Sleep, is essential for all areas of our physical and mental wellbeing. We usually know when we are not getting enough, or how energised we feel after a good night’s rest. Sometimes, however due to illness, stress, changes in environment, routine, lifestyle or for a multitude of other reasons our sleep can become disrupted.
Never being what I would call “a good sleeper” I am always interested in new information or guidelines to help improve my own sleep. This is a compilation of information and resources I have found useful and supportive to help me develop a better sleep pattern, help me accept my own erratic sleep is how I sleep and most importantly spend less time in the early morning hours, trapped in a world of intrusive thoughts, worry and the dread that I have to face the morning exhausted and sleep deprived.
Sleep, or lack of it and the need for humans to be well rested to function well, has now become a substantial industry where mattresses, sprays, natural medication, pillows, sleep apps and other sleep related paraphernalia are available to help improve sleep. However, understanding some of the biology behind sleep, and some of the basics before spending a lot of money is probably the best place to start. This is often known as “Sleep Hygiene”.
Sleep Hygiene: The basics
Set a schedule
Establish a regular sleep schedule every day of the week. Try not to sleep in more than an hour even on your days off.
Avoid napping
Napping during the day will make sleep more difficult at night. Naps that are over an hour long, or those later in the day are especially harmful to sleep hygiene.
Why?
Humans experience a naturally occurring rhythm called the circadian rhythm which runs over a period of approximately 24 hours. It signals to the body when we should be asleep and when we should be awake. The circadian rhythm has a tendency to run either a bit shorter or longer than 24 hours. This is genetically inherited and determines whether we prefer to rise early (larks) or prefer to stay up late (owls). We reset our circadian rhythm every day when the light hits our superchiasmatic nucleus (SNC) and the cycle begins again of ideally after 16 hours wakefulness followed by 8 hours sleep. Timings of mealtimes can influence our circadian clock. Having a regular sleep routine where we rise and go to bed at exactly the same time every day and sticking to regular routines during the day will support optimum sleep and health.
Avoid gadgets which emit blue light
Avoid using computers, phone screens or anything which contains blue light at least an hour before sleeping or ensure sleep mode is switched on.
Why?
Our bodies evolved for extremes of light (during the day) and darkness (during the night). In the modern age we rarely get enough light during the day (indoor artificial light does not equal outdoor day light) and we may get too much in the evening with some forms of artificial lighting. This will impact on our sleep. Daylight is rich in light from the blue end of the spectrum which tells our brains to produce a protein, melanopsin which increases how alert and awake we feel. But our computers, LED and screen based devices also emit blue-wavelength light which continues to stimulate the production of melanopsin keeping us awake. This continued stimulation of the production of melanopsin also delays the release of the day’s accumulation of melatonin, the hormone that signals our body and brain that it is time to sleep.
Avoid caffeine, alcohol and nicotine
Consuming, caffeine, alcohol and nicotine can affect your ability to fall asleep and the quality of your sleep, even if they’re used earlier in the day. Caffeine can stay in the body for up to twelve hours and even decaffeinated drinks contain some caffeine.
Exercise and eat well.
A healthy diet and exercise can support better sleep. However avoid strenuous exercise and big meals for 2 hours before going to bed
Why?
We fall asleep at the intersection between greatest sleep rhythm (when our circadian clock is signalling the right time) and the greatest “sleep pressure”. Sleep pressure involves the build-up of a substance called adenosine which increases the longer we have gone without sleep. Ideally sleep pressure peaks after around 16 hours of wakefulness, initiating 8 hours of sleep during which adenosine is flushed from the brain. Getting up at the same time every morning ensures that our sleep pressure is at a maximum at bed time which should also be at the same time every night. We can reduce sleep pressure temporarily with caffeine which blocks the adenosine receptors in the brain.
Caffeine accumulates in the body throughout the day and so any consumption after midday may significantly reduce sleep pressure at bedtime making it harder to fall asleep, especially if we miss the critical intersection point of sleep pressure and sleep rhythm. Exercise and mental stimulation especially involving novelty, also increase sleep pressure so a day out, exploring new places or social contexts will result in us feeling more sleepy compared to a quiet day at home.
Sleep in a comfortable environment
It’s important to sleep in an area that is adequately quiet, comfortable and dark. Try using an eye mask, ear plugs, fans or white noise if necessary
New born babies have to be trained to fall asleep indicating that as humans (unlike cats) we are not very good at it but also shows we can learn and relearn how to fall asleep. In evolutionary terms, being still and unaware of our environment would have made humans easy prey to predators and so we have had to train our bodies to sleep at night. Emotional distress such as trauma can disrupt this learning in many ways and our brains can soon get out of the habit of knowing how to fall asleep. As adults we may need to train ourselves to learn how to sleep again. Just as with infants, a bedtime routine is key as it signals to the brain that it is now time to sleep. This simple, repeated behaviour releases neurotransmitters and hormones that prepare our bodies for sleep. We can help this transition by cooling the body (keeping the room temperature cool) and also for example, diffusing the aroma of lavender, avoiding the use of phones, gadgets, TV’s and by keeping the room dark. There should also be a gap of several hours between our last meal and bedtime as food signals the brain that it is time to be awake.
Don’t force yourself to sleep
Ideally the bedroom should be only used for sleep (and sex) but as we know, during lockdown our rooms were used for everything including exercise, work, entertainment, hobbies and sleep. This is why having a regular day time and night time routine and avoiding the obvious interferences with sleep (caffeine, blue light, and noise) can help. Many of us do not have a choice that our rooms have become multifunction places so being aware of how we can support our natural daily rhythm will help. If your body learns to associate your bed with sleep, you should start to feel tired as soon as you lie down. Using your phone, watching TV, or working can have the opposite effect increasing your level of alertness.
What if I can’t fall asleep?
If you haven’t fallen asleep after 20 minutes, the general advice is get up and do something calming. Read a book, listen to soothing music, draw or write a journal. Avoid anything stimulating which could lead to becoming more awake.
Try not to worry about sleep, it may be that you are getting enough, but it is just less than you expect. The amount of sleep you need is very individual and will change throughout your life.
For myself, when I have found sleep elusive I have learned not to worry about it. I ensure I follow the basic sleep hygiene rules but as an avid reader, reading in bed is now the trigger for me to either fall asleep, or if I wake in the night (which annoyingly can happen several times) reading helps me fall back to sleep again. When I had stress related sleeping difficulties I did find relaxation apps really helpful as it distracted me from my own thoughts, did actually relax me and if I needed to I would listen to them on repeat. Eventually without releasing I would fall to sleep.
What else can I do to help support sleep?
Food and drink
Some foods apparently support sleep. Studies found that people who ate two kiwis an hour before bedtime fell asleep faster and for longer and had better sleep quality. Foods containing melatonin have also been shown to help such as tart cherries, milk (especially malted milk). Chamomile tea is also one that has been reported to help relaxation and restful sleep.
Apps
NHS Sleep app for students
There are a multitude of apps available that help support sleep. The one I usually recommend for students to start with has been developed by the NHS specifically for students. If you would like to try this follow the link here
F.lux
F.lux is an app which if you are working on your computer, late into the evening will adjust the blue light levels in line with your own circadian rhythm and sets a custom lighting schedule in which you are able to adjust the times to suit you.
Sleep Cycle is an app that follows your sleep pattern using your phones microphone and reports to using the data it gathers to wake you when you are in a lighter period of sleep
Pzizz recommended by the NHS to help you quickly calm your mind, fall asleep fast, stay asleep, and wake up refreshed Pzizz
Headspace create the conditions for a restful night’s sleep with sleepcasts, music, and other unique audio experiences Headspace
Calm provides sleep stories and meditation aimed to help you sleep Calm
Video
CALM youtube channel - sleep stories, white noise and sleep masterclasses
Books
Why We Sleep: The New Science of Sleep and Dreams by Matthew Walker - using research to look at why we sleep and the factors that can affect our sleep
Sleep by Nick Littlehales - proven solutions for better nights, from an elite sleep coach
Podcasts
Sleep With Me by Drew Ackerman - bedtime stories to help grownups fall asleep
Yoga nidra - guided meditation to help you fall asleep
The Military Method
This method recently circulated around wellbeing sites and it does make sense that it should work as if you are in the military often in uncertain, dangerous and stressful situations being able to fall asleep quickly and be rested is extremely important and could be lifesaving. It does reiterate that it needs time to learn so if you are needing to relearn how to sleep again it could be worth a try.
Developed by Dr Andrew Weil, an integrative medicine specialist at the University of Arizona, the 4-7-8 method is founded in ancient meditation and breathing-focused techniques.
"It’s the single best method that I’ve found for dealing with getting back to sleep if you wake up in the middle of the night," Dr Weil told Medical News Today. "It's the regularity of doing this over a period of weeks, months, years that produces the changes that you want."
It should be noted that the first few times you try the 4-7-8 method, it may take a little longer than 60 seconds to help you drift off. The idea, as Dr Weil pointed out, is that it becomes more effective the more you practice it. Also, if you suffer with a respiratory illness or a similar ailment that affects your breathing, check with your GP before trying the 4-7-8 method.
Here's how to do it...
1. Adopt a comfortable position and relax your body.
2. Inhale quietly through your nose for 4 seconds.
3. Hold your breath for a count of 7 seconds.
4. Exhale through your mouth, making a whoosh sound, for 8 seconds.
5. Repeat the cycle up to 4 times.
Stick with it over the coming weeks
Most relaxing music ever!
The most relaxing music ever! (Do not drive!) Weightless by Marconi Union. This can be found on Spotify too.
Extended version for going to sleep
And if you have trouble getting out of bed in the morning…
Try Alarmy: This is the most annoying alarm clock in the world and makes ignoring your alarm practically impossible without breaking your phone! When you set an alarm, you have a number of options that you can choose from; tasks that you must complete before the alarm will silence. You might go simple and choose to have to shake your phone vigorously, or you could choose to be given a maths problem. Other options are to take a picture of a bar code or to take a picture of an object, the alarm only silencing once you have taken a picture of the barcode or object again (and getting the object in the correct position can be a challenge, especially with your alarm going off!) https://alar.my/
To summarise
If you are not a naturally a good sleeper (like myself), it is helpful to understand the biology
behind sleep, follow the basic sleep hygiene guidelines and find a range of strategies that suit you and will help you fall asleep, remembering that if you have lost the ability to sleep you will need to spend a bit of time and retrain yourself to do this again.
Written by Vivian Farrand Faculty of Science