The best way to evaluate the quality of your sleep is to look at the quality of your wakefulness during the day. Do you function with alertness at your job and while driving – or do you tend to fall asleep without a constant caffeine boost?
If you are someone who can work creatively, drive dependably and carry on quiet activities (reading, conversations) without falling asleep, you might be getting better sleep than you realize. Many people worry about their sleep unnecessarily. Waking frequently, for instance, might be annoying but is not damaging if you are able to return to sleep and function normally the next day. If this applies to you – imperfect sleep, but adequately rested during the day – you might want to improve different aspects of your sleep, but you can take some comfort from the fact that you are getting enough sleep for your good health.
If, on the other hand, you are someone who does get sleepy during the day – unable to stay awake while driving, working, or sitting quietly – you probably already know that you are not getting enough good quality sleep.
The first step to improving your sleep is to increase awareness of the factors that influence sleep quality, including daytime lifestyle choices, sleep routines, and sleep behavior.
Let’s start with lifestyle choices: the choices you make as you go through your day can have a major influence on how well you sleep.
Balance your blood sugar. Eating regular and nutritious meals is the first step toward balancing your blood sugar. When each meal contains healthy proteins and fats and sugar consumption is minimized, the level of sugar in your blood stays at a moderate and healthy value and you are less likely to experience sharp increases or drops in blood sugar. If you never get a “sugar high” or “sugar blues”, your blood sugar probably stays level throughout the night and is less likely to wake you. Folks that over-indulge in sugars will one day find themselves to be awake sometime between 2 to 4 a.m. when their blood sugar falls, and their adrenal glands produce enough cortisol to normalize blood sugar and, oops – side effect, cause wakefulness.
Get some regular exercise. Exercise is beneficial, but should not be vigorous in the last 4-6 hours before bed. There is some thought that exercise performed outside in the early morning hours promotes ease of falling asleep, and late afternoon outdoors exercise might help you stay asleep. Either way, it’s certainly known to be helpful to incorporate some modest or vigorous activity on a consistent basis in your routines, and settle down to rest in the last few hours before bed.
Avoid exciting stimuli before bed. Individual sensitivity to all sorts of stimulation varies widely. Consider all these sources of stimulation and notice how well you sleep if you avoid them close to bedtime. I’ll include sample routines for each.
- Caffeine – many people do well to avoid caffeine after 2 p.m., for others it’s better to avoid it completely, or on the other hand, some folks seem to get sleepy with coffee, something I’ve never understood.
- Bright lights – we evolved living outside, with gradually fading light. Some people are very sensitive to lights and the simple practice of turning off all overhead lights and gradually dimming table lights over the evening seems to result in better sleep.
- Computers and television – it’s fairly straightforward that exciting brain activity results in brain stimulation, wakefulness and poorer quality sleep. A reasonable strategy is to avoid computers and television in the last one to three hours before bed, depending on your individual sensitivity.
- Emotions – emotions can awaken your brain as well, so any worries or urgent conversations might be better written down in a “Do Tomorrow” location, so that your mind can relax for the night, knowing that those issues can wait for the next day.
Once you’ve looked carefully at daytime choices, ask yourself if you have a standard routine for bed. Most of us know that children benefit from a regular bedtime, and then forget to apply that same rule to ourselves as adults. For those who want to improve their quality of sleep, it can be quite informative to look at how near or far we are to a regular routine.
Before bed, do you follow a routine? How do you spend your pre-bedtime hours? Take a close look at your pattern, if you have one, and make a conscious choice about how you think you might best settle your mind and body for sleep.
- Your night-time routine is yours alone, but for most people starts with closing down their daytime activities. As mentioned above, gradually dimming the lights in your general environment actually begins to prepare your brain for sleep. We spent millions of years living by the sun, and our brains still naturally follow the sun's routines. It is well documented that people are at increased risk of serious diseases when their jobs keep them awake in hours of darkness and require them to sleep when the sun is up. Diabetes, breast cancer, and other illnesses have been found to occur more frequently in shift or night workers.
- The next step for many people is personal hygiene, which might include a shower or a bath for extra relaxation.
- If you take supplements or sleep aids (for suggestions see the discussion on the Insomnia page), spread them out over the last hour before bed rather than taking them all at once.
- Do you stretch or meditate or read before bed? All of those activities can be helpful, but for people with sleep challenges, it might be best to limit in-bed reading to about 5 or 10 minutes. If you're wakeful for a longer time, move to a comfortable place to sit and only return to your bed when you're close to turning off the light.
- Speaking of lights - how do you set up your bedroom? Keeping your sleeping area on the cool side, with a little fresh air if possible, and as dark as possible can all set the stage for a night of sound sleep.
- For many people sexual activity is a helpful prelude to sleep.
How does the night go for you? Do you fall quickly asleep, or linger for minutes or even an hour in bed before you nod off?
- If it takes you a long time to fall asleep, you are either resting peacefully - perhaps catching little minutes of sleep outside your awareness - or you are getting frustrated and worried about not getting the rest you need. If frustration accompanies delayed sleep onset, you will ultimately benefit from getting yourself back out of bed and addressing what seems to be keeping you awake. Read for a while, do something boring (I have ironing available if you don't), or write down any thoughts that persist in your busy brain. Drink some warm water, soothing herbal tea (chamomile blends are good), or warm milk if you like. Take a warm bath. Return to bed when you feel more relaxed. Spending worried time wakeful in bed creates a body memory that is not helpful for the sleep you want to create for yourself.
- Perhaps you wake up in the night, once or more. If you wake suddenly, there is a possibility that you have sleep apnea, manifest by snoring, or gasping, or - for the sleeper - just sudden wakefulness. Ask your doctor for a sleep apnea evaluation if this is true for you. If you wake with a full bladder, remind yourself to drink less the following evening, take care of nature's calling with as little light as possible, and return to bed. If you find yourself unable to return to sleep, practice some gentle relaxation, perhaps the meditation instructions listed here, or some progressive relaxation of different muscle groups.
- Do you wake up a few hours before you plan to, perhaps between 3-5 a.m.? Early morning wakening is usually a sign that your adrenal glands, which usually secrete some "wake-up" cortisol just before rising, can sometimes be triggered earlier than desired, waking you up hours ahead of schedule, finding yourself unable to go to sleep until that surge of cortisol settles down. For most people, catching a "cat nap" from 6-8 a.m. may feel terrific but probably doesn't fit well into your daily schedule very well. Two lifestyle areas to investigate if this is true for you are
- blood sugar issues: if your carbohydrate load is sufficiently high that you have blood sugar "highs" and "lows", then that same pattern can wake you during the night, and
- life stressors: if you can identify and modify any daytime stressors that may be encroaching on your good night's sleep, you can sometimes eliminate pre-dawn wakefulness.
Finally, let's talk about waking up in the morning. On waking in the morning: do you feel refreshed? remember a few dreams? feel ready to start your day? If not, you may have compromised sleep quality even if you think you are sleeping all the way through the night.
The most important variable in your sleep routine might just be the hour that you get up from sleep. Particularly if you know or think you have some sleep challenges, or your sleep quality is not as good as you like, the most valuable choice you can make - and this one you really can control, though it can be difficult - is to get out of bed every day at the same time, give or take 30 minutes. If you absolutely have to get out of bed by 7 a.m. to get to work, you will give yourself the best chance of healthy sleep if your weekends see you rising by 7:30. No harm in returning to bed with a cup of tea and a book, even falling asleep again - but get yourself out of bed and do some part of your morning routine. Lucky you if you have a neighborhood rooster you can respond to!
So tell me what you think - how easy is it for you to get the sleep you want? Do you have any special lifestyle tips that have made it easy for you to sleep sweetly at night and rise refreshed in the morning?