body parts equally; even at the heaviest points, your hips and shoulders.
Mattress toppers and memory foam for custom comfort
Unfortunately, couples often have different mattress preferences, primarily because body weight is a big factor in mattress support. Sometimes the issue can be resolved with a topper. You can actually have a firmer mattress with a soft feel by purchasing a bed with large quilting on the surface or by using a cushioned mattress pad.
Because people over the age of 40 lose elasticity in their skin, they have less tolerance for a firm mattress surface. Memory foams, the current darlings of the market, can bring harmony to the bedroom by adjusting for the individual body type, but many people find these mattresses to be exceptionally warm, which is especially unwelcome if you’re suffering hot flashes.
Invest in a good mattress
As much as I hate to break this news, a recent study from the Musculoskeletal and Human Physiology Research Lab at Oklahoma State University showed that price does make a difference.
Changing from a cheaper to a moderately high-priced mattress significantly improves sleep quality.
Another similarly rigorous study showed that by switching to a better mattress (in this case an adjustable air-spring/box-spring combination) a full 95 percent of study participants with chronic low back pain reported reduction in pain, and 88 percent reported a better night’s sleep. This data was supported by a Consumer Reports survey that found more than two thirds of people with high-end mattresses were “very or completely” satisfied with their purchase compared to one-third of conventional mattress owners.
You may want to take a look at spending priorities: Spending less on bedding and more on the mattress could be a sleep-inducing strategy.
You can use artificial full-spectrum lights in the morning to help reset the body clock so you can get to sleep at a more appropriate time in the evening.
In the past decade, pioneering research lead by Columbia University investigator Michael Terman, Ph.D. established that the circadian rhythms that help set your sleep patterns are highly susceptible to changes in exposure to light rays — whether from the sun or from bulbs that mimic the full-spectrum of sunlight.
Better sleep with the right light
By exposing the eyes to specially designed fullspectrum lights (10,000 lux fluorescent bulbs) for 30 minutes in the early morning, scientists have helped people get to sleep earlier and stay asleep longer.
It is thought that regular exposure to such light in the morning triggers a more advantageous nighttime release of melatonin, the hormone that governs your body clock, but the mechanisms are not fully understood.
Light conquers depression
You may be more familiar with light therapy for its use in treating seasonal affective disorder (SAD), a type of depression that shows up in winter months and stems from sunlight deprivation. Studies have shown that a course of light therapy treatments can have a dramatically positive effect on both sleep and symptoms of depression.
Light therapy can truly work wonders for people who find it difficult to fall asleep before midnight and are sluggish in the morning. Rapid improvement in falling asleep earlier is often experienced after just a few days of 30 minutes of exposure to a light therapy box upon awakening in the morning (see www.cet.org for more information on the boxes). For people (even teenagers) with more severe insomnia, who regularly stay awake until 1:00 a.m. or longer, shifting sleep patterns can involve sensitive timing.
So while the procedure can be done at home, it is a better idea to work with a sleep specialist to devise the treatment program for serious insomnia. The treatment also usually requires waking up a little earlier each morning, which takes real commitment. But if you are miserable from insomnia, it’s worth trying.
On the research forefront are special dawn-simulating sleep masks with embedded lights that turn on gradually four hours before the end of sleep. One might think leaving the shades open will do the same thing, but bare windows raise the possibility that your bedroom will be flooded with ambient nighttime light, which poses its own set of problems that are conveniently the subject of the next discussion, Dark Therapy.
If exposing your eyes to light in the morning helps you fall asleep earlier and sleep longer, it should come as no surprise that blocking exposure to light at night can positively influence sleep.
Scientists digging further into the sunlight-melatonin connection have discovered that the blue spectrum of light has the greatest impact on melatonin and circadian rhythms. If you are exposed to blue light late at night – from a computer or television screen or a digital clock near your bed – it can wreak havoc with your body clock making it harder for you to get to sleep and to get up in the morning. Keep your room pitch dark at night, covering all digital clock or DVD player readouts.
Interestingly, a 2008 study from the Corvallis Psychiatric Clinic in Oregon showed that using ambertinted glasses blocked the excitatory blue spectrum of light commonly encountered during television and computer viewing. Using amber glasses during evening screen-watching time had a significant effect in inducing and promoting a good night’s sleep.
Here’s the Catch-22 of sleep psychology: worrying about not getting enough sleep can stop you from getting enough sleep. Sleep docs have even developed a protocol of behavioral modification that’s been shown to work 70 to 80 per cent of the time for people who can’t sleep because of excessive preoccupation with, or apprehension about, falling sleep.
Here’s the drill:
• Go to bed only when sleepy.
• Get out of bed if you haven’t fallen asleep in 20 minutes.
• Curtail all nonsleep activities in bed (no watching TV, eating, planning, or problem solving).
• Arise at the same time every morning.
• Avoid daytime napping.
• Don’t get attached to unreal expectations about getting a perfect sleep every night.
• Do not blame insomnia for all daytime problems.
• Do not catastrophize (imagine all the bad things that will happen as a result) after a poor night’s sleep.
Throughout the night, your brainwaves are continually cycling between slowwave activity of non-rapid eye movement, and fastwave activity of rapid eye movement.
Meditation and relaxation exercises can significantly help you get back into slowwave activity if you are awakened in the middle of the night.
For getting to sleep faster or for falling back to sleep in the middle of the night try meditation or relaxation exercises as a way of hopping onto the slowwave sleep train that pulls you into the deepest stages of regenerative rest.
Acupuncture is a helpful adjunct for treating insomnia. Thousands of research articles attest to the neurochemical effects of acupuncture, which significantly elevates endorphins to block pain pathways, promotes the production of chemicals that reduce inflammation, enhances circulation, and reduces the activity of neuromuscular spasm.
In as much as acupuncture balances the nervous system and neurotransmitters, there’s a logic for its use in promoting relaxation, which results in a better quality sleep.
In China acupuncture has been used successfully for two thousand years to treat sleep problems, though this effect has yet to be studied in controlled trials that are considered the gold standard in Western medicine.
In my own practice I use acupuncture as part of a comprehensive approach to insomnia in conjunction with other treatments based on the underlying causes of the sleep problem.