Sleep. It is so essential for optimal functioning. All of us know that heavy, dreary feeling associated with a miserable night’s sleep. It makes it so hard to complete our jobs. For those of us who engage in artistic projects, poor sleep is a creativity killer.
Sleep can also affect our physical and emotional health. Poor sleep makes us more susceptible to illness and increases the severity and duration of infection. Disrupted sleep can impair our body’s ability to repair itself and to consolidate memories important for learning.
As a psychiatrist, poor sleep is a common complaint. Sleep quality can affect mood and worsen mental health conditions. In many cases, poor sleep can be avoided or improved through a series of behavioral interventions. Listed below are some common culprits of poor sleep I see in my practice and ways to improve them.
- Caffeine. Perhaps the most obvious but most common cause of poor sleep. Products other than coffee that contain caffeine include chocolate, black/green teas, and soda. Try avoiding these products in the afternoon as they may not only prevent you from falling asleep but cause difficulty maintaining sleep.
- Sleep Apnea. Do you snore? Sleep apnea is a significant cause of poor sleep. Untreated sleep apnea is associated with cardiovascular conditions and worsening depression and anxiety. If you’ve been diagnosed with sleep apnea, use your CPAP nightly. If you suspect you might have sleep apnea get a sleep study.
- Alcohol. Alcohol dehydrates brain cells and can lead to fragmented sleep. It is also a depressant. If you choose to drink, make sure to stay hydrated.
- Sleep Hygiene. Sleep hygiene represents a collection of behaviors that improve your chances of a good night’s sleep. For example, use the bed for only two things: sleep and sex. Watching television, reading magazines, and doing other activities in bed makes us associate the bed and the bedroom with wakeful states. Try to avoid this if you can. Also, try to dim the lights and turn off any digital screens (televisions, computer screens, laptops, tablets, phones) about 30-60 minutes before bed. These devices and ambient light, in general, can inhibit melatonin release and the process of sleep. If you are lying in bed and can’t sleep, get up and do a quiet (tedious) activity until you feel tired and try again. Ruminating in bed will get you nowhere. Lastly, set a wake-up time, but be flexible with you to bedtime. This can be a little painful if you had a bad night’s sleep, but it will improve the probability that you have a restful night’s sleep the next day.
- To Nap or Not to Nap. I recommend people not nap if possible. There is some evidence that short naps can be restful and do not affect nighttime sleep. In general, naps longer than 30 minutes are not restful because you awaken from a deeper stage of sleep. The more you sleep during the day, the harder it will be to initiate sleep at night. Tell your doctor if you experience chronic fatigue that requires you to nap daily, as this may be a symptom of a condition like sleep apnea mentioned above. If you do choose to nap, set a timer, so you don’t wake from a deeper stage of sleep.
- Pain. As we age, all of us will develop osteoarthritic joint pains. Pain can cause problems with sleep maintenance and initiation. In medicine, we always say its easier to stay ahead of pain rather than chase it. If you suffer from chronic pain that wakes you at night, consider pretreating it before bed. Of course, consult with your doctor before initiating any long term treatment.
- Mental Health. Poor sleep and sleep disturbance are diagnostic symptoms found in several mental health disorders. Adequately addressing and treating mental health conditions can have a profound impact on sleep. In addition to medication management, there are specific therapies developed to improve sleep like CBT for insomnia that many people find helpful.
- Exercise. Exercise, especially cardiovascular exercise, is associated with better sleep and improved mood. It also protects against obesity, which can be related to sleep apnea and pain syndromes.
- Diet. According to researchers at Johns Hopkins, complex carbohydrates like whole-wheat toast or crackers are the best thing to eat before bed. These foods will trigger the release of the serotonin, a hormone that helps put you to sleep. Avoid spicy foods or foods high in fat and protein as they may disrupt sleep as digestion slows. Also, avoid tyramine containing foods like cheeses and cured meats that can cause the release of norepinephrine and stimulate wakefulness.