By Stacy Kehl, APRN, FNP-BC, Element Primary Care & Esthetics
It’s a common complaint: not enough sleep, poor quality sleep, no sleep. We crave good sleep. We need to awaken refreshed and ready for the day. Yet consistent, good quality sleep can remain elusive for many. I often counsel patients on the steps needed for good sleep; it’s usually a multifaceted solution. For many, achieving restful sleep requires mindful, deliberate efforts. Here are a few of my recommendations:
First, address any health-related barriers to poor sleep:
• Unmanaged pain
• Respiratory problems (heavy snoring, sleep apnea)
• Urinary problems
• GERD (acid reflux, heartburn)
• Hormonal imbalances
• Psychiatric issues like depression and anxiety
• Restless legs syndrome
• Substance abuse/overuse (alcohol, drugs, nicotine, caffeine)
• Medication side effects
“Sleep hygiene” refers to habits and practices that are conducive to sleeping well on a regular basis. There are simple, effective steps we can take to clean up our sleep habits. Sometimes little changes can make a big difference, like limiting caffeine after lunchtime. More often though, it’s an overhaul: moving electronics out of the bedroom, avoiding alcohol, adding an exercise routine, or making dietary changes. Here are the basics:
Out with the electronics
TV, phone, tablets, etc. all have blue light that negatively affects sleep by decreasing natural melatonin production. Even e-reader use in bed can disturb your ability to fall asleep. Many of us use our phones as alarm clocks, but we don’t think about middle of the night notifications and updates that keep our phones buzzing and lighting up. Device use should be avoided 2-3 hours before bedtime (that includes TV). Charge your phone somewhere else and use a dimmable alarm clock with only the necessary “bells and whistles.” Move the TV out of the bedroom, or at least leave it off. Consider blue light glasses.
Get it dark and cool
Get room darkening shades/curtains and cover small lights (like an alarm system panel) with tape. Even small amounts of light peeping in can wake us up and make it difficult to get back to sleep. If you need a night light for a middle of the night bathroom trip, make sure its motion sensor, so it only comes on when you’re already up and moving, and it’s only as bright as needed to make it safe. Bonus points for getting a night light that has a red light instead of white. Optimal sleeping temperature is 68-70 degrees.
Lighten up at dinner
Heavy meals at dinner contribute to problems like intestinal bloating, gas, and acid reflux. Same goes for spicy or fatty meals. Make your biggest meal at lunchtime or move up dinner time a few hours to give food time to digest.
Give animals their own place
We love our pets, but they don’t have to worry about staying awake during work hours, so keep them out of your bedroom and give them their own space to sleep so they don’t disturb your sleep.
Exercise
Exercise definitely has a long list of benefits, sleep is but one of them. Vigorous exercise should be done during the early part of the day to boost energy and wakefulness, and increase calorie burn throughout the day. Reserve late day exercise for an after-dinner walk, some light stretching or yoga.
Limit naps
I love a nice siesta after lunch, but limit your napping to 20 minutes. Longer naps will inhibit your ability to sleep at night. No matter how tired you are from the previous night’s insomnia, avoid the urge for the long midday nap.
Review your medications
Sometimes, adjusting your dosage or dosing schedule can help with sleep problems. Medication side effects often include effects on sleep. Review your list with your provider and see if any changes can be made to help get you more sleep.
Avoid the avoidable
Alcohol, tobacco and non-prescription drugs also have a huge effect on sleep. Nicotine is a stimulant, it encourages wakefulness. Alcohol is a nervous system depressant; it makes us sleepy initially, but actually wakes us and makes us restless as the effects start to wear off during the night.
De-stress
Easier said than done sometimes, but learning to manage and cope with stress and anxiety are life-long skills that will benefit more than just sleep. Avoid facing your stress and anxiety in the bedroom (that means no fighting in the bedroom). Make the bedroom a respite away from stressors of the day.
If you have any questions about sleep, read up on it or ask your healthcare provider. If you have more questions, I’m taking new patients! (850) 708-1623, or stacy@elementpcp.com.
