Sleep hygiene refers to a collection of behavioral and environmental guidelines designed to promote healthy sleep patterns, initially devised for addressing mild to moderate insomnia. In sleep hygiene education, individuals are educated about cultivating positive sleep habits and urged to adhere to a set of recommendations to enhance their sleep quality—such as abstaining from caffeine or engaging in regular exercise. Despite established connections between specific sleep hygiene elements and subsequent sleep outcomes, research on the effectiveness of sleep hygiene education as management for sleep disorders such as insomnia, has been limited and inconclusive. In this blog, I cover a broad overview (not exhaustive) of some widely used strategies to improve your sleep hygiene...
CAFFEINE
Research indicates that high doses of caffeine (such as coffee or energy drinks) near bedtime significantly disrupts our sleep, while lower doses yield smaller and less consistent effects. The long-term impact of caffeine abstinence in habitual users remains uncertain, but current evidence suggests potential benefits for light or intermittent users compared to habitual users.
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NICOTINE
Evidence suggests that nicotine exposure (especially high doses) is linked to sleep issues. However, advising individuals to quit nicotine use is complicated by the temporary exacerbation of sleep problems during the acute withdrawal period and the limited evidence on long-term benefits. During the initial phases of quitting smoking, experiencing sleep issues is common. This is primarily attributed to nicotine withdrawal, leading to increased arousal and cravings. Strategies to address withdrawal-related sleep disturbances during cessation may enhance the effectiveness of sleep hygiene recommendations related to nicotine use.
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ALCOHOL
Occasional alcohol consumption (even small amounts), shortly before bedtime can negatively affect sleep for non-dependent individuals. The impact of afternoon or early evening alcohol use on sleep is not well understood. Chronic sleep problems are common among alcohol-dependent individuals, especially during acute withdrawal. Research involving healthy adults has consistently indicated a dose-response correlation between the quantity of alcohol consumed and the onset and depth of sleep, implying that increased alcohol intake is linked to poorer sleep quality.
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REGULAR SLEEP SCHEDULE
The evidence highlights a clear link between irregular sleep schedules and sleep issues. Findings from studies exploring the transition from irregular to regular sleep schedules may not be broadly applicable to those most likely to adopt sleep hygiene advice, as the individuals lacked sleep complaints. While untested, there's a plausible suggestion of a dose-response relationship between sleep timing regularity and sleep problems. This could potentially explain the varied benefits observed in individuals with insomnia compared to those without sleep complaints.
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NAPPING
Most research has taken place in controlled laboratory settings with scheduled nap opportunities, necessitating additional studies in more natural environments. Exploring the effects of habitual napping is crucial, considering its common practice among individuals. It remains unknown whether nocturnal sleep adapts to the influence of daytime napping. The potential differences between occasional and habitual nappers in how daytime napping affects nocturnal sleep are also uncertain. Individual variations, especially age-related changes in circadian rhythms, lifestyle, and health factors, may influence the consequences of daytime napping on nocturnal sleep.
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EXERCISE
Exercise could serve as a beneficial behavioural strategy to alleviate sleep disturbances. However, the multifaceted nature of exercise, including factors like mode, duration, intensity, and timing, has not been thoroughly investigated. The impact of exercise on core body temperature becomes particularly significant in the afternoon or evening, given that sleep onset aligns with the rapid decrease in body temperature. Exercise contributes to this process by initially elevating core body temperature and subsequently accelerating its decline. The optimum room temperature for sleeping is recommended at 18 degrees celsius.
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STRESS
Methods proven to diminish stress and arousal, such as relaxation and mindfulness-based stress reduction, have been investigated concerning their impact on sleep, showing initial evidence supporting stress management as an effective recommendation for promoting better sleep. Various relaxation techniques, specifically those linked to improved sleep in individuals with insomnia, offer a range of options for implementing stress reduction strategies.
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The parasympathetic nervous system, a.k.a. the "rest and digest" system, operates in contrast to the sympathetic nervous system, which roles encompasses things like reducing your heart rate, stimulating digestion and contractility of cardiac muscle. Gaining access to this nervous system can be accomplished through the practice of relaxation techniques, including meditation, breathing, yoga and manual therapy that I can personally recommend.
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NOISE
Noise is a distinct source of sleep disruption, and sleep hygiene suggestions often recommend minimising noise in the sleep environment. Yet, nocturnal sounds commonly present in one's usual surroundings, such as local traffic, music, or machinery, can affect sleep, even if not consciously observed. Studies indicate that the connection between noise and sleep is influenced by specific characteristics of the noise (such as continuity, type, and relevance) and individual differences in noise sensitivity. Therefore, certain noise such as, a city humming, to some individuals may help with their sleep
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WHAT DO THE SLEEP EXPERTS SUGGEST?
Here's a great video by Matt Walker (sleep scientist) who discusses some of the points listed above (including more) and recommends six useful tips for improved sleep hygiene...