Establishing good sleep hygiene practices

By Sakuni Weerasinghe

In light of the pandemic situation we are currently facing, hygiene practices are being discussed across the world. We speak of handwashing, showering, the appropriate use of washrooms, and hygienic conditions for the preparation of food. Each of these practices contributes immensely to our health, which includes both physical and mental health. Perhaps the most neglected practice is that of sleep hygiene. Sleep hygiene includes a range of practices and habits that guarantee good quality nighttime sleep and full daytime alertness. Good sleep hygiene has been found to improve productivity and overall quality of life. As young adults, it is necessary that we form good sleep habits to ensure we continue to reap its benefits as we grow older.

First, let’s try to understand how our sleep cycle works. There are two basic types of sleep: rapid eye movement (REM) sleep and non-REM sleep, which comprise three different stages. The differentiation is based on specific brain waves and neuronal activity. Two of our body’s biological mechanisms regulate the sleep-wake cycles, one being circadian rhythms which control the timing of your sleep based on the body’s biological clock. Sleep-wake homeostasis is another system that tracks your sleep requirements. This is what causes you to sleep longer and more deeply after a period of deprived sleep. Mind you, this does not mean you can catch up on lost sleep during the weekend if you deprive yourself of quality sleep throughout the week.

Stage 1 is a transitional stage between waking and sleep. Muscle tone is relaxed and jerks or abrupt muscle spasms may be experienced, including the sensation of falling.

Stage 2 is a stage of light sleep, but awakenings typically do not occur. Memory consolidation occurs during this stage. Your body temperature begins to decrease and heart rate begins to slow down.

Stage 3 is the most restorative stage of sleep. It consists of delta waves or slow waves.  Parasomnias such as sleepwalking and sleep talking may occur during this stage.

Stage 4 is marked by REM sleep where eye movements are rapid. Brain waves are more active than in Stages 2 and 3 of sleep. This is the stage where vivid dreams could occur and awakenings are a possibility.

The main takeaway from this bundle of information is that deep sleep (in Stage 3) is important for both short-term and long-term memory, cell regeneration, growth and repair of tissues and bones, strengthening of the immune system, and feeling refreshed when you wake up. This is precisely why it is important to have good quality sleep. Quantity-wise, at least seven to nine hours of sleep as an adult are required.

As you can imagine, sleep has quite an effect on our overall health, especially our mental health. Disturbances in sleep bring about a host of mental health concerns. Three common sleep-wake disorders include insomnia, obstructive sleep apnea, and narcolepsy. These experiences are very distressing to the individuals experiencing them. 

  • Insomnia refers to problems getting to sleep or staying asleep. To warrant a diagnosis, the sleep difficulties must occur at least three nights a week for at least three months and cause significant distress to the person
  • Obstructive sleep apnea is having breathing problems which cause snoring, snorting, or gasping during sleep, resulting in interrupted sleep. This causes daytime sleepiness and fatigue. Obesity, male gender, and having a family history of sleep apnea are risk factors for its development
  • Narcolepsy is excessive daytime sleepiness (“sleep attacks”) combined with sudden muscle weakness several times a week

Misunderstandings about the nature of these issues lead many to perceive those experiencing them as slacking during the day at work, or constantly “complaining” of sleepiness when you suggest going out for a meal or a movie. If you or anyone you know have been experiencing similar signs, it’s important that we remain attentive to these experiences. You can make sure that professional help is sought when these experiences are causing a lot of distress and are starting to affect personal, social, and work life.

Establishing good sleep hygiene habits can act as valuable preventive measures against the health concerns we may face as a result of disturbed sleep.

Here are my tips to help you work on your sleep hygiene.

  1. Develop a sleep-and-wake routine

We love consistency in general and are readily able to form habits. As such, developing a sleep-and-wake routine will enable your body to prepare for sleep and to wake almost effortlessly. Speaking of preparing your body to sleep, make sure you have a wind-down routine for the evening. Have a set time by which you will finish your work for the day. Make sure you have your dinner at least two hours before going to bed and avoid consumption of caffeine prior to sleeping. Try engaging in a light read, doing some colouring, or listening to some calming music, all of which can serve as cues for your body to prepare for sleep.

  1. Focus on the ambience of the room

If you are having problems with sleep, the main culprit is likely to be the state of your room. It’s important that the lights are switched off or at least in a dim setting in order for your brain to recognise it as the time to sleep. Melatonin, the key hormone responsible for regulating sleep, tends to naturally increase in the body during 9 p.m. and 7 a.m., the hours traditionally associated with darkness. However, artificial lighting can suppress its secretion, thereby causing disruptions in sleep. Yes, this does mean no TV in the bedroom, or in the least, switching it off hours before bedtime. Ideally, the temperature of the room ought to be slightly cooler, and you would find yourself sleeping better in a quiet, clean room rather than a noisy, cluttered one.

  1. Do not allow yourself to take your worries to bed

Often enough, we have a tendency to take our worries to bed, thinking through the day’s troubles and ruminating on where we have gone wrong for a while before we are even able to shut our eyes. Owing to the nature of our brains to make associations, over time we pair the bed with stress, anxiety, and worry. As a result, we find it difficult to get to sleep and often experience disturbances in staying asleep. There is a way out of this loop though, because what is learned can also be unlearned. You can stop yourself from bringing your worries to bed, especially if you can allocate another place in your house to do the thinking and worrying. When you do come to bed, ensure that your worries are mulled over elsewhere in the house, or written down in a journal at your desk.

  1. Practise some breathing exercises before bed

You can help your body adjust to the first stage of sleeping where the muscles are relaxed by practising a few breathing exercises in bed to relax your mind and body. Try deep, paced breathing where you breathe in deep through your nose to a mental count of four. This will result in your belly extending to make space for all the air. Hold the breath for a count of seven and exhale through the mouth to a count of eight. You can also try guided imagery by taking yourself mentally to a place where you felt most calm and at peace with yourself.