What?

What is Sleep Hygiene?

Sleep Hygiene consists of our bedtime rituals and nightly habits. They address our lack of sleep preparation and our inconsistent fostering of good sleep opportunities. The term refers to sleep prep behaviors.

Why?

Why Optimize Your Sleep?

Sleep should be improved not just to feel better. Sleep should be improved because poor sleep causes safety risks & medical conditions such as hypertension, diabetes, obesity, heart-disease, and many more.

Sure?

Do These Tips Really Work?

Sleep prep behavioral tips may not appear to have much gravitas on their own, but that is only because they have been pulled out of their context for easy messaging. If you know the context, they're powerful.

Yes!

Understand The Context

Poor sleep starts physiological mechanisms that drive other common disorders. Poor preparation drives poor sleep and other vicious cycles that broadly impact your day. We invite you to consider these links.

Our Conceptual Model

As we introduce a common list of "sleep hygiene" and "good sleep practices", we should take note of a powerful way to conceive of the collective tips. If we consider the rising and falling ebb and flow of our circadian rhythm in general, we notice that athletes and performance-orientated persons strive to (1) harness the peak windows that naturally occur as they simultaneously (2) ensure that dips and troughs remain controllable and placed exactly where they want them. Conversely, employers and Human Resources departments who are concerned with safety & productivity strive to (1) protect their employees from dips and troughs that are profound enough to cause unwanted intrusions of sleep and reduced vigilance while they also seek to have employees (2) utilize the peak periods of the day to remain productive. In the end, these two inverse goals are simply two sides of the same circadian rhythm "coin", with athletes focused on the "rising tide" and risk managers focused on the receding flow of energy and attentiveness that circadian dips manifest. Sleep preparation is really embedded in this larger pattern of circadian rhythm because there are natural turning points in the rhythm that should not be interfered with even inadvertently, or sleep difficulties will arise. We will see this ebb-and-flow model throughout this platform. It reminds us that poor sleep is not always "willful" reductions in sleep opportunity and that impacts can blunt sleep quality in a crucial way from stimuli that we often remain completely unaware of. Moreover, when we are provided with sleep hygiene tips, the suggestions tend to not have the force required to effect behavioral change unless or until that larger context is provided. This platform is about that context, because many sleep hygiene and good sleep practice tips remain integrated, just as they are in our natural physiology.
Dark

See Why Light Matters

Keeping the bedroom dark is crucial for avoiding the optimal circadian rhythm "shift window" that will delay natural sleep onset later than desired. Even low light from smartphone & tablet monitors delay sleep.

Cool

Core Body Temp Matters

A cool bedrooms (low to mid 60s) assists with an abrupt downward shift in core body temperature from circadian-driven hormones in preparation for sleep. If this dip doesn't occur, sleep-onset is harder.

Quiet

External Stimuli Interrupt Sleep

Keep your subconscious subconscious. External stimuli have the power to keep your brain ever-ready to poke you out of necessary deep sleep stages and engage only a lighter, far less restorative sleep.

Sleep

Identify Bedroom With Sleep

As the saying goes, the bedroom should be identified with only sleep and sex. It is not a media entertainment center. If the bedroom begins to be associated with sleep difficulties, those difficulties will stick.

Keep It Real

The first step in creating a viable sleep optimization strategy is to know your actual patterns as they currently exist. It is well-established that we overestimate our sleep time (based on estimates of time in bed), and we overestimate our capacity to get by on sub-par sleep. Studies that look at performance and medical outcomes are not ambiguous on the matter. Increased risks are associated with average sleep times that fall short of those recommended and individuals that boast of immunity from the impacts of short sleep on productivity, safety, and performance are often the most likely to have critical increases in micro-sleep episodes and vigilant lapses that they are not aware of. Moreover, the links between poor sleep and cardiovascular, metabolic, cognitive, and mental disorders is robust. The Nourish Sleep Assess-and-Educate gateway to this material has provided your first level of education about sleep-disorder risk screening and follow-up recommendations for confirmation. That is the first priority for any sleep optimization strategy, however good sleep preparation behaviors and good sleep hygiene should be enacted even if potential sleep disorder indicators are followed-up on.

Step It Up. Step It Down

Step ONE: Find out how much sleep you're actually getting. Consumer sleep technologies are not always reliable relative to their claims, but they can give you a fairly good idea of how long you remained motionless enough for the device (or app) to assume that you were sleeping. Sleep logs can also help.
Step TWO: Go to bed the same time every night, or as close to it as possible. A number of factors can shift your rhythm later and later without you knowing it. For example, apart from the light from your device monitors, the cognitive arousal associated with the content that has engaged you on your devices (or left you expectant for incoming texts, news or correspondence) can also delay sleep onset, but also shift your circadian rhythm for a later sleep time tomorrow. The flip-side of a consistent bedtime is a consistent rise time. Individuals that plan for sleep loss during the week and attempt catch-up sleep on the weekend are engaged in bad practices for two reasons. First, they will never fully catch up. Second, they will create a mistimed circadian rhythm relative to their desired schedule. See the Risk Mitigation (or HR & Occupational Risk) link for more impacts from the first point. See the Circadian Rhythm Intro section for more on the second.
Step THREE: Keep your (not so) smart devices out of the bedroom. Even the low light emitted from device monitors can shift your rhythm later or delay sleep onset in general. Even blue-blocking screen technology has limitations.
Step FOUR: Keep the bedroom dark, particularly if you engage in night-shift or rotating-shift work that places your sleep opportunity only during daylight hours. The importance of light for fundamentally anchoring or shifting your circadian rhythm is discussed in the Circadian Rhythm Intro and Light/Dark subsection. You will discover there and in subsequent pages that two 'framing' windows are very important with regard to light. Low light after sunset and a few hours prior to bed is important for dim light melatonin onset (DLMO), a critical marker for core body temperature to stop rising and begin to dip and for sleep onset preparatory processes to begin exchanging a general 'sympathetic' tone in your nervous system to a 'parasympathetic' tone. The other frame is bright morning light soon after awakening. This helps anchor your rhythm to your desired schedule. You can even wake up earlier and get a couple hours of bright light to shift your rhythm earlier if you happen to be sliding later and later. There is a real science to the process however, so be sure to visit the circadian rhythm learning section.
Step FIVE: Keep the bedroom cool. When core body temperature does not dip slightly, then sleep is likely to be delayed until it does. Core body temperature is also discussed in the Circadian Rhythm main section, as well as the Day-Walk page that walks through the hormonal ebb-and-flow of a "circadian day".
Step SIX: Find your sleep preparation ritual. You've got to discover your own way to consciously create a sleep preparation window at least an hour (preferably two) before bedtime. Ride along the natural melatonin sleep preparation pathway (so long as you don't delay its onset with bright light). Find a way to wind down the body and mind. Core body temperature dips nicely after a warm bath. Late afternoon or early evening exercise, assists also. In both cases, the rise in body temperature is followed by a welcome "overshoot" past the baseline in preparation for restorative sleep. One major caveat though, exercise should not occur too close to bedtime (even less than 4 hours), because it takes significant time for core body temperature to start the decline following exercise. Another benefit to exercise (even if engaged in the morning) is that deep stages of sleep are "driven" by exercise after a period of accommodation to it. Until then, it can act as a stressor, so wait for the adaptation phase when all the feel good chemistry is sustained and restorative sleep is ensured. Aside from exercise, mindfulness meditation techniques can assist. Studies have also shown that simply getting outdoors for part of the day can assist for a number of reasons. But that is the subject of another entire learning series.
Step SEVEN: Exercise. We'll say it again. As long as you don't exercise too late, exercise will be beneficial to your sleep and your health. Check out the Tri-Nourish link to learn more.
Step EIGHT: Get some sunlight. You'll learn about light and the "framing" window opportunities that can shift or anchor your circadian rhythm. Recent studies have also suggested that getting outdoor light even outside the sensitive timing window for shifting or anchoring your rhythm may help. These sensitive "shifting" timing periods include: (a) early morning bright light and (b) late evening dim light. Getting consistent outdoor light during the day apart from these sensitive times apparently 'blunts' some of the bad shift-delays that late exposure to artificial light brings.
Step NINE: Find a quiet place to sleep that is conducive to sleep, and not a chill entertainment center. Even when you believe that you are sound asleep, noise can interrupt the deeper stages of sleep that you hope to engage. On the other side of the coin, absolute quietness can be disturbing for the "echo chamber" of an overly ruminating modern mind. In that case, white-noise machines or relaxing music may assist.
Step TEN: Most sleep hygiene lists say to avoid naps. This is true only in certain circumstances, particularly if you have difficulty with sleep-onset. However, shift workers, including night-shift workers, rotating-shift workers and extended-shift workers such as hospital staff, first responders, and situation responders should actually utilize naps, not avoid them. To understand the difference, see NAPS.
Step ELEVEN: Watch what and when you eat. Remember what your momma used to tell you? Sure enough, high calorie meals, fatty meals, and carbohydrate-laden meals too close to bedtime can interfere with sleep not only because of the need for digestion, but because energy-rich meals can also serve as an entrainment stimuli that your circadian rhythm will anticipate by delaying sleep onset tomorrow night in the hope of receiving the same good stuff.
Step TWELVE: Train yourself to consider the bedroom only for sleep or sex. If you have difficulty getting to sleep, get out of bed and don't try to sleep on the couch. Engage in a quiet activity such as reading a book (remember books?). The point is to wait until you are physiologically sleepy again, and not just 'fatigued'. This strategy is part of a larger set of protocols that constitute cognitive behavioral therapy for insomnia (CBT-I). Even if you do not believe that you meet the criteria of full blown insomnia, check out the CBT-I components below to gain a better sense for how these tips can work together.
Real

Know Your Actual Pattern

You probably over-estimate how much sleep you are actually getting. Step One is to discover a more realistic estimate.

Same

Strive For Sleep Consistency

Try to go to bed at the same time each night and wake up the same time. This also includes weekends.

Calm

Body & Mind Need Calm

Discover ways to calm your mind in preparation for sleep. "Wag the Dog": calm your body and your mind will follow.

Prep

Pay Attention To Sleep Prep

Most of all, be mindful and consciously aware of what you are doing in preparation for sleep each night.

Sleep Hygiene Education

SLEEP HYGIENE EDUCATION: Sleep hygiene education appears to be everywhere these days in the form of isolated lists that are often presented as "the" condensed formula for better sleep. In contrast to presenting only concise "tips-and-tricks", this learning platform has been created precisely because sleep bullet-points do not have the power to effect positive change unless they have been boiled down from a larger context that is specific to the individual. Context matters. Lists are effective the way that cheat sheets are effective: a condensed cheat sheet works best if it prods important features at the same time that it activates a broader association with where, why and how those select features are important. If isolated from context, their importance is not transferred.

Sleep hygiene education complements other therapies and good baseline practices. Sleep hygiene includes:

(1) Avoiding stimulants such as caffeine and nicotine for several hours prior to bedtime. See also ths to contextualize the5-6 hour half-life of caffeine.

(2) Avoid alchohol around bedtime because it fragments sleep. See the sleep architecture section to understand why the REM-suppressing qualities of alcohol are so disruptive.

(3) Exercise regularly. Exercise timing is also important to ensure that circadian rhythm delays do not interfere with desired sleep onset time. Morning and late afternoon exercise may be beneficial, provided that core body temperature is allowed to be reduced. Late evening exercise is not recommended.

(4) Allow at least a 1-hour period to unwind and prepare for sleep. This preparation aligns with a natural inflection point in our circadian rhythm that should occur to assist a sleep onset preparation period.

(5) Keep the bedroom environment quiet, dark and at a comfortable temperature. Our natural dim light melatonin onset (DLMO) is interrupted with bright light, as is the inflection of a previous late afternoon rise in our circadian rhythm that abruptly turns downward in preparation for sleep to reduce our core body temperature. The bedroom should be between 62 and 68 degrees Fahrenheit to maintain this reduction.

(6) Maintain a regular sleep schedule to keep your circadian rhythm from drifting.

(7) Remove electronic devices from the bedroom. Devices emit enough light to interrupt normal melatonin release. In addition, increased cortical arousal delays sleep onset.

Sleep Hygiene is rarely adequate to treat sleep onset difficulties on its own in the absence of a multi-component therapy similar to those available in the form of CBT-I. CBT-I is cognitive behavioral therapy for insomnia. You don't have to have a clinical threshold of insomnia to appreciate that the basic components may be very helpful for achieving better sleep in the context of today's challenges.
CBT-I

Stimulus Control

The goal is to turn your negative reflexives about the challenges you have with sleep onset into positive, confident associations with your bedroom and your sleep environment.

CBT-I

Sleep Restriction

It is completely counter-intuitive at first but one of the best ways to "reset" your association with sleep is to make you physiologically sleepy enough to overcome your intruding concerns.

CBT-I

Relaxation & Feedback

You will learn in the circadian rhythm education section that sleep onset follows a natural dip that prepares the way for sleep. Relaxation techniques can assist this natural process.

CBT-I

Cognitive Control & Therapy

Therapy, guided imagery and mindfulness can help control intrusive thoughts. After all, one of sleep's basic functions is to "finish" processing your emotions if you are ready to let it.

Context Matters.