Your Evidence Based Guide To Sleep
TLDR: Don’t stress about your sleep. Do whatever you can to build the habit of falling asleep easily and avoid building the habit of not being able to sleep. Cultivate your circadian rhythm. Avoid doing things that stress you out at night. Do things that are restorative and calming consistently to build strong sleep habits.
Sleep is funny. Our sleep is one of the many things that has been fundamentally altered in our modern lives, but it’s useful to understand that our sleep environments have never actually been more conducive to sleeping well. Our ancestors would have slept on the hard ground in loud communal environments under the bright light of the stars. They would not have slept for more than a few hours at a time and often took long naps during the day. In contrast to our soft beds, comfortable pillows, blackout curtains and temperature controlled rooms our modern world has created the environment to sleep much better than our ancestors ever would have. But, if you’re struggling with your sleep the following guide should be incredibly helpful to better understand the areas you could improve to feel better rested and have more energy throughout the day.
First and foremost, there are most likely many who should not actually read past this paragraph. In my opinion, our collective neuroses and obsession over sleeping well is actually the biggest impediment to it. The first and most important category of things you can do to improve your sleep is simply trying to not worry about it. Sleep anxiety has the potential to become a self fulfilling cycle, where worrying about our sleep generally causes us to sleep worse, which causes more worry, which causes us to sleep worse. So how do we break this cycle? For one, we should strive to create habits that create the conditions for good sleep. Don’t read or watch tv or eat in your bed. Create the connection in your mind that your bed is only used for sleep so that you become sleepy as soon as your head hits the pillow. On that note, only get into bed when you actually are sleepy. We want to avoid building the habit of trying to fall asleep unsuccessfully. If you feel yourself unable to sleep after 30 minutes, or you feel yourself starting to feel anxious about it, get up and do something like read or meditate outside of your bed until your mind is calmed. Above all else, establishing habits and routines that lower the amount of anxiety you have around sleep is going to be one of the best things you can do to sleep better. I had terrible sleep anxiety for many years. I struggled with my sleep for years and it wasn’t until I was able to shed the anxiety around that it actually improved.
But if we don’t feel anxious around our sleep and are still looking for tips to get the most out of that time, there are a couple other categories of things we should address. The first category revolves around establishing our circadian rhythm. Our circadian rhythm essentially refers to the interaction of various hormones that help govern our sleep. Principle among these are cortisol and melatonin. Cortisol should naturally spike in the morning and then gradually fall throughout the day, whereas melatonin should spike in the evening and fall throughout the night. If we have issues regulating these two hormones it can make falling and staying asleep very difficult. As an aside, it has been well established in the literature that there is such a thing as ‘night owls’ and ‘early birds.’ For different people their cortisol and melatonin mix might generate a natural sleep schedule that is earlier or later. Our 9-5 schedules have confined humans to routines that don’t work for everyone. In other words, you’re not lazy if you want to go to sleep later and wake up later, you may just have a different naturally occurring circadian rhythm.
One of the best ways to set your circadian rhythm up for success is to consistently go to sleep and wake up at the same time every day. While acknowledging this is not possible or practical for everyone, the more we can strive towards consistency the better. In addition to building a consistent schedule, there are a series of activities we can implement to help facilitate your circadian rhythm. Getting bright sunlight and some form of exercise first thing in the morning helps regulate cortisol so that it spikes when we want it to. Additionally, stress triggers cortisol and so we want to make sure we avoid a lot of stress in the evening before we are meant to go to bed. Establishing a bedtime routine around limiting our light, loud noise and eliminating any blue light (the light from phones and tv) will do wonders for our circadian rhythm. Inversely, we should actively seek out activities that relax us before bed, ideally not involving our phone. Consider creating a routine of relaxing activities you do every single day that naturally integrates into your bedtime to continue to build positive associations with sleep.
A few final tips to add into your bedtime routine to promote good sleep. Avoid eating too close to bedtime because having your stomach working to digest a ton of food can be disruptive. Make sure to limit your caffeine intake in the afternoon / evening. A hot shower or bath will raise our core temperature and encourage it to drop as we get out, which encourages a shift that should naturally occur as we go to sleep. Although there is conflicting evidence around this topic, I generally don’t recommend napping to my clients. Long naps specifically can disrupt our circadian rhythm, making falling asleep in the evening more challenging. Make sure you don’t drink too much water as having to pee in the middle of the night can be very disruptive. And any amount of alcohol around bedtime can prevent us from reaching the deeper, most restorative phases of sleep.
Finally, maybe the easiest changes you can make are based around our sleep environment. Generally, we sleep best when the room is pitch black, so adding blackout curtains to your bedroom can be really helpful. Noise can disrupt our sleep, and so noise cancelling headphones or earplugs can be useful as well. Humans generally sleep the best when the room is cold and so I recommend most of my clients sleep in the 66-72 degree range.
It’s worth mentioning to close that if you have implemented many or most of these changes and are still having issues, you should get tested for sleep apnea. Many sleep apneas go untreated and can cause serious health issues in the long run in the way they prevent us from getting enough deep sleep.
