12 Habits for Sound Sleep

John D. McKellar, PhDPrivate Practice SF Bay Area

Bay Area Pain and Wellness Center

Today’s Discussion

• Key Concepts for improving sleep

• Definition of insomnia

• How insomnia develops

• 12 Habits for improving your sleep

Key Concepts

• Sleep Drive – Like hunger should be lowest after waking and

increase over the course of the day

• Circadian Rhythms– Biological clock– What kind of a bird are you…..?

Are you an owl??

Are you a Lark??

What is Insomnia

Insomnia•Subjective complaints of poor sleep •Difficulties in initiating and/or wake after sleep onset is greater than 30 minutes •Duration of insomnia is longer than 6 months •Subjective report of daytime sequelae (fatigue, performance impairment •The sleep disturbance or impairment causes significant distress •Rule out other disorders such as sleep apnea

Sleep Hygiene

• Sleep is biological but how you sleep is a habit!!!

• Recall sleep drive, we want to increase sleep drive at night

• Remember your bird, go with the natural rhythms of you clock

• And now…

12 Habits for Sound Sleep

1. Follow a schedule: Maintain a regular wake time schedule including weekend.

This is the #1 rule from sleep experts

Wake at the same time every day- even on weekends when you are tempted to sleep-in. Creating this routine can help train you body and mind to sleep more easily.

Remember waking up at the same time increases your SLEEP DRIVE.

12 Habits for Sound Sleep

2. Use your bed and bedroom ONLY for sleep and sexThis strengthens your brains sleep wake schedule

It is best not to eat, WORK, watch TV, or spend time on the computer in your bed- don’t do things that get you “thinking”

12 Habits for Sound Sleep3. Break the link between your bed and being awake

Reconnect your bed with sleeping rather than being awake and frustrated - Get out of bed when you can’t fall asleep or can’t get back to sleep for 20 minutes. - Do something VERY BORING. Return to bed only when you feel sleepy. - Repeat these steps as often as necessary.

- Remember the key here is to re-program your body and mind to recognize that your bed is meant for sleep (not being awake)

12 Habits for Sound Sleep4. Exercise regularly.Daytime physical activity is an excellent way to help you not only fall asleep easier at night, but get more quality sleep.

However, exercising sporadically or right before going to bed will make falling asleep more difficult because your body temperature rises during exercise, and takes a much as 6 hours to begin to drop.

A cooler body temperature is associated with falling asleep.

Finish your exercise at least 3-4 hours before bedtime.

12 Habits for Sound Sleep5. Avoid daytime napping

- Confuses your body’s internal clock .

- Reduces sleep drive

12 Habits for Sound Sleep6. Do a bedroom check. Create a positive sleep environment, that is, dark, quiet, comfortable, and cool.

Block out noise and distractions. Turn off radios, televisions, or stereos in the bedroom. If you can’t control noise, try using earplugs or devices that create “white noise” like humidifiers or fans.

Reduce light. Avoid exposure to bright lights before bedtime because it signals to your brain to stay awake and not sleep. Even a minimal amount of light can disrupt your sleep. Possible solution: Ask your sleep partner to read in another room; wear a “sleep mask”; use heavy shades that keep the room very dark.

Adjust the room temperature. If you are too warm or too cold, you are less likely to sleep soundly. Adjust the thermostat, your clothing, or your bedding, open or close a window until you find a comfortable temperature.

Move the clock. If you can’t sleep, looking at the clock can make you anxious and make it more difficult to sleep. Move your clock so it is less visible.

12 Habits for Sound Sleep7. Wind-down time: Establish a regular, relaxing bedtime routine

Unwind mentally, About 30 minutes before going to bed, enjoy low-key activity such as reading or listening to music.

Avoid stimulating activities before bedtime like working, paying bills, engaging in competitive games (including video games) or family problem-solving

Taking a warm bath before going to bed can make it easier to sleep. This should be done early enough that you are not sweating or over-heated before bed.

Find a routine that works for you.

12 Habits for Sound Sleep8. Avoid caffeine (e.g., coffee, tea, soft drinks, chocolate) close to bedtime

-Caffeine is a stimulant, which means is can produce an alerting effect.-Caffeine can delay your sleep and cause you to wake up during the night.-Caffeine can stay in your system for 10 hours (tea 4-5 hours) Even if you don’t think caffeine affects you, it may be disrupting and changing your quality of sleep. -Avoiding caffeine after noon can help improve your sleep quality.

12 Habits for Sound Sleep9. Avoid nicotine (e.g., cigarettes, tobacco) close to bedtime.

Nicotine is also a stimulant. It can cause difficulty falling asleep, problems waking in the morning, and may also cause nightmares.

When smokers go to sleep, they experience withdrawal symptoms from nicotine, which also cause sleep problems

12 Habits for Sound Sleep10. Avoid alcohol close to bedtime.

Although many people think alcohol helps them sleep, it actually disrupts your sleep, causing nighttime awakenings and less quality deep sleep.

Consuming alcohol leads to a night of less restful sleep. It is best to avoid alcohol before bedtime.

12 Habits for Sound Sleep11. Finish eating at least 2-3 hours before your regular bedtime.

-Eating too much before close to bedtime causes your digestive system to kick in, which raises body temperature and keeps you awake.

-It is important to avoid a heavy meal too close to bedtime.

-Also, spicy foods can cause heartburn, which leads to difficulty falling asleep and discomfort during the night.

12 Habits for Sound Sleep12. Break the link between your bed and being awake

-Reconnect your bed with sleeping rather than being awake and frustrated

- Get out of bed when you can’t fall asleep or can’t get back to sleep for 20 minutes. - Do something VERY BORING. Return to bed only when you feel sleepy. - Repeat these steps as often as necessary.

- Remember the key here is to re-program your body and mind to recognize that your bed is meant for sleep (not being awake)