Sleep is the third and final pillar of health, alongside nutrition and exercise.
The summary I will provide you below will hopefully give you enough understanding to see if sleep is an issue for you. It should help you to gain knowledge so that you can see what is going on for you. Finally, it will give you enough tips and tricks so that you know what you can do about it.
To begin with, there are three questions that you need to ask about your sleep if you want to do a brief assessment of what is going on for you. You need to ask:
- Is my sleep pressure high enough when I go to bed at night?
- Am I going to bed at the right time for my body clock? And
- Is my arousal (or chronic stress) level low enough when I am in bed at night and trying to sleep?
To determine if your sleep pressure is high enough, you need to see if you can fall asleep fairly quickly at the start of the night. If it generally takes you less than 15 minutes to fall asleep once you get into bed, your sleep pressure may be high enough. If it is high enough, your sleep pressure can also help you to remain asleep for most of the night until you want to wake up and get out of bed in the morning. It’s normal to have a brief awakening at the end of a sleep cycle. During this time, we may move our sleeping position a little, return to sleep, and begin another sleep cycle. Many people may not even remember being awake or moving around the next morning. It’s not that it hasn’t happened. They don’t pay any attention to it and resume sleep quickly. Sleep cycles can happen every 90 to 120 minutes; we have about four to five of these each night.
HOW TO INCREASE YOUR SLEEP PRESSURE
If you want to make your sleep pressure high enough, aim to be out of bed for 16 hours each day. If you want to go to bed at 11pm each night, try to get up and out of bed at 7am each morning. If you get up at 8am, try not to sleep until midnight. If you want to sleep at 10pm, you may want to try getting up consistently at 6am.
Caffeine can reduce your sleep pressure, so try not to consume too much of it during the day and not too late at night. Caffeine has a half-life of 4.5 hours, so you will still have 25% of it in your system nine hours later. Minimising caffeine consumption after 2pm will help your sleep pressure.
Napping can reduce your sleep pressure, with naps longer than 20-30 minutes more than short power naps. If you have to nap, keep your nap opportunity time to less than 30 minutes and before 4pm during the day.
Lastly, engaging in physically or cognitively demanding tasks during the day can improve your sleep pressure for that night. If you’d like to ensure your sleep pressure is high at night, see if you can do something challenging for your mind or body during the day. Because these tasks can also put a certain amount of stress on your brain and body, try not to do too many of them in the three hours before bed, and do things to wind down and relax before bedtime.
Everyone has a natural internal body clock, or circadian rhythm, that helps them feel alert and function well when awake. Circadian rhythms also help people to feel sleepy and rest when they want to sleep and recover. Some people are morning people or ‘larks’, whose brain and body want to help them get to sleep at 9pm, wake up, and get out of bed at 5am. Other people are night people or ‘owls’, whose body wants to help them function well until they sleep at 1am and then not wake them up until 9am, when most people have already begun their workday. Most people are somewhere between, with a body clock that helps them get to sleep between 10-11:30pm and wake up between 6-7:30am.
Sometimes, morning people feel that they have to stay up later or try to sleep in, and they cannot. It leads to them not sleeping as much as they would like to, often being awake in bed in the mornings, and feeling worse for wear during the day. More often, night people try to sleep earlier and wake up earlier than their body wants them to. As a result, they also sleep less than they need, spend hours awake in bed at the beginning of the night, feel exhausted and find it hard to get up and move in the mornings.
HOW TO WORK WITH YOUR INTERNAL BODY CLOCK
The easiest and best thing to do is to start becoming aware of your natural circadian rhythms or body patterns and begin sleeping at the right times for you. If you are a morning person, get up at your natural time and enjoy the longer and more gradual start to the day. It might give you more peace and quiet and time for yourself than you can get at other times in the day. If you are an evening person, try to wait until you feel sleepy before going to bed, and then aim to get up 8 hours after that. Regardless of who you are, you will sleep better if it is at a more natural time for you.
You can bring your body clock forward if you are more of an evening person and cannot sleep at your natural times during the week because of your school or work schedule. You can advance your circadian rhythms by having a consistent wake-up time, getting some morning sunlight soon after you get out of bed, not eating your meals too late, especially your dinner, and minimising how much bright light you expose your eyes to at night time. Some people think that blue-light wavelengths in your screens are particularly problematic. Avoid using screens too much in the last two hours before you go to bed; use f.lux if you need to use the computer, or night shift or similar devices on your phone that make the screen look more orange or red. Or you can invest in some blue-light blocking glasses that look orange/red in colour.
Chronic stress, or hyper-arousal, can play havoc with your sleep and lead to insomnia or other sleep disorders over time. It is therefore important to manage how much chronic stress you have in your life. A little bit every now and then is fine and can even help you be more productive and achieve better results until the stressor is gone. However, if that stress becomes chronic and doesn’t go away, it can negatively impact your brain and body and disrupt sleep.
If you’d like to determine your arousal level, imagine it on a scale from 0 to 10, where 0 is none, and 10 is full-blown panic and feeling completely overwhelmed. During the day, between a 4 and 6 is probably optimal in helping you perform well and do what you need to do at home, with your family, or at work. At night, however, between a 2 and a 4 may be better for falling and staying asleep.
HOW TO LOWER YOUR AROUSAL LEVELS
If you would like to lower your arousal levels, there are several things you can do. You can try to only focus on things that are under your control or things that you can do. The more you worry about things out of your control, the more you are likely to feel stress and anxiety. Understanding and accepting things that are out of your control is better than trying to change them or continuously wishing they were different. Once you have understood and accepted these things, try to change your focus back to whatever is most important to you at that moment or the situation you are in.
Noticing whenever your mind wanders to unimportant things or things out of your control is a skill that can improve and become quicker and easier over time. Getting better at this helps you bring your attention back to what is in your control faster. It helps you to prioritise what is most important to you and what you can do about it.
Other things you can do to lower your arousal levels include taking more breaks at work, doing less during the day, and engaging in activities that give you a sense of fun, play, awe, beauty, gratitude, pleasure, mastery or achievement. You can socialise with people you like and feel accepted by and connected to. You can also learn things like yoga, Pilates, meditation, and relaxation. Or go get a massage or have a spa, steam or sauna. Whatever it is, as long as you find that it reduces how much chronic stress you are experiencing or gives you some relief, it is worth doing and incorporating it into your life sustainably.
Having a consistent wind-down or relaxation routine before bed can also be helpful, as is not forcing yourself to sleep when you are in bed. Instead, try having a good anchor point to focus on when you are in bed and bring your attention back to it if you begin worrying. A good anchor point can be thinking about things in your life that you are grateful for, an imagery exercise of a place that you find peaceful, focusing on your breath and keeping it slow and deep and exhaling all the air out each breath you take. Anything really, as long as you find that it works for you. Sometimes people listen to white noise, a podcast or an audiobook with a timer. If it helps you to feel relaxed and not stress about not sleeping or anything else, it can be an effective anchor point and keep your arousal levels low until you fall asleep.
One of my favourites if I am in bed by myself is to listen to stand-up comedy. I’m not hating being awake and enjoying what I am listening to and occasionally smiling and chuckling. Before I know it, I am generally asleep, and the comedy show switches itself off once it finishes.
If your sleep pressure is high enough each night, you are going to bed at the right time for your internal body clock, and your arousal levels are low, you’re likely to begin sleeping much better consistently.
Dr Damon Ashworth