I tend to wake up feeling tired in the morning like I could use a couple extra hours of sleep.
As public health professionals we have a number of general recommendations for helping you improve your sleep but keep in mind that what may work for one individual will not work for another individual. The truth is, we do not understand sleep very well. The Science of Dieting would argue that sleep recommendations are far more unique to the individual than are diet and exercise recommendations. With that being said, there are a few high evidence BEST PRACTICES that can be universally beneficial to everyone, namely stress management and exercise. There are also a number of GENERAL RECOMMENDATIONS THAT YOU MAY BENEFIT FROM as well.
But before we get into those, please keep this in mind. What you do during the day has a huge effect on how you sleep at night. The vast majority of us will acknowledge this connection when we hear it but in reality, we tend to partition off the nighttime version of us and the daytime version of us. The great comedian Jerry Seinfeld once said that morning Jerry always hates evening Jerry. Evening Jerry always gets to do what he wants and stays up as late as he wants… and Morning Jerry pays the price for Evening Jerrys acts.
Many of us view our relationship with sleep like Jerry. We try to manage the couple of hours before we go to bed to try to help us sleep better and yes, those hours are important, like the last kick in a race you are running, but the rest of your day and the rest of the race also matter greatly. If you do not put in the work during the day (stress management and exercise) you are not going to be able to make up for it just before you go to bed. All too often we get caught in a vicious cycle of
- We do not sleep well — get me my caffeine.
- I am tired in the afternoon — more caffeine please.
- I made it to the evening and just want to relax — too tired to exercise so no exercise, too tired to cook, and please give me a drink or two to help me relax, it has been a long day.
- Late afternoon coffee + stress of the day + no exercise + alcohol = bad sleep.
- Repeat the cycle.
How we manage our day will help determine how well we sleep at night. Now in some cases there is no getting around timelines, busy schedules, and demanding bosses but let us get into some of the BEST PRACTICES for managing your sleep.
BEST PRACTICES - STRESS MANAGEMENT & EXERCISE:
Have a Way to De-stress, especially at Night: meditate, stretch, listen to calm music, use mindfulness techniques, etc. We need to find a way to slow our minds down and to distract our brains from thinking about all the things we need to do. Despite conventional wisdom, the brain is not great at multitasking. If we force our brains to focus on something more calming and relaxing it does not have the bandwidth to focus on what is worrying us.
At the End of Your Day, Make Your to Do List for the Next Day: Knowing what you have to do and when you have to do them is much preferable to having a bunch of tasks rattling around in your head and trying not to forget anything that is due tomorrow. In general, the fear of the unknown gives us more anxiety than the known. Let me ask you this. How many times have you found yourself worrying about having to do something, thinking it is going to be so awful and then when you actually perform the task, it was not as bad as you thought it was. Sometimes starting the task is as or more difficult than performing the task itself.
Those of you with a chronic disease know that sometimes the anticipation of pain and the anxiety of the pain is worse than the pain itself. If you are lying in bed in the morning thinking about how much your back hurts and how you did not sleep well last night your anxiety about how the day is going to go or your confidence in being able to get through your day will oftentimes bring you more anxiety than getting through the day gives you. The point in making a to do list for the next day, is not to overwhelm you with how much you have going on, it is to give you a sense of control over the situation. You know what you are up against, and you have done it before. You will be able to do it again.
If Possible, Set a Time each Day that You will End Your Workday, say 7:00pm: Working too late into the evening does not give our bodies time to cool down and our brains will continue trying to solve problems through the night. Yesterday’s workday will bleed into your next workday, and we will not be able to operate at 100%. You need some down time to recharge your batteries. Many successful people have adopted the habit of shutting the work machine down at a set time every day. Trying to squeeze out additional work, oftentimes shortens our effectiveness the next day or the day after. Think of working past 7:00pm as overtraining. You might get some good short-term adaptations, but you will burn yourself out and be injured in the long term.
Take Breaks during the Day: far too many people (including myself) think that hey, if I work as hard as I can and as fast as I can, I will get my work done sooner. This tends to lead to inefficient work, i.e. you are logging the hours but you are not getting much done. And the number of hours you spend working is directly correlated to the amount of stress you feel.
Practice Deep Work: in his book, Deep Work, Cal Newport emphasizes WORKING DEEPLY by minimizing distractions and deeply focusing and engaging in what you are doing. Hopefully, by practicing deep work and getting a lot done, you will have less to think about (stress about). Block out time during your workday where you do not check your email, browse social media or answer telephone calls. Get –in your zone– and get as much work done as you can during that time, relax, and then do it again.
Set Reasonable Expectations: if you are in control of how much you produce, set reasonable expectations. Everything takes longer than what you think it is going to take. By setting reasonable expectations you are setting yourself up for success, not failure. If you are constantly feeling like you are not getting enough done, try adjusting your expectations to something you can actually do. There is nothing worse than consistently producing good quality work but feeling like a failure because you are not getting as much done as you arbitrarily thought you should be getting done.
Delegate, Prioritize, and Practice Gratitude: if you feel like you have too much to do, ask for help (delegate). Prioritize the things you have to do in your life. What do you HAVE to do and what are you choosing to do? For example, does your child really need to be in seven after school activities/year or will three suffice? Be grateful for what you have. You do not have to look very hard, heck you could stumble into it blindly, people will and always will have more than you. Try to be mindful of how many great things you have in your life while ignoring what your neighbors have or your friend on social media has.
Exercise: the Nike slogan applies here, Just Do It! The timing, doses, type, and duration of exercise for quality sleep is largely unknown and is likely unique to the individual. But, for the most part, exercise has consistently shown to improve the quality of your sleep. If you are feeling too tired to exercise, decrease your intensity, the amount of time you exercise or the number of sets you perform. For example, if you do not have time to do 3 sets per body part, just do one set per body part to failure. Doing something always feels so much better than doing nothing. Exercise does not have to be all or nothing. Do as much as your body allows you to do.
I realize this section is a little long and not every recommendation will apply to you. We could continue this list indefinitely, but we thought we would at the very least give you a few places to start. It is impossible to rank any of these suggestions as –the best– as they will be unique to you, the point is, that stress management and exercise are the two best practices in sleep hygiene that seem to work for everyone.
GENERAL RECOMMENDATIONS THAT YOU MAY BENEFIT FROM:
Avoid Caffeine in the Afternoon and Evening: people sensitive to caffeine should limit their intake in the afternoon and evening due to its stimulatory effects. We did not include the avoidance of caffeine in our best practices as some individuals have a tolerance to caffeine and will not be as greatly affected. Cutting back on caffeine is, in our estimation, still worth trying.
Avoid Alcohol: although alcohol may help some people fall asleep, it has also been shown to increase wakefulness during the night. Both caffeine and alcohol are diuretics so you may also find yourself getting up to go to the bathroom. The negative impact of caffeine and alcohol also seem to be dose dependent, the more you have the worse you sleep. But again, those individuals with a tolerance to alcohol may not be as greatly affected in their sleep quality.
Nicotine: is a stimulant and is therefore thought to affect sleep, however the evidence for avoiding nicotine before bed to promote sleep is not strong. Furthermore, former smokers sleep patterns do not tend to improve after quitting smoking. Of course, with that being said, we would encourage you to quit smoking for a myriad of other health reasons.
Limit Bedroom Noise: limiting noise interruptions (by others) may help improve sleep. Anecdotally, my wife and I like to sleep with a fan on throughout the year as a background/white noise to help drown out any other noise interruptions. Whether this white noise actually helps us sleep or is just part of our bedtime routine is unknown.
Daytime Naps: most health coaches will recommend you limit/avoid daytime naps; however, the academic literature shows virtually no relationship between napping and the ability to sleep at night (much to the delight of nappers).
Go to Bed Earlier: my mother has a saying that –morning comes around fast–. As obvious as it sounds, you cannot sleep more hours than the number of hours you are in bed. Try getting to bed earlier to maximize the potential number of hours of sleep you can get. You obviously do not want to go to bed too early because then there is the danger of not being able to fall asleep or stay asleep. You may have to make micro adjustments to your sleep schedule, i.e., adjusting 5-10 minutes/night to get to your goal of sleeping an additional 90 minutes.
Turn off the TV, Phone, and Laptop at Least 2 hours Before Bedtime: Two hours is not a hard and fast rule but limiting your amount of blue light exposure prior to bedtime may help you sleep more restfully. The evidence of this rule tends to be mixed. For some people this may help while for others it will have a limited impact.
Have a Nighttime Ritual: a nighttime ritual can help let your body know that it is the end of the day and that it is time to wind down. Brushing your teeth, putting on your pajamas, turning on your fan, dimming the lights, reading a book, and setting the coffee maker out is an example of an evening ritual. It can be whatever you want it to be, just make it yours.
Read Before Bed: some people find that reading puts them to sleep. My bias is that reading is another form of distraction and forces your brain to focus on what you are reading rather than on your worries of the day. Although I have no evidence to back this up, I would error on the side of caution and, if possible, read a paper book that is nonfiction, rather than scrolling through your social media feeds. There is no need to remind yourself about how great everyone else is doing or if you are on LinkedIn, what is going on at work.
Wake Up at the Same Time and go to Bed at the Same Time Every Day: this is another popular piece of advice from health coaches, yet has shown limited efficacy in practice. In theory it makes sense to get your body into a rhythm and it has also been shown that irregular sleep is associated with poor overall sleep, however with that being said, assigning people to regular sleep schedules does not seem to improve their sleep.
Avoid Sleeping in on Weekends: studies have shown that you cannot –catch up– on sleep by cramming in a few extra hours on the weekends. Better to try to get more sleep during the week as well. This is another recommendation that may or may not help you but you will only know if you try it.
Sleep in Darkness; Buy Black Out Curtains if You have To: I do not know about you but if it is June (in the northern hemisphere) and it gets light out at 5:30am, I am more apt to wake up early whether I intend to or not. Sleeping in total darkness helps me sleep in a little later. I would also add that for shift workers, black out curtains are a must.
- Do not drink caffeine in the late afternoon or early evening hours.
- Limit Your alcohol consumption to two drinks or less.
- Prepare a healthy breakfast the night before so you have one less thing to worry about in the morning.
- Drink water, but not too much within a few hours of bedtime.
- If you have heartburn, avoid spicy and acidic foods in the evening.
Other than that, there are not too many things you can do in your diet to help you sleep. Again, stress management and exercise are the two things you should be focusing on if you want to sleep better. There are many other things that may help you sleep better but these recommendations are not universal. You will only know if you try them.