Information and Tips on Sleep

Almost everyone has trouble sleeping sometimes. Depression, anxiety, and stress (even from positive stressors) can keep up from sleeping normally. Common stressors might be a new job, work stress, financial worries, relationship problems, birth of a child, or loss of a loved one

What is normal sleep? Most adults need about 7-8 hrs of sleep a night, though some individuals seem to need more or less than the “normal” 7-8 hours. Most people fall asleep in 20 minutes or less. After about age 50, it is normal to need to get up once or twice during the night to use the bathroom, and be able to get back to sleep fairly quickly. With normal sleep, one should feel rested, not tired, on awakening.

What is sleep? Sleep is an in interesting and mysterious part of our lives, and we are just beginning to understand how complex it is. All organisms, except the most primitive, need some kind of regular rest to remain healthy. During sleep our body repairs and rebuilds itself. Without good sleep we lose our ability to function normally, and we become vulnerable to illness. Sleep moves through several stages during the night. We descend gradually from light sleep to deeper sleep. In the deepest phase (Stage IV) our mind rests and our body may toss and turn, and in the REM stage (for rapid eye movement) our mind is active, dreaming, and our body is still. A period of several hours of continuous sleep is necessary to reach these essential stages of sleep, so frequent awakening can interfere with the quality of sleep and cause us to feel tired the next day.

What can interfere with sleep? In addition to stress and worry, there are a number of things that can interfere with sleep. These include:

• Sleep deprivation due to work, young children at home, or other demands on our time.
• Disruption due to travel, time change, changing shifts, unfamiliar surroundings.
• Unusual noise or light.
• Indigestion or heartburn.
• Acute or chronic pain conditions.
• Uncomfortable bed.
• Bed partner snoring.
• Room (or covers) too hot.
• Pre-bedtime habits not conducive to sleep.

What are sleep disorders? There are several medical disorders that are related to sleep and can affect our physical health. These include sleep walking, “restless legs,” narcolepsy (sudden daytime sleep attacks), sleep paralysis (awake but briefly unable to move), and sleep apnea (breathing is briefly interrupted during sleep). Occasional body jerks when falling asleep (myoclonus), talking during sleep, and teeth grinding at night (bruxism) are all considered "normal" behaviors associated with sleep.

Self-Care tips to improve sleep:

• Set a regular sleep schedule. Try to have roughly the same bedtime and getting-up time each day. This helps your body establish a regular sleep-wake cycle.
• Avoid naps, or limit an occasional nap to 15-20 minutes. Naps tend to reduce night-time sleep and disrupt the normal sleep cycle.
• Create a good sleep environment. Your bed should be comfortable, and your bedroom as quiet and dark as posible. The ideal temperature for sleep is 62 - 65 degrees. Sleep experts advise against a TV or computer in the bedroom, and suggest that you reserve your bedrroom for sleep and sex.
• Regular exercise can reduce stress and improves sleep, but you should avoid heavy exercise within 3 hours of bedtime.
• Watch what you eat or drink in the evening. A large or spicy meal sometimes causes a bad night. A large glass of water before bed almost guarantees one or more trips to the bathroom. While alcohol can cause drowsiness, it also decreases the quality of sleep and can cause wakefulness when it wears off. Caffeine is a powerful stimulant, and is one of the most common causes of poor sleep. Our tolerance for caffeine often decreases as we get older. Try to limit caffeine consumption (from coffee, tea, sodas, or chocolate) to one or two caffeinated drinks in the morning. Nicotine is also a stimulant, and smokers should avoid a cigarette before bed.
• Have a routine of "winding down" or relaxation during the hour or so before bedtime. Find what works best for you; some suggestions include reading, watching TV (not the news), listening to music, meditation, prayer, or a warm bath.
• Light cues our body that it is daytime and time to wake up, so it is best to avoid any exposure to bright light during the night. You can try equipping your bedroom and bathroom with nightlights, preferably dim and near the floor, so that you have enough light to move around safely without turning on the room lights. Conversely, exposure to sunlight or other bright light can help us wake up and be more alert in the morning.
• If you have persistent heartburn that is worse after you lie down, ask your medical provider to give you medication to reduce stomach acid. If you have a condition called GERD (gastro-esophogeal reflux), your doctor may also advise placing blocks under the head of your bed to give it a gentle down-hill slope.

David Ringo MD